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Found 457 results
  1. News Article
    The National Institute for Health and Care Excellence has issued an unprecedented implementation statement1 setting out the practical steps needed for its updated guideline on the diagnosis and management of myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome (ME/CFS)2 to be implemented by the NHS. Such statements are only issued when a guideline is expected to have a “substantial” impact on NHS resources, and this is thought to be the first. It outlines the additional infrastructure and training that will be needed in both secondary and primary care to ensure that the updated ME/CFS guideline, published in October 2021, can be implemented. The statement is necessary because the 2021 guideline completely reversed the original 2007 guideline recommendations that people with mild or moderate ME/CFS be treated with cognitive behavioural therapy (CBT) and graded exercise therapy (GET). Instead the guideline recommends that any physical activity or exercise programmes should only be considered for people with ME/CFS in specific circumstances and should begin by establishing the person’s physical activity capability at a level that does not worsen their symptoms. It also says a physical activity or exercise programme should only be offered on the basis that it is delivered or overseen by a physiotherapist in an ME/CFS specialist team and is regularly reviewed. Although cognitive behavioural therapy (CBT) has sometimes been assumed to be a cure for ME/CFS, the guideline recommends it should only be offered to support people who live with ME/CFS to manage their symptoms, improve their functioning and reduce the distress associated with having a chronic illness. Read full story Source: BMJ, 16 May 2022
  2. Content Article
    Lisa Drake, an NHS ex General Practice Manager now working in a digital advisory role, shares some of the missed opportunities for digital ways of working she witnessed when she was a patient herself.
  3. News Article
    Relentless. Unbearable. Overwhelming. These are just some of the words used by the thousands of people who have revealed their battle with long-term, persistent pain. An exclusive survey of over 4,000 adults aged 16-75 for BBC News, carried out by research company Ipsos, suggests that a quarter of people in the UK are living with chronic pain - an often hidden and misunderstood condition. And pain specialists warn the health service is not set up to deal with such complex conditions. They say the treatments on offer are decades behind the science, leaving millions of patients without the support they need to manage their pain. Jen Proudler says chronic pain has left her grieving for "the person she was". It started four years ago with sporadic back pain. After several incorrect diagnoses, Jen was eventually told by a neurosurgeon that she had a "pretty massive" far lateral disc herniation in her spine. The pain has now spread around her body - Jen has burning pins and needles sensations down her leg, as well as sharp pain, as if being cut by a razor. Sometimes it's so bad, she can't even bear any fabric to touch it. "Our nervous system becomes more and more protective, it feels danger and sends warning signals - and those warning signals contribute to the pain," explains Dr Chris Barker, clinical director of an NHS community pain service in Ainsdale, Merseyside. He says such pain can be hard to diagnose, and the difficulty of getting the correct treatment can make things worse. "Incorrect diagnoses, delayed diagnoses, poor experiences in and out of the health system, not being believed - all of these can contribute to a more intense experience of pain." Dr Barker says the NHS is not set up to deal with such a complex condition, despite the fact it is so common. "The prevalence of pain is huge. It dwarfs most other conditions." Read full story Source: BBC News, 11 May 2022 Further reading: Is pain a patient safety issue? Blog from Patient Safety Learning
  4. News Article
