Abstract
This study aims to assess the effectiveness of psychosocial techniques to decrease
postoperative pain and improve perioperative clinical care in orthopedic surgery.
A systematic review and meta-analysis was performed to evaluate the effects of psychosocial
methods among adults undergoing orthopedic surgeries. The systematic review included
both randomized and nonrandomized trials, but only randomized controlled clinical
trials (RCTs) were included in the meta-analysis. Key outcomes were postoperative
pain, analgesic requirement, perioperative anxiety, quality of life, and recovery.
After searching the databases from January 1980 to September 2016, a total of 62 RCTs
were included with a pooled sample size of 4,908. Psychosocial interventions significantly
reduced postoperative pain (Hedges’ g = 0.31 [95% confidence interval = 0.14, 0.48]),
and preoperative and postoperative anxiety (g = 0.26 [0.11, 0.42] and g = 0.4 [0.21,
0.59], respectively). Furthermore, psychosocial interventions improved recovery (g = 0.38
[0.22, 0.54]). However, no significant effects were found for postoperative analgesic
use (g = 0.16 [−0.01, 0.32]) and quality of life (g = 0.14 [−0.05, 0.33]). Patient
education and relaxation techniques produced the most consistent positive effects,
showing benefits on pain, anxiety, and recovery. Cognitive or behavioral techniques
improved recovery. Furthermore, larger effects were found for studies that included
acute surgeries compared to elective surgeries. The results indicate that psychosocial
interventions, especially patient education and relaxation training, may reduce perioperative
side effects and improve recovery in patients undergoing orthopedic procedures, but
the quality of evidence is generally low. More well-powered, high-quality studies
are needed to increase confidence.
Perspective
In this meta-analysis of RCTs in orthopedic surgeries, significant benefits in postoperative
pain, perioperative anxiety, and recovery were found, suggesting that psychosocial
interventions, especially patient education and relaxation techniques, are useful
in improving clinical care.
Key words
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References
- The effectiveness of communication skills training for older orthopedic patients [PhD dissertation].University of Memphis, Memphis1998
- Behavioral strategies for the reduction of pain and anxiety associated with orthopedic trauma.Biofeedback and self-regulation. 1989; 14: 101-114
- The effect of a dyadic intervention on self-efficacy, physical functioning and anxiety in older adults post joint replacement surgery [PhD dissertation].UCLA, Los Angeles2008
- The effects of personalized information upon the recovery of surgical patients [PhD dissertation].Michigan State University, East Lansing1982
- Practice guidelines for acute pain management in the perioperative setting: an updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management.Anesthesiology. 2012; 116: 248-273
- Patient education and involvement in care [PhD dissertation].University of North Flordia, Jacksonville2011
- The use of guided imagery to manage pain in an elderly orthopaedic population.Orthopaedic Nursing. 2004; 23: 335-340
- Postoperative pain experience: Results from a national survey suggest postoperative pain continues to be undermanaged.Anesth Analg. 2003; 97: 534-540
- The effects of training surgery patients to self-regulate stress [PhD dissertation].California School of Professional Psychology, San Diego1982
- Australia Orthopaedic Association National Joint Replacement Registry:.(Annual report, Adelaide, Australian Orthopaedic Association 2012. Available at:)https://aoanjrr.dmac.adelaide.edu.au(Accessed June 15, 2017)Date: 2012
- No major effects of preoperative education in patients undergoing hip or knee replacement-A systematic review.Dan Med J. 2015; 62: A5106
- Effects of video information on preoperative anxiety level and tolerability of joint lavage in knee osteoarthritis.Arthritis Care Res. 2002; 47: 380-382
- Advances in cognitive theory and therapy: The generic cognitive model.Annu Rev Clin Psychol. 2014; 10: 1-24
- Operating characteristics of a rank correlation test for publication bias.Biometrics. 1994; 50: 1088-1101
