Publications

Yarborough, B.J.H., Smith, N., Stumbo, S.P., Janoff, S., Keast, E., Wartko, P.D., Yeung, K., Zhu, W., Petronis, K.R., Ahmedani, B.K., Andrade, S.E., Campbell, C.I., Clark, R.E., Cottler, L.B., Hechter, R.C., Starrels, J.L., Boudreau, D.M., in press. Incidence of opioid use disorder among patients prescribed long-term opioid therapy: An observational study. Drug Alcohol Depend
Aguiar C*, Bolus M*, Mudumbai SC. A Standardized Framework for Evaluating State Opioid Surveillance Dashboards: A Health Informatics Assessment. Journal of Medical Systems. J Med Syst 50, 85 (2026)
Rowe J, Liu J, Mudumbai SC, Mariano ER, Umeh UO. Study design and statistical methods for health equity research in anesthesiology and perioperative care. Anesth Analg. 2026 Mar 23. doi: 10.1213/ANE.0000000000008037. Epub ahead of print. PMID: 41874960. Contributed clinical domain expertise in statistical methods; participated in manuscript revision
Mudumbai SC, Chen JQ, Hunter OO, Nool D, Pham J, Morse CA, Kumar G, Harrison TK, Mariano ER, Clark JD. Utilization and opioid outcomes of a transitional pain service in high-risk surgical veterans: A cohort study Reg Anesth Pain Med. 2025 Dec 24:rapm-2025-107092. doi: 10.1136/rapm-2025-107092. PMID: 41443747.
Mudumbai SC, Chung P, Chen JQ, Litake O, Regala S, Madhok J, Krause M, Pearl RG, Boateng Evans A, Gabriel RA. Evaluating Large Language Model Performance in Generating Clinically Relevant Intensive Care Unit Discharge Summaries. A A Pract. 2025;19(9):e02057. PMID: 40952021.
Mudumbai SC, Han LC, O’Reilly-Shah, Rothman, B Large Language Models for Semantic Interoperability in Value-Based Perioperative Care. Journal of Medical Systems J Med Syst 50, 81 (2026).
Xie J, O’Reilly-Shah V, Bernstein M, Mudumbai SC. The evolving landscape of information sharing and the anesthesiologist’s role: responsibly releasing anesthetic records under the Cures Act. ASA Monitor. (In press)

Mudumbai SC., Chung P., Chen J-Q., Litake O., Regala S., Madhok J., Krause M., Pearl R., Boateng A., Gabriel RA. Evaluating Large Language Model Performance in Generating Clinically Relevant ICU Discharge Summaries. Anesthesia & Analgesia Practice, In press
Graham, L. A., Illarmo, S. S., Odden, M. C., Mudumbai, SC., Wren, S. M., Multimodal Analgesia to Reduce Pain and Opioid Use Following Noncardiac Surgery: An Instrumental Variable Analysis Regional Anesthesia & Pain Medicine, In Press
Raghunathan, K.., Wongsripuemtet, P, Barbeito, A, Pepin, MJ, Krishnamoorthy, V.,; Ohnuma, T.,; Cobert, J, Mudumbai, SC; Watwe, R.; Bryan, W. Rapid, Safe, and Efficient Reduction in the Carbon Footprint of Preoperative Travel: A Nationwide Study. Anesthesiology 143(1):p 209-212, July 2025. | DOI: 10.1097/ALN.0000000000005466
Bolus M, Chen JQ, Regala S, Kapoor A, Barbeito A, Raghunathan K, Stafford RS, Mariano ER, Mudumbai SC. Influence of Social Support and Personality Traits on Digital Health Technology Adoption Among U.S. Veterans: A Mixed-Methods Study. Mil Med. 2025 Jun 13:usaf258. doi: 10.1093/milmed/usaf258. Epub ahead of print. PMID: 40511743.
Mudumbai SC, Baurley J, Coombes CE, Stafford RS, Mariano ER. Beyond the ‘black box’: choosing interpretable machine learning models for predicting postoperative opioid trends. Anaesthesia. 2025 Feb 2. doi: 10.1111/anae.16553. Epub ahead of print. PMID: 39894917.

