The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index; none of the 2 sources its claims cite is checked for support yet.
Cross-Sectional Studies
Open accessAbstract
Cross-sectional studies are observational studies that analyze data from a population at a single point in time. They are often used to measure the prevalence of health outcomes, understand determinants of health, and describe features of a population. Unlike other types of observational studies, cross-sectional studies do not follow individuals up over time. They are usually inexpensive and easy to conduct. They are useful for establishing preliminary evidence in planning a future advanced study. This article reviews the essential characteristics, describes strengths and weaknesses, discusses methodological issues, and gives our recommendations on design and statistical analysis for cross-sectional studies in pulmonary and critical care medicine. A list of considerations for reviewers is also provided.
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In the paper
“Prevalenceincidence bias (also called the Neyman bias) is also particularly common in cross-sectional studies.13”
§ Cross-Sectional Studies Strengths, Weaknesses, and Recommendations > Bias
What the sources say
- Not checked — no full text of the sourcecites [13] Tripepi, 2010, Selection bias and information bias in clinical research, Nephron Clin Pract source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“They cannot be used to look at individual change (as in a cohort study).”
§ Cross-Sectional Studies Strengths, Weaknesses, and Recommendations > Description of Subtypes of Cross-Sectional Studies
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Because the outcome and exposure variables are measured at the same time, it is relatively difficult to establish causal relationships from a cross-sectional study.”
- Also stated in: § Description of Subtypes of Cross-Sectional Studies · plain
“The exposures and outcomes are measured simultaneously; therefore, it is difficult to determine whether the exposures preceded or followed the outcomes in an analytical cross-sectional study.”
- Also stated in: § Benefits and Downside of Cross-Sectional Studies · plain
“The weaknesses of cross-sectional studies include the inability to assess incidence, to study rare diseases, and to make a causal inference.”
§ Cross-Sectional Studies Strengths, Weaknesses, and Recommendations > General Overview of Cross-Sectional Study Design
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § Description of Subtypes of Cross-Sectional Studies · plain
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thus, repeated cross-sectional studies can be used for analyzing population changes over time (also known as aggregate change over time).”
§ Cross-Sectional Studies Strengths, Weaknesses, and Recommendations > Description of Subtypes of Cross-Sectional Studies
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“If one wants to compare two prevalence rates in an analytical cross-sectional study, the commonly used sample size formula is the same as is used when designing a cohort study.6”
§ Cross-Sectional Studies Strengths, Weaknesses, and Recommendations > Sample Size Determination
What the sources say
- Not matchedcites [6] Fleiss, 2013
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Unlike studies starting from a series of patients, cross-sectional studies often need to select a sample of subjects from a large and heterogeneous study population.Thus, they are susceptible to sampling bias.”
§ Cross-Sectional Studies Strengths, Weaknesses, and Recommendations > Benefits and Downside of Cross-Sectional Studies
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The subjects are neither deliberately exposed nor treated; thus, there are seldom ethical difficulties.”
§ Cross-Sectional Studies Strengths, Weaknesses, and Recommendations > Benefits and Downside of Cross-Sectional Studies
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
- Probably not a substantial claim. 4
- It may state two separate claims as one. 3
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Stepwise selection methods and P value-based criteria are discouraged due to overfitting and because they often allow too many parameters to be included, which reduces the generalizability of the model.”
§ Cross-Sectional Studies Strengths, Weaknesses, and Recommendations > Additional information
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Confounding could result in a distortion of the association between exposure and outcome.”
§ Cross-Sectional Studies Strengths, Weaknesses, and Recommendations > Confounding
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Note that the sample size in a descriptive study does not depend on statistical power because this concept only applies to statistical comparisons.”
§ Cross-Sectional Studies Strengths, Weaknesses, and Recommendations > Sample Size Determination
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The weaknesses of cross-sectional studies include the inability to assess incidence, to study rare diseases, and to make a causal inference.”
- Also stated in: § 1. The study population and the research question. · plain
“Unable to measure the incidence”
§ Cross-Sectional Studies Strengths, Weaknesses, and Recommendations > Benefits and Downside of Cross-Sectional Studies
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
- Also stated in: § 1. The study population and the research question. · plain
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Only with full and transparent reporting of information on all aspects of a cross-sectional study can potential usefulness of its findings and risk of bias be adequately assessed.”
