Cited by 2,751Nutrition and Health in AgingBody Composition Measurement TechniquesClinical Nutrition and Gastroenterology

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Screening for Undernutrition in Geriatric Practice: Developing the Short-Form Mini-Nutritional Assessment (MNA-SF)

Rubenstein, L. Z., Harker, J. O., Salva, A., Guigoz, Y., Vellas, B.·2001·The Journals of Gerontology Series A: Biological Sciences and Medical Sciences

DOI 10.1093/gerona/56.6.m366

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Abstract

BACKGROUND: The Mini-Nutritional Assessment (MNA) is a validated assessment instrument for nutritional problems, but its length limits its usefulness for screening. We sought to develop a screening version of this instrument, the MNA-SF, that retains good diagnostic accuracy. METHODS: We reanalyzed data from France that were used to develop the original MNA and combined these with data collected in Spain and New MEXICO: Of the 881 subjects with complete MNA data, 151 were from France, 400 were from Spain, and 330 were from New MEXICO: Independent ratings of clinical nutritional status were available for 142 of the French subjects. Overall, 73.8% were community dwelling, and mean age was 76.4 years. Items were chosen for the MNA-SF on the basis of item correlation with the total MNA score and with clinical nutritional status, internal consistency, reliability, completeness, and ease of administration. RESULTS: After testing multiple versions, we identified an optimal six-item MNA-SF total score ranging from 0 to 14. The cut-point score for MNA-SF was calculated using clinical nutritional status as the gold standard (n = 142) and using the total MNA score (n = 881). The MNA-SF was strongly correlated with the total MNA score (r = .945). Using an MNA-SF score of > or = 11 as normal, sensitivity was 97.9%, specificity was 100%, and diagnostic accuracy was 98.7% for predicting undernutrition. CONCLUSIONS: The MNA-SF can identify persons with undernutrition and can be used in a two-step screening process in which persons, identified as "at risk" on the MNA-SF, would receive additional assessment to confirm the diagnosis and plan interventions.

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“For example, MNA takes 10-15 minutes to administer (38, 39), but the MNA-SF takes less than 5 minutes.”
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“It could also be used as a two-part and twostage scale (4).”
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“299 [15] Rubenstein LZ, Harker JO, Salva A, Guigoz Y, Vellas B.”
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Background
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Influential
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Method
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Background
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Method
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Method
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Validity and reliability of Fried frailty phenotype in Turkish population
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“The MNA-SF developed by Rubenstein et al. (2001) consists of six questions.”
BackgroundMethod
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Risch, L., Hotzy, F., Vetter, S., Hiller, S., Wallimann, K., Seifritz, E., & Mötteli, S. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20010109 · Cited by 35
“Mini Nutritional Assessment-Short Form (MNA-SF): The MNA-SF is also a validated and widely used nutritional risk screening tool in hospital settings and care homes [20,26].”
Method
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“This was evaluated using the Mini Nutritional Assessment Short Form (MNA-SF) [15,16], which is a short questionnaire applied to assess the nutritional status of a single individual.”
Method
Validation of the revised mini nutritional assessment short-forms in nursing homes in Spain
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“This tool consists of six items (including BMI) from the full MNA and only classifies subjects in two categories, “well nourished” and the “possibility of malnutrition” without distinguishing specifically people at risk (2).”
