Top PDF Shoulder pain mapping for common shoulder disorders

Shoulder pain mapping for common shoulder disorders

Shoulder pain mapping for common shoulder disorders

On the contrary, there were differences between the current study and previous literature in relation to radiation of the pain for other shoulder disorders. A far greater radiation of pain occurred in impingement syndrome and gleno-humeral arthritis in our study. Subacromial irritation in Gerber’s paper resulted in an “intense” pain mainly in the lateral border of the acromion and the lateral portion of the deltoid muscle (Gerber et al., 1998). Dutton describes the pain due to rotator cuff pathology and impingement is usually felt over the anterior or lateral part of the shoulder and he mentions that this pain is characterised by radiation down the upper arm, and is aggravated with overhead activities. However, the pain that radiates beyond the elbow is far less likely to be due to shoulder pathology, particularly if it is associated with any sensory disturbance in the limb such as distal radiation or pain, numbness or paresthesia (Dutton, 2008). Similarly, Woodward and Best (2000) concluded that the pain related to impingement usually occurs over the anterolateral aspect of the shoulder, often with some radiation to, but not usually beyond, the elbow.
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Prevalence Of Wrist, Neck And Shoulder Pain Symptoms Among Ironing Workers In Occupational Laundry Shop

Prevalence Of Wrist, Neck And Shoulder Pain Symptoms Among Ironing Workers In Occupational Laundry Shop

The occupational work injuries seem to be the most common problem among Indian workers. In Indian the people are not aware of the health hazards caused due to repetitive work. In this study, it is obvious that the male and female ironing workers who involved in ironing of clothes face many work related disorders during ironing under different postures. The Table 1 niceties the dates about the ironing workers like gender, age, height of the person, weight of the person, working time, quantity of clothes ironed / day and much more occupational information’s.[10] The repeated working postures may lead to the musculoskeletal disorder among the ironing workers. In India most of the ironing workers in a standing posture continuously at the time of ironing work. The activity like stretching, bending and lifting of iron box is the most frequent motion among ironing personnel in laundry shop. These frequent and repetitive motions results in muscular exhaustion. The results substantiated by the SPSS results is depicted in Table 3, which point out the symptoms among the defendants has been persuaded by the work sector, in an related manner, by the gender, age and also by the other personal factors [11]. These factors are not only considered for the analysis but also the hazardous work injuries and disorder signs were also considered. The work concert and surroundings significantly contributes due to muscles, tendons and others disorders are considered to work related.[12] The occurrence of the work related musculoskeletal disorder is common in most of the manual working environments. In this study both the male and female workers were considered. Here in this ironing work both the male and female workers were exposed to the common discomfort parameters like neck pain, hand/wrist
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Rotator cuff disorders: a survey of current (2016) UK physiotherapy practice.

Rotator cuff disorders: a survey of current (2016) UK physiotherapy practice.

Background Shoulder pain is a common musculoskeletal presentation, with disorders of the rotator cuff (RC) regarded as the most frequent cause. Conservative treatment is often the initial management however, findings from a previous survey showed considerable variations in clinical practice, including the use of modalities that are not supported in the literature; suggesting that research is not impacting on practice. Objectives To survey current UK physiotherapy practice for the management of RC disorders and to determine whether this has changed over the five-year period since the last survey was conducted.
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The Prevalence and Characteristics of Thoracic Outlet Syndrome in High School Baseball Players

The Prevalence and Characteristics of Thoracic Outlet Syndrome in High School Baseball Players

