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Wass, M., Anmyr, L., Lyxell, B., Karltorp, E., Östlund, E. & Löfkvist, U. (2025). Longitudinal predictors of reading ability in children with CI learning to read in Swedish. Journal of Communication Disorders, 114, Article ID 106497.
Open this publication in new window or tab >>Longitudinal predictors of reading ability in children with CI learning to read in Swedish
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2025 (English)In: Journal of Communication Disorders, ISSN 0021-9924, E-ISSN 1873-7994, Vol. 114, article id 106497Article in journal (Refereed) Published
Abstract [en]

Purpose: This study investigated long-term predictors of reading development (phonological decoding, word recognition, and reading comprehension) in 24 children with cochlear implants (CIs). Method: The predictor variables were age, sex, nonverbal intelligence, working memory, paired associate learning, receptive vocabulary, phonological skills, grammatical knowledge, age at implantation, speech perception, and reported interest in reading. The children's mean age was approximately 7;8 years at the start of the study and they were then measured at three time points. The first and second assessments took place approximately 13 months apart, and the children were approximately 11;8 years of age at the third time point. Results: Decoding ability at age 11 was associated with early measures of nonverbal cognitive ability, visual-verbal paired associate learning, and grammatical knowledge when 0.05 was used as significance level but none of them remained significant after correcting for multiple comparisons. Several predictor variables from earlier measurements were significantly related to reading comprehension at age 11. The predictors that remained significant after Bonferroni correction were receptive vocabulary and grammatical knowledge. Discussion: The findings from this research suggest that early exposure to hearing and language, in particular vocabulary and grammar, is associated with reading outcomes at age 11.

Place, publisher, year, edition, pages
Elsevier Inc., 2025
Keywords
Children with cochlear implants, Reading ability, Reading comprehension, Decoding
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:ltu:diva-111634 (URN)10.1016/j.jcomdis.2025.106497 (DOI)001417082100001 ()39893743 (PubMedID)2-s2.0-85216564892 (Scopus ID)
Funder
Riksbankens Jubileumsfond, P15-0442:1Sven Jerring FoundationSwedish Research Council, 2020-03403
Note

Validerad;2025;Nivå 2;2025-02-28 (u5);

Full text licenes: CC BY 4.0;

Funder: FAS and the European Commission (2011–0086); Hörselforskningsfonden (2014-460)

Available from: 2025-02-28 Created: 2025-02-28 Last updated: 2025-06-24Bibliographically approved
Socher, M., Löfkvist, U. & Wass, M. (2022). Comparing the semantic networks of children with cochlear implants and children with typical hearing: Effects of length of language access. Journal of Communication Disorders, 99, Article ID 106247.
Open this publication in new window or tab >>Comparing the semantic networks of children with cochlear implants and children with typical hearing: Effects of length of language access
2022 (English)In: Journal of Communication Disorders, ISSN 0021-9924, E-ISSN 1873-7994, Vol. 99, article id 106247Article in journal (Refereed) Published
Abstract [en]

Purpose

Kenett et al. (2013) report that the sematic networks, measured by using an oral semantic fluency task, of children with cochlear implants (CI) are less structured compared to the sematic networks of children with typical hearing (TH). This study aims to evaluate if such differences are only evident if children with CI are compared to children with TH matched on chronological age, or also if they are compared to children with TH matched on hearing age.

Method

The performance of a group of children with CI on a verbal fluency task was compared to the performance of a group of chronological-age matched children with TH. Subsequently, computational network analysis was used to compare the semantic network structure of the groups. The same procedure was applied to compare a group of children with CI to a group of hearing-age matched children with TH.

Results

The children with CI perform on the same level on an oral semantic verbal fluency task as the children with TH matched on hearing age. There are significant differences in terms of the structure of the semantic network between the groups. The magnitude of these differences is very small and they are non-significant for a proportion of nodes included in the bootstrap analysis. This indicates that there is no true difference between the networks. Hearing age, but not age at implantation was found to be significantly positively correlated with semantic verbal fluency performance for the children with CI.

