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Article ; Online: Novel Pulsed Ultrahigh-frequency Spinal Cord Stimulation Inhibits Mechanical Hypersensitivity and Brain Neuronal Activity in Rats after Nerve Injury.

Yang, Chin-Tsang / Guan, Yun / Chen, Chih-Cheng / Lin, Wei-Tso / Lu, Kuo-Hsiang / Lin, Chung-Ren / Shyu, Bai-Chuang / Wen, Yeong-Ray

Anesthesiology

2023 Volume 139, Issue 5, Page(s) 646–663

Language	English
Publishing date	2023-07-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	269-0
ISSN	1528-1175 ; 0003-3022
ISSN (online)	1528-1175
ISSN	0003-3022
DOI	10.1097/ALN.0000000000004680
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Article: Risk of Acute Myocardial Infarction in Pneumoconiosis: Results from a Retrospective Cohort Study.

Chang, Ju-Hsin / Shen, Te-Chun / Chen, Ke-Wei / Lin, Cheng-Li / Hsu, Chung Y / Wen, Yeong-Ray / Chang, Kuan-Cheng

Biomedicines

2023 Volume 11, Issue 3

Abstract: Background: Pneumoconiosis (PCN) has several comorbidities, most notably pulmonary and cardiovascular diseases. However, much is still unknown about the relationship between PCN and acute myocardial infarction (AMI). The present study aimed to clarify ... ...

Abstract	Background: Pneumoconiosis (PCN) has several comorbidities, most notably pulmonary and cardiovascular diseases. However, much is still unknown about the relationship between PCN and acute myocardial infarction (AMI). The present study aimed to clarify the association between PCN and subsequent AMI risk using a retrospective cohort study design. Methods: This was a population-based, retrospective cohort study that used data from Taiwan's National Health Insurance Database. A total of 7556 newly diagnosed patients with PCN and 7556 individuals without PCN were included in the PCN and comparison cohort (PC and CC), respectively, between 2008 and 2018, with propensity score matching for age, gender, comorbidity, medication, and date of PCN diagnosis. The occurrence of AMI was monitored until the end of 2019, and AMI risk was assessed using Cox proportional hazard regression models. Results: The overall incidence of AMI was 1.34-fold higher in the PC than in the CC (4.33 vs. 3.23 per 1000 person-years, respectively, Conclusion: Patients with PCN had a significantly higher risk of developing AMI than those without PCN. Clinicians should pay more attention to prevent AMI episodes in patients with PCN.
Language	English
Publishing date	2023-03-14
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2720867-9
ISSN	2227-9059
ISSN	2227-9059
DOI	10.3390/biomedicines11030897
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Article ; Online: Risk of Acute Myocardial Infarction in Pneumoconiosis

Ju-Hsin Chang / Te-Chun Shen / Ke-Wei Chen / Cheng-Li Lin / Chung Y. Hsu / Yeong-Ray Wen / Kuan-Cheng Chang

