2025
Comparative efficacy and safety of stent retrievers as a bailout strategy following failed contact aspiration technique in acute stroke thrombectomy
Ezzeldin M, Hukamdad M, Kasem R, Ezzeldin R, Maier I, T A, Jabbour P, Kim J, Howard B, Alawieh A, Wolfe S, Starke R, Psychogios M, Shaban A, Goyal N, Dye J, Alaraj A, Yoshimura S, Fiorella D, Tanweer O, Romano D, Navia P, Cuellar H, Fragata I, Polifka A, Mascitelli J, Osbun J, Siddiqui F, Moss M, Limaye K, Mokin M, Matouk C, Park M, Brinjikji W, Daglioglu E, Williamson R, Altschul D, Ogilvy C, Crosa R, Levitt M, Gory B, Grandhi R, Paul A, Kan P, Casagrande W, Chowdhry S, Stiefel M, Chaubal V, Spiotta A. Comparative efficacy and safety of stent retrievers as a bailout strategy following failed contact aspiration technique in acute stroke thrombectomy. Journal Of NeuroInterventional Surgery 2025, jnis-2024-022781. PMID: 39884851, DOI: 10.1136/jnis-2024-022781.Peer-Reviewed Original ResearchSymptomatic intracranial hemorrhageTrevo stent retrieverContact aspirationStent retrieverAcute ischemic strokeEndovascular thrombectomyRecanalization rateFunctional outcomesAssociated with higher recanalization ratesOdds of symptomatic intracranial hemorrhageHigher recanalization ratesAssociated with higher oddsEndovascular thrombectomy patientsContact aspiration techniqueIntracranial hemorrhageMulticenter registryRecanalizationReduced oddsStroke thrombectomyHigher oddsIschemic strokeThrombectomyAspiration techniqueBailout strategyOddsMechanical thrombectomy in elderly stroke patients with low ASPECTS: insights from STAR
Cunningham C, Hubbard Z, Kasem R, Elawady S, Sowlat M, Matsukawa H, Maier I, Jabbour P, Kim J, Wolfe S, T A, Starke R, Psychogios M, Samaniego E, Goyal N, Yoshimura S, Cuellar H, Howard B, Alawieh A, Alaraj A, Ezzeldin M, Romano D, Tanweer O, Mascitelli J, Fragata I, Polifka A, Siddiqui F, Osbun J, Grandhi R, Crosa R, Matouk C, Park M, Levitt M, Brinjikji W, Moss M, Daglioglu E, Williamson R, Navia P, Kan P, De Leacy R, Chowdhry S, Altschul D, Al Kasab S, Spiotta A. Mechanical thrombectomy in elderly stroke patients with low ASPECTS: insights from STAR. Journal Of NeuroInterventional Surgery 2025, jnis-2024-022677. PMID: 39855673, DOI: 10.1136/jnis-2024-022677.Peer-Reviewed Original ResearchAlberta Stroke Program Early CT ScoreLow Alberta Stroke Program Early CT ScorePropensity score matchingSymptomatic intracranial hemorrhageEndovascular thrombectomyAnterior circulation large vessel occlusion acute ischemic strokeElderly patientsLVO-AISAssociated with 90-day mortalityRate of atrial fibrillationScore matchingLarge vessel occlusion acute ischemic strokeFirst-pass reperfusionAcute ischemic strokeCT scoreIntracranial hemorrhagePatient selectionMRS scoreAtrial fibrillationClinical factorsFavorable outcomeRecanalization ratePrimary outcomeMechanical thrombectomyPatients
2024
Prolonged intracranial catheter dwell time exacerbates penumbral stress and worsens stroke thrombectomy outcomes
Alawieh A, Elawady S, Zohdy Y, Chalhoub R, Cunningham C, Howard B, Cawley C, Barrow D, Akbik F, Pabaney A, Tong F, Al Kasab S, Jabbour P, Goyal N, Arthur A, Siddiqui F, Yoshimura S, Park M, Brinjikji W, Matouk C, Romano D, Altschul D, Williamson R, Moss M, De Leacy R, Ezzeldin M, Kan P, Levitt M, Grandhi R, Mascitelli J, Grossberg J, Spiotta A. Prolonged intracranial catheter dwell time exacerbates penumbral stress and worsens stroke thrombectomy outcomes. Journal Of NeuroInterventional Surgery 2024, jnis-2024-022271. PMID: 39542713, DOI: 10.1136/jnis-2024-022271.Peer-Reviewed