Method
Identifying Geriatric Malnutrition in Nursing Practice: The Mini Nutritional Assessment (MNA®)—An Evidence-Based Screening Tool
Skates, J. J., & Anthony, P. S. (2012) · Journal of Gerontological Nursing · doi:10.3928/00989134-20120207-50 · Cited by 39
Sarcopenia Is Highly Prevalent in Older Medical Patients With Mobility Limitation
Maeda, K., Shamoto, H., Wakabayashi, H., & Akagi, J. (2016) · Nutrition in Clinical Practice · doi:10.1177/0884533616680355 · Cited by 33
Impact of Nutritional State on Critical Limb Ischemia Early Outcomes (DENUCRITICC Study)
du Mont, L. S., Leclerc, B., Morgant, M., Besch, G., Laubriet, A., Steinmetz, E. F., & Rinckenbach, S. (2017) · Annals of Vascular Surgery · doi:10.1016/j.avsg.2017.04.030 · Cited by 32
Pearls of optimizing nutrition and physical performance of older adults undergoing cancer therapy
Vigano, A. A. L., Kasvis, P., di Tomasso, J., Gillis, C., Kilgour, R. D., & Carli, F. (2017) · Journal of Geriatric Oncology · doi:10.1016/j.jgo.2017.08.013 · Cited by 32
Predictive value of the mini-nutritional assessment short form (MNA-SF) and nutritional risk screening (NRS2002) in hip fracture
Helminen, H., Luukkaala, T. H., Saarnio, J., & Nuotio, M. S. (2018) · European Journal of Clinical Nutrition · doi:10.1038/s41430-018-0267-y · Cited by 32
Association Between Appetite and Sarcopenia in Patients With Mild Cognitive Impairment and Early-Stage Alzheimer's Disease: A Case-Control Study
Kimura, A., Sugimoto, T., Niida, S., Toba, K., & Sakurai, T. (2018) · Frontiers in Nutrition · doi:10.3389/fnut.2018.00128 · Cited by 34
Effect of risk of malnutrition on 30-day mortality among older patients with acute heart failure in Emergency Departments
Martín‐Sánchez, F. J., Triana, F. M. C., Rosselló, X., PARDO-GARCIA, R., García, G., Caimari, F., Vidán, M. T., Ruiz‐Artacho, P., del Castillo, J. M. G., Llorens, P., et al. (2019) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2019.04.014 · Cited by 33
The relationship between common geriatric syndromes and potentially inappropriate medication use among older adults
Küçükdağlı, P., Bahat, G., Bay, İ., Kılıç, C., Ören, M. M., Türkmen, B. Ö., & Karan, M. A. (2019) · Aging Clinical and Experimental Research · doi:10.1007/s40520-019-01239-x · Cited by 33
Correlation between malnutrition and health-related quality of life (HRQOL) in elderly Iranian adults
Khatami, F., Shafiee, G., Kamali, K., Ebrahimi, M., Azimi, M., Ahadi, Z., Sharifi, F., Tanjani, P. T., & Heshmat, R. (2019) · Journal of International Medical Research · doi:10.1177/0300060519863497 · Cited by 32
“5 indicate risk of malnutrition, and scores <16 indicate malnourishment.(26,27)”
Background
SARC-F as a Screening Tool for Sarcopenia and Possible Sarcopenia Proposed by AWGS 2019 in Hospitalized Older Adults
Ishida, Y., Maeda, K., Nonogaki, T., Shimizu, A., Yamanaka, Y., Matsuyama, R., Kato, R., Ueshima, J., Murotani, K., & Mori, N. (2020) · The journal of nutrition health & aging · doi:10.1007/s12603-020-1462-9 · Cited by 33
“Malnutrition was diagnosed according to the ESPEN definition criteria (25) for malnutrition that has been previously described (26).”
Method
Post-discharge Telemonitoring of Physical Activity, Vital Signs, and Patient-Reported Symptoms in Older Patients Undergoing Cancer Surgery
Jonker, L. T., Lahr, M. M. H., Oonk, M. H. M., de Bock, G. H., & van Leeuwen, B. L. (2021) · Annals of Surgical Oncology · doi:10.1245/s10434-021-09707-3 · Cited by 32
Higher frailty burden in older adults with chronic constipation
Lim, J., Park, H., Lee, H., Lee, E., Lee, D., Jung, H., & Jang, I. (2021) · BMC Gastroenterology · doi:10.1186/s12876-021-01684-x · Cited by 32
“The risk of malnutrition was defined as a score of ≤ 11 on the MiniNutritional Assessment-Short Form [26].”