Biomedicines, Vol 11, Iss 897, p

Results from a Retrospective Cohort Study

2023 Volume 897

Abstract	Background: Pneumoconiosis (PCN) has several comorbidities, most notably pulmonary and cardiovascular diseases. However, much is still unknown about the relationship between PCN and acute myocardial infarction (AMI). The present study aimed to clarify the association between PCN and subsequent AMI risk using a retrospective cohort study design. Methods: This was a population-based, retrospective cohort study that used data from Taiwan’s National Health Insurance Database. A total of 7556 newly diagnosed patients with PCN and 7556 individuals without PCN were included in the PCN and comparison cohort (PC and CC), respectively, between 2008 and 2018, with propensity score matching for age, gender, comorbidity, medication, and date of PCN diagnosis. The occurrence of AMI was monitored until the end of 2019, and AMI risk was assessed using Cox proportional hazard regression models. Results: The overall incidence of AMI was 1.34-fold higher in the PC than in the CC (4.33 vs. 3.23 per 1000 person-years, respectively, p < 0.05), with an adjusted hazard ratio (aHR) of 1.36 (95% confidence interval (CI): 1.08–1.72) after controlling for age, gender, comorbidity, and medication. Further analyses showed a higher risk of AMI with increased annual number of emergency department visits among patients with PCN (aHR: 1.30, 95% CI: 1.01–1.66 (<1) and aHR: 1.68, 95% CI: 1.13–2.50 (≥1)). Conclusion: Patients with PCN had a significantly higher risk of developing AMI than those without PCN. Clinicians should pay more attention to prevent AMI episodes in patients with PCN.
Keywords	interstitial lung disease (ILD) ; pneumoconiosis ; coronary artery disease (CAD) ; acute myocardial infarction (AMI) ; Biology (General) ; QH301-705.5
Subject code	610
Language	English
Publishing date	2023-03-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
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Article ; Online: Efficacy and safety of cervicothoracic epidural blood patch for patients with spontaneous intracranial hypotension.

Hsu, Chieh-Min / Liu, Yu-Cheng / Chen, Ying-Chu / Fuh, Jong-Ling / Huang, Hui-Chun / Wang, Yen-Feng / Chiang, I-Ying / Wen, Yeong-Ray

Pain practice : the official journal of World Institute of Pain

2022 Volume 22, Issue 6, Page(s) 586–591

Abstract: Background: Epidural blood patch (EBP) is a generally effective treatment for spontaneous intracranial hypotension (SIH) caused by cerebrospinal fluid (CSF) leakage through the spinal dura mater. It is still unclear; however, whether application near ... ...

Abstract	Background: Epidural blood patch (EBP) is a generally effective treatment for spontaneous intracranial hypotension (SIH) caused by cerebrospinal fluid (CSF) leakage through the spinal dura mater. It is still unclear; however, whether application near the leakage site (targeted EBP) is more effective than distal application (untargeted EBP). Further, EBP targeted to high thoracic or cervical spine levels is infrequent due to greater technical requirements and potential complications. Here, we examined the safety and efficacy of EBP applied to high thoracic or cervical spine levels. Methods: We retrospectively reviewed the clinical and outcome data of 13 patients receiving cervical or high thoracic EBP for SIH. All patients were referred by neurologists following poor response to conservative treatment and presented with persistent headache aggravated by orthostatic changes. Results: Neuroimaging confirmed CSF leakage and targeted EBP resulted in immediate pain improvement. Repeated injections provided additional improvement for patients with recurrent headache. No serious adverse events were documented during follow-up. Conclusion: Based on recent studies and our clinical experience, we conclude that EBP targeted to the high thoracic and cervical spine is safe and effective for early-stage SIH.
MeSH term(s)	Blood Patch, Epidural/methods ; Cerebrospinal Fluid Leak/complications ; Cerebrospinal Fluid Leak/therapy ; Cervical Vertebrae ; Headache/complications ; Headache/therapy ; Humans ; Intracranial Hypotension/complications ; Intracranial Hypotension/diagnostic imaging ; Intracranial Hypotension/therapy ; Magnetic Resonance Imaging ; Retrospective Studies
Language	English
Publishing date	2022-05-27
Publishing country	United States
Document type	Case Reports
ZDB-ID	2151272-3
ISSN	1533-2500 ; 1530-7085
ISSN (online)	1533-2500
ISSN	1530-7085
DOI	10.1111/papr.13126
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Article: Prescription Opioid Use among Patients with Chronic Noncancer Pain before and after the COVID-19 Outbreak in Taiwan: A Multicenter Prospective Observational Study.

