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- W2073706874 abstract "Physicians often scan a select number of journals to keep up to date with practice evidence for patients with kidney conditions. This raises the question of where relevant studies are published. We performed a bibliometric analysis using 195 renal systematic reviews. Each review used a comprehensive method to identify all primary studies for a focused clinical question relevant to patient care. We compiled all the primary studies included in these reviews, and considered where each study was published. Of the 2779 studies, 1351 (49%) were published in the top 20 journals. Predictably, this list included Transplantation Proceedings (5.9% of studies), Kidney International (5.3%), American Journal of Kidney Diseases (4.7%), Nephrology Dialysis Transplantation (4.3%), Transplantation (4.2%), and Journal of the American Society of Nephrology (2.4%). Ten non-renal journals were also on this list, including New England Journal of Medicine (2.4%), Lancet (2.3%), and Diabetes Care (2.2%). The remaining 1428 (51%) studies were published across other 446 journals. When the disciplines of all journals were considered, 59 were classified as renal or transplant journals (42% of articles). Other specialties included general and internal medicine (16%), endocrinology (diabetes) and metabolism (6.5%), surgery (6.2%), cardiovascular diseases (6.1%), pediatrics (4.3%), and radiology (3.3%). About half of all renal practice evidence is published in non-renal journals. Browsing the top journals is important. However, relevant studies are also scattered across a large range of journals that may not be routinely scanned by busy physicians, and keeping up with this literature requires other continuing education strategies. Physicians often scan a select number of journals to keep up to date with practice evidence for patients with kidney conditions. This raises the question of where relevant studies are published. We performed a bibliometric analysis using 195 renal systematic reviews. Each review used a comprehensive method to identify all primary studies for a focused clinical question relevant to patient care. We compiled all the primary studies included in these reviews, and considered where each study was published. Of the 2779 studies, 1351 (49%) were published in the top 20 journals. Predictably, this list included Transplantation Proceedings (5.9% of studies), Kidney International (5.3%), American Journal of Kidney Diseases (4.7%), Nephrology Dialysis Transplantation (4.3%), Transplantation (4.2%), and Journal of the American Society of Nephrology (2.4%). Ten non-renal journals were also on this list, including New England Journal of Medicine (2.4%), Lancet (2.3%), and Diabetes Care (2.2%). The remaining 1428 (51%) studies were published across other 446 journals. When the disciplines of all journals were considered, 59 were classified as renal or transplant journals (42% of articles). Other specialties included general and internal medicine (16%), endocrinology (diabetes) and metabolism (6.5%), surgery (6.2%), cardiovascular diseases (6.1%), pediatrics (4.3%), and radiology (3.3%). About half of all renal practice evidence is published in non-renal journals. Browsing the top journals is important. However, relevant studies are also scattered across a large range of journals that may not be routinely scanned by busy physicians, and keeping up with this literature requires other continuing education strategies. Physicians make better clinical decisions when they understand the circumstances and preferences of their patients, and the clinical evidence underlying the available options.1.Haynes R.B. Devereaux P.J. Guyatt G.H. Physicians' and patients' choices in evidence based practice.BMJ. 2002; 324: 1350Crossref PubMed Google Scholar The public also expects that physicians are taking up new research findings in a timely way.2.Fones C.S. Kua E.H. Goh L.G. ‘What makes a good doctor?’ – views of the medical profession and the public in setting priorities for medical education.Singapore Med J. 1998; 39: 537-542PubMed Google Scholar To keep up to date, clinicians employ a number of continuing education strategies.3.Pyne T. Newman K. Leigh S. et al.Meeting the information needs of clinicians for the practice of evidence-based healthcare.Health Libr Rev. 1999; 16: 3-14Crossref PubMed Google Scholar A common technique is to regularly browse a set of journals that are perceived as relevant to clinical care.4.Burke D.T. DeVito M.C. Schneider J.C. et al.Reading habits of physical medicine and rehabilitation resident physicians.Am J Phys Med Rehabil. 