    Hundreds of severely mentally ill prisoners in urgent need of hospital treatment are being left in prison cells due to bed shortages in secure NHS psychiatric units, an investigation has discovered. Freedom of information (FoI) responses from 22 NHS trusts reveal for the first time that just over half of the 5,403 prisoners in England assessed by prison-based psychiatrists to require hospitalisation were not transferred between 2016 and 2021 – an 81% increase on the number of prisoners denied a transfer in the previous five years. In some areas, the majority of mentally ill prisoners were not admitted, which could be the result of long delays or a trust refusing to take certain patients. Norfolk and Suffolk NHS foundation trust, which was rated inadequate by the Care Quality Commission last month, only admitted 16 of 41 prisoners referred in 2021. Essex Partnership University NHS foundation trust only admitted 24 of 57 prisoners referred in 2021. Lancashire and South Cumbria NHS foundation trust only accepted 18 of the 38 prisoners referred in 2021. Peter Dawson, the director of the Prison Reform Trust, said the figures unearthed by the investigation suggested hundreds of very ill people were being denied the treatment they needed. “It is shocking that a growing number of people are not getting the transfer to hospital that clinicians say is essential for their mental health,” he said. “Instead they are languishing in often overcrowded and dilapidated prisons. It is cruel and guarantees people will leave prison in a worse state than when they came in, with every likelihood that the behaviour that originally led to their arrest and conviction will continue.” Read full story Source: The Guardian, 10 May 2022
  5. Content Article
    This study in the International Journal of Environmental Research and Public Health aimed to investigate physical activity patterns in people with Long Covid, and the relationship between physical activity and Long Covid symptoms. It also aimed to find out the type of physical activity that people with Long Covid were being recommended, and what they were actually doing. The authors found that 75% of participants reported Long Covid symptoms worsening after physical activity. They also found that many participants received contradictory advice on whether or not to exercise with Long Covid.
  6. News Article
    Remdesivir has no significant effect on patients with Covid-19 who are already being ventilated but has a small effect against death or progression to ventilation among other patients admitted to hospital, the World Health Organization’s Solidarity trial has found. This appears to be a change from findings reported in February 2021, when preliminary trial data suggested that remdesivir “had little or no effect on patients admitted to hospital with Covid-19.” The updated results, published in the Lancet, reported that overall 14.5% of patients assigned to remdesivir died compared with 15.6% assigned to the control group. The release of these results has prompted questions about why it has taken so long to publish these data, especially considering WHO’s recommendation against the use of remdesivir in patients with Covid-19. Read full story Source: BMJ, 4 May 2022
  7. News Article
    A record 2.7 million people were referred for cancer checks in the last year, NHS England has said. It comes after figures suggested the Covid pandemic saw numbers dramatically decline in 2020. But at least 30,000 people are still waiting to start treatment. Charities have welcomed the increase in referrals but warned of the "devastating" impact the pandemic has had on cancer care. Referrals for suspected cancer remain at about 16% higher than pre-pandemic levels and rose overall from 2.4 million to 2,65m in the past 12 months. Dame Cally Palmer, national cancer director for NHS England, said there were still 30,000 people who had not started treatment due to the pandemic but that the new figures suggested some progress. She said: "We are going further and faster than ever before in our ambitions to diagnose more cancers at an earlier stage so that we can save more lives." It is "vital that we keep these referral rates high", she added. Read full story Source: BBC News, 2 May 2022
  8. Content Article
    Nearly half of all adults and approximately 8% of children (aged 5-17) worldwide have a chronic condition. Yet, studies have consistently shown that adherence to medication is poor; estimates range from under 80% to under 50%, with an average of 50%. There could be a considerable improvement in health outcomes (and consequently longevity), not only by developing new drugs, but by helping people adhere to existing treatment regimens that have already been researched, tested and prescribed for them. But adherence isn’t usually prioritised by governments, health providers or healthcare professionals (HCPs). Adherence isn’t measured at a national level for any disease, apart from in Sweden where hypertension is recorded. And as governments don’t prioritise adherence, health providers aren’t measured or incentivised for improving it, meaning HCPs may not have the time and resources (or reminders) to focus on it during consultations.  This report from the International Longevity Centre-UK (ILC) makes a series of recommendations.