Chen, Jia-Lin / Ho, Shung-Tai / Sun, Wei-Zen / Tsai, Yu-Chuan / Cheng, Kuang-I / Liu, Yen-Chin / Hsieh, Yi-Jer / Wen, Yeong-Ray / Wang, Po-Kai / Sung, Chun-Sung / Yeh, Chun-Chang / Lin, Tso-Chou

Healthcare (Basel, Switzerland)

2022 Volume 10, Issue 12

Abstract: Background: The COVID-19 outbreak disrupted medical access for patients receiving chronic opioid therapy. This study investigated their prescription opioid dosages before and after the 2020 outbreak in Taiwan.: Methods: A prospective questionnaire ... ...

Abstract	Background: The COVID-19 outbreak disrupted medical access for patients receiving chronic opioid therapy. This study investigated their prescription opioid dosages before and after the 2020 outbreak in Taiwan. Methods: A prospective questionnaire survey was conducted among registered outpatients receiving long-term opioids before July 2019 in Taiwan. The questionnaire included items from the Taiwanese Brief Pain Inventory and quality of life assessment. Follow-up surveys in outpatient departments through October 2020 were conducted to collect opioid prescription data. Results: After a mean of 531 days, the questionnaire responses of 103 of the initial 117 respondents were reviewed. Daily opioid doses decreased for 31 respondents (30.1%), remained roughly equivalent (defined as ±2.5%) for 27 (26.2%), and increased for 45 (43.7%) after the first wave of the pandemic. The use of strong opioids and nonopioid medications did not significantly differ among the three groups, but less fentanyl patch use was noted in the decreased-dose group after the outbreak. More than 70% of the patients received daily high-dose opioids (≥90 morphine milligram equivalents); moreover, 60% reported constipation. No deaths due to opioid overdose occurred during the study period. Conclusions: The COVID-19 outbreak in 2020 did not interrupt access to long-term opioid prescriptions for most registered patients with chronic pain in Taiwan. Less fentanyl patch use was observed in participants whose opioid dose was tapering.
Language	English
Publishing date	2022-12-06
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2721009-1
ISSN	2227-9032
ISSN	2227-9032
DOI	10.3390/healthcare10122460
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Article ; Online: Behavioral Survey of Effects of Pulsed Radiofrequency on Neuropathic and Nociceptive Pain in Rats: Treatment Profile and Device Implantation.

Huang, Ren-Yu / Poree, Lawrence / Ho, Kok-Yuen / Tsai, Shih-Ying / Liu, Yu-Chen / Tan, Ping-Heng / Wen, Yeong-Ray

Neuromodulation : journal of the International Neuromodulation Society

2020 Volume 24, Issue 8, Page(s) 1458–1466

Abstract: Objectives: Pulsed radiofrequency (PRF) stimulation is widely used for intractable pain; however, there is no consensus on treatment protocols and appropriate types of pain. We compared effectiveness of bipolar and unipolar PRF on neuropathic or ... ...