Method
A study of molecular changes relating to energy metabolism and cellular stress in people with Huntington’s disease: looking for biomarkers
Krzysztoń-Russjan, J., Zielonka, D., Jackiewicz, J., Kuśmirek, S., Bubko, I., Klimberg, A., Marcinkowski, T., & Anuszewska, E. (2012) · Journal of Bioenergetics and Biomembranes · doi:10.1007/s10863-012-9479-3 · Cited by 32
“The MNA-cohorts reflected a study group differentiation performed on the basis of the nutrition status assessment according to the MNA scale (Table 1a) (Rubenstein et al. 2001).”
Method
Social and economic correlates of malnutrition in Polish elderly population: The results of PolSenior study
Krzymińska-Siemaszko, R., Mossakowska, M., Skalska, A., Klich‐Rączka, A., Tobis, S., Szybalska, A., Cylkowska-Nowak, M., Olszanecka‐Glinianowicz, M., Chudek, J. T., & Wieczorowska–Tobis, K. (2014) · The journal of nutrition health & aging · doi:10.1007/s12603-014-0572-7 · Cited by 32
“Over the last two decades the questionnaire has been modified three times (14, 15) and is currently available in 24 language versions (16).”
Malnutrition in Turkish nursing homes: A correlate of short term mortality
Ülger, Z., Halil, M. G., Cankurtaran, M., Yavuz, B. B., Yeşil, Y., Kuyumcu, M. E., Güngör, A. E., İzgi, H., Iskit, A. T., Abbasoğlu, O., et al. (2013) · The journal of nutrition health & aging · doi:10.1007/s12603-013-0016-9 · Cited by 32
“its usage was also validated for the assessment of protein-calorie malnutrition in the nursing home population (4, 20, 21).”
Nurse home visits with or without alert buttons versus usual care in the frail elderly: a randomized controlled trial
García‐Peña, C., Favela, J., Sánchez‐García, S., Juárez‐Cedillo, T., Franco-Marina, Rodríguez, M. D., Castro, L. A., Mora, & Bermudez, C. E. (2013) · Clinical Interventions in Aging · doi:10.2147/cia.s38618 · Cited by 32
“30 This is a validated nutritional screening and assessment tool that can identify geriatric patients age 65 years and above who are malnourished or at risk of malnutrition.”
Validation of the modified mini nutritional assessment short-forms in different populations of older people in Poland
Kostka, J., Borowiak, E., & Kostka, T. (2013) · The journal of nutrition health & aging · doi:10.1007/s12603-013-0393-0 · Cited by 32
“in clinical practice, two versions of this questionnaire are used: a full version worked out in 1994 (8) and a short form known as the MNa-sF (17).”
Diagnostic test accuracy of preoperative nutritional screening tools in adults for malnutrition: a systematic review and network meta-analysis
Cheung, H. H. T., Joynt, G. M., & Lee, A. S. Y. (2023) · International Journal of Surgery · doi:10.1097/js9.0000000000000845 · Cited by 34
“…(MST) [9] , Malnutrition Universal Screening Tool (MUST) [10] , Mini Nutritional Assessment (MNA) [11] , short-form Mini Nutritional Assessment (MNA-SF) [12] , Nutritional Risk Index (NRI) [13] , Nutrition Risk Screening Tool 2002 (NRS-2002) [14] and Preoperative Nutrition Screening (PONS) [15] .”
