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Barriers and Facilitators in Implementing Online Educational Interventions for Physicians: Systematic Review of Reviews | medRxiv
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This pre-print is available under a Creative Commons License (Attribution-NonCommercial-NoDerivs 4.0 International), CC BY-NC-ND 4.0, as described at http://creativecommons.org/licenses/by-nc-nd/4.0/" /> <meta name="DC.AccessRights" content="restricted" /> <meta name="DC.Description" content="The implementation of online educational interventions for physicians presents both barriers and facilitators that shape the integration of digital learning into medical education frameworks. This systematic review of reviews aims to synthesize evidence on factors influencing the successful implementation of online educational interventions for physicians. We conducted searches across databases including, PubMed/Medline, Cochrane, Web of Science, Embase, PsycInfo, CINAHL spanning the years 2018 to 2023. Inclusion criteria comprised systematic reviews focusing on the implementation of e-learning. Data synthesis followed meta-ethnography principles, with categorization guided by the Consolidated Framework for Implementation Research (CFIR). Twenty-one relevant reviews were analyzed, highlighting factors within the CFIR domains: Innovation, Outer Setting, Inner Setting, Individuals, and Implementation Process. Facilitators included evidence-based practices, adaptability, leadership engagement, and resource availability, while barriers encompassed limited funding, regulatory hurdles, technological constraints, and resistance to change. The results emphasize how crucial it is for healthcare institutions, policymakers, educators, and technology providers to work together in order to effectively incorporate online learning into medical education. In conclusion, the study highlights the importance of tailored implementation strategies and policy recommendations, utilizing evidence-based practices and addressing various factors, to enhance online medical education’s effectiveness and ensure its integration into healthcare systems for improved patient outcomes. ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Protocols <https://www.crd.york.ac.uk/prospero/#myprospero> ### Funding Statement This study was a part of project SOM20230404 that is funded by Grant 064.01.01 of Nazarbayev University, Kazakhstan. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as [ClinicalTrials.gov][1]. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors [1]: http://ClinicalTrials.gov" /> <meta name="DC.Contributor" content="Akbota Tolegenova" /> <meta name="DC.Contributor" content="Akbota Kanderzhanova" /> <meta name="DC.Contributor" content="Faye Foster" /> <meta name="DC.Contributor" content="Paolo Colet" /> <meta name="DC.Contributor" content="Valentina Stolyarova" /> <meta name="DC.Contributor" content="Antonio Sarria-Santamera" /> <meta name="article:published_time" content="2024-11-18" /> <meta name="citation_title" content="Barriers and Facilitators in Implementing Online Educational Interventions for Physicians: Systematic Review of Reviews" /> <meta name="citation_abstract" lang="en" content="<h3>Abstract</h3> <p>The implementation of online educational interventions for physicians presents both barriers and facilitators that shape the integration of digital learning into medical education frameworks. This systematic review of reviews aims to synthesize evidence on factors influencing the successful implementation of online educational interventions for physicians. We conducted searches across databases including, PubMed/Medline, Cochrane, Web of Science, Embase, PsycInfo, CINAHL spanning the years 2018 to 2023. Inclusion criteria comprised systematic reviews focusing on the implementation of e-learning. Data synthesis followed meta-ethnography principles, with categorization guided by the Consolidated Framework for Implementation Research (CFIR). Twenty-one relevant reviews were analyzed, highlighting factors within the CFIR domains: Innovation, Outer Setting, Inner Setting, Individuals, and Implementation Process. Facilitators included evidence-based practices, adaptability, leadership engagement, and resource availability, while barriers encompassed limited funding, regulatory hurdles, technological constraints, and resistance to change. The results emphasize how crucial it is for healthcare institutions, policymakers, educators, and technology providers to work together in order to effectively incorporate online learning into medical education. In conclusion, the study highlights the importance of tailored implementation strategies and policy recommendations, utilizing evidence-based practices and addressing various factors, to enhance online medical education’s effectiveness and ensure its integration into healthcare systems for improved patient outcomes.