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        <title>Thinking Allowed</title>
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        <description>Welcome to my blog. I'm a physician, educationalist, digital innovator, and medical affairs professional. Coder and founder OutcomesEngine.com. This is also the home of The Crap Artist (Official) blog posts. Dr Dean Jenkins FRCP. Note. This is a personal blog for sharing and reflecting on my own learning. Any discussion on health matters is as accurate and comprehensive as possible but only general - it is not a substitute for the individual advice you may recieve from your own doctor. Other doctors reading this blog should use their own clinical judgement when interpreting the information and deciding how best to apply it to the care of patients.</description>
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<item><title><![CDATA[The power of nature - mental health services for children]]></title><description><![CDATA[CAMHS Goes Wild! (a child and adolescent mental health service project at Cornwall Partnership NHS Foundation Trust) has been awarded funding from NHS Charities Together.Before I go any further, a declaration of interest - our daughter Molly has been pushing for this service for a long time and ran the pilot that this award is based on. Go Molly!The project has been awarded £150,000 to further their work partnering with Newquay Orchard introducing young people to nature, food production, and healthy lifestyle choices."We're so pleased to be awarded this funding. It enables us to deliver a nature-based lifestyle medicine programme. It is co-created and co-delivered with Newquay Orchard. We will be consulting with young people from the start to create meaningful outcomes over the next 2 years." said Molly Jenkins, Clinical Associate Psychologist for Mid Cornwall CAMHS.It doesn't take long sitting in natural surroundings to notice that living things are very busy at thriving. Plants literally grow over any constraints that humans put in the way of them. Nature is messy. We strongly suspect nature can heal us. There is evidence for it too, but also a call for more research. Here's hoping this work in Cornwall will help support that."Findings support the contention that nature positively influences mental health; however, in most cases, additional research with more rigorous study designs and objective measures of both nature and mental health outcomes are needed to confirm statistically significant relationships." Tillmann S, Tobin D, Avison W, Gilliland J. Mental health benefits of interactions with nature in children and teenagers: A systematic review. J Epidemiol Community Health. 2018 Oct 1;72(10):958-66.]]></description><link>https://deanjenkins.me/som/post.php?id=2888</link><guid>https://deanjenkins.me/som/post.php?id=2888</guid><pubDate>Tue, 20 Jan 2026 18:40:00 +0000</pubDate></item>
<item><title><![CDATA[Medical Education predictions for 2025]]></title><description><![CDATA[Some predictions for educational technology in healthcare in 2025.Mixed Reality (MR)The hardware for mixed / augmented / virtual reality is becoming more accessible and with it the opportunity for applications.There are many examples of educational technology businesses in this space - Osso VR, GigXR, FundamentalVR, Virtus Tech - and papers.Asoodar, M., Janesarvatan, F., Yu, H. et al. Theoretical foundations and implications of augmented reality, virtual reality, and mixed reality for immersive learning in health professions education. Adv Simul 9, 36 (2024).Mühling, T., Späth, I., Backhaus, J. et al. Virtual reality in medical emergencies training: benefits, perceived stress, and learning success. Multimedia Systems 29, 2239–2252 (2023).Neher, A.N., Bühlmann, F., Müller, M. et al. Virtual reality for assessment in undergraduate nursing and medical education – a systematic review. BMC Med Educ 25, 292 (2025).Mixed reality will continue to be a promising area of growth and practical application in simulation and skills-based learning in medical education.Agentic AIWe spent a lot of time at OnExamination looking at how to optimize the learning paths of doctors preparing for postgraduate examinations. We got knee-high in statistics, python code, and algorithms but it was before the current AI breakthroughs with Large Language Models (and we didn't have banks of GPUs).Agentic AI - linking systems and using multiple scenarios - to create artificially intelligent 'agents' is being widely discussed in education. In fact it has been discussing agency for sometime - "To be an agent is to influence the course of events by one's actions." Albert Bandura, 2017. How AI might support (or replace - or is it displace?) human agency is an area of great interest.In 2025 Agentic AI may make progress in automating administrative tasks for medical education programmes