Method
Breathlessness, Frailty, and Sarcopenia in Older Adults
An, T. J., Lim, J., Lee, H., Ji, S., Jung, H., Baek, J. Y., Lee, E., & Jang, I. (2024) · CHEST Journal · doi:10.1016/j.chest.2024.07.180 · Cited by 34
M ini N utritional A ssessment S hort‐ F orm predicts exacerbation frequency in patients with chronic obstructive pulmonary disease
Yoshikawa, M., Fujita, Y., Yamamoto, Y., Yamauchi, M., Tomoda, K., Koyama, N., & Kimura, H. (2014) · Respirology · doi:10.1111/resp.12380 · Cited by 31
Postoperative recovery of accelerometer-based physical activity in older cancer patients
Jonker, L. T., Hendriks, S., Lahr, M. M. H., Munster, B. C. V., de Bock, G. H., & van Leeuwen, B. L. (2020) · European Journal of Surgical Oncology · doi:10.1016/j.ejso.2020.06.012 · Cited by 31
Translating Evidence-Based Guidelines into Practice—Are We Getting It Right? A Multi-Centre Prospective International Audit of Nutrition Care in Patients with Foregut Tumors (INFORM)
Findlay, M., Bauer, J., Dhaliwal, R., de van der Schueren, M. D. V., Laviano, A., Widaman, A., Martin, L., Day, A., & Gramlich, L. (2020) · Nutrients · doi:10.3390/nu12123808 · Cited by 20
“The validated tools for nutrition screening used in participating sites included the Malnutrition Screening Tool (MST) [40], Nutrition Risk Screening 2002 [41], Mini Nutrition Assessment-Short Form (MNA-SF) [42] and the Short Nutritional Assessment Questionnaire (SNAQ) [43].”
Method
Pancreatic Cancer Prognosis, Malnutrition Risk, and Quality of Life: A Cross-Sectional Study
Poulia, K., Antoniadou, D., Sarantis, P., & Karamouzis, M. V. (2022) · Nutrients · doi:10.3390/nu14030442 · Cited by 31
Impact of social engagement on the development of sarcopenia among community‐dwelling older adults: A Kashiwa cohort study
Tanaka, T., Son, B., Lyu, W., & Iijima, K. (2022) · Geriatrics and gerontology international/Geriatrics & gerontology international · doi:10.1111/ggi.14372 · Cited by 32
Associations between diet quality, health status and diabetic complications in patients with type 2 diabetes and comorbid obesity
Mangou, A., Grammatikopoulou, M. G., Mirkopoulou, D., Sailer, N., Kotzamanidis, C., & Tsigga, M. (2011) · Endocrinología y Nutrición · doi:10.1016/j.endonu.2011.10.003 · Cited by 31
Food Consumption Analysis in Spanish Elderly Based upon the Mini Nutritional Assessment Test
Cuervo, M., Ansorena, D., García, A., Astiasarán, I., & Martínez, J. A. (2008) · Annals of Nutrition and Metabolism · doi:10.1159/000151483 · Cited by 31
Similar effects of leucine rich and regular dairy products on muscle mass and functions of older polymyalgia rheumatica patients: A randomized crossover trial
Bjorkman, M. P., Pilvi, T. K., Kekkonen, R. A., Korpela, R., & Tilvis, R. S. (2010) · The journal of nutrition health & aging · doi:10.1007/s12603-010-0276-6 · Cited by 33
Mini Nutritional Assessment and short-form Mini Nutritional Assessment can predict the future risk of falling in older adults – Results of a national cohort study
Tsai, A. C.-H., & Lai, M.-Y. (2013) · Clinical Nutrition · doi:10.1016/j.clnu.2013.10.010 · Cited by 31
Fixed-duration venetoclax plus obinutuzumab improves quality of life and geriatric impairments in FCR-unfit patients with CLL
van der Straten, L., Stege, C. A. M., Kersting, S., Nasserinejad, K., Dubois, J. M. N., Dobber, J. A., Mellink, C. H. M., van der Kevie-Kersemaekers, A.-M. F., Evers, L. M., de Boer, F., et al. (2023) · Blood · doi:10.1182/blood.2023020195 · Cited by 31
Malnutrition prevalence according to GLIM and its feasibility in geriatric patients: a prospective cross-sectional study
Enge, M., Peelen, F. O., Nielsen, R. L., Beck, A. M., Olin, A. Ö., Cederholm, T., Boström, A., & Paur, I. (2024) · European Journal of Nutrition · doi:10.1007/s00394-023-03323-5 · Cited by 30
“The Mini Nutritional Assessment-short form (MNA-SF) has so far often been used to both screen and determine malnutrition in older adults [5].”