Graham, L. A., Illarmo, S. S., Wren, S. M., Odden, M. C., Mudumbai, S. C. Variations in the Current Practice and Common Protocols of Intraoperative Multimodal Analgesia: A 6-Hospital Cross-sectional Study within a Single United States Healthcare System, Anesthesia & Analgesia, In press
Graham, L. A., Illarmo, S. S., Wren, S. M., Odden, M. C., Mudumbai, S. C. Use of natural language processing method to identify regional anesthesia from clinical notes. Regional anesthesia and pain medicine DOI 10.1136/rapm-2024-105340 PubMedID 38580338
Mudumbai SC, He H, Chen JQ, Kapoor A, Regala S, Mariano ER, Stafford RS, Abnet CC, Pfeiffer RM, Freedman ND, Etemadi A. Opioid use in cancer patients compared with noncancer pain patients in a veteran population. JNCI Cancer Spectrum. 2024 Feb 29;8(2):pkae012. DOi: 10.1093/jncics/pkae012. PMID: 38457606; PMCID: PMC11009465.
Mudumbai,SC, Gabriel RA, Howell S, Tan JM, Freundlich RE, O’Reilly-Shah V, Kendale S,Poterack K, Rothman BS. Public Health Informatics and the Perioperative Physician: Looking to the Future. Anesthesia & Analgesia 138(2):p 253-272, February 2024. | DOI: 10.1213/ANE.0000000000006649. Epub 2024 Jan 12. PMID: 38215706; PMCID: PMC10825795.

Barbeito, A., Raghunathan, K., Connolly, S., Mariano, E. R., Blitz, J., Stafford, R. S., & Mudumbai, S. (2023). Barriers to Implementation of Telehealth Pre-anesthesia Evaluation Visits in the Department of Veterans Affairs. Federal practitioner: for the health care professionals of the VA, DoD, and PHS, 40(7), 210–217a. DOI 10.12788/fp.0387
Mulumba, K. Y., Mariano, E. R., Leng, J. C., Kou, A., Hunter, O. O., Tamboli, M., Memtsoudis, S. G., & Mudumbai, S. C. (2023). Changing a clinical pathway to increase spinal anesthesia use for elective hip arthroplasty: a single-centre historical cohort study. Canadian journal of anaesthesia, 70(2), 211–218. DOI 10.1007/s12630-022-02371-5
Harris, A. H. S., Finlay, A. K., Hagedorn, H. J., Manfredi, L., Jones, G., Kamal, R. N., Sears, E. D., Hawn, M., Eisenberg, D., Pershing, S., & Mudumbai, SC. (2023). Identifying Strategies to Reduce Low-Value Preoperative Testing for Low-Risk Procedures: a Qualitative Study of Facilities with High or Recently Improved Levels of Testing. Journal of general internal medicine, 10.1007/s11606-023-08287-0. Advance online publication. DOI 10.1007/s11606-023-08287-0
Coffman, C. R., Leng, J. C., Ye, Y., Hunter, O. O., Walters, T. L., Wang, R., Wong, J. K., Mudumbai, S. C., & Mariano, E. R. (2023). More Than a Perioperative Surgical Home: An Opportunity for Anesthesiologists to Advance Public Health. Seminars in cardiothoracic and vascular anesthesia, 10892532231200620. Advance online publication. DOI 10.1177/10892532231200620