Thoracic outlet syndrome (TOS) is one of the common neurovascular disord- ers of the upper extremities, and the compression or traction of the brachial plexus is the main pathology. We hypothesized that baseball players are more likely to be affected by TOS compared with other overhead-throwing athletes because of strenuous use of their throwing arm. The purpose of this study was to investigate the prevalence and clinical characteristics of TOS in high school baseball players. One thousand two hundred eighty-eight high school baseball players were included in this study. The prevalence of symptomatic TOS and its association to disorders of the upper extremities were investigated. The prevalence of symptomatic TOS was 32.8%. Age- and position-adjusted logis- tic regression analysis revealed that subjects with symptomatic TOS were at significantly higher risk of shoulder and/or elbow pain (odds ratio [OR]: 1.96, 95% confidence interval [CI]: 1.50 - 2.58) and a higher recurrence rate of shoulder and/or elbow pain during the previous season (OR: 2.38, 95% CI: 1.87 - 3.04). As for physical findings, subjects with symptomatic TOS were al- so at significantly higher risk of MUCL tenderness (OR: 2.53, 95% CI: 1.83 - 3.50), positive milking maneuver, (OR: 2.63, 95% CI: 1.78 - 3.91), positive subacromial impingement sign (OR: 1.92, 95% CI: 1.20 - 3.07), and positive posterior impingement sign (OR: 2.34, 95% CI: 1.67 - 3.28) compared to the subjects without symptomatic TOS. It is necessary to recognize that TOS is not a rare pathology in overhead-throwing athletes, especially baseball players, and that players with symptomatic TOS are at significantly higher risk of shoulder/elbow pain.
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The effects of scapular stabilization based exercise therapy on pain, posture, flexibility and shoulder mobility in patients with shoulder impingement syndrome: a controlled randomized clinical trial

The effects of scapular stabilization based exercise therapy on pain, posture, flexibility and shoulder mobility in patients with shoulder impingement syndrome: a controlled randomized clinical trial

Subjects: A total of 98 subjects was ini- tially recruited from Hazrat Rasool-e- Akram hospital sports medicine and ortho- pedic clinics and judged to meet the criteria for the study. Twenty six subjects did not fulfill the inclusion criteria (Fig 1). Inclu- sion and exclusion criteria were assessed for each subject based on a clinical exami- nation performed by the first author. The inclusion criteria were as follows: (1) Male and female mentally fitted between the ages of 18 to 75 years; (2) Unilateral shoulder pain of more than one month localized (an- terior and/or anterolateral) to the acromion; (3) Tenderness to palpation of the rotator cuff tendons; (4) Positive impingement tests, or a painful arc of movement (60°– 120°) ;(5) Pain produced or increased dur- ing flexion and/or abduction of the symp- tomatic shoulder.
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The Effects of a 6-Week Dry Land Exercise Program for High School Swimmers

The Effects of a 6-Week Dry Land Exercise Program for High School Swimmers

In the sport of swimming, the body is actually pulled over the arms of the swimmer, with the pectoralis major, latissimus dorsi and triceps brachii as the primary movers. Due to the dominance of the pectoralis major and latissimus dorsi, swimmers tend to have increased adduction and internal rotation strength. Factor this with the large amount of swim distances performed over the course of a year, an overdevelopment of anterior shoulder musculature may occur, thereby creating a strength imbalance with posterior shoulder musculature. Specifically, decreased lower trapezius and serratus anterior strength may account for impaired scapulohumeral rhythm. With increased fatigue and decreased force output, the inability to stabilize the scapula against the thoracic cage causes further scapular upward rotation.(Blanch, 2004) Literature also links an imbalance between the internal and external shoulder rotators and shoulder pain in swimmers.(Batalha et al., 2013; Straub & Mattacola, 2004)Weak scapular stabilizing muscles might cause a loss of proximal stability that would increase demands on the rotator cuff and perhaps contribute to faulty stroke mechanics, and ultimately, shoulder pain.(Russ, 1998; Tate et al., 2012)Numerous studies have reported that the internal rotator musculature is stronger in swimmers because of the repetitive concentric contractions required during the propulsive phase of the swim stroke. (Batalha et al., 2013; Beach et al., 1992; Straub & Mattacola, 2004; K. Swanik et al., 2002; K. A. Swanik et al., 2002) In contrast, external rotator strength is consistently weaker in swimmers and literature states that the high eccentric demands placed on the external rotator muscles cause chronic fatigue making it difficult to control glenohumeral-joint translation.(Straub & Mattacola, 2004; Weldon III & Richardson, 2001) As a swim season progresses, there is evidence that suggests an increase of muscular imbalances in the shoulder rotators of young swimmers, largely due to increased levels of internal rotator strength and endurance that are larger than those of the external rotators.(Batalha et al., 2013)
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Design and pilot validation of A-gear: a novel wearable dynamic arm support