and perhaps make better suggestions for collaboration with other learners, but probably not fulfil the promise of personalised learning paths, or adaptation to individual learners.Conversational AICould improved AI that engages in authentic conversation - and remember a lot of what it has discussed with the same learner before, and challenge the learner - narrow the gap in performance between 1:1 tutoring and other forms of learning? This challenge - the 2 Sigma problem - laid down by Benjamin Bloom in the 1980s is what a lot of elearning development has been trying to achieve.The astonishing advances in the conversation and safety of discussion in generative AI in the past year would suggest that this may be something that could be achieved.Should we get started now with whatever AI tools we have available to us and get used to working as the 'human in the loop'?Eachempati, P., Supe, A., Kumbargere Nagraj, S. et al. Integrating AI with healthcare expertise: Introducing the Health Care Professional-In-The-Loop Framework: Part 1. BDJ In Pract 38, 51–53 (2025)I'm sceptical. In 2025 Conversational AI will make great advances for many learners but still won't be reliable for the specialist learners in medical education.The (continuing) battle for platform LMSExamples of businesses in this space are:Relias - a healthcare workforce learning platform.MedShr Learning - a peer-to-peer learning management systemXpeer - a community designed for collaborative learningThere could be a breakthrough in 2025 with one - perhaps peer to peer - system gaining ground on the dominant medical education platforms.Micro-learningWill micro learning become even shorter? No, but it's effective.Monib WK, Qazi A, Apong RA. Microlearning beyond boundaries: A systematic review and a novel framework for improving learning outcomes. Heliyon. 2024 Dec 20;11(2):e41413.However, there's a problem. The learning moment for this is in the flow of work and electronic health records, search engines, or well-organised guidelines at a healthcare organisation have the monopoly of that opportunity. See ERP below.Enterprise Resource Planning (ERP)Real time insights from electronic healthcare records with integrated analytics could allow learning to be planned around patient needs, critical incidents, and clinical risks.There are large vendors in this area - for example:Cornerstone - a human resources and training software companyHealthstream Learning - a healthcare training LMSHowever, it could be "déjà vu all over again".Rose, C., Chen, J.H. Learning from the EHR to implement AI in healthcare. npj Digit. Med.7, 330 (2024).Many contracts will be signed and fees paid to consultants to integrate ERP systems in 2025 but there will be little in the way of innovation in education and it risks adding to the burden of healthcare staff having to validate suggested actions / reports / summaries.]]></description><link>https://deanjenkins.me/som/post.php?id=2886</link><guid>https://deanjenkins.me/som/post.php?id=2886</guid><pubDate>Wed, 15 Jan 2025 18:00:00 +0000</pubDate></item>
<item><title><![CDATA[The risks of automation of education]]></title><description><![CDATA[Unintended consequences such controlling the norms of behaviour and framing knowledge can be brought with automation ... and the problem is not a new one."Although intended as an act of freedom, the self-instruction provided by an Automatic Teacher also habituated learners to the authoritative norms underwriting self-regulation and self-governance. They not only learned to think in and about school subjects (arithmetic, geography, history), but also how to discipline themselves within this imposed structure. They were regulated not only through the knowledge and power embedded in the school subjects but also through the self-governance of their moral conduct. Both knowledge and personality were normalized in the minutiae of individualization and in the machinations of mass education."Petrina S. Sidney Pressey and the automation of education, 1924-1934. Technology and Culture. 2004;45(2):305-30.]]></description><link>https://deanjenkins.me/som/post.php?id=2885</link><guid>https://deanjenkins.me/som/post.php?id=2885</guid><pubDate>Wed, 18 Dec 2024 12:10:00 +0000</pubDate></item>