§ Cross-Sectional Studies Strengths, Weaknesses, and Recommendations > Additional information
Strength:plain· not yet calibratedTests✓ Asserted: passes✗ Checkable: fails✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Because exposure and outcome are measured simultaneously in a cross-sectional study, prior knowledge of the condition might influence the ascertainment of the exposure or the outcome, which results in recall bias.”
§ Cross-Sectional Studies Strengths, Weaknesses, and Recommendations > Bias
Strength:hedged· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
The paper relies on this without support.
Cross-sectional studies are usually quick and inexpensive to conduct.
“They are usually inexpensive and easy to conduct.”
“The main strength of cross-sectional studies is that they are relatively quick and inexpensive to conduct.”
The paper relies on this without support.
Cross-sectional studies are the best way to determine prevalence.
“They are the best way to determine the prevalence and can study the associations of multiple exposures and outcomes.”
The paper relies on this without support.
Cross-sectional studies can study the associations of multiple exposures and outcomes.
“They are the best way to determine the prevalence and can study the associations of multiple exposures and outcomes.”
The paper relies on this without support.
Cross-sectional studies are useful for establishing preliminary evidence in planning a future advanced study.
“They are useful for establishing preliminary evidence in planning a future advanced study.”
The paper relies on this without support.
Cross-sectional studies are suitable for generating hypotheses and may provide information about the prevalence of outcomes and exposures that informs other study designs.
“They are suitable for generating hypotheses and may provide information about the prevalence of outcomes and exposures that informs other study designs.”
The paper relies on this without support.
Using questionnaires to reach a large sample of the population of interest is relatively inexpensive but can result in low response rates.
“Using questionnaires to reach a large sample of the population of interest is relatively inexpensive but can result in low response rates.”
The paper relies on this without support.
Interviews are more expensive and time-consuming than using questionnaires, potentially limiting the sample size but leading to a higher response rate.
“Interviews are more expensive and time-consuming than using questionnaires, potentially limiting the sample size but leading to a higher response rate.”
The paper relies on this without support.
Cross-sectional studies cannot study rare diseases.
“The weaknesses of cross-sectional studies include the inability to assess incidence, to study rare diseases, and to make a causal inference.”
The paper relies on this without support.
Probability sampling methods are more accurate and rigorous than nonprobability sampling methods.
“In general, probability sampling methods are preferred over nonprobability ones, as the former are considered to be more accurate and rigorous.”
The paper relies on this without support.
Nonresponse bias is usually encountered in cross-sectional survey studies with mailed questionnaires.
“A common type of selection bias is the nonresponse bias, which is usually encountered in crosssectional survey studies with mailed questionnaires.”
The paper relies on this without support.
Recall bias and detection bias are two common information biases.
“Recall bias and detection bias are two common information biases.”
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“As long as the study sample is representative of the overall population, cross-sectional studies are adequate for measuring the prevalence of health outcomes, understand determinants of health, and describe features of a population (Wang and Cheng, 2020).”
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“This design is useful for public health issues such as CP and for the generation of hypotheses but it is limited in time (Wang & Cheng 2020).”
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“31 In comparison with cohort studies, case– control and cross-sectional studies are more likely to include recall bias and selection bias, potentially compromising the accuracy of the results.”
Molin, F., Paulsson, S. Å., Hellman, T., & Svartengren, M. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18126509 · Cited by 11
“Since data was gathered at one point in time made it difficult to draw casual inference, and it was difficult to investigate the temporal relation between variables [66].”
BackgroundGiovanni, L. Y., Suryadinata, H., Sofiatin, Y., Rakhmilla, L. E., & Ruslami, R. (2021) · Journal of preventive medicine and hygiene · doi:10.15167/2421-4248/jpmh2021.62.3.1885 · Cited by 7
“Second, as this is a cross-sectional study design, which capture the data at one point in time, the determinants found in this study need to be further verified [28].”