2004; 83: 551-559Crossref PubMed Scopus (16) Google Scholar,5.Schein M. Paladugu R. Sutija V.G. Wise L. What American surgeons read: a survey of a thousand Fellows of the American College of Surgeons.Curr Surg. 2000; 57: 252-258Abstract Full Text Full Text PDF PubMed Google Scholar This raises the question of where relevant studies are published. By its very nature, nephrology draws on, and contributes to, many other disciplines including endocrinology, cardiology, and rheumatology. It is possible that a substantial portion of renal practice evidence is published in non-renal journals. To help inform continuing physician education, we performed a bibliometric analysis to map the degree to which various journals publish clinical evidence relevant to renal patient care. Our primary aim was to identify the nucleus of top journals, and to determine the degree to which clinical studies are scattered across journals of other disciplines. We also characterized the features of these journals, including the language of publication and whether they were indexed in major bibliographic databases. We compiled a total of 2779 unique primary renal studies that were published from the years 1961 to 2005. Studies most often addressed questions of treatment (71%), followed by prognosis (13.7%), etiology (8%), diagnosis (6.5%), and economics (0.3%). The 2779 studies were published across 466 journals (Figure 1). Of the 2779 studies, 1351 (49%) were published in the top 20 journals ranked by publication frequency, whereas the remaining 1428 (51%) studies were published across another 446 journals. The scatter of studies across journals was consistent with Bradford's distribution. When we divided all the studies into three zones with a roughly equal number of studies (zone 1 – the first set consisting of the top 10 journals, zone 2 – the second set of 55 journals, and zone 3 – the third set of 401 journals), the observed ratio of journal number among these three zones was 1:6:40 which was quite close to the predicted distribution of 1:6:62 (i.e. 36). Stated in another way, of the 466 journals, 12% published 10 or more studies, 10% five to nine studies, 5% four studies, 7% three studies, 19% two studies, and 47% one study. A list of the top 50 journals which published studies relevant to the care of renal patients is presented in Table 1. Predictably, this list included renal and transplant journals such as Transplant Proceedings (5.9% of the studies), Kidney International (5.3%), American Journal of Kidney Diseases (4.7%), Nephrology Dialysis Transplantation (4.3%), Transplantation (4.2%), and Journal of the American Society of Nephrology (2.4%). For the topics within nephrology, the top journals were dependent on the content area considered (Table 2, Figure 2). For example, for the topic of acute kidney injury, the journals Critical Care Medicine and Intensive Care Medicine featured prominently. Conversely for the topic of chronic kidney disease, the journal Diabetes Care was important. The degree of scatter across journals was also dependent on the content area considered (Table 2). For example, 82% of studies published in the topic area of transplantation were concentrated in the top 10 journals, compared to only 32% of studies published in the topic area of acute kidney injury. The visual map depicts journals which published the highest number of studies relevant to each renal topic area, as well as a cluster of journals which published studies relevant to a variety of topic areas (Figure 2).Table 1Top 50 journals that published the highest number of studies relevant to renal careRankJournalPercent of relevant studies (n=2779)Cumulative percent 1Transplantation Proceedings5.95.9 2Kidney International5.311.2 3American Journal of Kidney Diseases4.715.8 4Nephrology, Dialysis, and Transplantation4.320.1 5Transplantation4.224.4 6New England Journal of Medicine2.426.8 7Journal of the American Society of Nephrology2.429.1 8Lancet2.331.5 9Nephron2.233.710Diabetes Care2.235.911Clinical Nephrology1.837.612Annals of Internal Medicine1.739.313BMJ1.640.914Journal of Vascular Surgery1.342.215Pediatric Nephrology1.243.416Journal of Pediatrics1.144.517Journal of Urology1.145.618Peritoneal Dialysis International1.146.719Archives of Disease in Childhood1.047.620Radiology1.048.621American Journal of Medicine0.949.522Diabetic Medicine0.850.323JAMA : the journal of the American Medical Association0.851.124Diabetologia0.851.925American Journal of Nephrology0.852.726Diabetes Research and Clinical