Conclusions

The results from the current study indicate that length of language exposure is an important factor for the structure of the semantic network and the performance on a semantic verbal fluency task for children with CI. Further studies are needed to explore the role of the accessibility of the language input for the development of semantic networks of children with CI.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
Semantic Network, Children, cochlear implants, DHH, Verbal fluency
National Category
Pediatrics Applied Psychology
Research subject
Engineering Psychology
Identifiers
urn:nbn:se:ltu:diva-92159 (URN)10.1016/j.jcomdis.2022.106247 (DOI)000854910800005 ()35843069 (PubMedID)2-s2.0-85134327183 (Scopus ID)
Funder
Riksbankens Jubileumsfond, P15-0442:1EU, FP7, Seventh Framework Programme, FP7-607139 (iCARE)Forte, Swedish Research Council for Health, Working Life and Welfare, 2013-01363
Note

Validerad;2022;Nivå 2;2022-08-19 (sofila)

Available from: 2022-07-13 Created: 2022-07-13 Last updated: 2022-09-30Bibliographically approved
Socher, M., Ingebrand, E., Wass, M. & Lyxell, B. (2022). The relationship between reasoning and language ability: comparing children with cochlear implants and children with typical hearing. Logopedics, Phoniatrics, Vocology, 47(2), 73-83
Open this publication in new window or tab >>The relationship between reasoning and language ability: comparing children with cochlear implants and children with typical hearing
2022 (English)In: Logopedics, Phoniatrics, Vocology, ISSN 1401-5439, E-ISSN 1651-2022, Vol. 47, no 2, p. 73-83Article in journal (Refereed) Published
Abstract [en]

Purpose

Language has been suggested to play a facilitating role for analogical reasoning tasks, especially for those with high complexity. This study aims to evaluate if differences in analogical reasoning ability between children with cochlear implants (CI) and children with typical hearing (TH) might be explained by differences in language ability.

Methods

The analogical reasoning ability (verbal; non-verbal; complex non-verbal: high relational integration demand) of children with CI (N = 15, mean age = 6;7) was compared to two groups of children with TH: age and language matched (TH-A+L, N = 23, mean age = 6;5), and age matched (TH-A, N = 23, mean age = 6;5).

Results

Children with CI were found to perform comparable to Group TH-A+L on non-verbal reasoning tasks but significantly more poorly on a verbal analogical reasoning task. Children with CI were found to perform significantly more poorly on both the non-verbal analogical reasoning task with high relational integration demand and on the verbal analogical reasoning task compared to Group TH-A. For the non-verbal analogical reasoning task with lower relational integration demand only a tendency for a difference between group CI and Group TH-A was found.

Conclusions

The results suggest that verbal strategies are influencing the performance on the non-verbal analogical reasoning tasks with a higher relational integration demand. The possible reasons for this are discussed. The verbal analogical reasoning task used in the current study partly measured lexical access. Differences between the children with CI and both groups of children with TH might therefore be explained by differences in expressive vocabulary skills.

Place, publisher, year, edition, pages
Taylor & Francis, 2022
Keywords
Language comprehension, analogical reasoning, DHH, cochlear implant
National Category
Production Engineering, Human Work Science and Ergonomics
Research subject
Engineering Psychology
Identifiers
urn:nbn:se:ltu:diva-81346 (URN)10.1080/14015439.2020.1834613 (DOI)000585433700001 ()33150820 (PubMedID)2-s2.0-85095774442 (Scopus ID)
Note

Validerad;2022;Nivå 2;2022-06-29 (joosat);

Funder: European Union Seventh Framework Program (FP7-607139) (iCARE); Swedish Research Council for Health, Working Life and Welfare (2013-01363)