<item><title><![CDATA[Markov blankets: can they help explain learning from a systems perspective?]]></title><description><![CDATA[Every now and then you find something, described a long time ago (in this case 1988), that could have helped you if only you'd known about it. In supporting pharma companies I have used several approaches to explaining why learning is complex, non-linear, and how we should look at it from a systems perspective.At my previous company we advocated an approach based on the COM-B model - a synthesis of 19 behaviour change frameworks. It shows that changing behaviour usually requires multiple coordinated approaches and it provides a way of analysing which should be prioritised for a particular purpose.However, a recent unrelated-to-learning review paper (1) explains the complexity of the causal relationships in psychopathology using the concept of a Markov blanket. A Markov blanket helps define (statistically) the boundary of a system.Think of a Markov blanket as an area that protects what is inside from the surrounding random world. A comfort blanket - where the effects of the world only affect what is inside if they affect the blanket itself. It is a way of isolating something by defining its relationships with its nearest neighbours and giving it 'conditional independence' from factors outside. A Markov blanket describes a specific area of a Bayesian network.Could this be another way of describing the complexity of learning? Conceptually at least we could use it to explain a systems approach.A simple, linear approach to learning, for example in diabetes with an objective to prioritise glycaemic control, might be as follows:We assume that by changing physician competencies this will prioritise glycaemic control, which will improve patient outcomes.The real world however, is more complex. Many other factors may affect the objective of prioritising glycaemic control - such as physician self-efficacy, the competencies of the multidisciplinary team, the resources available, and the design of a particular clinical setting.If these other factors can be defined then they represent a possible Markov blanket for, in our case, prioritising glycaemic control. The blanket includes parent factors (in green) that directly affect the objective, and the other parents (i.e. spouses in pink) of the children (in yellow) of our objective.These are just proposed factors - to prove this mathematically we would need to make observations (hundreds of data points perhaps). However, it does form a hypothesis for how outcomes and impact measurements could be applied to measure a particular learning programme. Prioritising glycaemic control could be directly measured and patient outcomes could be analysed by clinical audit or checking electronic health records. Other indicators of improvement and other opportunities for intervention could be identified and outcomes measures defined for evaluating them.What do you think? What factors would be outside the Markov blanket in this example given? Are the systems factors identified here the right ones? What would such a Markov blanket look like for other therapy areas? Could a simulation be set up to test some of the assumptions? How would observations in the real world help confirm or modify the relationships? Could a quality improvement programme systematically explore these relationships over a period of time?(1) Briganti G, Scutari M, Epskamp S, Borsboom D, Hoekstra RH, Golino HF, Christensen AP, Morvan Y, Ebrahimi OV, Costantini G, Heeren A. Network analysis: An overview for mental health research. International Journal of Methods in Psychiatric Research. 2024 Dec;33(4):e2034.]]></description><link>https://deanjenkins.me/som/post.php?id=2884</link><guid>https://deanjenkins.me/som/post.php?id=2884</guid><pubDate>Mon, 25 Nov 2024 13:07:00 +0000</pubDate></item>
<item><title><![CDATA["Understanding by Design" session at the 17th European CME Forum]]></title><description><![CDATA[We are proud to be presenting a workshop at the 'Core Competencies in CME/CPD' session in the forthcoming 17th European CME Forum in Madrid.This approach to instructional design is one that we champion at Outcomes Engine when our tools are used or when we advise teams on how to develop their learning plans.Come and join the workshop. The big ideas for "Understanding by Design"[1] are teach and assess for understanding and transfer, and use backward design (what are the outcomes, how will we measure them, how will we deliver the learning to achieve them). This approach makes our CME/CPD more likely to have an impact on the practice of healthcare and the health of our patients. Learn how we can adapt this design process to our practice in healthcare.[1] Bowen, R. S. (2017). Understanding by Design. Vanderbilt University Center for Teaching. Retrieved [18 Oct 2024] from https://cft.vanderbilt.edu/understanding-by-design/.#outcomesengine #backwarddesign #learningoutcomes]]></description><link>https://deanjenkins.me/som/post.php?id=2882</link><guid>https://deanjenkins.me/som/post.php?id=2882</guid><pubDate>Fri, 18 Oct 2024 12:00:00 +0000</pubDate></item>
