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Estimation of Premorbid Functioning in Pediatric Neuropsychology: Review and Recommendations

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Abstract

One of the most important procedures when working with a patient with a known or suspected acquired injury or neurodegenerative condition is determining their premorbid level of neurocognitive functioning. Although this process has been relatively well-researched in the adult/geriatric neuropsychological literature, there are comparatively few publications for the pediatric population and less consensus regarding how to translate findings into practice. This is likely due to a combination of factors, including children having obtained fewer developmental milestones, the highly variable nature of neurodevelopment in children, and that pediatric neuropsychologists frequently work with children with congenital/neurodevelopmental conditions in which determination of premorbid functioning may feel less important. This manuscript reviews the literature on this topic and offers recommendations for the best practice as well as future research directions in the estimation of premorbid functioning in a pediatric population.

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References

  • Alves, L., Simões, M. R., & Martins, C. (2011). The estimation of premorbid intelligence levels among Portuguese speakers: the Irregular Word Reading Test (TeLPI). Archives of Clinical Neuropsychology, 27(1), 58–68.

    Article  PubMed  Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Arlington: American Psychiatric Association.

    Book  Google Scholar 

  • Axelrod, B. N., Vanderploeg, R. D., & Rawlings, D. B. (1999). WAIS-R prediction equations in patients with traumatic brain injury. Journal of Clinical and Experimental Neuropsychology, 21, 368–374.

    Article  PubMed  Google Scholar 

  • Baade, L. E., & Schoenberg, M. R. (2004). A proposed method to estimate premorbid intelligence utilizing group achievement measures from school records. Archives of Clinical Neuropsychology, 19(2), 227–243.

    Article  PubMed  Google Scholar 

  • Baade, L. E., Heinrichs, R. J., Coady, E. L., & Stropes, J. (2011). Assessment of premorbid functioning in a pediatric population. In A. S. Davis (Ed.), The handbook of pediatric neuropsychology (pp. 191–200). New York: Springer Publishing Company, LLC.

    Google Scholar 

  • Barona, A., Reynolds, C. R., & Chastain, R. (1984). A demographically based index of premorbid intelligence for the WAIS—R. Journal of Consulting and Clinical Psychology, 52(5), 885.

    Article  Google Scholar 

  • Barulli, D., & Stern, Y. (2013). Efficiency, capacity, compensation, maintenance, plasticity: emerging concepts in cognitive reserve. Trends in Cognitive Sciences, 17(10), 502–509.

    Article  PubMed  Google Scholar 

  • Basso, M. R., & Bornstein, R. A. (2000). Estimated premorbid intelligence mediates neurobehavioral change in individuals infected with IV across 12 months. Journal of Clinical and Experimental Neuropsychology, 22, 208–218.

    Article  PubMed  Google Scholar 

  • Batty, G. D., Deary, I. J., & Gottfredson, L. S. (2007). Premorbid (early life) IQ and later mortality risk: Systematic review. Annals of Epidemiology, 17(4), 278–288.

    Article  PubMed  Google Scholar 

  • Brooks, B. L. (2010). Seeing the forest for the trees: prevalence of low scores on the Wechsler Intelligence Scale for Children, (WISC-IV). Psychological Assessment, 22(3), 650.

    Article  PubMed  Google Scholar 

  • Brooks, B. L., Strauss, E., Sherman, E., Iverson, G. L., & Slick, D. J. (2009). Developments in neuropsychological assessment: refining psychometric and clinical interpretive methods. Canadian Psychology/Psychologie Canadienne, 50(3), 196.

    Article  Google Scholar 

  • Burin, D. I., Jorge, R. E., Arizaga, R. A., & Paulsen, J. S. (2000). Estimation of premorbid intelligence: the word accentuation test-Buenos Aires version. Journal of Clinical and Experimental Neuropsychology, 22, 677–685.

    Article  PubMed  Google Scholar 

  • Cohen, M. (1997). Children’s memory scale. San Antonio: The Psychological Corporation.

    Google Scholar 

  • Crawford, J. R., & Allan, K. M. (1997). Estimating premorbid IQ with demographic variables: regression equations derived from a UK sample. The Clinical Neuropsychologist, 11, 192–197.