Available from: 2020-11-09 Created: 2020-11-09 Last updated: 2025-01-15Bibliographically approved
Socher, M., Ellis, R. J., Wass, M. & Lyxell, B. (2020). Comparison of Expressive Spoken Language Skills in Children With Cochlear Implants and Children With Typical Hearing. Frontiers in Psychology, 11, Article ID 1405.
Open this publication in new window or tab >>Comparison of Expressive Spoken Language Skills in Children With Cochlear Implants and Children With Typical Hearing
2020 (English)In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 11, article id 1405Article in journal (Refereed) Published
Abstract [en]

When children start formal education, they are expected to be able to express complex thoughts. However, in order to do so, they need to be able to use both complex grammatical structures and a variety of words. One group that is at risk of having a delay in terms of their expressive language ability is children with cochlear implants (CI). In this study, we evaluated whether children with CI perform comparably to children with typical hearing (TH) on a standard expressive spoken grammar and a standard expressive spoken vocabulary task when the groups were matched on non-verbal intelligence and working memory capacity. It was found that the children with CI in this study performed more poorly on a standard expressive spoken vocabulary task but not on a standard expressive spoken grammar task when compared to the children with TH. Differences in terms of expressive spoken vocabulary do not seem to be explained by differences in cognitive ability. In addition, the variation in terms of expressive spoken language ability was larger in the children with CI compared to the children with TH. This might be explained by additional confounding factors, like the time of language deprivation or by a greater influence of cognitive differences for the acquisition of spoken language for children with CI.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2020
Keywords
expressive grammar, expressive vocabulary, working memory, non-verbal intelligence, cochlear implant, children
National Category
Production Engineering, Human Work Science and Ergonomics
Research subject
Engineering Psychology
Identifiers
urn:nbn:se:ltu:diva-80608 (URN)10.3389/fpsyg.2020.01405 (DOI)000560121800001 ()32765338 (PubMedID)2-s2.0-85088795747 (Scopus ID)
Note

Validerad;2020;Nivå 2;2020-08-31 (alebob)

Available from: 2020-08-31 Created: 2020-08-31 Last updated: 2022-04-13Bibliographically approved
Nakeva von Mentzer, C., Wallfelt, S., Engström, E., Wass, M., Sahlén, B., Pfändtner, K., . . . Uhlén, I. (2020). Reading Ability and Working Memory in School-Age Children Who Are Deaf and Hard of Hearing Using Cochlear Implants and/or Hearing Aids: A 3-Year Follow-Up on Computer-Based Phonics Training. Perspectives of the ASHA Special Interest Groups, 5(6), 1388-1399
Open this publication in new window or tab >>Reading Ability and Working Memory in School-Age Children Who Are Deaf and Hard of Hearing Using Cochlear Implants and/or Hearing Aids: A 3-Year Follow-Up on Computer-Based Phonics Training
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2020 (English)In: Perspectives of the ASHA Special Interest Groups, E-ISSN 2381-473X, Vol. 5, no 6, p. 1388-1399Article in journal (Refereed) Published
Abstract [en]

Purpose

The aim of the current study was to investigate reading ability in children who are deaf and hard of hearing (DHH) using cochlear implants (CI) or hearing aids (HA) 3 years after computer-assisted phonics intervention. Reading ability was examined in relation to cognitive and audiological aspects and compared to a reference group of children with typical hearing (TH).

Method

Participants were 73 Swedish primary school children (Mdn = 9 years). Fifty-five of the children were TH, and 18 children were DHH using CI (n = 10) or HA (n = 8). Twenty-seven of the children (all children who were DHH and nine of the children with TH) had participated in computer-based phonics intervention 3 years earlier. Children were assessed on word and nonword decoding, reading comprehension, and three working memory (WM) tasks. Age at diagnosis, age of amplification, and duration of unaided hearing loss formed the audiological variables.

Results

Comparable word decoding skills and reading comprehension were observed in all three groups (CI, HA, and TH). Children with CI showed strong and significant correlations between two aspects of WM capacity (phonological and complex WM) and all aspects of reading. For children with TH, similar but weaker correlations as in children with CI was observed, and correlations with visual WM were also evident. In children with HA only, complex WM correlated strongly and significantly with nonword decoding. Duration of unaided hearing loss was the single audiological variable that was significantly associated with reading.

