Publications by authors named "Shreya M Shah"

20 Publications

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A prospective cohort study on the epidemiology of ocular trauma associated with closed-globe injuries in pediatric age group.

Indian J Ophthalmol 2022 02;70(2):707

Vitreoretina Shreya Shah-Pediatric Ophthalmology, Drashti Netralaya, Dahod, Gujarat, India.

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http://dx.doi.org/10.4103/ijo.IJO_2335_21DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9023925PMC
February 2022

Therapeutic implications of germline vulnerabilities in DNA repair for precision oncology.

Cancer Treat Rev 2022 Mar 5;104:102337. Epub 2022 Jan 5.

Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, United States; Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA, United States. Electronic address:

DNA repair vulnerabilities are present in a significant proportion of cancers. Specifically, germline alterations in DNA repair not only increase cancer risk but are associated with treatment response and clinical outcomes. The therapeutic landscape of cancer has rapidly evolved with the FDA approval of therapies that specifically target DNA repair vulnerabilities. The clinical success of synthetic lethality between BRCA deficiency and poly(ADP-ribose) polymerase (PARP) inhibition has been truly revolutionary. Defective mismatch repair has been validated as a predictor of response to immune checkpoint blockade associated with durable responses and long-term benefit in many cancer patients. Advances in next generation sequencing technologies and their decreasing cost have supported increased genetic profiling of tumors coupled with germline testing of cancer risk genes in patients. The clinical adoption of panel testing for germline assessment in high-risk individuals has generated a plethora of genetic data, particularly on DNA repair genes. Here, we highlight the therapeutic relevance of germline aberrations in DNA repair to identify patients eligible for precision treatments such as PARP inhibitors (PARPis), immune checkpoint blockade, chemotherapy, radiation therapy and combined treatment. We also discuss emerging mechanisms that regulate DNA repair.
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http://dx.doi.org/10.1016/j.ctrv.2021.102337DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9016579PMC
March 2022

A prospective cohort study on the epidemiology of ocular trauma associated with closed-globe injuries in pediatric age group.

Indian J Ophthalmol 2020 03;68(3):500-503

Department of Pediatric Ophthalmology, Drashti Netralaya, Dahod, Gujarat, India.

Purpose: To study the epidemiology of mechanical ocular trauma and closed globe injury using the Birmingham Eye Trauma Terminology System in patients belonging to the pediatric age group.

Methods: This work involved a prospective cohort study of all ocular trauma patients (pediatric age group) registered between 2002 and 2017 at the ocular trauma care center. The data were collected using the international ocular trauma society form through our online MIS data and exported to the Excel sheet. The statistical analyses including the univariate analysis and cross tabulation were carried out using SPSS 22 software.

Results: Our cohort consisted of 12687 patients with mechanical ocular trauma. There were 7546 (59.4%) eyes with open globe ocular injuries and 5328 (41.9%) with closed globe injuries. Of all closed globe injury patients, 1010 (19.0%) belonged to the pediatric age group (0-18 years), including 690 males (68.3%) and 320 females (31.7%). The mean age of the patients was 10.2 ± 5.1 years. Of all closed globe injuries, 692 (68.5%) were closed globe contusion and 318 (31.5%) were lamellar laceration.

Conclusion: Closed globe injury is an important in cause of vision loss in children (24% <1/60). The condition is more prevalent in males and >51.7% in children under 10 years of age. The treatment has significant impact on the visual outcome in patients belonging to the pediatric age group.
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http://dx.doi.org/10.4103/ijo.IJO_463_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7043148PMC
March 2020

Innovative cost-effective method to repair lacrimal cannaliculi laceration - finding proximal end and stent.

GMS Ophthalmol Cases 2019 31;9:Doc20. Epub 2019 May 31.

Drashti Netralaya, Dahod, Gujarat, India.

To explore a new technique to find out the proximal end of lacerated canaliculi and a new material for the stent. Surgery was performed on 9 eyes of 9 patients using a 5/0 prolene suture needle as a modified probe. Prolene suture was inserted as a stent and left in place for two months. All the data were analyzed. The surgery was successful in all cases and the prolene were removed after two months. The mean follow-up time after the tube removal was 3.8 months (range 3-6 months). No other complications associated with the prolene sutures were noticed except for epiphora and corneal irritation in three cases. All the tubes were removed successfully without any difficulty. No iatrogenic injuries occurred during prolene removal. The reported surgical technique is a very cost-effective option for lacrimal canalicular laceration repair.
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http://dx.doi.org/10.3205/oc000109DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6607446PMC
May 2019

Comparative study of visual outcome between open- and closed-globe injuries following surgical treatment of traumatic cataract in children.