    Article  Google Scholar 

  • Crawford, J. R., Millar, J., & Milne, A. B. (2001). Estimating premorbid IQ from demographic variables: a comparison of a regression equation vs. clinical judgement. British Journal of Clinical Psychology, 40(1), 97–105.

    Article  PubMed  Google Scholar 

  • Del Ser, T., González-Montalvo, J. I., Martı́nez-Espinosa, S., Delgado-Villapalos, C., & Bermejo, F. (1997). Estimation of premorbid intelligence in Spanish people with the Word Accentuation Test and its application to the diagnosis of dementia. Brain and Cognition, 33(3), 343–356.

    Article  PubMed  Google Scholar 

  • Devlin, B., Daniels, M., & Roeder, K. (1997). The heritability of IQ. Nature, 388(6641), 468–471.

    Article  PubMed  Google Scholar 

  • Donders, J. (2005). Performance on the Test of Memory Malingering in a mixed pediatric sample. Child Neuropsychology, 11(2), 221–227.

    Article  PubMed  Google Scholar 

  • Duckworth, A. L., & Seligman, M. E. (2005). Self-discipline outdoes IQ in predicting academic performance of adolescents. Psychological Science, 16(12), 939–944.

    Article  PubMed  Google Scholar 

  • Eppinger, M. G., Craig, P. L., Adams, R. L., & Parsons, O. A. (1987). The WAIS-R index for estimating premorbid intelligence: cross-validation and clinical utility. Journal of Consulting and Clinical Psychology, 55(1), 86–90.

    Article  PubMed  Google Scholar 

  • Estevis, E., Basso, M. R., & Combs, D. (2012). Effects of practice on the Wechsler Adult Intelligence Scale-IV across 3- and 6-month intervals. The Clinical Neuropsychologist, 26(2), 239–254.

    Article  PubMed  Google Scholar 

  • Finch, W. H., Chang, M., Davis, A. S., Holden, J. E., Rothlisberg, B. A., & McIntosh, D. E. (2011). The prediction of intelligence in preschool children using alternative models to regression. Behavior Research Methods, 43(4), 942–952.

    Article  PubMed  Google Scholar 

  • Flanagan, D. P., & Alfonso, V. C. (2010). Essentials of specific learning disability identification. Hoboken: Wiley.

    Google Scholar 

  • Franzen, M. D., Burgess, E. J., & Smith-Seemiller, L. (1997). Methods of estimating premorbid functioning. Archives of Clinical Neuropsychology, 12(8), 711–738.

    Article  PubMed  Google Scholar 

  • Gavett, B. E. (2015). The value of Bayes’ theorem for interpreting abnormal test scores in cognitively healthy and clinical samples. Journal of the International Neuropsychological Society, 21(3), 249–257.

    Article  PubMed  Google Scholar 

  • Green, R. E. A., Melo, B., Christensen, B., Ngo, L., Monette, G., & Bradbury, C. (2008). Measuring premorbid IQ in traumatic brain injury: an examination of the validity of the Wechsler Test of Adult Reading (WTAR). Journal of Clerical and Experimental Neuropsychology, 30, 163–172.

    Article  Google Scholar 

  • Gutman, L. M., Sameroff, A. J., & Cole, R. (2003). Academic growth curve trajectories from 1st grade to 12th grade: effects of multiple social risk factors and preschool child factors. Developmental Psychology, 39(4), 777.

    Article  PubMed  Google Scholar 

  • Hauerwas, L. B., Brown, R., & Scott, A. N. (2013). Specific learning disability and response to intervention: state-level guidance. Exceptional Children, 80(1), 101–120.

    Article  Google Scholar 

  • Hogan, R., & Weiss, D. S. (1974). Personality correlates of superior academic achievement. Journal of Counseling Psychology, 21(2), 144.

    Article  Google Scholar 

  • Hogarth, R. M. (1975). Cognitive processes and the assessment of subjective probability distributions. Journal of the American statistical Association, 70(350), 271–289.