Conclusions

This 3-year follow-up showed overall positive reading results at the group level in children who are DHH. However, some children still lag behind their peers with TH. Early hearing experience and intervention are stressed as crucial factors in preventing negative outcomes in these children.

Place, publisher, year, edition, pages
American Speech-Language-Hearing Association, 2020
National Category
Production Engineering, Human Work Science and Ergonomics
Research subject
Engineering Psychology
Identifiers
urn:nbn:se:ltu:diva-81619 (URN)10.1044/2020_PERSP-20-00027 (DOI)
Note

Godkänd;2021;Nivå 0;2021-02-22 (johcin)

Available from: 2020-11-25 Created: 2020-11-25 Last updated: 2025-04-17Bibliographically approved
Wass, M., Löfkvist, U., Anmyr, L., Karltorp, E., Östlund, E. & Lyxell, B. (2019). Correlates of Orthographic Learning in Swedish Children With Cochlear Implants. Frontiers in Psychology, 10, Article ID 143.
Open this publication in new window or tab >>Correlates of Orthographic Learning in Swedish Children With Cochlear Implants
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2019 (English)In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 10, article id 143Article in journal (Refereed) Published
Abstract [en]

This study set out to explore the cognitive and linguistic correlates of orthographic learning in a group of 32 deaf and hard of hearing children with cochlear implants, to better understand the factors that affect the development of fluent reading in these children. To date, the research about the mechanisms of reading fluency and orthographic learning in this population is scarce. The children were between 6:0 and 10:11 years of age and used oral language as their primary mode of communication. They were assessed on orthographic learning, reading fluency and a range of cognitive and linguistic skills including working memory measures, word retrieval and paired associate learning. The results were analyzed in a set of correlation analyses. In line with previous findings from children with typical hearing, orthographic learning was strongly correlated with phonological decoding, receptive vocabulary, phonological skills, verbal-verbal paired-associate learning and word retrieval. The results of this study suggest that orthographic learning in children with CI is strongly dependent on similar cognitive and linguistic skills as in typically hearing peers. Efforts should thus be made to support phonological decoding skill, vocabulary, and phonological skills in this population.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2019
Keywords
orthographic learning, reading fluency, deaf and hard of hearing children, cochlear implants, reading development
National Category
Production Engineering, Human Work Science and Ergonomics
Research subject
Engineering Psychology
Identifiers
urn:nbn:se:ltu:diva-73325 (URN)10.3389/fpsyg.2019.00143 (DOI)000460018800001 ()30881321 (PubMedID)2-s2.0-85065145272 (Scopus ID)
Note

Validerad;2019;Nivå 2;2019-03-27 (oliekm)

Available from: 2019-03-27 Created: 2019-03-27 Last updated: 2025-02-05Bibliographically approved
Wass, M., Ching, T. Y. C., Cupples, L., Wang, H.-C., Lyxell, B., Martin, L., . . . Castles, A. (2019). Orthographic Learning in Children Who Are Deaf or Hard of Hearing. Language, speech & hearing services in schools, 50(1), 99-112
Open this publication in new window or tab >>Orthographic Learning in Children Who Are Deaf or Hard of Hearing
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2019 (English)In: Language, speech & hearing services in schools, ISSN 0161-1461, E-ISSN 1558-9129, Vol. 50, no 1, p. 99-112Article in journal (Refereed) Published
Abstract [en]

Purpose The purpose of the current study was to investigate the relationship between orthographic learning and language, reading, and cognitive skills in 9-year-old children who are deaf or hard of hearing (DHH) and to compare their performance to age-matched typically hearing (TH) controls.

Method Eighteen children diagnosed with moderate-to-profound hearing loss who use hearing aids and/or cochlear implants participated. Their performance was compared with 35 age-matched controls with typical hearing. Orthographic learning was evaluated using a spelling task and a recognition task. The children were assessed on measures of reading ability, language, working memory, and paired-associate learning.