BackgroundKe, S. Y., Wu, H., Sun, H., Zhou, A., Liu, J., Zheng, X., Liu, K., Westover, M. B., Xu, H., & Kong, X. (2024) · Frontiers in Neuroscience · doi:10.3389/fnins.2024.1330556 · Cited by 11
“Although most previous studies have primarily reported reduced long-range spectral coherence in ASD (Perez Velazquez et al., 2009; Khan et al., 2013), a few studies have also reported solely increased coherence both short range and long range (Sheikhani et al., 2012; Wang et al., 2020).”
BackgroundKarim, A. R., Darsono, D., Harisudin, M., et al. (2024) · Open Agriculture · doi:10.1515/opag-2022-0257 · Cited by 6
Mtshweni, B. V. (2024) · AAOU Journal/AAOU journal · doi:10.1108/aaouj-10-2023-0119 · Cited by 6
Li, J., Zhang, X. N., & Barr, B. (2024) · BMJ Public Health · doi:10.1136/bmjph-2023-000601 · Cited by 6
Venäläinen, J., Låftman, S. B., & Landberg, J. (2024) · BMC Public Health · doi:10.1186/s12889-024-20517-6 · Cited by 7
Alajrab, S. S., Oweidat, I. A., Nassar, O., ALBashtawy, M., & Nashwan, A. J. (2025) · BMC Nursing · doi:10.1186/s12912-024-02518-3 · Cited by 7
Wang‐Chen, Y., Yang, H. M., Kellow, N. J., & Choi, T. S. T. (2025) · Obesity Reviews · doi:10.1111/obr.13913 · Cited by 7
Zhang, L., Du, Y., Zhou, J., Liu, C., Li, J., & Qiao, C. (2025) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-025-07330-8 · Cited by 5
Climate change distress and impairment among adolescents in Germany
König, L., Schröder, R., Breves, P. L., Linnemann, G. A., Hamer, T., & Suhr, R. (2025) · Frontiers in Climate · doi:10.3389/fclim.2025.1568676 · Cited by 7
“Firstly, as noted above, this study was exploratory and used a cross-sectional study design that does not allow causal interpretation of the investigated associations (Wang and Cheng, 2020).”
Svanström, J., Skytt, B., Lindberg, M., & Lindberg, M. (2025) · Work · doi:10.1177/10519815251326470 · Cited by 11
Fehr, L., & Koob, C. (2025) · BMC Nursing · doi:10.1186/s12912-025-03033-9 · Cited by 8
Impact of dental caries on the quality of life of adolescents: A systematic review and meta-analysis
Botelho-Filho, C. R., Bordin, G. M., de Paula, I. C. S. F., et al. (2025) · Revista Brasileira de Epidemiologia · doi:10.1590/1980-549720250018 · Cited by 6
Inaccurate and misleading meta-analysis of E-cigarettes and population-based diseases
Rodu, B., Plurphanswat, N., & Rodu, J. S. (2025) · Internal and Emergency Medicine · doi:10.1007/s11739-025-03956-w · Cited by 7
Tol, Z. V., Middel, A., Vanos, J., & Ferguson, K. M. (2025) · GeoHealth · doi:10.1029/2025gh001372 · Cited by 6
“Like any cross‐sectional study (Wang & Cheng, 2020), results represent only a small snapshot in time and are limited in both geographic and temporal scope.”
Taş, B., Azık, D., & Öz, B. (2025) · BMC Psychology · doi:10.1186/s40359-025-02932-5 · Cited by 6
The relationship between grit, resilience and physical activity: a systematic review
Martin, J. R., Hromyak, A., van der Weyden, M. S., Weinstein, A. A., & Boolani, A. (2025) · Frontiers in Sports and Active Living · doi:10.3389/fspor.2025.1563382 · Cited by 7
Ren, L., Deng, S., Men, L., & Boudouaia, A. (2025) · Humanities and Social Sciences Communications · doi:10.1057/s41599-025-05378-7 · Cited by 6
“Cross-sectional methodology enables data to be collected at a time of relevance and purposive sampling ensures that the most relevant individuals, those with direct authority and knowledge, are recruited into the study (Campbell et al., 2020; Setia, 2016; Wang & Cheng, 2020).”