  • Kareken, D. A., & Williams, J. M. (1994). Human judgment and estimation of premorbid intellectual function. Psychological Assessment, 6, 83–91.

    Article  Google Scholar 

  • Kaufman, A. S. (1990). Assessing adolescent and adult intelligence. Boston: Allyn & Bacon.

    Google Scholar 

  • Kennepohl, S., Shore, D., Nabors, N., & Hanks, R. (2004). African American acculturation and neuropsychological test performance following traumatic brain injury. Journal of the International Neuropsychological Society, 10(4), 566–577.

    Article  PubMed  Google Scholar 

  • Kim, S. G., Lee, E. H., Hwang, S. T., Park, K., Chey, J., Hong, S. H., & Kim, J. H. (2015). 12 and demographic variables. The Clinical Neuropsychologist, 9(1), 83–88.

    Google Scholar 

  • Klesges, R. C. & Sanchez, V. C. (1981). Cross-validation of an index of premorbid intellectual functioning in children. Journal of Consulting and Clinical Psychology, 49, 141.

  • Klesges, R. C. (1982). Confusing clinical and statistical significance? A reply to Reynolds and Gutkin. Journal of Consulting and Clinical Psychology, 50, 772–774.

  • Korkman, M., Kirk, U., & Kemp, S. (2007). NEPSY-II. San Antonio: Harcourt.

    Google Scholar 

  • Krull, K. R., Scott, J. G., & Sherer, M. (1995). Estimation of premorbid intelligence from combined performance and demographic variables. The Clinical Neuropsychologist, 9(1), 83–88.

    Article  Google Scholar 

  • Lezak, M. D., Howieson, D. B., Bigler, E. D., & Tranel, D. (2012). Neuropsychological assessment (5th ed.). New York: Oxford University Press.

    Google Scholar 

  • Mackinnon, A., Ritchie, K., & Mulligan, R. (1999). The measurement properties of a French language adaptation of the National Adult Reading Test. International Journal of Methods in Psychiatric Research, 8(1), 27–38.

    Article  Google Scholar 

  • Manly, J. J., Byrd, D. A., Touradji, P., & Stern, Y. (2004). Acculturation, reading level, and neuropsychological test performance among African American elders. Applied Neuropsychology, 11(1), 37–46.

    Article  PubMed  Google Scholar 

  • Matsuoka, K., Uno, M., Kasai, K., Koyama, K., & Kim, Y. (2006). Estimation of premorbid IQ in individuals with Alzheimer’s disease using Japanese ideographic script (Kanji) compound words: Japanese version of National Adult Reading Test. Psychiatry and Clinical Neurosciences, 60(3), 332–339.

    Article  PubMed  Google Scholar 

  • Miller, C. J., Marks, D. J., & Halperin, J. M. (2005). Comparison of measured and estimated cognitive ability in older adolescents with and without ADHD. Journal of Attention Disorders, 9(2), 444–450.

    Article  PubMed  Google Scholar 

  • Nelson, H. E. (1982). National Adult Reading Test (NART): for the assessment of premorbid intelligence in patients with dementia: test manual. NFER-Nelson.

  • Nelson, H. E., & Willison, J. (1991). National adult reading test (NART). Windsor: Nfer-Nelson.

  • No Child Left Behind Act of 2001, P.L. 107–110, 20 U.S.C. § 6319 (2002).

  • Pearson, N. C. S. (2008). WAIS-IV: technical and scoring manual. San Antonio: Author.

    Google Scholar 

  • Pearson. (2009). Advanced clinical solutions administration and scoring manual. San Antonio: Author.

    Google Scholar 

  • Peebles, R., Sabella, C., Franco, K., & Goldfarb, J. (2005). Factitious disorder and malingering in adolescent girls: case series and literature review. Clinical Pediatrics, 44(3), 237–243.

    Article  PubMed  Google Scholar 

  • Powell, B. D., Brossart, D. F., & Reynolds, C. R. (2003). Evaluation of the accuracy of two regression-based methods for estimating premorbid IQ. Archives of Clinical Neuropsychology, 18(3), 277–292.