Original ResearchSymptomatic intracranial hemorrhageAcute ischemic strokeModified Rankin ScaleMechanical thrombectomyRecanalization successIncreasing SICHDuration of catheter useBlood flowCatheter dwell timeNegative predictors of outcomeAnalysis of patientsMulticenter international registryPropensity scorePredictors of outcomeInternal carotid arteryCerebral artery blood flowMiddle cerebral arteryArtery blood flowIn vitro modelIntracranial hemorrhageCatheter placementCatheter useCaliber catheterProcedure timeAIS patientsIs Clot Composition Associated With Cause of Stroke? A Systematic Review and Meta‐Analysis
Sujijantarat N, Templeton K, Antonios J, Renedo D, Koo A, Haynes J, Fathima B, Amllay A, Nowicki K, Huttner A, Giles J, Navaratnam D, Sansing L, Hebert R, King J, Matouk C. Is Clot Composition Associated With Cause of Stroke? A Systematic Review and Meta‐Analysis. Stroke Vascular And Interventional Neurology 2024, 4 DOI: 10.1161/svin.124.001426.Peer-Reviewed Original ResearchCause of strokeRed blood cellsWhite blood cellsBlood cellsMechanical thrombectomyCardioembolic groupHistological compositionMeta-analysisLow red blood cellQuantity of red blood cellsRandom-effects meta-analysisAcute ischemic strokeEffects meta-analysisEnglish-language articlesMean percentage differenceAdult patientsMEDLINE databaseCochrane LibraryClinical utilityIschemic strokeLanguage articlesPatientsPercentage differenceArteryCellular compositionLumbocaval Shunt for Idiopathic Intracranial Hypertension: A Technical Report and Case Series
Sujijantarat N, Koo A, Elsamadicy A, Antonios J, Renedo D, Haynes J, Fathima B, Theriault B, Chavez M, Amllay A, Nowicki K, Kanzler M, Jiang J, Shekar A, Hebert R, DiLuna M, Matouk C. Lumbocaval Shunt for Idiopathic Intracranial Hypertension: A Technical Report and Case Series. Neurosurgery Open 2024, 5: e00113. PMID: 39959535, PMCID: PMC11810006, DOI: 10.1227/neuprac.0000000000000113.Peer-Reviewed Original ResearchIdiopathic intracranial hypertensionIntracranial hypertensionTreatment of idiopathic intracranial hypertensionManagement of idiopathic intracranial hypertensionMedical records of patientsAssessment of long-term outcomesHigh-pressure headachesMedian operative timeDifficult-to-manage patientsLow-pressure headacheCerebrospinal fluid shuntsElectronic medical records of patientsRecords of patientsFollow-up visitLong-term outcomesLumbar shuntDifficult-to-manage casesIntraoperative complicationsShunt revisionImprove headacheCase seriesEarly outcomesSurgical techniqueNeurosurgical managementOperative timeImprovement in cranial nerve palsies following treatment of intracranial aneurysms with flow diverters: Institutional outcomes, systematic review and study-level meta-analysis
Sujijantarat N, Antonios J, Renedo D, Koo A, Haynes J, Fathima B, Jiang J, Hengartner A, Shekhar A, Amllay A, Nowicki K, Hebert R, Gilmore E, Sheth K, King J, Matouk C. Improvement in cranial nerve palsies following treatment of intracranial aneurysms with flow diverters: Institutional outcomes, systematic review and study-level meta-analysis. Clinical Neurology And Neurosurgery 2024, 246: 108555. PMID: 39357321, DOI: 10.1016/j.clineuro.2024.108555.Peer-Reviewed Original ResearchStudy-level meta-analysisRate of improvementCN deficitsMeta-analysisIntracranial aneurysmsCN palsySystematic reviewFactors associated with recoveryPooled rateRandom-effects meta-analysisCranial nervesManual citation searchingEffects meta-analysisRate of clinical improvementCranial nerve palsyMechanism of injuryIncreased rate of improvementFlow diversionRare presenting symptomSymptomatic intracranial aneurysmsTreatment of intracranial aneurysmsCitation searchingPalsyNerve palsyRetrospective reviewImproved technical outcomes with converting thrombectomy techniques after failed first pass recanalization