<item><title><![CDATA[My favourite tech hacks ... a thread]]></title><description><![CDATA[I started a thread on Bluesky of my favourite tech hacks earlier in the year and just added a couple more.Will keep a parallel list running here.Invidious (YouTube alternative front end - Not working so well Dec 2024)Pixabay (photos with appropriate Copyright)Etherpad (collaborate on a document with colleagues very easily)Cal (scheduling a call by sharing your availability)Organic Maps (offline maps based on OpenStreetMap)Humanitarian OpenStreetMap Team (volunteer in remote areas by mapping)Rallly (schedule a meeting with a group)Unsplash (another photo site with appropriate Copyright)Research Rabbit (explore research concepts based on connections between published works, great for literature reviews)yt1d.com (Grab a video for guaranteed playback when off line or during a presentation)]]></description><link>https://deanjenkins.me/som/post.php?id=2881</link><guid>https://deanjenkins.me/som/post.php?id=2881</guid><pubDate>Fri, 18 Oct 2024 00:52:00 +0000</pubDate></item>
<item><title><![CDATA[What would my peers say?]]></title><description><![CDATA["We're all used to giving our opinion with a Likert-type scale - choices from strongly disagree to strongly agree - but what if we were instead asked to predict what the overall score would be from our peers? Would using a prediction method be better than an opinion method?"From my LinkedIn article.]]></description><link>https://deanjenkins.me/som/post.php?id=2879</link><guid>https://deanjenkins.me/som/post.php?id=2879</guid><pubDate>Wed, 04 Sep 2024 00:04:23 +0000</pubDate></item>
<item><title><![CDATA[Designing for Outcomes: Putting the Learner at the Heart of Your Educational Strategy]]></title><description><![CDATA["Are you measuring educational outcomes but failing to capture the true impact on your learners? As a CME/CPD professional, you know that proving the effectiveness of your educational programs is crucial. But in the rush to gather data and report metrics, it's easy to overlook the individual learner's experience and perspective."Enjoyed joining Alex for one of her podcasts.]]></description><link>https://deanjenkins.me/som/post.php?id=2880</link><guid>https://deanjenkins.me/som/post.php?id=2880</guid><pubDate>Wed, 03 Apr 2024 00:29:12 +0000</pubDate></item>
<item><title><![CDATA[Deciphering ancient charred texts - the power of a prize.]]></title><description><![CDATA[The Vesuvius Prize reward has encouraged work on deciphering scans of ancient charred scrolls from Herculaneum."First passages of rolled-up Herculaneum scroll revealed Marchant, Jo. Nature 2024. ... Researchers used artificial intelligence to decipher the text of 2,000-year-old charred papyrus scripts, unveiling musings on music and capers."]]></description><link>https://deanjenkins.me/som/post.php?id=2878</link><guid>https://deanjenkins.me/som/post.php?id=2878</guid><pubDate>Mon, 05 Feb 2024 23:38:21 +0000</pubDate></item>
<item><title><![CDATA[65 Reasons To Celebrate The 6502]]></title><description><![CDATA["The legendary chip from 1975 that helped start the home computer revolution."I can remember sharing the manual for the 6502 with my school friend, Chris. He had a BBC micro computer and I had a Commodore Vic 20.To do the machine code I remember you had to:compile into 6502 instructions what you wanted to do yourself - probably on paper(the machine code had absolute power to read and change any memory address anywhere)write a BASIC function that 'poked' the individual 8 bit codes of those instructions into memorythen call that set of instructions as an assembler programWe were chuffed when we managed to draw a straight line from one point to another on the screen.]]></description><link>https://deanjenkins.me/som/post.php?id=2877</link><guid>https://deanjenkins.me/som/post.php?id=2877</guid><pubDate>Fri, 26 Jan 2024 00:26:53 +0000</pubDate></item>
<item><title><![CDATA[AI Watermarking Won't Curb Disinformation]]></title><description><![CDATA["Generative AI allows people to produce piles upon piles of images and words very quickly. It would be nice if there were some way to reliably distinguish AI-generated content from human-generated content. It would help people avoid endlessly arguing with bots online, or believing what a fake image purports to show."Article from the Electric Frontier Foundation explaining different watermarking techniques for text and images but unfortunately saying that none of them are likely to fully work against AI-generated content.The same is true for techniques trying to distinguish materials submitted by human students from fake ones written by AI.]]></description><link>https://deanjenkins.me/som/post.php?id=2875</link><guid>https://deanjenkins.me/som/post.php?id=2875</guid><pubDate>Mon, 22 Jan 2024 00:03:32 +0000</pubDate></item>
<item><title><![CDATA[Nightshade, the free tool that ‘poisons’ AI models, is now available for artists to use]]></title><description><![CDATA["The tool's creators are seeking to make it so that AI model developers must pay artists to train on data from them that is uncorrupted."Artists can now use this software to modify their art and influence the big tech owners of AI tools to properly recognise the original works.Growing the poisonous plant Belladona (deadly nightshade) on the other hand is prohibited in some countries.]]></description><link>https://deanjenkins.me/som/post.php?id=2874</link><guid>https://deanjenkins.me/som/post.php?id=2874</guid><pubDate>Sun, 21 Jan 2024 00:13:19 +0000</pubDate></item>