    Article  PubMed  Google Scholar 

  • Quereshi, M. Y. (1968). Practice effects on the WISC subtest scores and IQ estimates. Journal of Clinical Neuropsychology, 24(1), 79–85.

    Google Scholar 

  • Rabin, L. A., Paolillo, E., & Barr, W. B. (2016). Stability in test-usage practices of clinical neuropsychologists in the United States and Canada over a 10-year period: a follow-up survey of INS and NAN members. Archives of Clinical Neuropsychology, 31(3), 206–230.

    Article  PubMed  Google Scholar 

  • Razani, J., Burciaga, J., Madore, M., & Wong, J. (2007). Effects of acculturation on tests of attention and information processing in an ethnically diverse group. Archives of Clinical Neuropsychology, 22(3), 333–341.

    Article  PubMed  Google Scholar 

  • Reynolds, C. R. (1997). Postscripts on premorbid ability estimation: conceptual addenda and a few words on alternative and conditional approaches. Archives of Clinical Neuropsychology, 12, 769–778.

    Article  PubMed  Google Scholar 

  • Reynolds, C. R., & Gutkin, T. B. (1979). Predicting the premorbid intellectual status of children using demographic data. Clinical Neuropsychology.

  • Reynolds, C. R., & Gutkin, T. B. (1982). Clinical samples of children with below-average IQs are not “nonimpaired” and other troubles: comment on Klesges and Sanchez. Journal of Consulting and Clinical Psychology, 50, 576–577.

    Article  PubMed  Google Scholar 

  • Reynolds, C. R. (1984). Critical measurement issues in learning disabilities. Journal of Special Education, 18, 451–476.

  • Reynolds, C., & Kamphaus, R. (2007). Test of irregular word reading efficiency. Austin: Pro-Ed.

    Google Scholar 

  • Roid, G. H. (2003). Stanford–Binet intelligence scales (5th ed.): technical manual. Itasca: Riverside.

    Google Scholar 

  • Rolstad, S., Nordlund, A., Gustavsson, M. H., Eckerström, C., Klang, O., Hansen, S., & Wallin, A. (2008). The Swedish National Adult Reading Test (NART-SWE): a test of premorbid IQ. Scandinavian Journal of Psychology, 49(6), 577–582.

    Article  PubMed  Google Scholar 

  • Saez, P. A., Bender, H. A., Barr, W. B., Rivera Mindt, M., Morrison, C. E., Hassenstab, J., et al. (2014). The impact of education and acculturation on nonverbal neuropsychological test performance among Latino/a patients with epilepsy. Applied Neuropsychology: Adult, 21(2), 108–119.

  • Sanjuro, N. S., Montañes, P., Matamoros, F. A. S., & Burin, D. (2015). Estimating intelligence in Spanish: regression equations with the Word Accentuation Test and demographic variables in Latin America. Applied Neuropsychology, 22, 252–261.

    Article  Google Scholar 

  • Satz, P. (1993). Brain reserve capacity on symptom onset after brain injury: a formulation and review of evidence for threshold theory. Neuropsychology, 7(3), 273–295.

    Article  Google Scholar 

  • Schoenberg, M. R., Scott, J. G., Duff, K., & Adams, R. L. (2002). Estimation of WAIS-III intelligence from combined performance and demographic variables: development of the OPIE-3. The Clinical Neuropsychologist, 16(4), 426–438.

    Article  PubMed  Google Scholar 

  • Schoenberg, M. R., Scott, J. G., Ruwe, W., Patton, D., & Adams, R. L. (2004). Assumptions that underlie predicting premorbid IQ: a comment on the “evaluation of the accuracy of two regression-based methods for estimating premorbid IQ”. Archives of Clinical Neuropsychology, 19(8), 1103–1106.

    Article  PubMed  Google Scholar 

  • Schoenberg, M. R., Duff, K., Scott, J. G., Patton, D., & Adams, R. L. (2006). Prediction errors of the Oklahoma Premorbid Intelligence Estimate-3 (OPIE-3) stratified by 13 age groups. Archives of Clinical Neuropsychology, 21(5), 469–475.