</p>" /> <meta name="citation_journal_title" content="medRxiv" /> <meta name="citation_publisher" content="Cold Spring Harbor Laboratory Press" /> <meta name="citation_publication_date" content="2024/01/01" /> <meta name="citation_mjid" content="medrxiv;2024.11.18.24317472v1" /> <meta name="citation_id" content="2024.11.18.24317472v1" /> <meta name="citation_public_url" content="https://www.medrxiv.org/content/10.1101/2024.11.18.24317472v1" /> <meta name="citation_abstract_html_url" content="https://www.medrxiv.org/content/10.1101/2024.11.18.24317472v1.abstract" /> <meta name="citation_full_html_url" content="https://www.medrxiv.org/content/10.1101/2024.11.18.24317472v1.full" /> <meta name="citation_pdf_url" content="https://www.medrxiv.org/content/medrxiv/early/2024/11/18/2024.11.18.24317472.full.pdf" /> <meta name="citation_doi" content="10.1101/2024.11.18.24317472" /> <meta name="citation_num_pages" content="28" /> <meta name="citation_article_type" content="Article" /> <meta name="citation_firstpage" content="2024.11.18.24317472" /> <meta name="citation_author" content="Akbota Tolegenova" /> <meta name="citation_author_institution" content="Department of Medicine, Nazarbayev University School of Medicine" /> <meta name="citation_author_email" content="atolegenova@nu.edu.kz" /> <meta name="citation_author_orcid" content="http://orcid.org/0000-0001-8121-3259" /> <meta name="citation_author" content="Akbota Kanderzhanova" /> <meta name="citation_author_institution" content="Department of Medicine, Nazarbayev University School of Medicine" /> <meta name="citation_author_orcid" content="http://orcid.org/0000-0002-8153-9774" /> <meta name="citation_author" content="Faye Foster" /> <meta name="citation_author_institution" content="Department of Medicine, Nazarbayev University School of Medicine" /> <meta name="citation_author_orcid" content="http://orcid.org/0000-0002-4790-6219" /> <meta name="citation_author" content="Paolo Colet" /> <meta name="citation_author_institution" content="Department of Medicine, Nazarbayev University School of Medicine" /> <meta name="citation_author_orcid" content="http://orcid.org/0000-0002-6503-2244" /> <meta name="citation_author" content="Valentina Stolyarova" /> <meta name="citation_author_institution" content="Department of Medicine, Nazarbayev University School of Medicine" /> <meta name="citation_author_orcid" content="http://orcid.org/0000-0002-0214-3027" /> <meta name="citation_author" content="Antonio Sarria-Santamera" /> <meta name="citation_author_institution" content="Department of Medicine, Nazarbayev University School of Medicine" /> <meta name="citation_author_orcid" content="http://orcid.org/0000-0001-5734-7468" /> <meta name="citation_reference" content="Adedoyın, O. 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Npj Digital Medicine, 6(1), Article 174. 10.1038/s41746-023-00908-6" /> <meta name="twitter:title" content="Barriers and Facilitators in Implementing Online Educational Interventions for Physicians: Systematic Review of Reviews" /> <meta name="twitter:site" content="@medrxivpreprint" /> <meta name="twitter:card" content="summary" /> <meta name="twitter:image" content="https://www.medrxiv.org/sites/default/files/images/medrxiv_logo_homepage7-5-small-test-up.png" /> <meta name="twitter:description" content="The implementation of online educational interventions for physicians presents both barriers and facilitators that shape the integration of digital learning into medical education frameworks. This systematic review of reviews aims to synthesize evidence on factors influencing the successful implementation of online educational interventions for physicians. We conducted searches across databases including, PubMed/Medline, Cochrane, Web of Science, Embase, PsycInfo, CINAHL spanning the years 2018 to 2023. Inclusion criteria comprised systematic reviews focusing on the implementation