Abstract	Objectives: Pulsed radiofrequency (PRF) stimulation is widely used for intractable pain; however, there is no consensus on treatment protocols and appropriate types of pain. We compared effectiveness of bipolar and unipolar PRF on neuropathic or inflammatory pains, and of targets at the dorsal root ganglion (DRG) and sciatic nerve (SN). We also examined efficacy of repetitive PRF stimulations. This preclinical study could serve as an extensive survey before human trials. Materials: Spare nerve injury (SNI)-induced neuropathic pain and complete Freund's adjuvant (CFA) injection-induced inflammatory pain were used. Behavioral responses were measured using von Frey test, acetone test, and Hargreave's test at preinjury and postinjury time points. In both models, we evaluated results of DRG stimulation with unipolar PRF (45 V) versus bipolar PRF (5 V), stimulation at DRG vs. SN, and repetitive stimulations. Results: Both unipolar and bipolar PRFs reduced SNI- or CFA-induced pain for a similar duration. In the SNI model, PRF-DRG had a stronger effect on tactile pain than PRF-SN but lower effect on cold allodynia, whereas in the CFA model PRF-DRG and PRF-SN showed similar effects. Repetitive PRF stimulation, by open technique or implantation method, produced analogous effect by each stimulus, and no evident analgesic tolerance or neurological deficit was shown. Conclusions: PRF temporarily attenuates neuropathic and inflammatory pain. Bipolar PRF generates significant analgesia with a much lower electrical power than unipolar PRF. Meanwhile, the minor variant effects between PRF-DRG and PRF-SN may indicate distinct mechanisms. The sustained-analgesia by repetitive treatments suggests implantation technique could be a promising choice.
MeSH term(s)	Animals ; Disease Models, Animal ; Ganglia, Spinal ; Neuralgia/therapy ; Nociceptive Pain ; Pulsed Radiofrequency Treatment ; Rats ; Rats, Sprague-Dawley
Language	English
Publishing date	2020-06-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	1500372-3
ISSN	1525-1403 ; 1094-7159
ISSN (online)	1525-1403
ISSN	1094-7159
DOI	10.1111/ner.13169
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Article ; Online: Gender Differences in Depression and Sex Hormones among Patients Receiving Long-Term Opioid Treatment for Chronic Noncancer Pain in Taiwan-A Multicenter Cross-Sectional Study.

Ho, Shung-Tai / Lin, Tso-Chou / Yeh, Chun-Chang / Cheng, Kuang-I / Sun, Wei-Zen / Sung, Chun-Sung / Wen, Yeong-Ray / Hsieh, Yi-Jer / Wang, Po-Kai / Liu, Yen-Chin / Tsai, Yu-Chuan

International journal of environmental research and public health

2021 Volume 18, Issue 15

Abstract: Background: Long-term use of opioids for chronic noncancer pain is associated with sex hormone disturbances. The interferences with sex hormones, sexual function, and depression were investigated in patients with chronic noncancer pain.: Methods: A ... ...

Abstract	Background: Long-term use of opioids for chronic noncancer pain is associated with sex hormone disturbances. The interferences with sex hormones, sexual function, and depression were investigated in patients with chronic noncancer pain. Methods: A cross-sectional multicenter survey was conducted on 170 officially registered outpatients receiving long-term opioid treatment in nine medical centers in Taiwan between October 2018 and July 2019. Serum sex hormone levels were examined after the collection of self-administered questionnaires containing the Taiwanese version of the Brief Pain Inventory, depressive status, and sexual function interference. Results: Among 117 (68.8%) questionnaire responses from 170 enrolled outpatients, 38 women and 62 men completed the sex hormone tests, among whom only 23 (23%) had previously received blood hormone tests. Low serum total testosterone levels were detected in 34 (89.5%) women (<30 ng/dL) and 31 (50%) men (<300 ng/dL). Over 60% of women and men reported reduced sexual desire and function despite a nearly 50% reduction in pain intensity and daily function interference over the previous week after opioid treatment. Women generally had higher risks of a depression diagnosis ( Conclusions: This survey demonstrated the high prevalence of depression diagnosis, low sex hormone levels, and reduced sexual function among Taiwanese patients with chronic noncancer pain receiving prolonged opioid therapy. Regular hypogonadal screenings are recommended for further management.
MeSH term(s)	Analgesics, Opioid/therapeutic use ; Chronic Pain/drug therapy ; Chronic Pain/epidemiology ; Cross-Sectional Studies ; Depression/drug therapy ; Depression/epidemiology ; Female ; Gonadal Steroid Hormones ; Humans ; Male ; Sex Factors ; Taiwan/epidemiology
Chemical Substances	Analgesics, Opioid ; Gonadal Steroid Hormones
Language	English
Publishing date	2021-07-23
Publishing country	Switzerland
Document type	Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph18157837
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Article ; Online: miR-200a-3p modulates gene expression in comorbid pain and depression: Molecular implication for central sensitization.