    Article  PubMed  Google Scholar 

  • Schoenberg, M. R., Lange, R. T., Brickell, T. A., & Saklofske, D. H. (2007a). Estimating premorbid general cognitive functioning for children and adolescents using the American Wechsler Intelligence Scale for Children—Fourth Edition: demographic and current performance approaches. Journal of Child Neurology, 22(4), 379–388.

    Article  PubMed  Google Scholar 

  • Schoenberg, M. R., Lange, R. T., & Saklofske, D. H. (2007b). A proposed method to estimate premorbid full scale intelligence quotient (FSIQ) for the Canadian Wechsler Intelligence Scale for Children–Fourth Edition (WISC-IV) using demographic and combined estimation procedures. Journal of Clinical and Experimental Neuropsychology, 29(8), 867–878.

    Article  PubMed  Google Scholar 

  • Schrank, F. A., Mather, N., & McGrew, K. S. (2014). Woodcock-Johnson IV tests of achievement. Rolling Meadows: Riverside.

    Google Scholar 

  • Selwa, L. M., Berent, S., Giordani, B., Henry, T. R., Buchtel, H. A., & Ross, D. A. (1994). Serial cognitive testing in temporal lobe epilepsy: longitudinal changes with medical and surgical therapies. Epilepsia, 35(4), 743–749.

    Article  PubMed  Google Scholar 

  • Siders, A., Kaufman, A. S., & Reynolds, C. R. (2006). Do practice effects on Wechsler’s performance subtests relate to children’s general ability, memory, learning ability, or attention? Applied Neuropsychology, 13(4), 242–250.

    Article  PubMed  Google Scholar 

  • Slovic, P., & Lichtenstein, S. (1971). Comparison of Bayesian and regression approaches to the study of information processing in judgment. Organizational Behavior and Human Performance, 6(6), 649–744.

  • Smith-Seemiller, L., Franzen, M. D., Burgess, E. J., & Prieto, L. R. (1997). Neuropsychologists’ practice patterns in assessing premorbid intelligence. Archives of Clinical Neuropsychology, 12(8), 739–744.

    Article  PubMed  Google Scholar 

  • Stern, Y. (2002). What is cognitive reserve? Theory and research application of the reserve concept. Journal of the International Neuropsychological Society, 8(3), 448–460.

    Article  PubMed  Google Scholar 

  • Tuma, J. M., & Applebaum, A. S. (1980). Reliability and practice effects of WISC-R IQ estimates in a normal population. Educational and Psychological Measurement, 40(3).

  • Uttl, B. (2002). North American Adult Reading Test: age norms, reliability, and validity. Journal of Clinical and Experimental Neuropsychology, 24(8), 1123–1137.

    Article  PubMed  Google Scholar 

  • Vanderploeg, R. D., & Schinka, J. A. (1995). Predicting WAIS-R IQ premorbid ability: combining subtest performance and demographic variable predictors. Archives of Clinical Neuropsychology, 10(3), 225–239.

    Article  PubMed  Google Scholar 

  • Vanderploeg, R. D., Schinka, J. A., & Axelrod, B. N. (1996). Estimation of WAIS—R premorbid intelligence: current ability and demographic data used in a best-performance fashion. Psychological Assessment, 8(4), 404.

    Article  Google Scholar 

  • Vanderploeg, R. D., Schinka, J. A., Baum, K. M., Tremont, G., & Mittenberg, W. (1998). WISC- III premorbid prediction strategies: demographic and best performance approaches. Psychological Assessment, 10(3), 277.

    Article  Google Scholar 

  • Walker, N. M., Jackson, D. C., Dabbs, K., Jones, J. E., Hsu, D. A., Stafstrom, C. E., et al. (2013). Is lower IQ in children with epilepsy due to lower parental IQ? A controlled comparison study. Developmental Medicine & Child Neurology, 55(3), 278–282.

  • Wechsler, D. (1974). Wechsler intelligence scale for children, revised. San Antonio: Psychological Corporation.

    Google Scholar 

  • Wechsler, D. (1981). Wechsler Adult Intelligence Scale–Revised. New York: Psychological Corporation.