- Action observation treatment improves recovery of postsurgical orthopedic patients: Evidence for a top-down effect?.Arch Phys Med Rehabil. 2010; 91: 1489-1494
- Pre-operative and post-operative effect of a pain management programme prior to total hip replacement: A randomized controlled trial.Pain. 2004; 110: 33-39
- The effect of stress inoculation training on athletes' anxiety, pain and return to functioning during rehabilitation from orthopedic injury [PhD dissertation].Saint Louis University, St. Louis1992
- Clinical pathways from conception to outcome.Topics in health information management. 1998; 19: 30-34
- Reducing the length of hospital stay and facilitating the recovery process of orthopedic surgical patients through crisis intervention and pastoral care [PhD dissertation].Northwestern University, Evanston1981
- Neither pre-operative education or a minimally invasive procedure have any influence on the recovery time after total hip replacement.Int Orthop. 2015; 39: 1475-1481
- The effect of anesthetic patient education on preoperative patient anxiety.Reg Anesth Pain Med. 1999; 24: 158-164
- A brief relaxation intervention reduces stress and improves surgical wound healing response: A randomised trial.Brain Behav Immun. 2012; 26: 212-217
- Preoperative use of anxiolytic-sedative agents; Are we on the right track?.J Clin Anesth. 2016; 33: 135-140
- Treatment and prevention of depression after surgery for hip fracture in older people: Randomized, controlled trials.J Am Geriatr Soc. 2007; 55: 75-80
Butler GS, Hurley CA, Buchanan KL, Smith-VanHorne J. : Prehospital education: effectiveness with total hip replacement surgery patients. Patient Educ Couns 29:189-197, 196
- Improving Pain Management and Long-Term Outcomes Following High-Energy Orthopaedic Trauma (Pain Study).J Orthop Trauma. 2017; 31: S71-S77
- Postoperative pain relief through relaxation in elderly patients with fractured hips.Orthop Nurs. 1984; 3: 11-19
- Acute postoperative pain following hospital discharge after total knee arthroplasty.Osteoarthritis Cartilage. 2013; 21: 1257-1263
- The effect of educational intervention on the pain and rehabilitation performance of patients who undergo a total knee replacement.J Clin Nurs. 2014; 23: 279-287
- Management of postoperative pain: a clinical practice guideline from the American pain society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' committee on regional anesthesia, executive committee, and administrative council.J Pain. 2016; 17: 131-157
- Postoperative pain in ambulatory surgery.Anesth Analg. 1997; 85: 808-816
- Follow-up telephone calls to patients discharged after undergoing orthopaedic surgery: double-blind, randomised controlled trial of efficacy.J Clin Nurs. 2015; 24: 2736-2744
- Use of complementary health approaches for musculoskeletal pain disorders among adults: United States, 2012.Nat Health Stat Rep. 2016; 98: 1-12
- Preparing patients for total hip replacement: a randomized controlled trial of a preoperative educational intervention.J Health Psychol. 1997; 2: 107-114
- Pre-operative self-efficacy education vs. usual care for patients undergoing joint replacement surgery: a pilot randomised controlled trial.Scand J Caring Sci. 2016; 30: 74-82
- Effects of relaxation and guided imagery on knee strength, reinjury anxiety, and pain following anterior cruciate ligament reconstruction.Rehabil Psychol. 2001; 46: 28-43
- Preoperative education for total hip and knee replacement patients.Arthritis Rheum. 1998; 11: 469-478
- Datamonitor: Epidemiology: Major orthopedic surgery. 2011.(Available at:) (Accessed February 15, 2016)
- Preparing for successful surgery: an implementation study.Perm J. 2005; 9: 23-27
- Videotape preparation of patients before hip replacement surgery improves mobility after three months.Zeitschrift fur Psychosomatische Medizin und Psychotherapie. 2000; 47: 140-152
- Videotape preparation of patients before hip replacement surgery reduces stress.Psychosom Med. 2000; 62: 365-373
- Evaluation of preoperative patient education and computer-assisted patient instruction.J Spinal Disord Tech. 1998; 11: 29-35
- The efficacy of guided imagery for recovery from anterior cruciate ligament (ACL) replacement [PhD dissertation].Utah State University, Logan, Utah1997