Stern, J. R., Kou, A., Kapoor, A., Regala, S., He, H., Stafford, R. S., Mariano, E. R., & Mudumbai, S. C. (2022). Single-center cross-sectional study of high opioid prescribing among U.S. veterans with peripheral arterial disease. Regional anesthesia and pain medicine, 47(10), 651–652. DOI 10.1136/rapm-2022-103574
Lahidji, S., Oliva, E., Jarzebowski, M., Mudumbai, S. C., Lake, T., Krishnamoorthy, V., Raghunathan, K., & Bryan, W. E., 3rd (2022). Naloxone Dispensing in Patients at Risk for Opioid Overdose After Total Knee Arthroplasty Within the Veterans Health Administration. Federal practitioner : for the health care professionals of the VA, DoD, and PHS, 39(2), 64–69. DOI 10.12788/fp.0227
Ding, Q., Trickey, A. W., Mudumbai, S., Kamal, R. N., Sears, E. D., & Harris, A. H. S. (2022). Prevalence and Factors Associated With Low-Value Preoperative Testing for Patients Undergoing Carpal Tunnel Release at an Academic Medical Center. Hand (New York, N.Y.), 17(1), 28–34. DOI 10.1177/1558944720906498
Burton, J. C., Regala, S., Williams, D., Desai, A., He, H., Aalami, O., Mariano, E. R., Stafford, R. S., & Mudumbai, S. C. (2022). A Comparative Utility Score for Digital Health Tools. Journal of medical systems, 46(6), 34. DOI 10.1007/s10916-022-01821-3
Bergen, A. W., Baurley, J. W., Ervin, C. M., McMahan, C. S., Bible, J., Stafford, R. S., Mudumbai, S. C., & Saxon, A. J. (2022). Effects of Buprenorphine Dose and Therapeutic Engagement on Illicit Opiate Use in Opioid Use Disorder Treatment Trials. International journal of environmental research and public health, 19(7), 4106. DOI 10.3390/ijerph19074106
Harris, A. H. S., Bowe, T., Kamal, R. N., Sears, E. D., Hawn, M., Eisenberg, D., Finlay, A. K., Hagedorn, H. J., & Mudumbai, S. (2022). Frequency and costs of low-value preoperative tests for patients undergoing low-risk procedures in the veterans health administration. Perioperative medicine (London, England), 11(1), 33. DOI 10.1186/s13741-022-00265-0

Mudumbai, S. C., & Rashidi, P. (2021). Linking Preoperative and Intraoperative Data for Risk Prediction: More Answers or Just More Data?. JAMA network open, 4(3), e212547. DOI 10.1001/jamanetworkopen.2021.2547
Mudumbai, S. C., Pershing, S., Bowe, T., Kamal, R. N., Sears, E. D., Hawn, M. T., Eisenberg, D., Finlay, A. K., Hagedorn, H., & Harris, A. H. S. (2021). Variability and Costs of Low-Value Preoperative Testing for Cataract Surgery Within the Veterans Health Administration. JAMA network open, 4(5), e217470. DOI 10.1001/jamanetworkopen.2021.7470