Eur J Ophthalmol 2018 Jul 26;28(4):406-411. Epub 2018 Feb 26.

Drashti Netralaya, Dahod, Gujarat, India.

Objective: To compare final visual outcomes of surgically treated traumatic cataract between open-globe and closed-globe injuries in children, as classified by the Birmingham Eye Trauma Terminology system.

Methods: This is an observational cohort study with permission from Hospital Ethical Committee. We enrolled children meeting specific inclusion criteria, examined their eyes to review any co-morbidities due to trauma, performed surgery for traumatic cataracts, and implanted lenses. The patients were re-examined postoperatively. We classified the cases of traumatic cataract as either open-globe (Group 1) or closed-globe (Group 2) according to the Birmingham Eye Trauma Terminology system and compared visual acuity.

Result: Our study cohort of 1076 eyes with traumatic cataracts included 405 eyes in Group 1 and 671 in Group 2. Postoperatively, the visual acuity was >20/60 in 223 (55.3%) and 377 (56.3%) operated eyes in Groups 1 and 2, respectively ( p < 0.001, analysis of variance). With further follow-up, >20/60 vision was significantly higher in Group 2 as compared to Group 1 (odds ratio = 1.61; 95% confidence interval = 0.85-3.02). Overall, 600 eyes (55.7%) regained final visual acuity >20/60.

Conclusion: Closed-globe injury has more favourable prognosis for the satisfactory (>20/60) visual recovery after effective management of traumatic cataracts in children.
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http://dx.doi.org/10.1177/1120672117747021DOI Listing
July 2018

Pediatric ocular trauma score as a prognostic tool in the management of pediatric traumatic cataracts.

Graefes Arch Clin Exp Ophthalmol 2017 May 22;255(5):1027-1036. Epub 2017 Feb 22.

Drashti Netralaya, Nr. GIDC, Chakalia Road, Dahod, 389151, Gujarat, India.

Objective: To introduce and validate the pediatric ocular trauma score (POTS) - a mathematical model to predict visual outcome trauma in children with traumatic cataract METHODS: In this retrospective cohort study, medical records of consecutive children with traumatic cataracts aged 18 and below were retrieved and analysed. Data collected included age, gender, visual acuity, anterior segment and posterior segment findings, nature of surgery, treatment for amblyopia, follow-up, and final outcome was recorded on a precoded data information sheet. POTS was derived based on the ocular trauma score (OTS), adjusting for age of patient and location of the injury. Visual outcome was predicted using the OTS and the POTS and using receiver operating characteristic (ROC) curves.

Results: POTS predicted outcomes were more accurate compared to that of OTS (p = 0.014).

Conclusion: POTS is a more sensitive and specific score with more accurate predicted outcomes compared to OTS, and is a viable tool to predict visual outcomes of pediatric ocular trauma with traumatic cataract.
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http://dx.doi.org/10.1007/s00417-017-3616-yDOI Listing
May 2017

Lens siderosis resulting from a small intralenticular metallic foreign body.

GMS Ophthalmol Cases 2015 2;5:Doc12. Epub 2015 Nov 2.

Drashti Netralaya, Dahod, Gujarat, India.

We report a rare case of lens siderosis with an undetectable intraocular foreign body by imaging. An 8-year-old boy presented with diminution of vision in the left eye since 3 months. His parents gave a preceding uncertain history of a foreign body injury to his left eye 3 months ago while playing. Presenting visual acuity in the left eye was perception of hand movements. Slit-lamp examination revealed a total white cataract with brownish-pigmented spots on the anterior capsule of the lens, but no intraocular foreign body was found. There was also no evidence of an intraocular foreign body on ultrasonography. Patient underwent cataract extraction with intraocular lens implantation. During the operation, a small (2×1×1 mm in size) intralenticular foreign body of metal material was found and removed carefully with a magnet. The patient regained 20/30 vision after surgery.
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http://dx.doi.org/10.3205/oc000034DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5015631PMC
September 2016

Spontaneous dislocation of lens bag with acrylic lens after uneventful cataract surgery - unusual complication of cataract surgery.

GMS Ophthalmol Cases 2015 2;5:Doc11. Epub 2015 Nov 2.

Drashti Netralaya, Dahod, Gujarat, India.

Introduction: Spontaneous dislocation of intraocular lens with bag is rare.

Methods: We report a case of a 56-year-old male who presented with spontaneous anterior dislocation of an in-the-bag intraocular lens 3 years after manual small incision cataract surgery. He had undergone manual small incision cataract surgery with foldable acrylic intraocular lens implantation, and 18 months after cataract surgery ND: YAG capsulotomy with uneventful post capsulotomy follow-up. 17 months after capsulotomy, the patient presented with sudden decrease of vision. On anterior segment examination, the intraocular lens with bag was dislocated into the anterior chamber.