Results On average, the DHH group performed more poorly than the TH controls on the spelling measure of orthographic learning, but not on the recognition measure. For both groups of children, there were significant correlations between orthographic learning and phonological decoding and between visual–verbal paired-associate learning and orthographic learning.

Conclusions Although the children who are DHH had lower scores in the spelling test of orthographic learning than their TH peers, measures of their reading ability revealed that they acquired orthographic representations successfully. The results are consistent with the self-teaching hypothesis in suggesting that phonological decoding is important for orthographic learning.

Place, publisher, year, edition, pages
American Speech-Language-Hearing Association (ASHA), 2019
National Category
Production Engineering, Human Work Science and Ergonomics
Research subject
Engineering Psychology
Identifiers
urn:nbn:se:ltu:diva-71435 (URN)10.1044/2018_LSHSS-17-0146 (DOI)000465297800007 ()30383206 (PubMedID)2-s2.0-85064315489 (Scopus ID)
Note

Validerad;2019;Nivå 2;2019-03-15 (oliekm)

Available from: 2018-11-05 Created: 2018-11-05 Last updated: 2025-03-13Bibliographically approved
Socher, M., Lyxell, B., Ellis, R., Gärskog, M., Hedström, I. & Wass, M. (2019). Pragmatic Language Skills: A Comparison of Children With Cochlear Implants and Children Without Hearing Loss. Frontiers in Psychology, 10, Article ID 2243.
Open this publication in new window or tab >>Pragmatic Language Skills: A Comparison of Children With Cochlear Implants and Children Without Hearing Loss
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2019 (English)In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 10, article id 2243Article in journal (Refereed) Published
Abstract [en]

Pragmatic language ability refers to the ability to use language in a social context. It has been found to be correlated with success in general education for deaf and hard of hearing children. It is therefore of great importance to study why deaf and hard of hearing children often perform more poorly than their hearing peers on tests measuring pragmatic language ability. In the current study the Pragmatics Profile questionnaire from the CELF-IV battery was used to measure pragmatic language ability in children using cochlear implants (N = 14) and children without a hearing loss (N = 34). No significant difference was found between the children with cochlear implants (CI) and the children without hearing loss (HL) for the sum score of the pragmatics language measure. However, 35.71% of the children with CI performed below age norm, while only 5.89% of the children without HL performed below age norm. In addition, when dividing the sum score into three sub-measures: Rituals and Conversational skills (RCS), Asking for, Giving, and Responding to Information (AGRI), and Nonverbal Communication skills (NCS), significant differences between the groups were found for the NCS measure and a tendency for a difference was found for the RCS measure. In addition, all three sub-measures (NCS, AGRI, RCS) were correlated to verbal fluency in the children with CI, but not the children without HL.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2019
Keywords
pragmatic language ability, hearing loss, cochlear implant, verbal fluency, childre
National Category
Production Engineering, Human Work Science and Ergonomics
Research subject
Engineering Psychology
Identifiers
urn:nbn:se:ltu:diva-76757 (URN)10.3389/fpsyg.2019.02243 (DOI)000496974600001 ()31649586 (PubMedID)2-s2.0-85074147169 (Scopus ID)
Note

Validerad;2019;Nivå 2;2019-11-19 (johcin)

Available from: 2019-11-19 Created: 2019-11-19 Last updated: 2025-04-25Bibliographically approved
Wass, M., Anmyr, L., Lyxell, B., Östlund, E., Karltorp, E. & Löfkvist, U. (2019). Predictors of Reading Comprehension in Children With Cochlear Implants. Frontiers in Psychology, 10, Article ID 2155.
Open this publication in new window or tab >>Predictors of Reading Comprehension in Children With Cochlear Implants
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2019 (English)In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 10, article id 2155Article in journal (Refereed) Published
Abstract [en]