Matsukawa H, Matouk C, Uchida K, Al Kasab S, Sowlat M, Elawady S, Maier I, Jabbour P, Kim J, Wolfe S, T A, Starke R, Psychogios M, Samaniego E, Arthur A, Cuellar H, Howard B, Romano D, Tanweer O, Mascitelli J, Fragata I, Polifka A, Osbun J, Crosa R, Park M, Levitt M, Brinjikji W, Moss M, Williamson R, Navia P, Kan P, De Leacy R, Chowdhry S, Ezzeldin M, Spiotta A, Yoshimura S, Alawieh A. Improved technical outcomes with converting thrombectomy techniques after failed first pass recanalization. Journal Of NeuroInterventional Surgery 2024, jnis-2024-022071. PMID: 39304195, DOI: 10.1136/jnis-2024-022071.Peer-Reviewed Original ResearchEfficacy of endovascular thrombectomyFirst-pass recanalizationLarge vessel occlusionModified Rankin scoreClinical outcomesMatched cohortMatched cohort of patientsAcute ischemic stroke secondary to large vessel occlusionFirst-passIschemic stroke secondary to large vessel occlusionAnterior circulation large vessel occlusionRisk of symptomatic hemorrhagePropensity score matched cohortMulticenter international studyCohort of patientsScore-matched cohortAssociated with higher oddsPropensity score matchingMRS 0Symptomatic hemorrhagePostprocedural hemorrhageTechnical successRecanalization attemptsRankin scorePrimary outcomeThe effect of intravenous thrombolysis in stroke patients with unsuccessful thrombectomy.
Elawady S, Kasem R, Matsukawa H, Cunningham C, Sowlat M, Nawabi N, Orscelik A, Venegas J, Isidor J, Loulida H, Maier I, Jabbour P, Kim J, Wolfe S, Rai A, Starke R, Psychogios M, Samaniego E, Goyal N, Yoshimura S, Cuellar H, Howard B, Alawieh A, Alaraj A, Ezzeldin M, Romano D, Tanweer O, Mascitelli J, Fragata I, Polifka A, Siddiqui F, Osbun J, Grandhi R, Crosa R, Matouk C, Park M, Levitt M, Brinjikji W, Moss M, Daglioglu E, Williamson R, Navia P, Kan P, De Leacy R, Chowdhry S, Altschul D, Spiotta A, Al Kasab S. The effect of intravenous thrombolysis in stroke patients with unsuccessful thrombectomy. Interventional Neuroradiology 2024, 15910199241279009. PMID: 39262342, PMCID: PMC11559907, DOI: 10.1177/15910199241279009.Peer-Reviewed Original ResearchAcute ischemic stroke patientsLarge vessel occlusionAcute ischemic strokeIntracranial hemorrhageBenefit of intravenous thrombolysisMechanical thrombectomyIntravenous thrombolysisMT alone groupAlone groupMT groupSecondary outcomesAnterior circulation large vessel occlusionSymptomatic intracranial hemorrhageEffect of intravenous thrombolysisIVT + MTIntravenous thrombolysis prior to MTPropensity score matchingMedian ageSymptomatic ICHMTICI scoreFailed recanalizationPrimary outcomeFunctional outcomesPatientsVessel occlusionO14 One-year safety of treating communicating hydrocephalus with the eShunt® implant
Lylyk P, Matouk C, Riina H, Siddiqui A, Lylyk I, Bleise C, Scrivano E, Lylyk P, Antonios J, Beneduce B, Levy E, Heilman C, Malek A. O14 One-year safety of treating communicating hydrocephalus with the eShunt® implant. 2024, a9.1-a9. DOI: 10.1136/jnis-2024-esmint.14.Peer-Reviewed Original ResearchEndovascular Thrombectomy With and Without Preceding Thrombolysis in Posterior Circulation Stroke—Insights From STAR