Chou, S., Lin, C., Wang, Y.-C., et al. (2025) · European Journal of Preventive Cardiology · doi:10.1093/eurjpc/zwaf413 · Cited by 6
Becker, J. L., MacDonald, M. E., Vessey, K. A., & Williams, R. J. (2025) · Neurobiology of Aging · doi:10.1016/j.neurobiolaging.2025.08.003 · Cited by 7
“This presents an inability to assess incidence or make causal inferences due to the non-experimental methods of data obtention (Wang and Cheng, 2020).”
Arslan, A., & DURMUŞ, E. (2025) · SAGE Open · doi:10.1177/21582440251365820 · Cited by 6
“Cross-sectional research is observational, involves looking at a snapshot of data collected from a group over a certain period, and is descriptive (Wang & Cheng, 2020).”
Boakye, P. A., Adaboh, E., Lomotey, A. Y., et al. (2025) · PLOS Global Public Health · doi:10.1371/journal.pgph.0005039 · Cited by 6
“This design was deemed appropriate, as the researchers aimed to collect data at a specific point in time and describe the characteristics of adolescents concerning sexual activity and contraceptive use [35].”
Rustagi, A. S., Jeffers, A. M., Graham, F., Cohen, B. E., Slatore, C. G., Byers, A. L., Glantz, S. A., & Keyhani, S. (2025) · Journal of General Internal Medicine · doi:10.1007/s11606-025-09833-8 · Cited by 6
Antwi‐Agyei, P., Eloh, V. Y. N., Nti, P. O., et al. (2025) · Discover Sustainability · doi:10.1007/s43621-025-01534-w · Cited by 6
“The quantitative component encompassed a cross-sectional survey and statistical analysis, while the qualitative aspect relied on focus group discussions and thematic analysis [31].”
Walking and cycling as recreational activities and their associated factors
Paydar, M. M., & Fard, A. K. (2025) · International Journal of Urban Sustainable Development · doi:10.1080/19463138.2025.2569344 · Cited by 7
“Furthermore, because cross-sectional designs are unable to record changes in variables or correlations over time, they are limited in their ability to track temporal changes and in establishing causality (Wang and Cheng 2020).”
Farajalla, F., Salameh, A., Halahla, A.-A., et al. (2026) · BMC Family Practice · doi:10.1186/s12875-026-03319-0 · Cited by 6
“This study employed a cross-sectional design, which is commonly used in public health as a reliable method for examining behaviors and associations within populations [28].”
Social and Religious Influences on Environmentally Ethical Behavior of Muslim Community in Malaysia
Nasir, Z. M., & Yaacob, M. (2022) · Creative Education · doi:10.4236/ce.2022.1312255 · Cited by 9
Qiu, H., Lü, H., Wang, X., Guo, Z., Xing, C., & Zhang, Y. (2024) · Heliyon · doi:10.1016/j.heliyon.2024.e30994 · Cited by 6
“Researchers examined multiple factors simultaneously in a cross-sectional study and found their relationship [102].”
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“However, a limitation of the cross-sectional method used is that the causal nature or direction of the association cannot be established (Wang and Cheng 2020).”
The impact of exclusive breastfeeding on breastfeeding duration
Mikołajczyk-Stecyna, J. (2024) · Applied Nursing Research · doi:10.1016/j.apnr.2024.151824 · Cited by 6
Perspectivas de docentes universitarios sobre la inteligencia artificial en la educación
González, S. J. G., & González, N. D. L. N. (2024) · Yachana Revista Científica · doi:10.62325/10.62325/yachana.v13.n2.2024.929 · Cited by 7
Does integrated talent management foster competitive advantage in higher education institutions?
Abiwu, L., & Martins, I. (2024) · SA Journal of Human Resource Management · doi:10.4102/sajhrm.v22i0.2669 · Cited by 6
Housing Instability Screening and Referral Programs: A Scoping Review
Asthana, S., Gago, L. C. A., Garcia, J., Beestrum, M., Pollack, T., Post, L. A., Barnard, C., & Goel, M. S. (2024) · The Joint Commission Journal on Quality and Patient Safety · doi:10.1016/j.jcjq.2024.08.007 · Cited by 6
Causal pathways in preeclampsia: a Mendelian randomization study in European populations
Tan, Z., Ding, M., Shen, J., Huang, Y., Li, J., Sun, A., Hong, J., Yang, Y., He, S., Pei, C., et al. (2024) · Frontiers in Endocrinology · doi:10.3389/fendo.2024.1453277 · Cited by 6
“Observational studies, while informative, are susceptible to confounding and reverse causation, which can obscure causal inferences (10 – 12).”