Practice0.753.427AJR. American Journal of Roentgenology0.754.128Archives of Internal Medicine0.654.729Arthritis and Rheumatism0.655.430Clinical transplantation0.656.031Journal of the American College of Cardiology0.656.632Critical Care Medicine0.657.233Intensive Care Medicine0.657.834QJM : monthly journal of the Association of Physicians0.658.335Contributions to Nephrology0.658.936American Journal of Cardiology0.559.437Diabetes0.560.038Transplant International0.560.539Circulation0.561.140Journal of Renal Nutrition0.561.641Renal Failure0.562.142European Journal of Vascular and Endovascular Surgery0.562.643Journal of Hypertension0.563.144Advances in Peritoneal Dialysis0.563.545British Journal of Surgery0.564.046American Journal of Hypertension0.564.547Journal of Diabetes and its Complications0.464.948European Journal of Clinical Pharmacology0.465.349Archives of Surgery0.465.750American Journal of Surgery0.466.1 Open table in a new tab Table 2The 20 journals which published the highest number of studies relevant to various renal topic areasAcute kidney injury (n=388)Chronic kidney disease and glomerulonephritis (n=1062)Chronic hemodialysis or peritoneal dialysis (n=585)Kidney transplantation (n=446)Pediatric nephrology (n=186)Journal%Journal%Journal%Journal%Journal% 1Kidney Int4.6Kidney Int6.1Am J Kidney Dis12.0Transplant Proc34.0Pediatr Nephrol11.0 2Am J Kidney Dis3.9Diabetes Care5.5Nephrol Dial Transplant8.5Transplantation26.0J Pediatr11.0 3Crit Care Med3.6Nephrol Dial Transplant3.6Kidney Int7.2Nephrol Dial Transplant3.8Arch Dis Child9.7 4Intensive Care Med3.6N Engl J Med3.4Nephron4.8J Am Soc Nephrol3.6J Urol9.7 5Lancet3.4Am J Kidney Dis3.0Perit Dial Int4.6Transpl Int3.4Lancet5.4 6Am J Med3.1Ann Intern Med2.9Clin Nephrol3.4Clin Transplant3.1Eur J Pediatr3.2 7N Engl J Med2.8BMJ2.8J Am Soc Nephrol3.2Am J Transplant2.2Kidney Int3.2 8Nephrol Dial Transplant2.6Lancet2.4J Vasc Surg2.6Kidney Int2.2BMJ2.2 9Antimicrob Agents Chemother2.3Clin Nephrol2.2Adv Perit Dial2.2Lancet2.2J Med Assoc Thai2.210J Clin Oncol2.1Diabet Med2.2J Ren Nutr2.1Am J Kidney Dis1.6Pediatrics2.211Nephron2.1Diabetologia2.1Am J Nephrol1.4N Engl J Med1.6N Engl J Med2.212Anesth Analg1.8Radiology2.0Int J Artif Organs1.4Arch Surg0.9Acta Paediatr1.613Ann Intern Med1.8Diabetes Res Clin Pract1.9Artif Organs1.2J Urol0.9Nippon Hinyokika Gakkai Zasshi1.614J Am Coll Cardiol1.8Nephron1.9Scand J Urol Nephrol1.2Ann Intern Med0.7Am J Dis Child1.115QJM1.8J Am Soc Nephrol1.8N Engl J Med1.2J Heart Lung Transplant0.7BJU Int1.116Br J Anaesth1.5J Vasc Surg1.8Blood Purif1.0Br J Surg0.7Child Nephrol Urol1.117Ren Fail1.5Arthritis Rheum1.7Dial Transplant1.0J Infect Dis0.7Clin Nephrol1.118Am J Nephrol1.3AJR Am J Roentgenol1.4Clin Chem0.9Am J Nephrol0.4Clin Pediatr Endocrinol1.119Anaesth Intensive Care1.3Diabetes1.4Trans Am Soc Artif Intern Organs0.9Ann Surg0.4Contrib Nephrol1.120Arch Intern Med1.3Am J Hypertens1.2Am J Surg0.7BMJ0.4J Am Soc Nephrol1.1Total for top 20 journals48.2Total for top 20 journals51.2Total for top 20 journals61.3Total for top 20 journals89.9Total for top 20 journals72.0The percentage of all renal studies published in each journal appears with the journal name. Open table in a new tab The percentage of all renal studies published in each journal appears with the journal name. When the disciplines of all 466 journals were considered, 59 journals or about 13% were classified as renal or transplant journals which contributed 42% of the all articles. Other specialties were common and included general and internal medicine (16% of articles), endocrinology (diabetes) and metabolism (6.5%), surgery (6.2%), cardiovascular diseases (6.1%), pediatrics (4.3%), and radiology (3.3%) (Table 3). Renal or transplant journals contributed 47% of all treatment studies, 35% of all etiology studies, 28% of all articles pertaining to prognostic questions, and 13% of all diagnostic studies. Of all the 466 journals, 2% were not indexed in Medline, 7% were not indexed in EMBASE, and 0.6% were not indexed in either database. Nine percent of the journals were published in languages other than English.Table 3Renal practice evidence was published across journals from many disciplinesPrimary disciplineNo. of journals (n=466)No. of articles (n=2779)% of articlesNephrology and Transplantation59115542.0General and Internal Medicine7443216.0Endocrinology (Diabetes) and Metabolism181826.5Surgery391716.2Cardiovascular Diseases411706.1Pediatrics301204.3Radiology21913.3Pharmacology21682.4Critical Care and Emergency Medicine11531.9Urology7491.8Anesthesiology14431.5Oncology16321.2Rheumatology8311.1Infectious