- Advancing research and practice: the revised APA Division 30 definition of hypnosis.Int J Clin Exp Hypn. 2015; 63: 1-9
- Effect of psychopathology on patient-perceived outcomes of total knee arthroplasty within an indigent population.J Bone Joint Surg Am. 2012; 94: e84
- The aging population and its impact on the surgery workforce.Ann Surg. 2003; 238: 170-177
- An educational intervention to decrease pain following ambulatory orthopedic surgery [PhD dissertation].Queen's University, Kingston, Canada2001
Fingar KR, Stocks C, Weiss AJ, Steiner CA. : Most frequent operating room procedures performed in US hospitals, 2003–-2012: Statistical Brief# 186. 2006
- Effect of structured touch and guided imagery for pain and anxiety in elective joint replacement patients—A randomized controlled trial: M-TIJRP.Perm J. 2015; 19: 18-28
- Internet based patient education improves informed consent for elective orthopaedic surgery: a randomized controlled trial.BMC Musculoskelet Disord. 2015; 16: 14
- Comparison of two pain-management strategies during chest tube removal: Relaxation exercise with opioids and opioids alone.Heart Lung. 2006; 35: 269-276
- Influence of a motivational exercise counseling intervention on rehabilitation outcomes in individuals with arthritis who received total hip replacement [PhD dissertation].University of Pittsburgh, Pittsburgh2004
- Counseling, quality of life, and acute postoperative pain in elderly patients with hip fracture.J Multidiscip Healthc. 2013; 6: 335-346
- Effect of preparatory information prior to elective total hip replacement on post-operative physical coping outcomes.Int J Nurs Stud. 1996; 33: 589-604
- Effect of preparatory information prior to elective total hip replacement on post-operative physchological coping outcomes.J Adv Nurs. 1996; 24: 303-308
- Incidence, patient satisfaction, and perceptions of post-surgical pain: results from a US national survey.Curr Med Res Opin. 2014; 30: 149-160
- A prospective, randomized trial of cognitive intervention for postoperative pain.Am Surg. 2006; 72: 414-418
- Positive effect of patient education for hip surgery: a randomized trial.Clin Orthop Relat Res. 2003; 1: 112-120
- Effects of guided imagery on postoperative outcomes in patients undergoing same-day surgical procedures: a randomized, single-blind study.AANA Journal. 2010; 78: 181-188
- Intervention focused on the patient and family for better postoperative pain relief.Pain Manag Nurs. 2014; 15: 76-86
- GRADE: an emerging consensus on rating quality of evidence and strength of recommendations.BMJ. 2008; 336: 924-926
- : A meta-analysis on the use of gabapentinoids for the treatment of acute postoperative pain following total knee arthroplasty.J Bone Joint Surg Am. 2016; 98: 1340-1350
- Effects of psychological distress and perceptions of illness on recovery from total knee replacement.Bone Joint J. 2014; 96: 210-216
- Distribution theory for Glass's estimator of effect size and related estimators.J Educ Behav Stat. 1981; 6: 107-128
- Assessing risk of bias in included studies.in: Higgins JPT Green S Cochrane Handbook for Systematic Reviews of Interventions. The Cochrane Collaboration, 2011: 187-241 (Version 5.1.0) (2008)
- Effects of relaxation with guided imagery on surgical stress and wound healing.Res Nurs Health. 1988; 11: 235-244
- Nursing intervention by telephone interviews of patients aged over 65 years after total hip replacement improves health status: A randomised clinical trial.Scand J Caring Sci. 2010; 24: 94-100
- Predictors of postoperative pain and analgesic consumption.A qualitative systematic review. Anesthesiology. 2009; 111: 657-677
- Toward identifying moderators of associations between presurgery emotional distress and postoperative pain outcomes: a meta-analysis of longitudinal studies.J Pain. 2016; 17: 874-888
- Relation of cognitive coping and catastrophizing to acute pain and analgesic use following breast cancer surgery.J Behav Med. 1996; 19: 17-29
- Guided imagery for total knee replacement: A randomized, placebo-controlled pilot study.J Altern Complement Med. 2016; 22: 563-575
- Coping with anxiety while waiting for surgery [PhD dissertation].University of Regina, Regina, Canada2007