Design and pilot validation of A-gear: a novel wearable dynamic arm support

The distance over which the hand marker moved reduced in three out of four subjects, when wearing the passive arm support. For the healthy subject and the patient with Brooke scale 2 (P1), this decrease in ROM was expected, because of the kinematics of the arm support, which restricted shoulder abduction beyond 90° and shoulder flexion beyond 120°. Since both the healthy subject and P1 were able to move the arm over the entire ROM without arm support, they were restricted in their shoulder movements by the passive arm support. For the patients with Brooke scale 3, we saw that the distance over which the hand moved during sin- gle joint movements increased in one patient (P2) and decreased in another patient (P3), when wear- ing the passive arm support. We would have expected an increase of the distance in both pa- tients with Brooke scale 3. One possible explanation of a reduction of the distance, over which the hand was moved in P3, might lie in the amount of com- pensatory movements that were used by this pa- tient, when he was not wearing the arm support. By using compensatory movements this patient was able to move the hand, but the movements were uncontrolled and not very functional, as can be seen by the lower PUL score without the arm sup- port. Consequently a large movement of the hand marker was seen. When this patient used the pas- sive arm support less compensatory movements were used and much more control over the move- ment could be executed, therefore his functional score improved.
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Pain, depression and the postoperative stiff shoulder

Pain, depression and the postoperative stiff shoulder

The pathology of the pathological postoperative stiff shoulder and its associated condition “ frozen shoulder ” are poorly understood and both lack formal objective clinical diagnostic criteria. Additionally, although factors associated with the development of idiopathic frozen shoulder have been well described, multiple studies looking at predictors of postoperative stiff shoulder have produced conflicting results. It has been hypothesised that increased pain in the postoperative period, and depression may be predictors of the development of postoperative stiff shoulder. Method: A prospective cohort study involving 132 consecutive participants. Preoperatively, participants undergoing arthroscopic subacromial decompression and/or excision of the distal clavicle and/or rotator cuff repair will complete questionnaires about their levels of shoulder pain using a numerical rating scale from 0 to 10, and answer a Patient Health Questionnaire – 9 depression questionnaire. Postoperatively, the participants ’ pain levels will be self-assessed at two, five and seven days and weeks four, seven and ten. They will complete the depression questionnaire twice, at the time of their routine first and final postoperative appointments with the treating surgeon. At the final appointment, approximately three months postoperatively, the treating surgeon will clinically diagnose participants as having a postoperative stiff shoulder or not. Their shoulders ’ range of motion will be measured. The incidence of postoperative stiff shoulder will be determined, both pain and depression will be analysed as predictors for its development and incidences determined by different objective criteria will be compared.
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Causes of Shoulder Pain in Women with Breast Cancer Related Lymphedema: A Pilot Study

Causes of Shoulder Pain in Women with Breast Cancer Related Lymphedema: A Pilot Study

The date of diagnosis, age, stage of tumor, type of surgery, number of lymph nodes dissected, and presence of metasta- sis were obtained from the medical history. Shoulder symp- toms related to BCRL were evaluated, including shoulder pain and limitation of range of motion. We measured the cir- cumference of the upper limbs. Pain intensity was measured using a 100 mm Visual Analogue Scale (VAS). Patients were asked to indicate the intensity of their shoulder pain. Range of motion was measured using a goniometer, and the differ- ence in circumference between the upper limbs was mea- sured using measuring tape. The same investigator per- formed all pain, range of motion, and arm circumference assessments. Functional disability was measured using the Korean version of the Disabilities of Arm, Shoulder and Hand (DASH) questionnaire. In addition, the DASH-glob- al, DASH-work, and DASH-sports questionnaires were used. The DASH-work and DASH-sports assessments were not completed by many patients; therefore, only the DASH- global was analyzed in this study. On this questionnaire, low scores indicate less disability.
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High Frequency Ultrasound in Determining the Causes of Acute Shoulder Joint Pain