Method
Investigating Frailty, Polypharmacy, Malnutrition, Chronic Conditions, and Quality of Life in Older Adults: Large Population-Based Study
Liu, Y., Huang, L., Hu, F., & Zhang, X. (2024) · JMIR Public Health and Surveillance · doi:10.2196/50617 · Cited by 35
“Older adult participants (aged ≥ 65 years) were additionally assessed for frailty using the Groningen Frailty Indicator (GFI) [56] and for malnutrition using the Mini Nutritional Assessment–Short Form (MNA-SF) [57]; both instruments were specifically designed for older adults.”
Evaluation of the mini-nutritional assessment short-form (MNA-SF) among institutionalized older patients in Spain.
de Luis, D. A., Mongil, R. L., Sagrado, M. G., Trigo, J. A. L., Mora, P. F., & Sanz, J. C. (2011) · PubMed · doi:10.1590/s0212-16112011000600023 · Cited by 30
Financial Strain Is Associated with Malnutrition Risk in Community-Dwelling Older Women
Samuel, L. J., Szanton, S. L., Weiss, C. O., Thorpe, R. J., Semba, R. D., & Fried, L. P. (2012) · Epidemiology Research International · doi:10.1155/2012/696518 · Cited by 32
The Association of Inflammation with Food Intake in Older Hospitalized Patients
Pourhassan, M., Böttger, S., Janssen, G., Sieske, L., & Wirth, R. (2017) · The journal of nutrition health & aging · doi:10.1007/s12603-017-0976-2 · Cited by 30
“According to MNA-SF, 46.0% of patients were malnourished, 13.0% at risk of malnutrition and 52.0% had no mobility.”
Influential
Nutritional Assessment and Intervention to Prevent and Treat Malnutrition for Fall Risk Reduction in Elderly Populations
Esquivel, M. K. (2017) · American Journal of Lifestyle Medicine · doi:10.1177/1559827617742847 · Cited by 30
“Valid and reliable nutrition screening tools are available for the elderly population; these tools include questions on changes in diet intake, weight loss, mobility, and mental status.(31) When concern over malnutrition arises, further assessment is warranted.”
Method
Urologic symptoms and burden of frailty and geriatric conditions in older men: the Aging Study of PyeongChang Rural Area
Jang, I., Lee, C. K., Jung, H., Yu, S. S., Lee, Y. S., Lee, E., & Kim, D. H. (2018) · Clinical Interventions in Aging · doi:10.2147/cia.s158717 · Cited by 31
“23 Malnutrition risk was defined as a score of # 11 according to the Mini-Nutritional Assessment-Short Form.”
Associations between nutrition risk status, body composition and physical performance among community‐dwelling older adults
Chatindiara, I., Williams, V., Sycamore, E., Richter, M., Allen, J. E., & Wham, C. A. (2018) · Australian and New Zealand Journal of Public Health · doi:10.1111/1753-6405.12848 · Cited by 30
The effects of sarcopenic dysphagia on the dynamics of swallowing organs observed on videofluoroscopic swallowing studies
Miyashita, T., Kikutani, T., Nagashima, K., Igarashi, K., & Tamura, F. (2020) · Journal of Oral Rehabilitation · doi:10.1111/joor.12936 · Cited by 30
Validation of Malnutrition Screening Tools in Liver Cirrhosis
Traub, J., Bergheim, I., Horvath, A., & Stadlbauer, V. (2020) · Nutrients · doi:10.3390/nu12051306 · Cited by 30
“After written informed consent, RFH-NPT [3], GMS [5], NRS- 2002 [6] and MNA-SF [7] were assessed.”