Mudumbai, S. C., Chung, P., Nguyen, N., Harris, B., Clark, J. D., Wagner, T. H., Giori, N. J., Stafford, R. S., & Mariano, E. R. (2020). Perioperative Opioid Prescribing Patterns and Readmissions After Total Knee Arthroplasty in a National Cohort of Veterans Health Administration Patients. Pain medicine (Malden, Mass.), 21(3), 595–603. DOI 10.1093/pm/pnz154
Kwong, J. Z., Mudumbai, S. C., Hernandez-Boussard, T., Popat, R. A., & Mariano, E. R. (2020). Practice Patterns in Perioperative Nonopioid Analgesic Administration by Anesthesiologists in a Veterans Affairs Hospital. Pain medicine (Malden, Mass.), 21(2), e208–e214. DOI 10.1093/pm/pnz226
Tien, M., Kou, A., Leppert, J. T., Mariano, E. R., & Mudumbai, S. C. (2020). Spinal anesthesia increases the rate of opioid-free recovery after transurethral urologic surgery. Journal of clinical anesthesia, 60, 109–110. DOI 10.1016/j.jclinane.2019.09.013
Tamboli, M., Mariano, E. R., Gustafson, K. E., Briones, B. L., Hunter, O. O., Wang, R. R., Harrison, T. K., Kou, A., Mudumbai, S. C., Kim, T. E., Indelli, P. F., & Giori, N. J. (2020). A Multidisciplinary Patient-Specific Opioid Prescribing and Tapering Protocol Is Associated with a Decrease in Total Opioid Dose Prescribed for Six Weeks After Total Hip Arthroplasty. Pain medicine (Malden, Mass.), 21(7), 1474–1481. DOI 10.1093/pm/pnz260
Tamboli, M., Leng, J. C., Hunter, O. O., Kou, A., Mudumbai, S. C., Memtsoudis, S. G., Walters, T. L., Lochbaum, G. M., & Mariano, E. R. (2020). Five-year follow-up to assess long-term sustainability of changing clinical practice regarding anesthesia and regional analgesia for lower extremity arthroplasty. Korean journal of anesthesiology, 73(5), 401–407. DOI 10.4097/kja.19400
Tamboli, M., Mariano, E. R., El-Boghdadly, K., Elkassabany, N. M., Kou, A., Chung, P., & Mudumbai, S. C. (2020). Making the case for a procedure-specific definition of chronic postoperative opioid use. Regional anesthesia and pain medicine, rapm-2020-101327. Advance online publication. DOI 10.1136/rapm-2020-101327
Joo, S. S., Hunter, O. O., Tamboli, M., Leng, J. C., Harrison, T. K., Kassab, K., Keeton, J. D., Skirboll, S., Tharin, S., Saleh, E., Mudumbai, S. C., Wang, R. R., Kou, A., & Mariano, E. R. (2020). Implementation of a patient-specific tapering protocol at discharge decreases total opioid dose prescribed for 6 weeks after elective primary spine surgery. Regional anesthesia and pain medicine, 45(6), 474–478. DOI 10.1136/rapm-2020-101324
Tamboli, M., Kou, A., Wang, R. R., Walters, T. L., Mudumbai, S. C., & Mariano, E. R. (2020). An analysis of perioperative eye injury in a veterans affairs inpatient surgical population. Journal of clinical anesthesia, 66, 109913. DOI 10.1016/j.jclinane.2020.109913
Mudumbai, S. C., Kim, T. E., Howard, S. K., Giori, N. J., Woolson, S., Ganaway, T., Kou, A., King, R., & Mariano, E. R. (2020). Corrigendum: An ultrasound-guided fascia iliaca catheter technique does not impair ambulatory ability within a clinical pathway for total hip arthroplasty. Korean journal of anesthesiology, 73(3), 267. DOI 10.4097/kjae.2016.69.4.368.e1
Mudumbai, S. C., Mariano, E. R., Clark, J. D., & Stafford, R. S. (2020). Collateral Damage as Crises Collide: Perioperative Opioids in the COVID-19 Era. Pain medicine (Malden, Mass.), 21(11), 3248–3249. DOI 10.1093/pm/pnaa308
Harris, A. H. S., Meerwijk, E. L., Kamal, R. N., Sears, E. D., Hawn, M., Eisenberg, D., Finlay, A. K., Hagedorn, H., Marshall, N., & Mudumbai, S. C. (2020). Variation in Surgeons’ Requests for General Anesthesia When Scheduling Carpal Tunnel Release. Hand (New York, N.Y.), 15(5), 608–614. DOI 10.1177/1558944719828006

Mudumbai, S. C., Lewis, E. T., Oliva, E. M., Chung, P. D., Harris, B., Trafton, J., Mariano, E. R., Wagner, T., Clark, J. D., & Stafford, R. S. (2019). Overdose Risk Associated with Opioid Use upon Hospital Discharge in Veterans Health Administration Surgical Patients. Pain medicine (Malden, Mass.), 20(5), 1020–1031. DOI 10.1093/pm/pny150
Yajnik, M., Kou, A., Mudumbai, S. C., Walters, T. L., Howard, S. K., Edward Kim, T., & Mariano, E. R. (2019). Peripheral nerve blocks are not associated with increased risk of perioperative peripheral nerve injury in a Veterans Affairs inpatient surgical population. Regional anesthesia and pain medicine, 44(1), 81–85. DOI 10.1136/rapm-2018-000006
King, R., Mariano, E. R., Yajnik, M., Kou, A., Kim, T. E., Hunter, O. O., Howard, S. K., & Mudumbai, S. C. (2019). Outcomes of Ambulatory Upper Extremity Surgery Patients Discharged Home with Perineural Catheters from a Veterans Health Administration Medical Center. PAIN MEDICINE., 20(11), 2256–2262. DOI 10.1093/pm/pnz023
Mudumbai, S. C., Pershing, S., Bowe, T., Kamal, R. N., Sears, E. D., Finlay, A. K., Eisenberg, D., Hawn, M. T., Weng, Y., Trickey, A. W., Mariano, E. R., & Harris, A. H. S. (2019). Development and validation of a predictive model for American Society of Anesthesiologists Physical Status. BMC health services research, 19(1), 859. DOI 10.1186/s12913-019-4640-x
Saraswathula, A., Chen, M. M., Mudumbai, S. C., Whittemore, A. S., & Divi, V. (2019). Persistent Postoperative Opioid Use in Older Head and Neck Cancer Patients. Otolaryngology–head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 160(3), 380–387. DOI 10.1177/0194599818778276
Harris, A. H. S., Meerwijk, E. L., Kamal, R. N., Sears, E. D., Hawn, M., Eisenberg, D., Finlay, A. K., Hagedorn, H., & Mudumbai, S. (2019). Variability and Costs of Low-Value Preoperative Testing for Carpal Tunnel Release Surgery. Anesthesia and analgesia, 129(3), 804–811. DOI 10.1213/ANE.0000000000004291
Wong, J. K., Kim, T. E., Mudumbai, S. C., Memtsoudis, S. G., Giori, N. J., Howard, S. K., Oka, R. K., King, R., & Mariano, E. R. (2019). Are Case Volume and Facility Complexity Level Associated With Postoperative Complications After Hip Fracture Surgery in the Veterans Affairs Healthcare System?. Clinical orthopaedics and related research, 477(1), 177–190. DOI 10.1097/CORR.0000000000000460
Chen, Q., Hsia, H. L., Overman, R., Bryan, W., Pepin, M., Mariano, E. R., Mudumbai, S. C., Buchheit, T., Krishnamoorthy, V., Good, C. B., Brookhart, M. A., & Raghunathan, K. (2019). Impact of an Opioid Safety Initiative on Patients Undergoing Total Knee Arthroplasty: A Time Series Analysis. Anesthesiology, 131(2), 369–380. DOI 10.1097/ALN.0000000000002771

