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This year less than 200 National Library of Medicine indexers expect to index 1 million articles, and this would not be possible without the assistance of the Medical Text Indexer (MTI) system. MTI is an automated indexing system that provides MeSH main heading/subheading pair recommendations to assist indexers with their heavy workload. Over the years, a lot of research effort has focused on improving main heading prediction performance, but automated fine-grained indexing with main heading/subheading pairs has received much less atten