of e-learning. Data synthesis followed meta-ethnography principles, with categorization guided by the Consolidated Framework for Implementation Research (CFIR). Twenty-one relevant reviews were analyzed, highlighting factors within the CFIR domains: Innovation, Outer Setting, Inner Setting, Individuals, and Implementation Process. Facilitators included evidence-based practices, adaptability, leadership engagement, and resource availability, while barriers encompassed limited funding, regulatory hurdles, technological constraints, and resistance to change. The results emphasize how crucial it is for healthcare institutions, policymakers, educators, and technology providers to work together in order to effectively incorporate online learning into medical education. In conclusion, the study highlights the importance of tailored implementation strategies and policy recommendations, utilizing evidence-based practices and addressing various factors, to enhance online medical education’s effectiveness and ensure its integration into healthcare systems for improved patient outcomes. ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Protocols <https://www.crd.york.ac.uk/prospero/#myprospero> ### Funding Statement This study was a part of project SOM20230404 that is funded by Grant 064.01.01 of Nazarbayev University, Kazakhstan. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as [ClinicalTrials.gov][1]. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors [1]: http://ClinicalTrials.gov" /> <meta name="og-title" property="og:title" content="Barriers and Facilitators in Implementing Online Educational Interventions for Physicians: Systematic Review of Reviews" /> <meta name="og-url" property="og:url" content="https://www.medrxiv.org/content/10.1101/2024.11.18.24317472v1" /> <meta name="og-site-name" property="og:site_name" content="medRxiv" /> <meta name="og-description" property="og:description" content="The implementation of online educational interventions for physicians presents both barriers and facilitators that shape the integration of digital learning into medical education frameworks. This systematic review of reviews aims to synthesize evidence on factors influencing the successful implementation of online educational interventions for physicians. We conducted searches across databases including, PubMed/Medline, Cochrane, Web of Science, Embase, PsycInfo, CINAHL spanning the years 2018 to 2023. Inclusion criteria comprised systematic reviews focusing on the implementation of e-learning. Data synthesis followed meta-ethnography principles, with categorization guided by the Consolidated Framework for Implementation Research (CFIR). Twenty-one relevant reviews were analyzed, highlighting factors within the CFIR domains: Innovation, Outer Setting, Inner Setting, Individuals, and Implementation Process. Facilitators included evidence-based practices, adaptability, leadership engagement, and resource availability, while barriers encompassed limited funding, regulatory hurdles, technological constraints, and resistance to change. The results emphasize how crucial it is for healthcare institutions, policymakers, educators, and technology providers to work together in order to effectively incorporate online learning into medical education. In conclusion, the study highlights the importance of tailored implementation strategies and policy recommendations, utilizing evidence-based practices and addressing various factors, to enhance online medical education’s effectiveness and ensure its integration into healthcare systems for improved patient outcomes. ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Protocols <https://www.crd.york.ac.uk/prospero/#myprospero> ### Funding Statement This study was a part of project SOM20230404 that is funded by Grant 064.01.01 of Nazarbayev University, Kazakhstan. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as [ClinicalTrials.gov][1]. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. 