High Frequency Ultrasound in Determining the Causes of Acute Shoulder Joint Pain

In conclusion, ultrasound for the shoulder joint presents a high accuracy and sensitivity in diagnosis a wide spectrum of shoulder joint lesions, with a diagnostic performance value near to that of MRI. Furthermore, it is a real time investigation that can afford comparison information of the two joints. There is also the possibility to reciprocate with the patient and demonstrate the results of the study. However, it is necessary to learn that it is impeding to envisage the entire cuff in obese patients and in patients with reduced range of movement or frozen shoulder as well.
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EFFECT OF GONG'S MOBILIZATION VERSUS MULLIGAN'S MOBILIZATION ON SHOULDER PAIN AND SHOULDER MEDIAL ROTATION MOBILITY IN FROZEN SHOULDER

EFFECT OF GONG'S MOBILIZATION VERSUS MULLIGAN'S MOBILIZATION ON SHOULDER PAIN AND SHOULDER MEDIAL ROTATION MOBILITY IN FROZEN SHOULDER

restricted active range of motion (AROM) and passive range of motion (PROM) in both external rotation and glenohumeral abduction was taken to indicate diagnosis of Capsulitis,[14] pain at night causing sleep disturbance and inability to lie on the affected side,[15] normal findings on radiographs. Subjects were excluded with previous surgery in the shoulder joint,[16] rotator cuff rupture,[16] history of recent fracture or severe trauma to the shoulder,[16] ROM was restricted due to burns or postoperative scars,[6] diagnosed instability or previous history of dislocation,[16] Systemic inflammatory conditions (e.g. rheumatoid arthritis) [16].
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The Value of MRI in Evaluation of Shoulder Pain

The Value of MRI in Evaluation of Shoulder Pain

Abstract: Objectives: To evaluate the role of MRI, MR Arthrography compared to arthroscopy in shoulder pain. Methods: This study was conducted on 100 patients complaining of shoulder pain. The patients were referred to the radiology department from the out patient clinics and the orthopedics department of Menoufia University Hospital. All patients were examined by conventional MRI while only 8 of them had additional MRA. Arthroscopy was performed to all patients. Results: There were fifty six males and forty four females, their ages ranged between 19 & 69 years (mean age, 31 years). There is significant positive correlation between MRI and arthroscopy with r = +0.9, 95% CI (0.82- 0.99) and p value = 0.003. MRI showed 100 % specificity for anterior labral tears, SS (supraspinatus) partial thickness tear and SS full thickness tear and 98.9 % specificity for SLAP (superior labrum anterior to posterior). MRI showed 76.9% sensitivity for anterior labral tears and SS partial thickness tear. Conventional MRI showed 54.5% sensitivity in diagnosis of SLAP tears and 83.3% sensitivity in diagnosis of supraspinatous full thickness tears. Conclusion: MRI of the shoulder is an accurate, useful and established technique for assessment of different shoulder lesions.
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Shoulder pain and disability index: cross cultural validation and evaluation of psychometric properties of the Spanish version

Shoulder pain and disability index: cross cultural validation and evaluation of psychometric properties of the Spanish version

Two physicians, with adequate expertise in shoulder dis- orders management and both lenguages, and an inde- pendent native professional interpreter translated the English version of SPADI into Spanish and organized a meeting to take account of possible cultural issues. A back-translation process was carried out by a specialist translator to guarantee the conceptual equivalence of the terms used, as recommended in the literature [21, 22]. People involved in translation worked inde- pendently. In a second meeting, we compared the two versions and found no appreciable differences between them. A final version of the Spanish Version of the SPADI was agreed and tested in a pilot study with 40 patients (24 females, age = 45,6 ± 13.0 years) with shoulder problems (fractures and tendinopaties) recruited from among rehabilitation outpatients at hospital setting. This pilot study included cognitive debriefing standardised interviews carried out for one member of the research staff to assess its com- prehensibility and ensure that the items retained the meaning of the original version.
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High prevalence of shoulder girdle muscles with myofascial trigger points in patients with shoulder pain