diseases9260.9Hematology12200.7Nutrition5110.4Obstetrics and gynecology590.3Gastroenterology680.3An additional 70 journals that contributed 108 articles were scattered across other disciplines. Open table in a new tab An additional 70 journals that contributed 108 articles were scattered across other disciplines. We live in the information age where the practice of medicine is becoming increasingly complex and specialized. Medline currently indexes over 4800 different journal titles with over 13 million citations.6.U.S. National Library of Medicine. MEDLINE Fact Sheet. c2005;[cited 2006 Jun 15]. Available from http://www.nlm.nih.gov/pubs/factsheets/medline.html.Google Scholar Here, we emphasized the journals which renal practitioners can scan to keep abreast with clinical evidence in their discipline. Physicians can anticipate that scanning the top 20 journals will identify about half the new practice evidence as it becomes available. Unfortunately, the remaining studies are published across a large range of journals, many of which are classified as non-renal. This characteristic scattering of published evidence poses a problem when trying to stay abreast of existing information on a topic. It becomes increasingly less efficient for the busy nephrologist to scan peripheral journals, where the potential for finding relevant studies is low. To our knowledge, this study represents the first time the degree to which different journals publish research directly relevant to renal patient management has been considered. We provided different core journal sets for those nephrologists who review literature to support specialized practices in transplantation, dialysis, chronic kidney disease, or pediatric nephrology (Table 2). We used systematic reviews to identify representative clinical studies for this analysis. This sampling approach was more comprehensive and objective than approaches used in other bibliometric studies7.Reed K.L. Mapping the literature of occupational therapy.Bull Med Libr Assoc. 1999; 87: 298-304PubMed Google Scholar,8.Sittig D.F. Identifying a core set of medical informatics serials: an analysis using the MEDLINE database.Bull Med Libr Assoc. 1996; 84: 200-204PubMed Google Scholar and similar to the approach taken by Birken.9.Birken C.S. Parkin P. In which journals will pediatricians find the best evidence for clinical practice?.Pediatrics. 1999; 103: 941-947Crossref PubMed Scopus (35) Google Scholar This helped reduce the chance that possible selection biases influenced the results. However, as with any sampling method, there is always the potential concern that the results do not generalize perfectly to the ‘universe’ of available articles. Thus, the numbers provided in this report should not be viewed as absolute. Studies published in languages other than English may be underrepresented because such studies are less likely to be cited by systematic reviews.10.Gregoire G. Derderian F. Le Lorier J. Selecting the language of the publications included in a meta-analysis: is there a Tower of Babel bias?.J Clin Epidemiol. 1995; 48: 159-163Abstract Full Text PDF PubMed Scopus (287) Google Scholar,11.Juni P. Holenstein F. Sterne J. et al.Direction and impact of language bias in meta-analyses of controlled trials: empirical study.Int J Epidemiol. 2002; 31: 115-123Crossref PubMed Google Scholar We also recognize that not all clinically relevant studies in nephrology have been subsequently cited in a systematic review. However, these results were very similar when we performed the same type of analysis using primary high-quality clinical studies identified from the Cochrane database on renal content (data not shown). Furthermore, systematic reviews tend to focus on areas where controversy or uncertainty exists – which would be of interest to the target audience of practicing nephrologists. We did not consider the efficiency of scanning, rather in the current analysis we ranked journals according to publication frequency, that is, the largest number of clinically relevant studies published within each journal. Clearly, the oldest journals that publish the greatest number of articles per year were favored by such an approach. All the primary studies included in this analysis were deemed to be sufficiently important, and of high enough quality, to be cited by the authors of the systematic reviews. Although some journals may publish more meritorious studies than others, it is somewhat subjective to assess the impact of any given study for changing a standard of care. Better characterization of the top journals in nephrology has a number of additional