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data-apath="/medrxiv/early/2024/11/18/2024.11.18.24317472.atom" data-hw-author-tooltip-instance=""><div class="highwire-cite highwire-cite-highwire-article highwire-citation-medrxiv-article-top clearfix has-author-tooltip" > <h1 class="highwire-cite-title" id="page-title">Barriers and Facilitators in Implementing Online Educational Interventions for Physicians: Systematic Review of Reviews</h1> <div class="highwire-cite-authors" ><span class="highwire-citation-authors"><span class="highwire-citation-author first hw-author-orcid-logo-wrapper" data-delta="0"><a href="http://orcid.org/0000-0001-8121-3259" target="_blank" class="hw-author-orcid-logo link-icon-only link-icon"><span class="hw-icon-orcid hw-icon-color-orcid"></span> <span class="title element-invisible">View ORCID Profile</span></a><span class="nlm-given-names">Akbota</span> <span class="nlm-surname">Tolegenova</span></span>, <span class="highwire-citation-author hw-author-orcid-logo-wrapper" data-delta="1"><a href="http://orcid.org/0000-0002-8153-9774" target="_blank" class="hw-author-orcid-logo link-icon-only link-icon"><span class="hw-icon-orcid hw-icon-color-orcid"></span> <span class="title element-invisible">View ORCID Profile</span></a><span class="nlm-given-names">Akbota</span> <span class="nlm-surname">Kanderzhanova</span></span>, <span class="highwire-citation-author hw-author-orcid-logo-wrapper" data-delta="2"><a href="http://orcid.org/0000-0002-4790-6219" target="_blank" class="hw-author-orcid-logo link-icon-only link-icon"><span class="hw-icon-orcid hw-icon-color-orcid"></span> <span class="title element-invisible">View ORCID Profile</span></a><span class="nlm-given-names">Faye</span> <span class="nlm-surname">Foster</span></span>, <span class="highwire-citation-author hw-author-orcid-logo-wrapper" data-delta="3"><a href="http://orcid.org/0000-0002-6503-2244" target="_blank" class="hw-author-orcid-logo link-icon-only link-icon"><span class="hw-icon-orcid hw-icon-color-orcid"></span> <span class="title element-invisible">View ORCID Profile</span></a><span class="nlm-given-names">Paolo</span> <span class="nlm-surname">Colet</span></span>, <span class="highwire-citation-author hw-author-orcid-logo-wrapper" data-delta="4"><a href="http://orcid.org/0000-0002-0214-3027" target="_blank" class="hw-author-orcid-logo link-icon-only link-icon"><span class="hw-icon-orcid hw-icon-color-orcid"></span> <span class="title element-invisible">View ORCID Profile</span></a><span class="nlm-given-names">Valentina</span> <span class="nlm-surname">Stolyarova</span></span>, <span class="highwire-citation-author hw-author-orcid-logo-wrapper" data-delta="5"><a href="http://orcid.org/0000-0001-5734-7468" target="_blank" class="hw-author-orcid-logo link-icon-only link-icon"><span class="hw-icon-orcid hw-icon-color-orcid"></span> <span class="title element-invisible">View ORCID Profile</span></a><span class="nlm-given-names">Antonio</span> <span class="nlm-surname">Sarria-Santamera</span></span></span></div> <div class="highwire-cite-metadata" ><span class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">doi:</span> https://doi.org/10.1101/2024.11.18.24317472 </span></div> </div> <div id="hw-article-author-popups-node-902491--21007002320" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">Akbota Tolegenova </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>1</span><span class='nlm-institution'>Department of Medicine, Nazarbayev University School of Medicine</span>, 5/1 Kerey and Zhanibek Khans St, Astana 020000, Kazakhstan</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&gs_type=author&author%5B0%5D=Akbota%2BTolegenova%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Tolegenova%20A&link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AAkbota%2BTolegenova%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link"><a href="http://orcid.org/0000-0001-8121-3259" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Akbota Tolegenova</a></li><li class="author-corresp-email-link last"><span>For correspondence: <a href="mailto:atolegenova@nu.edu.kz" class="" data-icon-position="" data-hide-link-title="0">atolegenova@nu.edu.kz</a></span></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">Akbota Kanderzhanova </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>1</span><span class='nlm-institution'>Department of Medicine, Nazarbayev University School of Medicine</span>, 5/1 Kerey and Zhanibek Khans St, Astana 020000, Kazakhstan</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&gs_type=author&author%5B0%5D=Akbota%2BKanderzhanova%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Kanderzhanova%20A&link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AAkbota%2BKanderzhanova%2B" rel="nofollow" class="" data-icon-position="" 