Heide E, Kasab S, Alawieh A, Arthur A, Brinjikji W, Chowdhry S, Crosa R, Cuellar H, Leacy R, Dumont T, Ernst M, Ezzeldin M, Fragata I, Howard B, Jabbour P, Kan P, Kim J, Levitt M, Mascitelli J, Matouk C, Moss M, Navia P, Osbun J, Park M, Polifka A, Psychogios M, Rai A, Romano D, Shaban A, Starke R, Tanweer O, Williamson R, Wolfe S, Yoshimura S, Spiotta A, Maier I. Endovascular Thrombectomy With and Without Preceding Thrombolysis in Posterior Circulation Stroke—Insights From STAR. Stroke Vascular And Interventional Neurology 2024, 4 DOI: 10.1161/svin.124.001334.Peer-Reviewed Original ResearchIntravenous thrombolysisLarge-vessel occlusionEndovascular thrombectomyAnterior circulation large-vessel occlusion strokeTreated with endovascular thrombectomyFavorable functional outcomeLikelihood of favorable functional outcomeEffect of intravenous thrombolysisLarge-vessel occlusion strokeRetrospective studyPosterior circulationRandomized trialsFunctional outcomesStroke thrombectomyLarge-vesselOcclusion strokeThrombectomyAneurysm RegistryHigher proceduralist stroke thrombectomy volume is associated with reduced inpatient mortality
Koo A, Renedo D, Ney J, Amllay A, Kanzler M, Stogniy S, Alawieh A, Sujijantarat N, Antonios J, Al Kasab S, Malhotra A, Hebert R, Matouk C, de Havenon A. Higher proceduralist stroke thrombectomy volume is associated with reduced inpatient mortality. Journal Of NeuroInterventional Surgery 2024, jnis-2024-022021. PMID: 39214687, DOI: 10.1136/jnis-2024-022021.Peer-Reviewed Original ResearchIn-hospital deathIn-hospital mortalityAcute ischemic strokeCut-pointsAbsolute risk of deathAssociated with lower oddsState Inpatient DatabasesFlorida State Inpatient DatabaseIn-hospital moralityRates of in-hospital mortalityDiagnosis of acute ischemic strokePrimary study outcomeRisk of deathStroke careOptimal cut-pointAssociated with reduced inpatient mortalityEndovascular thrombectomyRetrospective cohort studyLower oddsPotential confoundersAbsolute riskAcute ischemic stroke patientsInpatient mortalityCohort studyInpatient DatabaseComparison of combined intravenous and intra-arterial thrombolysis with intravenous thrombolysis alone in stroke patients undergoing mechanical thrombectomy: a propensity-matched analysis
Elawady S, Kasem R, Mulpur B, Cunningham C, Matsukawa H, Sowlat M, Orscelik A, Nawabi N, Isidor J, Maier I, Jabbour P, Kim J, Wolfe S, Rai A, Starke R, Psychogios M, Samaniego E, Yoshimura S, Cuellar H, Howard B, Alawieh A, Alaraj A, Ezzeldin M, Romano D, Tanweer O, Mascitelli J, Fragata I, Polifka A, Siddiqui F, Osbun J, Grandhi R, Crosa R, Matouk C, Park M, Brinjikji W, Moss M, Daglioglu E, Williamson R, Navia P, Kan P, De Leacy R, Chowdhry S, Altschul D, Spiotta A, Levitt M, Goyal N. Comparison of combined intravenous and intra-arterial thrombolysis with intravenous thrombolysis alone in stroke patients undergoing mechanical thrombectomy: a propensity-matched analysis. Journal Of NeuroInterventional Surgery 2024, jnis-2024-021975. PMID: 39179373, DOI: 10.1136/jnis-2024-021975.Peer-Reviewed Original ResearchSymptomatic intracranial hemorrhageAIS-LVO patientsIntracranial hemorrhageIntra-arteriallyModified Rankin ScaleNeurological improvementMechanical thrombectomyIAT groupFunctional outcomesIntra-arterial groupModified Rankin scale 0Long-term functional outcomeRate of recanalizationPropensity-matched analysisIntra-arterial thrombolysisLarge vessel occlusionStroke patientsAcute ischemic strokeSecondary outcomesPrimary outcomePropensity score matchingNo significant differencePropensity matchingAIS-LVOMT+IVT groupClinical and radiographic outcomes after mechanical thrombectomy in medium-vessel posterior cerebral artery occlusions: Subgroup analysis from STAR.