High prevalence of shoulder girdle muscles with myofascial trigger points in patients with shoulder pain

Next, the observer examined each subject for the pre- sence of MTrPs in the shoulder muscles of their affected shoulder according to the guidelines outlined in Simons et al [26]; the non-affected shoulder was examined as a control. Following these guidelines, an MTrP is defined as: a nodule in a taut band that is extremely painful upon compression, and may produce referred pain or sensations. MTrPs were classified as either ‘ active ’ when the pain was recognized by the patient as a familiar pain, and ‘ latent ’ when the observer found a firm nodule in a taut band, which was painful on compression, but did not produce a recognizable pain. The inter-examiner reliability of trigger point palpation has been established in several studies [35,57,58]. All 17 muscles that are known to produce pain in the shoulder or may result in dysfunction of shoulder muscles were systematically examined and the number of muscles with MTrPs in the affected shoulder was counted, regardless of the number of MTrPs per muscle (Table 1). The two obser- vers were physical therapists, each with 30 years of clini- cal experience in primary care practice. Both observers had attended an extensive, postgraduate course on MTrP diagnosis and therapy and had more than 5 years experience in identifying MTrPs and treating patients with MTrPs prior to the start of the study.
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Prevalence and anatomical location of muscle tenderness in adults with nonspecific neck/shoulder pain

Prevalence and anatomical location of muscle tenderness in adults with nonspecific neck/shoulder pain

A limitation is the small number of men (n = 24), which increases the risk of statistical type II errors. Also, the anatomical overlap of several neck/shoulder muscles - e. g. trapezius and supraspinatus - may weaken the ability to precisely determine tenderness of specific muscles. Further, the study would have been strengthened by measuring pressure pain threshold of all the investigated anatomical locations and relating this to the manual pal- pation scores. As manual palpation scores are prone to many errors, the inclusion of a calibrated team of trained examiners may have strengthened the study. Although, the tenderness scale of ‘no’, ‘some’ and
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<div>Role of radiographs in shoulder pathology: a clinical review</div>

<div>Role of radiographs in shoulder pathology: a clinical review</div>

Abstract: Shoulder pain is a very common complaint, and affects as many as 20% of all people at some point during their lives. Despite the availability of more advanced imaging modalities, X-ray remains the first imaging test to be performed in the investigation of any shoulder pain. However, with their increasing availability, ultrasound and magnetic resonance imaging have in recent years become first-line techniques for the diagnostic imaging of the shoulder. Moreover, ultrasound of the shoulder is increasingly performed in lieu of radiography. Nevertheless, many patients who visit a shoulder specialist for their pain are referred by a family physician or com- munity orthopedist without an X-ray having ever been performed. Shoulder pain can be caused by many conditions, including rotator cuff tears, calcification within the tendons of the rotator cuff, stiff shoulder, subacromial impingement, space-occupying lesions, degenerative changes, and rheumatoid arthritis. This paper reviews various types of shoulder injury and the radiographic symptomatology of each, with the goal of encouraging the use of radiography by demonstrating the importance of this basic tool in the diagnostic process for these injuries.
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Tendinopathy of the long head of the biceps tendon: histopathologic analysis of the extra-articular biceps tendon and tenosynovium

Tendinopathy of the long head of the biceps tendon: histopathologic analysis of the extra-articular biceps tendon and tenosynovium