Result: It was managed with intraocular lens explantation with bag, anterior vitrectomy and sclera fixated intraocular lens.

Conclusion: Spontaneous intraocular lens dislocation with bag is possible after 1.5 years of uneventful surgery which may be managed using different techniques.
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http://dx.doi.org/10.3205/oc000033DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5015627PMC
September 2016

Maximizing the visual outcome in traumatic cataract cases: The value of a primary posterior capsulotomy and anterior vitrectomy.

Indian J Ophthalmol 2014 Nov;62(11):1077-1081

Department of Vitreo Retinal, Drashti Netralaya, Dahod, Gujarat, India.

Objective: The objective was to provide evidence-based care for patients with traumatic cataracts, we assessed whether a posterior capsulotomy and anterior vitrectomy, as part of the primary surgical procedure, could be a positive predictor of final visual outcome. Materials and Methods: This is a prospective randomized control trial. Patients presenting at our hospital between January 2010 and December 2012 having ocular trauma and traumatic cataracts were enrolled, according to the inclusion criteria. We enrolled two groups: Those with and without primary posterior capsulotomy and vitrectomy. Information regarding demographic and ocular trauma were collected using the World Eye Trauma Registry form at the first visit and follow-up, and specific information was collected for both the group who underwent posterior capsulectomies and vitrectomies as a part of the primary procedure, and the control group. Data were analyzed to evaluate the predictive value of primary posterior capsulectomy and anterior vitrectomy. Results: We enrolled 120 cases, 60 in each group, comprising 31 females and 89 males. When all other variables were controlled for, the visual outcome (best corrected visual acuity) differed significantly (P < 0.001) between the groups. Conclusion: Performance of posterior capsulectomy and anterior vitrectomy as part of the primary procedure improves the final visual outcome.
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http://dx.doi.org/10.4103/0301-4738.146757DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4290198PMC
November 2014

Cannula dacryocystorhinostomy: a simple, innovative and cost-effective method of lacrimal surgery.

Int Ophthalmol 2014 Aug 20;34(4):845-9. Epub 2013 Dec 20.

Drashti Netralaya, Nr. GIDC, Chakalia Road, Dahod, 389151, Gujarat, India,

To compare our innovative, cost-effective method of lacrimal surgery with other methods. A prospective cohort study. The study included 80 eyes of 80 consecutive patients who presented to our clinic between January 2009 and December 2011. The patients underwent surgery using a new technique with a specially designed cannula and were followed according to our protocol. Patency on irrigation. Of the 80 cases enrolled, the procedure was successful in 52.5 % with a mean follow-up of 247.2 days. The success rate was significantly affected by the preoperative conditions (p = 0.001) and follow-up duration (p = 0.006). This simple innovative technique was cost-effective and the results were comparable with those of other techniques.
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http://dx.doi.org/10.1007/s10792-013-9889-1DOI Listing
August 2014

Visual outcome of cataract in pediatric age group: does etiology have a role.

Eur J Ophthalmol 2014 Jan-Feb;24(1):76-83. Epub 2013 May 13.

Drashti Netralaya, Dahod, Gujarat - India.

Purpose: To compare visual outcome results among traumatic and nontraumatic groups of eyes with cataract in the pediatric age group.

Method: This is a retrospective cohort study. This study comprised a consecutive series of pediatric patients under 5 years of age with unilateral congenital, developing, or traumatic cataract who underwent surgery between January 1999 and April 2012 at Drashti Netralaya, Dahod. Records were retrieved from the medical record department. Patients were grouped as traumatic or nontraumatic and their demographics, cataract type, presenting symptoms, surgical intervention, and postoperative visual acuity follow-up refractive changes were recorded and compared.

Results: A total of 128 eyes of 128 children under 5 years of age were included with unilateral cataract. A total of 85 (66.4%) were traumatic and 43 (33.3%) nontraumatic. The age at surgery ranged from 1 to 60 months. Eyes were grouped by etiology: group 1- traumatic 85 (66.4%) eyes that had traumatic cataracts. Group 2 non-traumatic 43 (33.3%) eyes that had congenital, developmental or complicated cataracts. The mean follow-up time was 117 days. Finally, 22 (51.1%) group 1 patients and 40 (47.1%) group 2 patients achieved visual acuity better than 20/200 (p = 0.000).