Almallouhi E, Findlay M, Maier I, Jabbour P, Kim J, Wolfe S, Rai A, Starke R, Psychogios M, Shaban A, Goyal N, Yoshimura S, Cuellar H, Howard B, Alawieh A, Alaraj A, Ezzeldin M, Romano D, Tanweer O, Mascitelli J, Fragata I, Polifka A, Siddiqui F, Osbun J, Crosa R, Matouk C, Park M, Levitt M, Brinjikji W, Moss M, Daglioglu E, Williamson R, Navia P, Kan P, De Leacy R, Chowdhry S, Altschul D, Spiotta A, Grandhi R. Clinical and radiographic outcomes after mechanical thrombectomy in medium-vessel posterior cerebral artery occlusions: Subgroup analysis from STAR. Interventional Neuroradiology 2024, 15910199241273839. PMID: 39140967, PMCID: PMC11569802, DOI: 10.1177/15910199241273839.Peer-Reviewed Original ResearchPosterior cerebral arteryMiddle cerebral arteryMedium vessel occlusionsFirst-pass recanalizationMechanical thrombectomyCerebral arteryPosterior cerebral artery occlusionStandard-of-care treatmentPatients' median ageFirst-pass success rateIntra-arterial thrombolysisLarge-vessel occlusionCerebral artery occlusionSalvageable brain tissuePrimary occlusionMedian ageClinical outcomesRadiographic outcomesRecanalization rateFollow-upSubgroup analysisArtery occlusionRecanalizationStroke thrombectomyPatientsDeep learning for prediction of post-thrombectomy outcomes based on admission CT angiography in large vessel occlusion stroke
Sommer J, Dierksen F, Zeevi T, Tran A, Avery E, Mak A, Malhotra A, Matouk C, Falcone G, Torres-Lopez V, Aneja S, Duncan J, Sansing L, Sheth K, Payabvash S. Deep learning for prediction of post-thrombectomy outcomes based on admission CT angiography in large vessel occlusion stroke. Frontiers In Artificial Intelligence 2024, 7: 1369702. PMID: 39149161, PMCID: PMC11324606, DOI: 10.3389/frai.2024.1369702.Peer-Reviewed Original ResearchEnd-to-endComputed tomography angiographyLarge vessel occlusionConvolutional neural networkDeep learning pipelineTrain separate modelsLogistic regression modelsResNet-50Deep learningAdmission computed tomography angiographyNeural networkLearning pipelineAdmission CT angiographyPreprocessing stepDiagnosis of large vessel occlusionsLarge vessel occlusion strokeReceiver operating characteristic areaEnsemble modelAutomated modelPre-existing morbidityCT angiographyReperfusion successNeurological examCross-validationOcclusion strokeO-035 Higher endovascular thrombectomy procedural volume is associated with reduced inpatient mortality
Koo A, Renedo D, Ney J, Amllay A, Kanzler M, Stogniy S, Nowicki K, Alawieh A, Sujijantarat N, Antonios J, Al Kasab S, Hebert R, Matouk C, de Havenon A. O-035 Higher endovascular thrombectomy procedural volume is associated with reduced inpatient mortality. 2024, a27.2-a28. DOI: 10.1136/jnis-2024-snis.35.Peer-Reviewed Original ResearchO-037 One-year follow-up of the eShunt® System for the treatment of normal pressure hydrocephalus
Lylyk P, Matouk C, Siddiqui A, Riina H, Lylyk I, Bleise C, Scrivano E, Lylyk P, Antonios J, Beneduce B, Levy E, Heilman C, Malek A. O-037 One-year follow-up of the eShunt® System for the treatment of normal pressure hydrocephalus. 2024, a29.1-a29. DOI: 10.1136/jnis-2024-snis.37.Peer-Reviewed Original ResearchP-031 One-year safety of the eShunt® implant used in the treatment of communicating hydrocephalus
Lylyk P, Matouk C, Siddiqui A, Riina H, Lylyk I, Bleise C, Scrivano E, Lylyk P, Antonios J, Beneduce B, Levy E, Heilman C, Malek A. P-031 One-year safety of the eShunt® implant used in the treatment of communicating hydrocephalus. 2024, a78.1-a78. DOI: 10.1136/jnis-2024-snis.103.Peer-Reviewed Original ResearchMulticenter early United States feasibility study and periprocedural safety of LVIS EVO for the treatment of unruptured intracranial aneurysms