benefits besides focusing the attention of busy physicians. A number of services already exist to increase physician awareness of new relevant research. These include local libraries, e-mail alerts, and journals and subscription services which summarize primary research results.6.U.S. National Library of Medicine. MEDLINE Fact Sheet. c2005;[cited 2006 Jun 15]. Available from http://www.nlm.nih.gov/pubs/factsheets/medline.html.Google Scholar, 12.Haynes R.B. Cotoi C. Holland J. et al.Second-order peer review of the medical literature for clinical practitioners.JAMA. 2006; 295: 1801-1808Crossref PubMed Scopus (53) Google Scholar, 13.BMJ Publishing Group and McMaster University’s Health Information Research Unit. BMJ Evidence Updates c2004; [cited 2006 Jun 15]: Available from http://bmjupdates.mcmaster.ca.Google Scholar, 14.UpToDate. UpToDate c2006; [cited 2006 Jun 15]: Available from http://www.uptodate.com/.Google Scholar Such service providers can use these results to develop systems of information retrieval, to maximize the coverage of relevant studies across journals. Science Citation Index Journal Impact Factors are a measure of the frequency with which the ‘average article’ in a journal has been cited in a particular year or period of time. However, impact factors do not highlight which journals publish the largest amount of clinical practice evidence. The information presented here can be used by authors to highlight which journals may be receptive to publishing clinical research in various renal topic areas, or where to publish their research to achieve maximal impact. Knowledge of the journals which publish evidence relevant to a renal practice can also improve the precision of bibliographic search strategies to reduce extraneous citations identified in such searches. Specifically, the strategy can be restricted to search only those journals which publish relevant studies.15.Bickley S.R. Harrison J.E. How to….find the evidence.J Orthod. 2003; 30: 72-78Crossref PubMed Scopus (13) Google Scholar Improving the precision of searches would benefit all types of users including the public, physicians, researchers, and policy makers. The affinity of various journals to publish studies relevant to clinical practice is continually changing. Indeed, some journals are discontinued while new journals are started (e.g., American Journal of Transplantation, Clinical Journal of the American Society of Nephrology). These results should be replicated in the future to characterize any secular changes in the ranked journal list. There could be a systematic difference in the types of studies and conclusions published in top journals, compared to those published in more peripheral journals. If new evidence published in peripheral journals does not change current treatment paradigms, then reviewing such journals may be less important. Finally, the real daunting issue remains that we need better methods to improve the timely translation of new health-care knowledge into patient care. Unfortunately, increasingly larger efforts are needed to keep current with the literature.16.Davidoff F. Haynes B. Sackett D. Smith R. Evidence based medicine.BMJ. 1995; 310: 1085-1086Crossref PubMed Google Scholar,17.Alper B.S. Hand J.A. Elliott S.G. et al.How much effort is needed to keep up with the literature relevant for primary care?.J Med Libr Assoc. 2004; 92: 429-437PubMed Google Scholar Research into best methods for continuing medical education remains a priority for the profession. Bibliometrics is the scientific study of publication patterns.18.White H.D. McCain K.W. Bibliometrics.Annu Rev Inform Sci Technol. 1989; 24: 119Google Scholar Previous bibliometric research in nephrology has examined the growth in published clinical trials,19.Strippoli G.F. Craig J.C. Schena F.P. The number, quality, and coverage of randomized controlled trials in nephrology.J Am Soc Nephrol. 2004; 15: 411-419Crossref PubMed Scopus (175) Google Scholar the failure of many conference abstracts to be subsequently published as full text articles,20.Glick N. MacDonald I. Knoll G. et al.Factors associated with publication following presentation at a transplantation meeting.Am J Transplant. 2006; 6: 552-556Crossref PubMed Scopus (14) Google Scholar and the scientific productivity of a group of investigators.21.Schena F.P. Zoccali C. Bibliometric analysis of the scientific productivity of the Italian Society of Nephrology for a period of five consecutive years (1990–1994).Nephrol Dial Transplant. 