Satyanarayanan, Senthil Kumaran / Shih, Yin-Hwa / Wen, Yeong-Ray / Palani, Mahalakshmi / Lin, Yi-Wen / Su, Huanxing / Gałecki, Piotr / Su, Kuan-Pin

Brain, behavior, and immunity

2019 Volume 82, Page(s) 230–238

Abstract: Chronic pain and depression are often comorbid exhibiting common clinical presentations and biological connections related to central nervous system sensitization. Epigenetic regulation of gene expression in the brain plays a crucial role in response to ... ...

Abstract	Chronic pain and depression are often comorbid exhibiting common clinical presentations and biological connections related to central nervous system sensitization. Epigenetic regulation of gene expression in the brain plays a crucial role in response to long-lasting stress and chronic pain, and microRNA imbalance in the prefrontal cortex (PFC) might be involved in central sensitization. Male Sprague Dawley rats were subjected to unpredictable chronic mild stress (UCMS) and spared nerve injury (SNI) to initiate depressive-like behavior and chronic pain behavior, respectively. The next-generation sequencing technique was employed to analyze PFC microRNAs in both the UCMS and SNI models. Rats exposed to either UCMS or SNI exhibited both depressive-like and chronic pain behaviors. Five specific microRNAs (miR-10a-5p, miR-182, miR-200a-3p, miR-200b-3p, and miR-429) were simultaneously down-regulated in the depressive-like and chronic pain models after 4 weeks of short-term stress. Gene ontology revealed that the 4-week period of stress enhanced neurogenesis. Only the miR-200a-3p level was continuously elevated under prolonged stress, suggesting roles of reduced neurogenesis, inflammatory activation, disturbed circadian rhythm, lipid metabolism, and insulin secretion in the co-existence of pain and depression. Thus we conclude that miR-200a-3p might be a specific biomarker of central sensitization in chronic pain and depression.
MeSH term(s)	Animals ; Central Nervous System Sensitization/genetics ; Comorbidity ; Depression/genetics ; Depression/metabolism ; Depressive Disorder/genetics ; Depressive Disorder/metabolism ; Disease Models, Animal ; Epigenesis, Genetic ; Gene Expression ; Male ; MicroRNAs/genetics ; MicroRNAs/metabolism ; Pain/genetics ; Pain/metabolism ; Rats ; Rats, Sprague-Dawley ; Stress, Psychological/metabolism
Chemical Substances	MIRN200 microRNA, rat ; MicroRNAs
Language	English
Publishing date	2019-08-31
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639219-2
ISSN	1090-2139 ; 0889-1591
ISSN (online)	1090-2139
ISSN	0889-1591
DOI	10.1016/j.bbi.2019.08.190
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Zs.A 2276: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Ovarian Hormone-dependent and Spinal ERK Activation-regulated Nociceptive Hypersensitivity in Female Rats with Acid Injection-induced Chronic Widespread Muscle Pain.

Chang, Ju-Hsin / Tsai, Shih-Ying / Zeng, Yen-Jing / Liu, Yu-Cheng / Li, Chi-Yuan / Chen, Kuen-Bao / Wen, Yeong-Ray

Scientific reports

2019 Volume 9, Issue 1, Page(s) 3077

Abstract: Symptoms of chronic widespread muscle pain (CWP) meet most of the diagnostic criteria for fibromyalgia syndrome, which is prevalent in females. We used an acid injection-induced muscle pain (AIMP) model to mimic CWP. After female rats received an ... ...