- Mechanisms of hypnosis: toward the development of a biopsychosocial model.Int J Clin Exp Hypn. 2015; 63: 34-75
- Five-year survival of 20,946 unicondylar knee replacements and patient risk factors for failure.J Bone Joint Surg Am. 2016; 98: 1691-1698
- Empowering orthopaedic patients through preadmission education: results from a clinical study.Patient Educ Couns. 2007; 66: 84-91
- Benefits of psychological preparation for surgery: A meta-analysis.Ann Behav Med. 1993; 15: 245
- Randomized clinical trial testing efficacy of a nurse-coached intervention in arthroscopy patients.Nurs Res. 2011; 60: 92-99
- Pre-operative patient education reduces length of stay after knee joint arthroplasty.Ann R Coll Surg Engl. 2010; 93: 71-75
- The effect of preoperative uncertainty and anxiety on short-term recovery after elective arthroplasty.J Clin Nurs. 2008; 17: 576-583
- Anaesthesia, surgery, and challenges in postoperative recovery.Lancet. 2003; 362: 1921-1928
- Persistent postsurgical pain: risk factors and prevention.Lancet. 2006; 367: 1618-1625
- The effectiveness of psychosocial interventions as adjuncts to orthopaedic surgery: a systematic review protocol.Musculoskeletal Care. 2017; 15: 69-78
- Positive suggestion techniques in somatic medicine: A review of the empirical literature.Interv Med Appl Sci. 2013; 5: 101-111
- Do psychological factors predict poor outcome in patients undergoing TKA? A systematic review.Clin Orthop Relat Res. 2015; 473: 2630-2638
- Psychological influences on surgical recovery.Perspectives from psychoneuroimmunology. Am Psychol. 1998; 53: 1209-1218
- Changes in surgical loads and economic burden of hip and knee replacements in the US: 1997-2004.Arthritis Care & Research. 2008; 59: 481-488
- Placebo psychotherapy: synonym or oxymoron?.Journal of clinical psychology. 2005; 61: 791-803
- Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030.J Bone Joint Surg Am. 2007; 89: 780-785
- Adjunctive non-pharmacological analgesia for invasive medical procedures: a randomised trial.Lancet. 2000; 355: 1486-1490
- Back to the future-feasibility of recruitment and retention to patient education and telephone follow-up after hip fracture: a pilot randomized controlled trial.Patient Prefer Adher. 2015; 9: 1343-1351
- Pain after total knee arthroplasty: a narrative review focusing on the stratification of patients at risk for persistent pain.Bone Joint J. 2015; 97-B: 45-48
- Advancement of physical process by mental activation: A prospective controlled study.J Rehabil Res Dev. 2012; 49: 1221-1228
- Effects of extended preoperative information on perioperative stress: An anaesthetic nurse intervention for patients with breast cancer and total hip replacement.Intensive Crit Care Nurs. 1998; 14: 276-282
- An evaluation of the effectiveness of relaxation therapy for patients receiving joint replacement surgery.J Clin Nurs. 2012; 21: 601-608
- Is postoperative pain a self-fulfilling prophecy? Expectancy effects on postoperative pain and patient-controlled analgesia use among adolescent surgical patients.J Pediatr Psychol. 2005; 30: 187-196
- Preoperative education addressing postoperative pain in total joint arthroplasty: review of content and educational delivery methods.Physiother Theory Pract. 2013; 29: 175-194
- Relationships between pre-operative education, patient self-efficacy, patient anxiety, body mass index, and patient satisfaction of geriatric patients receiving primary total hip or total knee arthroplasty [PhD dissertation].Dowling College, Oakdale, NY2012
- Guided imagery to improve functional outcomes post-anterior cruciate ligament repair: Randomized-controlled pilot trial.Scand J Med Sci Spor. 2012; 22: 816-821
- Orthopedic surgery and bone fracture pain are both significantly attenuated by sustained blockade of nerve growth factor.Pain. 2015; 156: 157-165
- Medical hypnosis and orthopedic hand surgery: pain perception, post-operative recovery, and adherence [PhD Dissertation].University of Miami, Coral Gables, FL1994
- Mental gait training-effectiveness of a therapy method in the rehabilitation after hip-replacement.Zeitschrift fur Orthopadie und ihre Grenzgebiete. 2004; 143: 419-423
- Role of patient information handouts following operative treatment of ankle fractures: a prospective randomized study.Foot Ankle Int. 2013; 34: 2-7