Mudumbai, S. C., Auyong, D. B., Memtsoudis, S. G., & Mariano, E. R. (2018). A pragmatic approach to evaluating new techniques in regional anesthesia and acute pain medicine. Pain management, 8(6), 475–485. DOI 10.2217/pmt-2018-0017

Mudumbai, S., Ayer, F., & Stefanko, J. (2017). Perioperative and ICU Healthcare Analytics within a Veterans Integrated System Network: a Qualitative Gap Analysis. Journal of medical systems, 41(8), 118. DOI 10.1007/s10916-017-0762-z

Mudumbai, S. C., Ganaway, T., Kim, T. E., Howard, S. K., Giori, N. J., Shum, C., & Mariano, E. R. (2016). Can bedside patient-reported numbness predict postoperative ambulation ability for total knee arthroplasty patients with nerve block catheters?. Korean journal of anesthesiology, 69(1), 32–36. DOI 10.4097/kjae.2016.69.1.32
Mudumbai, S. C., Kim, T. E., Howard, S. K., Giori, N. J., Woolson, S., Ganaway, T., Kou, A., King, R., & Mariano, E. R. (2016). An ultrasound-guided fascia iliaca catheter technique does not impair ambulatory ability within a clinical pathway for total hip arthroplasty. Korean journal of anesthesiology, 69(4), 368–375. DOI 10.4097/kjae.2016.69.4.368
Mudumbai, S. C., Walters, T. L., Howard, S. K., Kim, T. E., Lochbaum, G. M., Memtsoudis, S. G., Kain, Z. N., Kou, A., King, R., & Mariano, E. R. (2016). The Perioperative Surgical Home model facilitates change implementation in anesthetic technique within a clinical pathway for total knee arthroplasty. Healthcare (Amsterdam, Netherlands), 4(4), 334–339. DOI 10.1016/j.hjdsi.2016.03.002
Mudumbai S. C. (2016). Implementation of an Anesthesia Information Management System in an Ambulatory Surgery Center. Journal of medical systems, 40(1), 22. DOI 10.1007/s10916-015-0390-4
Mudumbai, S. C., Oliva, E. M., Lewis, E. T., Trafton, J., Posner, D., Mariano, E. R., Stafford, R. S., Wagner, T., & Clark, J. D. (2016). Time-to-Cessation of Postoperative Opioids: A Population-Level Analysis of the Veterans Affairs Health Care System. Pain medicine (Malden, Mass.), 17(9), 1732–1743. DOI 10.1093/pm/pnw015