Conclusions: Surgical treatment with intraocular lens implantation for children with congenital, developmental, or traumatic cataract is an effective treatment for visual rehabilitation. Visual outcome is significantly better (p = 0.005) in case of nontraumatic cataracts than traumatic cataracts.
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http://dx.doi.org/10.5301/ejo.5000309DOI Listing
February 2014

Ocular Trauma Score as a predictor of final visual outcomes in traumatic cataract cases in pediatric patients.

J Cataract Refract Surg 2012 Jun;38(6):959-65

Drashti Netralaya, Gujarat, India.

Purpose: To validate the predictive value of the Ocular Trauma Score (OTS) in children with traumatic cataract.

Design: Retrospective cohort study.

Setting: Tertiary eye care center at nexus of Gujarat, Madhya Pradesh, and Rajasthan states, central Western India.

Methods: After meeting inclusion criteria, eyes with traumatic cataract were enrolled and examined to review comorbidities caused by trauma. Surgery was performed for traumatic cataract, intraocular lenses were implanted, and patients were treated for amblyopia, as applicable. Patients were reexamined 6 weeks postoperatively. Based on ocular trauma described according to the Birmingham Eye Trauma Terminology System, the patients were divided into 2 traumatic cataract groups: open-globe injury and closed-globe injury. The relationship between final corrected distance visual acuity (CDVA) and demographic and clinical variables was analyzed. Visual outcomes were predicted using the OTS, and the predictions were compared with actual outcomes using statistical tests.

Results: The study enrolled 354 children. Six weeks postoperatively, the CDVA was better than 20/200 in 181 eyes (63.0%) and 20/40 or better in 110 eyes (38.4%) in the open-globe group and better than 20/200 in 36 eyes (53%) and 20/40 or better in 15 eyes (22.4%) in the closed-globe group. The differences between the groups were not significant (P=.143). Of all eyes, 214 (61.3%) achieved a final CDVA of better than 20/200 and 123 eyes (35.3%), of 20/40 or better.

Conclusion: The OTS was a reliable predictor of the final visual outcome in cases of pediatric traumatic cataract.
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http://dx.doi.org/10.1016/j.jcrs.2011.12.032DOI Listing
June 2012

OcularTrauma Score: a useful predictor of visual outcome at six weeks in patients with traumatic cataract.

Ophthalmology 2012 Jul 27;119(7):1336-41. Epub 2012 Mar 27.

Drashti Netralaya, Dahod, Gujarat, India.

Objective: To validate the predictive value of the Ocular Trauma Score (OTS) in injury cases with traumatic cataracts.

Design: Retrospective cohort study.

Participants: A total of 787 eyes.

Methods: A total of 787 eyes of 787 subjects with traumatic cataracts were enrolled using specific inclusion criteria. The eyes were examined to review comorbidities caused by trauma. Surgery was performed for traumatic cataracts, lenses were implanted, and patients were treated for amblyopia, as applicable. The patients were reexamined 6 weeks postoperatively. On the basis of ocular trauma described according to the Birmingham Eye Trauma Terminology System, the patients were divided into 2 traumatic cataract groups: open globe injury and closed globe injury. The relationship of visual acuity (VA) with demographic and clinical variables was analyzed. The visual outcomes were predicted using the OTS, and the predictions were compared with the actual outcomes using statistical tests.

Main Outcome Measures: Visual acuity.

Results: At 6 weeks postoperatively, 245 eyes (31%) had a VA ≥ 20/40 and 480 eyes (61.0%) had a VA >20/200. The OTS prediction was not significantly different when compared with actual visual outcome at 6 weeks postoperatively in all OTS categories.

Conclusions: The relationship of VA at 6 weeks with demographic and clinical variables was analyzed. In this study, the OTS was found as a reliable tool to predict visual outcome in cases of traumatic cataracts 6 weeks postoperatively.
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http://dx.doi.org/10.1016/j.ophtha.2012.01.020DOI Listing
July 2012

Visual outcome of traumatic cataract in pediatric age group.

Eur J Ophthalmol 2012 Nov-Dec;22(6):956-63. Epub 2012 Feb 17.

Drashti Netralaya, Dahod, Gujarat - India.

Purpose: To review results of traumatic cataracts in children.

Methods: This is a retrospective cohort study done at a tertiary eye care center at the junction of Gujarat, Madhya Pradesh, and Rajasthan states in central western India. We enrolled children with specific inclusion criteria, examined their eyes to review the comorbidities due to trauma, performed surgery for traumatic cataracts, and implanted a lens, treating amblyopia if applicable. The patients were re-examined 6 weeks postoperatively. We divided the traumatic cataract cases into open-globe (group 1) and closed-globe (group 2) groups according to the ocular trauma based on the Birmingham Eye Trauma Terminology System and compared the determinants of visual acuity.