- Postoperative pain management after total knee arthroplasty in elderly patients: treatment options.Drugs & Aging. 2014; 31: 83-91
- Preoperative education for hip or knee replacement.The Cochrane Library, 2004. 2004;
- Does preoperative hip rehabilitation advice improve recovery and patient satisfaction?.J Arthroplasty. 2004; 19: 464-468
- General anesthesia and day-case patient anxiety.J Adv Nurs. 2010; 66: 1059-1071
- Management of catastrophising and kinesiophobia improves rehabilitation after fusion for lumbar spondylolisthesis and stenosis.A randomised controlled trial. Eur Spine J. 2014; 23: 87-95
- An intervention study exploring the effects of providing older adult hip fracture patients with an information booklet in the early postoperative period.J Clini Nurs. 2011; 20: 3404-3413
- The relationship and influence of anxiety on postoperative pain in the coronary artery bypass graft patient.J Pain Symptom Manage. 1998; 15: 102-109
- A review of obesity and orthopaedic surgery: the critical issues.Niger Postgrad Med J. 2012; 19: 175-180
- YouTube videos to create a “virtual hospital experience” for hip and knee replacement patients to decrease preoperative anxiety: a randomized trial.Interact J Med Res. 2016; 5: e10
- Motivational interviewing increases physical activity and self-efficacy in people living in the community after hip fracture: a randomized controlled trial.Clin Rehabil. 2016; 30: 1108-1119
- Contribution of verbal suggestion to the therapeutic efficacy of an analgesic agent for acute primary headache.Cephalagia. 2015; 35: 579-584
- The influence of nursing-measurements regarding incision pain and the use of opioid in the post surgery phase [German].Pflege. 2000; 13: 306-314
- Exploring the experience of osteoarthritic patients awaiting hip and knee arthroplasty: Informing and evaluating the effectiveness of a health maintenance intervention [PhD dissertation].University of West England, Bristol, United Kingdom2011
- The influence of psychological preparation on short- and long-term recovery from surgery [PhD dissertation].University of Liverpool, Liverpool, United Kingdom2000
- Increasing self-efficacy through empowerment: preoperative education for orthopaedic patients.Orthop Nurs. 1998; 17: 48-59
- Use of nonpharmacologic interventions for pain and anxiety after total hip and total knee arthroplasty.Orthop Nurs. 2005; 24: 182-190
- Hip arthroplasty.Lancet. 2012; 380: 1768-1777
- Psychological preparation and postoperative outcomes for adults undergoing surgery under general anaesthesia.The Cochrane Library, 2016. 2016;
- Persistent pain following knee arthroplasty.Eur J Anaesthesiol. 2010; 27: 455-460
- Nurses' experiences and perceptions of influencing barriers to postoperative pain management.Scand J Caring Sci. 2009; 23: 274-281
- Effect of systematic relaxation techniques on anxiety and pain in older patients undergoing abdominal surgery.Int J Nurs Pract. 2013; 19: 462-470
- Preoperative cognitive-behavioural intervention improves in-hospital mobilisation and analgesic use for lumbar spinal fusion patients.BMC Musculoskelet Disord. 2016; 17: 217
- Does a preoperative cognitive-behavioral intervention affect disability, pain behavior, pain, and return to work the first year after lumbar spinal fusion surgery?.Spine. 2015; 40: 593-600
- Teaching of patients undergoing total hip replacement surgery.Int J Nurs Stud. 1994; 31: 135-142
- Overview of pain management in older adults.Clin Geriatr Med. 2016; 32: 635-650
- Effectiveness of relaxation for postoperative pain and anxiety: randomized controlled trial.J Adv Nurs. 2008; 62: 681-688
- The impact of preoperative information on state anxiety, postoperative pain and satisfaction with pain management.Patient Educ Couns. 2003; 51: 169-176
- Health behavior change counseling in surgery for degenerative lumbar spinal stenosis. Part I: Improvement in rehabilitation engagement and functional outcomes.Arch Phys Med Rehabil. 2015; 96: 1200-1207
- The benefits of psychotherapy.Johns Hopkins University Press, Baltimore1980
- Cost-effectiveness evaluation of an RCT in rehabilitation after lumbar spinal fusion: a low-cost, behavioural approach is cost-effective over individual exercise therapy.Eur Spine J. 2008; 17: 262-271
