What does it mean to start a PHP function with an ampersand?

An ampersand before a function name means the function will return a reference to a variable instead of the value.

Returning by reference is useful when
you want to use a function to find to
which variable a reference should be
bound. Do not use return-by-reference
to increase performance. The engine
will automatically optimize this on
its own. Only return references when
you have a valid technical reason to
do so.

See Returning References.

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