  • Wechsler, D. (1991). WISC-III: Wechsler Intelligence Scale for Children (3rd ed.). San Antonio: Psychological Corporation.

    Google Scholar 

  • Wechsler, D. (1997a). Wechsler Adult Intelligence Scale (3rd ed.). San Antonio: Psychological Corporation.

    Google Scholar 

  • Wechsler, D. (1997b). Wechsler memory scale (3rd ed.). San Antonio: Psychological Corporation.

    Google Scholar 

  • Wechsler, D. (2001). Wechsler test of adult reading. Psychological Corporation.

  • Wechsler, D. (2002). Escala de Inteligencia de Wechsler para Adultos-III, Adaptacio’ n Espanola [Wechsler Adult Intelligence Scale-III, Spanish adaptation]. Buenos Aires: Paidos.

  • Wechsler, D. (2003). Wechsler intelligence scale for children–fourth edition (WISC-IV). San Antonio: Psychological Corporation.

    Google Scholar 

  • Wechsler, D. (2008a). Escala de Inteligência de Wechsler para Adultos – Terceira edição [Wechsler Adult Intelligence Scale-Third Edition], Lisboa: Cegoc.

  • Wechsler, D. (2008b). Wechsler Adult Intelligence Scale (4th ed.). San Antonio: Psychological Corporation.

    Google Scholar 

  • Wechsler, D. (2009a). Wechsler individual achievement test–III. San Antonio: Harcourt Assessment, Inc..

    Google Scholar 

  • Wechsler, D. (2009b). Wechsler memory scale (Fourth ed.). San Antonio: NCS Pearson.

  • Wechsler, D. (2014a). Wechsler intelligence scale for children (5th ed.). San Antonio: NCS Pearson.

    Google Scholar 

  • Wechsler, D. (2014b). Wechsler intelligence scale for children–fifth edition technical and interpretive manual. San Antonio: NCS Pearson.

    Google Scholar 

  • Wilkinson, G. S. (1993). The wide range achievement test. Wilmington: Wide Range, Inc..

    Google Scholar 

  • Williams, J. M. (1997). The prediction of premorbid memory ability. Archives of Clinical Neuropsychology, 12(8), 745–756.

    Article  PubMed  Google Scholar 

  • Wood, A. C., Rijsdijk, F., Johnson, K. A., Andreou, P., Albrecht, B., Arias-Vasquez, A., et al. (2011). The relationship between ADHD and key cognitive phenotypes is not mediated by shared familial effects with IQ. Psychological Medicine, 41(4), 861–871.

  • Yates, A. (1956). The use of vocabulary in the measurement of intellectual deterioration: a review. Journal of Mental Science, 102, 409–440.

    Article  PubMed  Google Scholar 

  • Yeates, K. O., & Taylor, H. G. (1997). Predicting premorbid neuropsychological functioning following pediatric traumatic brain injury. Journal of Clinical and Experimental Neuropsychology, 19(6), 825–837.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Ball State University, Muncie, IN, USA

    Andrew S. Davis & D. J. Bernat

  2. Texas A&M University, College Station, TX, USA

    Cecil R. Reynolds

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  1. Andrew S. Davis
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  2. D. J. Bernat
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  3. Cecil R. Reynolds
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Correspondence to Andrew S. Davis.

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This article does not contain any studies with human participants or animals performed by the authors. This manuscript was accepted and refereed by a Guest Action Editor who is the Editor-in-Chief of another neuropsychology journal. The authors, including the first author who is the Editor-in-Chief of the Journal of Pediatric Neuropsychology, were blinded to the names of the reviewers.

Conflict of Interest

Dr. Reynolds is the author of the Test of Irregular Word Reading Efficiency and receives royalties for the sale of such. The other authors declare that they have no conflict of interest.

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Davis, A.S., Bernat, D.J. & Reynolds, C.R. Estimation of Premorbid Functioning in Pediatric Neuropsychology: Review and Recommendations. J Pediatr Neuropsychol 4, 49–62 (2018). https://doi.org/10.1007/s40817-018-0051-x

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