Kayan Y, Almandoz J, Copelan A, Matouk C, Chaudry M, Altschul D, Essibayi M, Goren O, Yim B, Tsappidi S, Zhang Y, Hui F, Samaniego E, Gudino A, Siddiqui A, Jaikumar V, Puri A, Kühn A, Singh J, Ringer A, Hanel R, De Toledo O, Dabus G, Gooch M, Sizdahkhani S, Field N, Paul A. Multicenter early United States feasibility study and periprocedural safety of LVIS EVO for the treatment of unruptured intracranial aneurysms. Journal Of NeuroInterventional Surgery 2024, 17: jnis-2024-021900. PMID: 38906689, DOI: 10.1136/jnis-2024-021900.Peer-Reviewed Original ResearchConceptsLow-profile visualized intraluminal supportIntracranial aneurysmsHemorrhagic complicationsTreatment of unruptured intracranial aneurysmsComplete neck coverageAverage aneurysm sizeInstitutional review board approvalClass I occlusionReview board approvalAnterior communicating arteryTreatment of intracranial aneurysmsMiddle cerebral artery bifurcationUnruptured intracranial aneurysmsSelf-expanding stentsCerebral artery bifurcationLength of stayParent vessel sizePatient agePeriprocedural complicationsPeriprocedural safetyAneurysm locationAneurysm sizeAntiplatelet therapyBoard approvalIntraluminal supportEarlier Endovascular Thrombectomy and Mortality in Patients with Anterior Circulation Large Vessel Occlusion: A Propensity-Matched Analysis of the Stroke Thrombectomy and Aneurysm Registry
Matsukawa H, Crosa R, Cunningham C, Maier I, Al Kasab S, Jabbour P, Kim J, Wolfe S, Rai A, Starke R, Psychogios M, Shaban A, Goyal N, Yoshimura S, Cuellar H, Howard B, Alawieh A, Alaraj A, Ezzeldin M, Romano D, Tanweer O, Mascitelli J, Fragata I, Polifka A, Siddiqui F, Osbun J, Matouk C, Park M, Levitt M, Brinjikji W, Moss M, Williamson R, Navia P, Kan P, De Leacy R, Chowdhry S, Spiotta A, Collaborators S. Earlier Endovascular Thrombectomy and Mortality in Patients with Anterior Circulation Large Vessel Occlusion: A Propensity-Matched Analysis of the Stroke Thrombectomy and Aneurysm Registry. World Neurosurgery 2024, 189: e435-e441. PMID: 38908685, DOI: 10.1016/j.wneu.2024.06.082.Peer-Reviewed Original ResearchConceptsAIS-LVO patientsAnterior circulation large vessel occlusionLarge vessel occlusionEndovascular thrombectomyAcute ischemic strokePoor outcomeVessel occlusionReceiver operating characteristic curve analysisCharacteristic curve analysisPropensity-matched analysisScore matching analysisSecondary outcomesPrimary outcomeIntracranial hemorrhageNo significant differencePuncture timePatientsStroke thrombectomyCurve analysisIschemic strokeAneurysm RegistryMortalityThrombectomyOutcomesSignificant differenceAutomated detection of early signs of irreversible ischemic change on CTA source images in patients with large vessel occlusion
Mak A, Matouk C, Avery E, Behland J, Haider S, Frey D, Madai V, Vajkoczy P, Griessenauer C, Zand R, Hendrix P, Abedi V, Sanelli P, Falcone G, Petersen N, Sansing L, Sheth K, Payabvash S, Malhotra A. Automated detection of early signs of irreversible ischemic change on CTA source images in patients with large vessel occlusion. PLOS ONE 2024, 19: e0304962. PMID: 38870240, PMCID: PMC11175522, DOI: 10.1371/journal.pone.0304962.Peer-Reviewed Original ResearchConceptsDiffusion-weighted imagingLarge vessel occlusionIrreversible ischemic changesPoor functional outcomeFunctional outcomesIschemic changesInfarct volumeAlberta Stroke Program Early CT ScorePredicting poor functional outcomeVessel occlusionFollow-up diffusion-weighted imagingAnterior circulation LVO strokeCTA source imagesReceiver operating characteristic curveExpert human readersPredicting final infarctionASPECTS regionsAdmission CTANon-inferior performanceBaseline CTACT scoreFinal infarctEndovascular therapyHU attenuationValidation cohort
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