Clinical judgment versus geriatric assessment for frailty in older patients with cancer
van Walree, I. C., Scheepers, E. R. M., van den Bos, F., van Huis‐Tanja, L. H., Emmelot‐Vonk, M. H., & Hamaker, M. E. (2020) · Journal of Geriatric Oncology · doi:10.1016/j.jgo.2020.05.011 · Cited by 30
Singapore multidisciplinary consensus recommendations on muscle health in older adults: assessment and multimodal targeted intervention across the continuum of care
Chew, S. T. H., Kayambu, G., Lew, C. C. H., Ng, T. P., Ong, F., Tan, J. J., Tan, N. C., & Tham, S.-L. (2021) · BMC Geriatrics · doi:10.1186/s12877-021-02240-8 · Cited by 33
Serum vitamin D status inversely associates with a prevalence of severe sarcopenia among female patients with rheumatoid arthritis
Minamino, H., Katsushima, M., Torii, M., Yamamoto, W., Fujita, Y., Ikeda, K., Okamura, E., Murakami, K., Watanabe, R., Murata, K., et al. (2021) · Scientific Reports · doi:10.1038/s41598-021-99894-6 · Cited by 32
Validity and Reliability of Nutrition Screening Administered by Nurses
Lim, S. L., Ang, E. N. K., Foo, Y. L., Ng, L. Y., Tong, C. Y., Ferguson, M. L., & Daniels, L. (2013) · Nutrition in Clinical Practice · doi:10.1177/0884533613502812 · Cited by 30
Prevalence of hospital malnutrition among cardiac patients: results from six nutrition screening tools
Pathirana, A., Lokunarangoda, N. C., Ranathunga, I., Santharaj, W. S., Ekanayake, R., & Jayawardena, R. (2014) · SpringerPlus · doi:10.1186/2193-1801-3-412 · Cited by 30
No correlation between Mini-Nutritional Assessment (short form) scale and clinical outcomes in 73 elderly patients admitted for hip fracture
Formiga, F., Chivite, D., Mascaró, J., Ramon, J. M., & Pujol, R. (2005) · Aging Clinical and Experimental Research · doi:10.1007/bf03324620 · Cited by 30

Authors: Rubenstein, L. Z., Harker, J. O., Salva, A., Guigoz, Y., & Vellas, B.
Affiliations: University of California, Los Angeles (US)
VA Sepulveda Ambulatory Care Center (US)
Nestlé (Switzerland) (CH)
Corresponding author: Rubenstein, L. Z.
ORCID: Rubenstein, L. Z.
Vellas, B.
Venue: The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
Publisher: Oxford University Press (OUP)
Published: 2001-06-01
Volume: 56
Issue: 6
Pages: M366-M372
ISSN: 1079-5006 (ISSN-L)
1758-535X
DOI: 10.1093/gerona/56.6.m366
OpenAlex: W2122613011
Cited by: 2,751
References: 14
Citations by year: 2026: 252 · 2025: 266 · 2024: 265 · 2023: 239 · 2022: 252 · 2021: 263 · 2020: 179 · 2019: 143 · 2018: 112 · 2017: 112 · 2016: 109 · 2015: 93 · 2014: 79 · 2013: 61 · 2012: 76
FWCI: 5.19
Type: journal article
Language: en
Open access: closed
Locations: The Journals of Gerontology Series A (publishedVersion)
PubMed (publishedVersion)
Funders: U.S. Department of Veterans Affairs
Geriatric Research Education and Clinical Center
VA Greater Los Angeles Healthcare System
Topics: Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
Health Sciences › Medicine › Physiology (medical) › Body Composition Measurement Techniques
Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
Keywords: Mini Nutritional Assessment, undernutrition screening, nutritional assessment, older adults, elderly nutrition, screening tool development, diagnostic accuracy, two-stage screening
MeSH terms: Aged, Female, Geriatrics, Humans, Male, Mass Screening, Nutrition Disorders, Professional Practice, Nutrition Assessment, Discriminant Analysis

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Screening for Undernutrition in Geriatric Practice: Developing the Short-Form Mini-Nutritional Assessment (MNA-SF)

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