Children with a profound hearing loss who have been implanted with cochlear implants (CI), vary in terms of their language and reading skills. Some of these children have strong language skills and are proficient readers whereas others struggle with language and both the decoding and comprehension aspects of reading. Reading comprehension is dependent on a number of skills where decoding, spoken language comprehension and receptive vocabulary have been found to be the strongest predictors of performance. Children with CI have generally been found to perform more poorly than typically hearing peers on most predictors of reading comprehension including word decoding, vocabulary and spoken language comprehension, as well as working memory. The purpose of the current study was to investigate the relationships between reading comprehension and a number of predictor variables in a sample of twenty-nine 11–12-year-old children with profound hearing loss, fitted with CI. We were particularly interested in the extent to which reading comprehension in children with CI at this age is dependent on decoding and receptive vocabulary. The predictor variables that we set out to study were word decoding, receptive vocabulary, phonological skills, and working memory. A second purpose was to explore the relationships between reading comprehension and demographic factors, i.e., parental education, speech perception and age of implantation. The results from these 29 children indicate that receptive vocabulary is the most influential predictor of reading comprehension in this group of children although phonological decoding is, of course, fundamental.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2019
National Category
Production Engineering, Human Work Science and Ergonomics
Research subject
Engineering Psychology
Identifiers
urn:nbn:se:ltu:diva-76341 (URN)10.3389/fpsyg.2019.02155 (DOI)000487594100001 ()31607988 (PubMedID)2-s2.0-85073000086 (Scopus ID)
Note

Validerad;2019;Nivå 2;2019-10-10 (johcin)

Available from: 2019-10-10 Created: 2019-10-10 Last updated: 2023-11-10Bibliographically approved
Wass, M., Löfkvist, U., Anmyr, L., Karltorp, E. & Lyxell, B. (2018). Learning to read when speech sounds different: Orthographic learning in children with cochlear implants. In: : . Paper presented at 25th Annual Society for the Scientific Study of Reading (SSSR) Meeting, 18-21 July, 2018, Brighton, UK. Society for the Scientific Study of Reading (SSSR)
Open this publication in new window or tab >>Learning to read when speech sounds different: Orthographic learning in children with cochlear implants
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2018 (English)Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Purpose

The aim of this study was to investigate orthographic learning and reading skill in Swedish children with cochlear implants (CI) in comparison with normal hearing peers (NH), and to explore relationships between orthographic learning and cognitive skills in the CI group.

Method

Eighteen children with CI and 43 NH children, matched for age and nonverbal IQ, participated. They were 7;10 - 10;4 years of age. All children were tested on reading fluency (words and nonwords), orthographic learning, existing orthographic representations, working memory (WM), and expressive vocabulary. The children with CI were also assessed on verbal fluency, paired associate learning (visual-visual, verbal-verbal and visual-verbal) and phoneme deletion. Group differences were analyzed with Mann-Whitney U tests. Relationships between skills were analyzed in partial correlations with age controlled.

Results

The children with CI performed below the level of hearing peers on the measures of WM, and expressive vocabulary. They also performed below age-norms on the phoneme deletion task.

On the other hand, the groups did not differ significantly on reading fluency, existing orthographic representations or orthographic learning. The group difference on orthographic learning approached significance (p=.07). In the CI group, orthographic learning was strongly correlated with reading fluency (words and nonwords respectively), visual-verbal and verbal-verbal paired associate learning, and verbal fluency.

Conclusions

Despite having poorer language skills and lower WM capacity, children with CI may successfully learn new orthographic representations and develop fluent reading. In line with the self-teaching hypothesis (Share, 1999), orthographic learning was strongly related to phonological decoding (nonword reading fluency) also in children with CI. In addition, paired associate learning, verbal fluency, and WM capacity were related to their orthographic learning skill.

Place, publisher, year, edition, pages
Society for the Scientific Study of Reading (SSSR), 2018
National Category
Production Engineering, Human Work Science and Ergonomics
Research subject
Engineering Psychology
Identifiers
urn:nbn:se:ltu:diva-71439 (URN)
Conference
25th Annual Society for the Scientific Study of Reading (SSSR) Meeting, 18-21 July, 2018, Brighton, UK
Available from: 2018-11-05 Created: 2018-11-05 Last updated: 2020-09-23Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-7360-4858

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