Result: Our cohort of 354 eyes with traumatic cataracts in children included 287 eyes in group 1 and 67 in group 2. Six weeks postoperatively, the visual acuity in the operated eye was >20/200 in 181 (63%) and =20/40 in 109 (38%) eyes in the open-globe group and >20/200 in 36 (53%) and =20/40 in 16 (22.4%) eyes in the closed-globe group (p = 0.143), and the difference between the groups was not significant in children. Overall, 125 (35.3%) eyes gained a visual acuity at 6 weeks of =20/40 and >20/200 in 214 (61.3%) cases.

Conclusions: Satisfactory visual outcome can be achieved in children with traumatic cataracts, with no significant difference found among open- and closed-globe injuries in the pediatric age group.
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http://dx.doi.org/10.5301/ejo.5000111DOI Listing
January 2016

Morphology of traumatic cataract: does it play a role in final visual outcome?

BMJ Open 2011 Jul 29;1(1):e000060. Epub 2011 Jul 29.

Drashti Netralaya, Dahod, Gujarat, India.

Aim To study the morphology of traumatic cataract as an important predictor for final visual outcome after treatment of traumatic cataracts. Setting Tertiary eye care centre in Dahod at the trijunction of Gujarat, Madhya Pradesh, and Rajasthan states in central western India. Methods This was a prospective observational cohort study among all patients presenting at the hospital with traumatic cataracts between January 2003 and December 2009. All information regarding demographic and ocular trauma was collected on a pretested World Eye Trauma Registry form for both the first visit and follow-up. In particular, the authors collected specific information about the morphology of traumatic cataracts; the surgical technique was determined accordingly. Data were entered and analysed with regard to the relationship between type of trauma and resulting injury, results achieved with particular surgical techniques, and the relationship between morphology and final visual outcome. Outcome measures Final visual outcome. Results Traumatic cataracts of different morphologies showed significant differences in the final visual outcome (χ(2) test, p=0.014). Conclusion The morphology of traumatic cataract plays an important role in the final visual outcome.
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http://dx.doi.org/10.1136/bmjopen-2011-000060DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3191399PMC
July 2011

Final visual outcome following re exploration of cataracts performed by trainee surgeons in India.

Indian J Med Sci 2011 Sep;65(9):365-70

Department of Vitreo Retinal, Drashti Netralaya, Dahod, Gujarat, India.

Objective: To investigate the outcome of secondary intraocular lens implantation, compare final visual outcome between different categories of surgeon, and evaluate care provided by teaching hospitals to patients with capsular complications.

Materials And Methods:

Setting: Teaching hospital.

Design: Retrospective study. Subjects were recruited by examination of electronic medical records. All patients operated for corrective surgery following capsular complications during cataract surgery were included. All patient medical records were reviewed, and data were collected for 359 eyes.

Main Outcome Measures: Visual acuity and major complications. All collected data were entered into Microsoft Excel and analyzed by SPSS 17 software using cross tabulation and Chi-squared tests.

Results: Surgical intervention made a significant difference to the final visual outcome (P < 0.001). The category of the trainee had a significant effect on the final visual outcome (P = 0.021).

Conclusion: Capsular complications during cataract surgery should be surgically treated to improve outcome.
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September 2011

Effect of interval between time of injury and timing of intervention on final visual outcome in cases of traumatic cataract.

Eur J Ophthalmol 2011 Nov-Dec;21(6):760-5

Drashti Netralaya, Dahod, Gujarat, India.

Purpose: There are no clear guidelines to treat traumatic cataract. This study was conducted to provide evidence-based care to patients with traumatic cataracts and to examine the effect of the time interval between injury and the first intervention on the final visual outcome.

Methods: In a prospective cohort study, all patients presenting to our hospital with traumatic cataracts between January 2003 and December 2009 were enrolled. Information regarding demographics and ocular trauma was collected on the pretested World Eye Trauma Registry form for both the first and follow-up visits. In particular, we collected specific information on the time interval between the injury and intervention. The relationship between this time interval and the final visual outcome was analyzed. The study was conducted at a tertiary eye care center, in Dahod, at the junction of Gujarat, Madhya Pradesh, and Rajasthan states, in central western India.

Results: The time interval between the injury and first intervention had a significant effect on the final visual outcome (p = 0.02, chi2 test).

Conclusions: The morphology of traumatic cataracts plays an important role in determining the appropriate surgical technique and the final visual outcome.
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http://dx.doi.org/10.5301/EJO.2011.6482DOI Listing
March 2012
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