Taccini, F., Rossi, A. A., & Mannarini, S. (2024) · Behavioral Sciences · doi:10.3390/bs14090799 · Cited by 14
“Consequently, establishing causality of the variables being examined [96] is not possible.”
BackgroundPattar, B. S. B., Gulamhusein, N., Rytz, C. L., Miranda, K. T., Beach, L. B., Marshall, Z., Collister, D., Greene, D. N., Whitley, C. T., Saad, N., et al. (2024) · PLoS ONE · doi:10.1371/journal.pone.0309169 · Cited by 6
“It is noteworthy that cross-sectional studies were the most common type of study informing care of TGD persons and that this study type is not designed to determine causal relationships [44].”
BackgroundNg, J. Y., Deol, G., Anheyer, D., et al. (2024) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2024.103097 · Cited by 6
Marange, T., Mangwanya, M. G., Maramura, T. C., et al. (2024) · SA Journal of Human Resource Management · doi:10.4102/sajhrm.v22i0.2717 · Cited by 6
Fiedler, J. M., Ayre, M. L., Rosanowski, S. M., & Slater, J. D. (2025) · Animal Welfare · doi:10.1017/awf.2024.69 · Cited by 9
“Survey testing was undertaken before utilising the snowball technique for the distribution (Wang & Cheng 2020).”
Musasa, A., Goto, J., & Lautenbach, G. (2025) · Contemporary Educational Technology · doi:10.30935/cedtech/15890 · Cited by 6
Sari, T. I., Hartoyo, H., & Muflikhati, I. (2025) · Journal of Consumer Sciences · doi:10.29244/jcs.10.1.145-172 · Cited by 9
“The research adopts a cross-sectional survey design, which collects data at a single point in time to describe the characteristics of the population or phenomenon without considering temporal changes (Wang & Cheng, 2020).”
Fitzgerald, S., Gracey, F., Trigg, E., & Broomfield, N. M. (2022) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2022.2052326 · Cited by 6
“In contrast, cross-sectional studies measure exposure and outcome at the same time whereby it is difficult to derive causal relationships (Wang & Cheng, 2020).”
BackgroundHadwen, B., He, J. W., Funk, C., et al. (2022) · Journal of Public Health · doi:10.1093/pubmed/fdac047 · Cited by 6
Soria‐Contreras, D. C., Oken, E., Téllez‐Rojo, M. M., Rifas‐Shiman, S. L., Perng, W., & Chavarro, J. E. (2022) · Annals of Epidemiology · doi:10.1016/j.annepidem.2022.06.033 · Cited by 6
Metadata
- Authors
- Wang, X., & Cheng, Z.
- Affiliations
- Cleveland Clinic (US)
- Zhongnan Hospital of Wuhan University (CN)
- Corresponding author
- Wang, Xiaofeng
- Venue
- CHEST
- Publisher
- Elsevier BV
- Published
- 2020-07
- Volume
- 158
- Issue
- 1
- Pages
- S65-S71
- ISSN
- 0012-3692 (ISSN-L)
- OpenAlex
- W3039445169
- Cited by
- 2,214
- References
- 29
- Citations by year
- 2026: 636 · 2025: 638 · 2024: 423 · 2023: 282 · 2022: 162 · 2021: 61 · 2020: 8
- FWCI
- 90.42
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- CHEST Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Health Sciences › Nursing › Research and Theory › Methodologies in Health Research and Practice
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Keywords
- cross-sectional study, observational study design, prevalence, health determinants, methodological issues, statistical analysis, respiratory medicine, intensive care, research design recommendations, peer review
- MeSH terms
- Cross-Sectional Studies, Humans, Guidelines as Topic
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