Abstract	Symptoms of chronic widespread muscle pain (CWP) meet most of the diagnostic criteria for fibromyalgia syndrome, which is prevalent in females. We used an acid injection-induced muscle pain (AIMP) model to mimic CWP. After female rats received an ovariectomy (OVX), acid saline solution was injected into the left gastrocnemius muscle. Time courses of changes in pain behaviours and p-ERK in the spinal cord were compared between groups. Intrathecal injections of oestradiol (E2) to the OVX group before two acid injections and E2 or progesterone (P4) injections in male rats were compared to evaluate hormone effects. We found that repeated acid injections produced mechanical hypersensitivity and enhanced p-ERK expression in the spinal dorsal horn. OVX rats exhibited significantly less tactile allodynia than did the rats in the other groups. The ERK inhibitor U0126 alleviated mechanical allodynia with lower p-ERK expression in the sham females but did not affect the OVX rats. Intrathecal E2 reversed the attenuated mechanical hypersensitivity in the OVX group, and E2 or P4 induced transient hyperalgesia in male rats. Accordingly, our results suggested that ovarian hormones contribute to AIMP through a spinal p-ERK-mediated pathway. These findings may partially explain the higher prevalence of fibromyalgia in females than males.
MeSH term(s)	Acids ; Animals ; Chronic Pain/chemically induced ; Chronic Pain/metabolism ; Disease Models, Animal ; Enzyme Activation ; Estradiol/metabolism ; Extracellular Signal-Regulated MAP Kinases/metabolism ; Female ; Fibromyalgia/metabolism ; Injections ; Male ; Myalgia/chemically induced ; Myalgia/metabolism ; Progesterone/metabolism ; Rats ; Rats, Sprague-Dawley ; Spinal Cord/metabolism
Chemical Substances	Acids ; Progesterone (4G7DS2Q64Y) ; Estradiol (4TI98Z838E) ; Extracellular Signal-Regulated MAP Kinases (EC 2.7.11.24)
Language	English
Publishing date	2019-02-28
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-019-39472-z
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Article ; Online: Gender Differences in Depression and Sex Hormones among Patients Receiving Long-Term Opioid Treatment for Chronic Noncancer Pain in Taiwan—A Multicenter Cross-Sectional Study

Shung-Tai Ho / Tso-Chou Lin / Chun-Chang Yeh / Kuang-I Cheng / Wei-Zen Sun / Chun-Sung Sung / Yeong-Ray Wen / Yi-Jer Hsieh / Po-Kai Wang / Yen-Chin Liu / Yu-Chuan Tsai

International Journal of Environmental Research and Public Health, Vol 18, Iss 7837, p

2021 Volume 7837

Abstract	Background: Long-term use of opioids for chronic noncancer pain is associated with sex hormone disturbances. The interferences with sex hormones, sexual function, and depression were investigated in patients with chronic noncancer pain. Methods: A cross-sectional multicenter survey was conducted on 170 officially registered outpatients receiving long-term opioid treatment in nine medical centers in Taiwan between October 2018 and July 2019. Serum sex hormone levels were examined after the collection of self-administered questionnaires containing the Taiwanese version of the Brief Pain Inventory, depressive status, and sexual function interference. Results: Among 117 (68.8%) questionnaire responses from 170 enrolled outpatients, 38 women and 62 men completed the sex hormone tests, among whom only 23 (23%) had previously received blood hormone tests. Low serum total testosterone levels were detected in 34 (89.5%) women (<30 ng/dL) and 31 (50%) men (<300 ng/dL). Over 60% of women and men reported reduced sexual desire and function despite a nearly 50% reduction in pain intensity and daily function interference over the previous week after opioid treatment. Women generally had higher risks of a depression diagnosis ( p = 0.034) and severe depressive symptoms ( p = 0.003) and nonsignificantly lower opioid treatment duration (median 81 vs. 120 months) and morphine milligram equivalent (median 134 vs. 165 mg/day) compared with men. Conclusions: This survey demonstrated the high prevalence of depression diagnosis, low sex hormone levels, and reduced sexual function among Taiwanese patients with chronic noncancer pain receiving prolonged opioid therapy. Regular hypogonadal screenings are recommended for further management.
Keywords	chronic pain ; opioid ; gender difference ; depression ; sex hormone ; Medicine ; R
Subject code	150
Language	English
Publishing date	2021-07-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
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