We prospectively identified 26 consecutive patients (mean age 45.4 ± 13.7 years; 63.3% male) undergoing biceps tenodesis and arthroscopic examination of the glenohumeral joint for pain that was localized to the bicipital groove by physical examination. Following the University Hospitals Case Medi- cal Center institutional review board approval, each patient was offered inclusion in the study and provided informed con- sent to participate in the study prior to surgery. A diagnosis of biceps tendinitis/tendinosis was suspected preoperatively based on physical examination and radiographic findings. All physical examinations were performed by the senior author (RG), and this author’s preoperative clinical examination included the Speed test, 27 O’Brien’s sign, 28 and tenderness to
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Different mechanisms of contralateral- or ipsilateral-acupuncture to modulate the brain activity in patients with unilateral chronic shoulder pain: a pilot fMRI study

Different mechanisms of contralateral- or ipsilateral-acupuncture to modulate the brain activity in patients with unilateral chronic shoulder pain: a pilot fMRI study

ference in pain intensity may be a result of the small sample size. Future studies with larger sample size may provide larger statistical effect. Second, there was a different educational level between the two groups, but it likely that it did not directly affect the results on shoulder pain. Third, we did not quantitatively evaluate the intensity of deqi sensation, which is thought to have an impact on acupuncture effect. Studies with deqi sensation quantification are needed in future stud- ies. Finally, future studies are needed to examine the clinical effects and illuminate the neural mechanism underlying the contra- and ipsi-acupuncture at ST 38 in healthy subjects.
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Quality of life, pain, and disability post surgical management of breast cancer

Quality of life, pain, and disability post surgical management of breast cancer

Our age group ranged between 32-78 this is because we included all breast cancer survivor’s post-surgical intervention due to the time limit. The majority of our patients were Muslims which is expected since the majority of Palestinians are Muslims with only 1% Christian population (The Diyar Consortium, 2007). As shown in the results section, the average age was 55 which is considered older than the average age reported in the studies of Bahgat, 2016 (21-60) and SabinoNeto, 2012 (18-60) (Sabino Neto et al., 2012; Bahgat et al., 2016). This shows that the Palestinian cancer victims may be affected at an older age than the international population. This could be due to many factors, like type of diet, genetic predisposition, and other environmental factors. This also shows the importance of health promotion and campaigns to raise awareness about this issue. This however, gives a motivation for further research to investigate the average age of breast cancer patients among the breast cancer cohort in Palestine. On the other hand, there could be many younger patients with undetected cancer due to lack of early screening which could decrease the age mean since many of mastectomy survivors were subjected to the surgery based on very early stage changes within the breast that were detected through public organized screening campaigns. The type of surgery that each of the participants had undergone was different and the majority had undergone both radical mastectomy and axillary lymph node dissection as its well known that this is the most common procedure based on medical necessity. From a prophylactic point of view from surgeons, but they don’t have any preventive measures against complications associated with mastectomy. Which means that they’re also negligent about the complications which was obvious in the behaviour of the medical staff before and after the surgery. This was shown in how the post-surgical breast cancer survivors answered the question of whether they received any instructions or not from the medical staff. The need for better advice and precautions for the patient by the health care provider puts emphasise the importance of helping the patient get prepared in a better way and add factors that would promote better physical function and wellbeing post-surgery. And this comes in consensus with
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Is coracohumeral distance associated with pain function, and shoulder range of movement, in chronic anterior shoulder pain?

Is coracohumeral distance associated with pain function, and shoulder range of movement, in chronic anterior shoulder pain?

There are some limitations that should be taken into consideration. Firstly, inter-rater reliability for ultra- sonography measures was not determined; hence re- sults should be taken with caution. Secondly, the difficulty in classifying shoulder pain disorders could mean that heterogeneity is present in the analyzed sample. Hence, previous studies have remarked on the lack of uniformity and reliability in the current diag- nostic classification system for shoulder pain [27, 28]. Thirdly, CHD is a two dimensional measurement of a three dimensional space. Therefore, any compromise of this space cannot be completely quantified by the measurement of CHD in isolation. This should be taken into account. Furthermore, the clinical value of CHD must not be outrightly rejected in the clinical as- sessment of shoulder pain. Finally, due to convenience sample analyzed in this study, results cannot be gener- alized to other populations.
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