Rasmussen, M., Kim, E., Kim, T. E., Howard, S. K., Mudumbai, S., Giori, N. J., Woolson, S., Ganaway, T., & Mariano, E. R. (2015). A retrospective comparative provider workload analysis for femoral nerve and adductor canal catheters following knee arthroplasty. Journal of anesthesia, 29(2), 303–307. DOI 10.1007/s00540-014-1910-y
Mudumbai, S. C., Barr, J., Scott, J., Mariano, E. R., Bertaccini, E., Nguyen, H., Memtsoudis, S. G., Cason, B., Phibbs, C. S., & Wagner, T. (2015). Invasive Mechanical Ventilation in California Over 2000-2009: Implications for Emergency Medicine. The western journal of emergency medicine, 16(5), 696–706. DOI 10.5811/westjem.2015.6.25736

Mudumbai, S. C., Kim, T. E., Howard, S. K., Workman, J. J., Giori, N., Woolson, S., Ganaway, T., King, R., & Mariano, E. R. (2014). Continuous adductor canal blocks are superior to continuous femoral nerve blocks in promoting early ambulation after TKA. Clinical orthopaedics and related research, 472(5), 1377–1383. DOI 10.1007/s11999-013-3197-y
Mudumbai, S. C., Wagner, T., Mahajan, S., King, R., Heidenreich, P. A., Hlatky, M., Wallace, A. W., & Mariano, E. R. (2014). Effectiveness of preoperative beta-blockade on intra-operative heart rate in vascular surgery cases conducted under regional or local anesthesia. SpringerPlus, 3, 227. DOI 10.1186/2193-1801-3-227
Mudumbai, S. C., Honkanen, A., Chan, J., Schmitt, S., Saynina, O., Hackel, A., Gregory, G., Phibbs, C. S., & Wise, P. H. (2014). Variations in inpatient pediatric anesthesia in California from 2000 to 2009: a caseload and geographic analysis. Paediatric anaesthesia, 24(12), 1295–1301. DOI 10.1111/pan.12500
Mudumbai, S. C., Takemoto, S., Cason, B. A., Au, S., Upadhyay, A., & Wallace, A. W. (2014). Thirty-day mortality risk associated with the postoperative nonresumption of angiotensin-converting enzyme inhibitors: a retrospective study of the Veterans Affairs Healthcare System. Journal of hospital medicine, 9(5), 289–296. DOI 10.1002/jhm.2182

Mudumbai, S. C., Cronkite, R., Hu, K. U., Heidenreich, P. A., Gonzalez, C., Bertaccini, E., Stafford, R. S., Cason, B. A., Mariano, E. R., & Wagner, T. (2013). Association of age and packed red blood cell transfusion to 1-year survival–an observational study of ICU patients. Transfusion medicine (Oxford, England), 23(4), 231–237. DOI 10.1111/tme.12010

Mudumbai, S. C., Wagner, T., Mahajan, S., King, R., Heidenreich, P. A., Hlatky, M., Wallace, A., & Mariano, E. R. (2012). Vascular surgery patients prescribed preoperative β-blockers experienced a decrease in the maximal heart rate observed during induction of general anesthesia. Journal of cardiothoracic and vascular anesthesia, 26(3), 414–419. DOI 10.1053/J.JVCA.2011.09.027
Mudumbai, S. C., Gaba, D. M., Boulet, J. R., Howard, S. K., & Davies, M. F. (2012). External validation of simulation-based assessments with other performance measures of third-year anesthesiology residents. Simulation in healthcare : journal of the Society for Simulation in Healthcare, 7(2), 73–80. DOI 10.1097/SIH.0b013e31823d018a

Mudumbai, S. C., Cronkite, R., Hu, K. U., Wagner, T., Hayashi, K., Ozanne, G. M., Davies, M. F., Heidenreich, P., & Bertaccini, E. (2011). Association of admission hematocrit with 6-month and 1-year mortality in intensive care unit patients. Transfusion, 51(10), 2148–2159. DOI 10.1111/j.1537-2995.2011.03134.x
Mudumbai, S. C., Gaba, D. M., Boulet, J., Howard, S. K., & Davies, M. F. (2011). Feasibility of an internet-based global ranking instrument. Journal of graduate medical education, 3(1), 67–74. DOI 10.4300/JGME-D-10-00162.1

Mudumbai, S. C., Fanning, R., Howard, S. K., Davies, M. F., & Gaba, D. M. (2010). Use of medical simulation to explore equipment failures and human-machine interactions in anesthesia machine pipeline supply crossover. Anesthesia and analgesia, 110(5), 1292–1296. DOI 10.1213/ANE.0b013e3181d7e097