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href="/content/10.1101/2024.11.18.24317472v1.full.pdf+html" class="panels-ajax-tab-tab" data-panel-name="biorxiv_tab_pdf" data-target-id="highwire_article_tabs" data-entity-context="node:902491" data-trigger="full.pdf+html" data-url-enabled="1"><i class="icon-file-alt"></i> Preview PDF</a><a href="/panels_ajax_tab/biorxiv_tab_pdf/node:902491/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li></ul></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-panel-tabs-container" > <div class="pane-content"> <div data-panels-ajax-tab-preloaded="biorxiv_tab_art" id="panels-ajax-tab-container-highwire_article_tabs" class="panels-ajax-tab-container"><div class="panels-ajax-tab-loading" style ="display:none"><img class="loading" src="https://www.medrxiv.org/sites/all/modules/contrib/panels_ajax_tab/images/loading.gif" alt="Loading" title="Loading" /></div><div class="panels-ajax-tab-wrap-biorxiv_tab_art"><div class="panel-display panel-1col clearfix" > <div class="panel-panel panel-col"> <div><div class="panel-pane pane-highwire-markup" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article abstract-view "><span class="highwire-journal-article-marker-start"></span><div class="section abstract" id="abstract-1"><h2 class="">Abstract</h2><p id="p-4">The implementation of online educational interventions for physicians presents both barriers and facilitators that shape the integration of digital learning into medical education frameworks. This systematic review of reviews aims to synthesize evidence on factors influencing the successful implementation of online educational interventions for physicians. We conducted searches across databases including, PubMed/Medline, Cochrane, Web of Science, Embase, PsycInfo, CINAHL spanning the years 2018 to 2023. Inclusion criteria comprised systematic reviews focusing on the implementation of e-learning. Data synthesis followed meta-ethnography principles, with categorization guided by the Consolidated Framework for Implementation Research (CFIR). Twenty-one relevant reviews were analyzed, highlighting factors within the CFIR domains: Innovation, Outer Setting, Inner Setting, Individuals, and Implementation Process. Facilitators included evidence-based practices, adaptability, leadership engagement, and resource availability, while barriers encompassed limited funding, regulatory hurdles, technological constraints, and resistance to change. The results emphasize how crucial it is for healthcare institutions, policymakers, educators, and technology providers to work together in order to effectively incorporate online learning into medical education. In conclusion, the study highlights the importance of tailored implementation strategies and policy recommendations, utilizing evidence-based practices and addressing various factors, to enhance online medical education’s effectiveness and ensure its integration into healthcare systems for improved patient outcomes.</p></div><h3>Competing Interest Statement</h3><p id="p-5">The authors have declared no competing interest.</p><h3>Clinical Protocols</h3><p id="p-6"> <a href="https://www.crd.york.ac.uk/prospero/#myprospero">https://www.crd.york.ac.uk/prospero/#myprospero</a> </p><h3>Funding Statement</h3><p id="p-7">This study was a part of project SOM20230404 that is funded by Grant 064.01.01 of Nazarbayev University, Kazakhstan.</p><h3>Author Declarations</h3><p id="p-8">I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.</p><p id="p-9">Yes</p><p id="p-10">I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.</p><p id="p-11">Yes</p><p id="p-12">I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as <a href="https://ClinicalTrials.gov">ClinicalTrials.gov</a>. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).</p><p id="p-13">Yes</p><p id="p-14">I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.</p><p id="p-15">Yes</p><div class="section fn-group" id="fn-group-1"><h2>Footnotes</h2><ul><li class="fn-others" id="fn-1"><p id="p-1"><strong>Funding</strong> This study is a part of project SOM20230404 that is funded by Grant 064.01.01 of Nazarbayev University.</p></li><li class="fn-conflict" id="fn-2"><p id="p-2"><strong>Declaration of conflicting interest</strong> The Authors declare that there is no conflict of interest.</p></li></ul></div><div class="section data-availability" 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