1996; 11: 2359-2360Crossref PubMed Google Scholar Although studies of evidence dispersion across journals have been performed in other disciplines,7.Reed K.L. Mapping the literature of occupational therapy.Bull Med Libr Assoc. 1999; 87: 298-304PubMed Google Scholar,8.Sittig D.F. Identifying a core set of medical informatics serials: an analysis using the MEDLINE database.Bull Med Libr Assoc. 1996; 84: 200-204PubMed Google Scholar to our knowledge no such analysis has been performed for renal content. To conduct this analysis, we first compiled a representative set of renal clinical studies, and then considered the journals where such studies were published. The method of assembling studies is a critical first step in any bibliometric mapping project. To avoid selection biases, we elected not to search bibliographic databases (i.e., Medline or EMBASE) with kidney terms as the initial method to identify primary studies of interest.8.Sittig D.F. Identifying a core set of medical informatics serials: an analysis using the MEDLINE database.Bull Med Libr Assoc. 1996; 84: 200-204PubMed Google Scholar Such an approach would have only emphasized articles published in those journals indexed in each database. It is also well recognized that even the most comprehensive search strategy often fails to identify a number of relevant studies.22.Helmer D. Savoie I. Green C. Kazanjian A. Evidence-based practice: extending the search to find material for the systematic review.Bull Med Libr Assoc. 2001; 89: 346-352PubMed Google Scholar,23.Greenhalgh T. Peacock R. Effectiveness and efficiency of search methods in systematic reviews of complex evidence: audit of primary sources.BMJ. 2005; 331: 1064-1065Crossref PubMed Scopus (251) Google Scholar Rather, we used renal systematic reviews as the source of primary clinical studies. A well-conducted systematic review is one which asks a focused question, uses comprehensive methods to identify all high-quality primary studies for that question, and appraises the methodological quality of the primary studies. Such studies often focus on whether to use a therapy (treatment), how patients fare (prognosis), how to best use a diagnostic test (diagnosis), or the cause of certain conditions (etiology). Certainly, there are other important articles in the literature which describe biology and pathophysiology, or epidemiology other than randomized trials, prognosis, diagnostic, and etiology studies. Some articles are also commentaries or case reports. These latter types of articles are not usually cited in systematic reviews. Thus, this analysis focused on those types of study designs best suited to provide high-quality clinical practice evidence for patients with kidney conditions. We identified the renal systematic reviews from a detailed search of Medline for the years 2001–2005, the Cochrane Database of Systematic Reviews, Cochrane Renal group records of non-Cochrane meta-analyses, and the McMaster University Health Information Research Unit Premium LiteratUre Service (PLUS) database (articles published in the years 2002–2005).12.Haynes R.B. Cotoi C. Holland J. et al.Second-order peer review of the medical literature for clinical practitioners.JAMA. 2006; 295: 1801-1808Crossref PubMed Scopus (53) Google Scholar Two nephrologists used a standardized checklist to independently confirm whether each review was pertinent to renal care. Pairs of reviewers also independently confirmed that each review met specified methodological criteria for quality. Methodologic criteria were met if the following were described in the text of the review: a statement of the clinical topic; explicit statements of the inclusion and exclusion criteria applied for selecting primary studies for detailed review; and methods used to identify primary studies for inclusion in the review (i.e., which bibliographic databases or reference lists were searched). A total of 195 relevant unique systematic reviews, which included meta-analyses, were identified.24.Adu D. Cockwell P. Ives N.J. et al.Interleukin-2 receptor monoclonal antibodies in renal transplantation: meta-analysis of randomised trials.BMJ. 2003; 326: 789Crossref PubMed Google Scholar, 25.Albers M. Romiti M. Braganca Pereira C.A. et al.A meta-analysis of infrainguinal arterial reconstruction in patients with end-stage renal disease.Eur J Vasc Endovasc Surg. 2001; 22: 294-300Abstract Full Text PDF PubMed Scopus (31) Google Scholar, 26.Alonso A. Lau J. 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- W2073706874 title "Lost in publication: Half of all renal practice evidence is published in non-renal journals" @default.
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