<item><title><![CDATA[Kenya's push to make 'boda-boda' motorbike taxis go electric]]></title><description><![CDATA["The government wants Kenya's three million motorbike taxi riders to go green but only a few have done so."I last went to Kenya over 10 years ago and I got around Kitale on the back of push bikes by local riders. Motorised bikes 'boda-boda' were only just being introduced at the time. Apparently there are motorbikes everywhere now ... and the price of the fairs have gone up.]]></description><link>https://deanjenkins.me/som/post.php?id=2873</link><guid>https://deanjenkins.me/som/post.php?id=2873</guid><pubDate>Sun, 21 Jan 2024 00:12:07 +0000</pubDate></item>
<item><title><![CDATA[Predicting students’ academic progress and related attributes in first-year medical students: an analysis with artificial...]]></title><description><![CDATA["BackgroundDropout and poor academic performance are persistent problems in medical schools in emerging economies. Identifying at-risk students early and knowing the factors that contribute to their success would be useful for designing educational interventions. Educational Data Mining (EDM) methods can identify students at risk of poor academic progress and dropping out. The main goal of this study was to use machine learning models, Artificial Neural Networks (ANN) and Naïve Bayes (NB), to identify first year medical students that succeed academically, using sociodemographic data and academic history.MethodsData from seven cohorts (2011 to 2017) of admitted medical students to the National Autonomous University of Mexico (UNAM) Faculty of Medicine in Mexico City were analysed. Data from 7,976 students (2011 to 2017 cohorts) of the program were included. Information from admission diagnostic exam results, academic history, sociodemographic characteristics and family environment was used. The main dataset included 48 variables. The study followed the general knowledge discovery process: pre-processing, data analysis, and validation. Artificial Neural Networks (ANN) and Naïve Bayes (NB) models were used for data mining analysis.ResultsANNs models had slightly better performance in accuracy, sensitivity, and specificity. Both models had better sensitivity when classifying regular students and better specificity when classifying irregular students. Of the 25 variables with highest predictive value in the Naïve Bayes model, percentage of correct answers in the diagnostic exam was the best variable.ConclusionsBoth ANN and Naïve Bayes methods can be useful for predicting medical students’ academic achievement in an undergraduate program, based on information of their prior knowledge and socio-demographic factors. Although ANN offered slightly superior results, Naïve Bayes made it possible to obtain an in-depth analysis of how the different variables influenced the model. The use of educational data mining techniques and machine learning classification techniques have potential in medical education."]]></description><link>https://deanjenkins.me/som/post.php?id=2872</link><guid>https://deanjenkins.me/som/post.php?id=2872</guid><pubDate>Sat, 20 Jan 2024 23:49:17 +0000</pubDate></item>
<item><title><![CDATA[Integrating basic sciences into clerkship rotation utilizing Kern’s six-step model of instructional design: lessons learned...]]></title><description><![CDATA[Worked example of curriculum design using Kern's six-step approach."Background It is generally agreed that basic and clinical sciences should be integrated throughout the undergraduate medical education, however, there is still need for continued formal integration of basic sciences into clinical clerkship in many medical schools across the globe. Methods Utilizing Kern’s Six-Step Model of Instructional Design, we aimed to develop an intervention that would facilitate cognitive integration of basic and clinical sciences. After problem identification and targeted needs assessment through focused group discussion with the students and faculty, objectives were devised with an implementation plan of using flipped class approach to develop a content-focused and learner-centered teaching strategy. This intervention was piloted in the 2-week cardiology clerkship in Year 5. Evaluation of the content, integration, student and faculty experiences were recorded through in-depth interviews, FGDs and a formative MCQ test. Results Flipped classroom based integrated sessions were successfully developed. The implementation phase was met with challenges that primarily stemmed from the diverse teaching styles among faculty