- The prevalence of postoperative pain in a sample of 1490 surgical inpatients.European journal of anaesthesiology. 2008; 25: 267-274
- A comparative study of the effectiveness of a preoperative education programme for total hip replacement patients.Br J Occup Ther. 1995; 58: 526-531
- Effects of motor imagery on hand function during immobilization after flexor tendon repair.Arch Phys Med Rehabil. 2009; 90: 553-559
- Regression methods to detect publication and other bias in meta-analysis.in: Rothstein HR Sutton AJ Borenstein M Publication Bias in Meta-analysis: Prevention, Assessment, and Adjustments. John Wiley & Sons Ltd, Chichester2005: 99-110
- Effect of a video intervention on functional recovery following hip replacement and hip fracture repair.Rehabil Nurs. 2003; 28: 148-153
- Is guided imagery effective in reducing pain and anxiety in the postoperative total joint arthroplasty patient?.Orthop Nurs. 2010; 29: 393-439
- Intervention and evaluation of preadmission patient education for patients underdoing [sic] total hip arthroplasty.J Japan Acad Nurs Sci. 2004; 24: 24-32
- Effectiveness of psychological support in patients undergoing primary total hip or knee arthroplasty: a controlled cohort study.J Orthop Traumatol. 2016; 17: 1-11
- Psychological approaches in the treatment of chronic pain patients - when pills, scalpels, and needles are not enough.Can J Psychiatry. 2008; 53: 213-223
- Does preoperative psychologic distress influence pain, function, and quality of life after TKA?.Clin Orthop Relat Res. 2014; 472: 2457-2465
- Groningen orthopaedic exit strategy: validation of a support program after total hip or knee arthroplasty.Patient Educ Couns. 2007; 65: 171-179
- Psychological factors predict disability and pain intensity after skeletal trauma.J Bone Joint Surg Am. 2014; 96: e20
- Biofeedback relaxation for pain associated with continuous passive motion in Taiwanese patients after total knee arthroplasty.Res Nurs Health. 2015; 38: 39-50
- A brief cognitive therapy intervention to reduce the fear of falling and enhance daily living amongst older adults undergoing rehabilitation after hip fracture [PhD dissertation].University of Wales, Bangor1999
- Nursing management: Pain.in: Lewis SM Heitkemper MM Dirksen SR Medical surgical nursing assessment and management of clinical problems. Mosby, St. Louis, MO2000: 126-153
- Pain management.in: Smeltzer SC Bare BG Brunner & Suddarth's textbook of medical surgical nursing. Lippincott Williams & Wilkins, Philadelphia, PA,2006: 216-248
- A randomized controlled trial of an individualized education intervention for symptom management following total knee arthroplasty [PhD Dissertation].University of Toronto, Toronto, Canada2011
- Effects of relaxation on postoperative pain in patients with total knee arthroplasty [PhD dissertation].Medical College of Ohio, Toledo, OH1998
- Can a brief educational intervention improve sleep and anxiety outcomes for emergency orthopaedic surgical patients?.Contemp Nurse. 2014; 47: 132-143
- Effectiveness of an educational intervention on levels of pain, anxiety and self-efficacy for patients with musculoskeletal trauma.J Adv Nurs. 2010; 66: 1120-1131
- Burden of major musculoskeletal conditions.Bull WHO. 2003; 81: 646-656
- Treatment of acute postoperative pain.Lancet. 2011; 377: 2215-2225
- Effects of progressive muscle relaxation intervention in extremity fracture surgery patients.West J Nurs Res. 2016; 38: 155-168
- Effects of multimedia with printed nursing guide in education on self-efficacy and functional activity and hospitalization in patients with hip replacement.Patient Educ Couns. 2005; 57: 217-224
- Web-based education prior to knee arthroscopy enhances informed consent and patient knowledge recall: a prospective, randomized controlled study.J Bone Joint Surg Am. 2015; 97: 964-971
- Patient education before hip or knee arthroplasty lowers length of stay.J Arthroplasty. 2010; 25: 547-551
- The Videoinsight method: improving rehabilitation following anterior cruciate ligament reconstruction—a preliminary study.Knee Surg Sports Traumatol Arthrosc. 2013; 21: 851-858
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Published online: May 25, 2018
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