members, hesitance to deviate from conventional practices, variations in clinic timings, and demanding schedules. Noteworthy observations were in terms of ownership of the project, the need for faculty development in modern student-centered teaching pedagogies, opportunities for content improvement, scheduling of sessions, and suggestion of revisiting fundamental concepts in basic sciences through a brief boot camp-style session at the onset of the clerkship. The role of flipped case model and clinical cases in integrating basic sciences into clinical sciences were appreciated by the students. Standardization in teaching practices was identified as the major challenge by the faculty. Conclusions A functional, learner-centered framework of cognitive integration of basic sciences in clinical sciences curriculum of cardiology rotation was developed with a potential to be implemented in other clerkship rotations."]]></description><link>https://deanjenkins.me/som/post.php?id=2871</link><guid>https://deanjenkins.me/som/post.php?id=2871</guid><pubDate>Thu, 18 Jan 2024 22:40:01 +0000</pubDate></item>
<item><title><![CDATA[OpenAI announces first partnership with a university]]></title><description><![CDATA["Starting in February, Arizona State University will have full access to OpenAI's ChatGPT Enterprise.""With the OpenAI partnership, ASU plans to build a personalized AI tutor for students, not only for certain courses, but also for study topics. STEM subjects are a focus and are “the make-or-break subjects for a lot of higher education,” Gonick said.The university will also use the tool in ASU’s largest course, Freshman Composition, to offer students writing help."A commercial sale to a University client and one that emphasises the support of learning. I wonder how science publishers will view this.]]></description><link>https://deanjenkins.me/som/post.php?id=2869</link><guid>https://deanjenkins.me/som/post.php?id=2869</guid><pubDate>Thu, 18 Jan 2024 17:32:01 +0000</pubDate></item>
<item><title><![CDATA[Microsoft Cloud AI Accelerates Search for New Battery Materials]]></title><description><![CDATA[Extremetech report that "Microsoft and Pacific Northwest National Laboratory used AI to narrow a list of 32 million candidate materials down to 18 in hours instead of years."]]></description><link>https://deanjenkins.me/som/post.php?id=2868</link><guid>https://deanjenkins.me/som/post.php?id=2868</guid><pubDate>Thu, 18 Jan 2024 00:46:15 +0000</pubDate></item>
<item><title><![CDATA[Three Epochs of Artificial Intelligence in Health Care Michael D. Howell. Greg S. Corrado. Karen B. DeSalvo. JAMA.]]></title><description><![CDATA[This Special Communication examines the evolution of artificial intelligence (AI) over the years, and how developments with AI can help decision-makers improve health care while also recognizing its risks.]]></description><link>https://deanjenkins.me/som/post.php?id=2867</link><guid>https://deanjenkins.me/som/post.php?id=2867</guid><pubDate>Wed, 17 Jan 2024 21:53:35 +0000</pubDate></item>
<item><title><![CDATA[A checklist for reporting, reading and evaluating Artificial Intelligence Technology Enhanced Learning (AITEL) research...]]></title><description><![CDATA["This paper proposes a checklist for reporting on AI systems, and covers the initial protocols and scoping, modelling and code, algorithm design, training data, testing and validation, usage, comparisons, real-world requirements, results and limitations, and ethical considerations. The aim is to have a systematic reporting process so that readers can have a comprehensive understanding of the AI system that was used in the research."The AITEL reporting checklist.Part 1: Protocols and scopingPart 2: Modelling and codePart 3: Algorithm designPart 4: Training data (if M-L)Part 5: Testing/validation (new systems)Part 6: Use/testing/validation (known systems)Part 7: Comparisons (if comparisons are made)Part 8: Real-world requirementsPart 9: ResultsPart 10: DiscussionPart 11: Ethics]]></description><link>https://deanjenkins.me/som/post.php?id=2866</link><guid>https://deanjenkins.me/som/post.php?id=2866</guid><pubDate>Wed, 17 Jan 2024 08:44:25 +0000</pubDate></item>
<item><title><![CDATA[Apple knew AirDrop users could be identified and tracked as early as 2019, researchers say | CNN Business]]></title><description><![CDATA[Security researchers warned Apple as early as 2019 about vulnerabilities in its AirDrop wireless sharing function that Chinese authorities claim they recently used to track down users of the feature, the researchers told CNN, in a case that experts say has sweeping implications for global privacy.]]></description><link>https://deanjenkins.me/som/post.php?id=2865</link><guid>https://deanjenkins.me/som/post.php?id=2865</guid><pubDate>Tue, 16 Jan 2024 22:03:12 +0000</pubDate></item>
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