  9. News Article
    Analysis of thousands of tumours has unveiled a treasure trove of clues about the causes of cancer, representing a significant step towards the personalisation of treatment, a study suggests. Researchers say that for the first time it is possible to detect patterns – called mutational signatures – in the DNA of cancers. These provide clues including about whether a patient has had past exposure to environmental causes of cancer such as smoking or UV light, for example. This is important as these signatures allow doctors to look at each patient’s tumour and match it to specific treatments and medications. Dr Andrea Degasperi, research associate at the University of Cambridge and first author, said: “Whole genome sequencing gives us a total picture of all the mutations that have contributed to each person’s cancer. “With thousands of mutations per cancer, we have unprecedented power to look for commonalities and differences across NHS patients, and in doing so we uncovered 58 new mutational signatures and broadened our knowledge of cancer.” The findings are now being incorporated into the NHS as researchers and clinicians now have the use of a digital tool called FitMS that will help them identify the mutational signature and potentially inform cancer management more effectively. Read full story Source: The Independent, 21 April 2022 You may also be interested to read hub blog: Genetic profiling and precision medicine – the future of cancer treatment
  10. Event
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    At this Bevan Brittan webinar, Dr Bell, a Consultant in Intensive Care and Anaesthesia will cover the following: 1. Background on scenarios in which consideration is given to treatment limitations. 2. Factors influencing decision-making. 3. The evolution of conflict. 4. Clinical perspective on the role of the courts. Register
  11. News Article
    It has long been clear that Black Americans have experienced high rates of coronavirus infection, hospitalisation and death throughout the pandemic. But those factors are now leading experts to sound the alarm about what will may come next: a prevalence of Long Covid in the Black community and a lack of access to treatment. Long Covid — with chronic symptoms like fatigue, cognitive problems and others that linger for months after an acute coronavirus infection has cleared up — has perplexed researchers, and many are working hard to find a treatment for people experiencing it. But health experts warn that crucial data is missing: Black Americans have not been sufficiently included in Long-Covid trials, treatment programmes and registries, according to the authors of a new report released on Tuesday. “We expect there are going to be greater barriers to access the resources and services available for Long Covid,” said one of the authors, Dr. Marcella Nunez-Smith, who is the director of Yale University’s health equity office and a former chair of President Biden’s health equity task force. “The pandemic isn’t over, it isn’t over for anyone,” Dr. Nunez-Smith said. “But the reality is, it’s certainly not over in Black America.” In the first three months of the pandemic, the average weekly case rate per 100,000 Black Americans was 36.2, compared with 12.5 for white Americans, the authors write. The Black hospitalisation rate was 12.6 per 100,000 people, compared with 4 per 100,000 for white people, and the death rate was also higher: 3.6 per 100,000 compared with 1.8 per 100,000. “The severity of Covid-19 among Black Americans was the predictable result of structural and societal realities, not differences in genetic predisposition.” "Many Black Americans who contracted the coronavirus experienced serious illness because of pre-existing conditions like obesity, hypertension and chronic kidney disease, which themselves were often the result of “differential access to high-quality care and health promoting resources,” the report says. Read full story (paywalled) Source: New York Times, 29 March 2022
  12. News Article
    A vaccine has been used to free a man who was trapped at home by a Covid infection that lasted for more than seven months. It is the first time that a vaccine has been used to "treat" Covid rather than "prevent" it. Ian Lester, 37, has a weakened immune system due to Wiskott-Aldrich syndrome, and was unable to defeat the virus on its own. He says he became a prisoner in his home in Caerphilly, Wales, as he isolated for months on end. He shielded during the first wave of Covid, but coronavirus eventually found him in December 2020. He had one of the classic symptoms - a slight loss of sense of taste and smell - which cleared up within a month. For most of us that would be the end of it, but Ian's Covid journey was only just beginning. His doctors wanted him to keep on testing because his weakened immune system meant there was a risk he could be contagious for longer than normal. But month after month, test after test came back positive. Ian had to give up work. Scientists and doctors were monitoring the battle between the virus and Ian's immune system at Cardiff University and at the Immunodeficiency Centre for Wales in the University Hospital of Wales. The analysis showed Ian had a long-term infection, it was not just "dead virus" being detected, and his symptoms were not long-Covid. Prof Stephen Jolles, clinical lead at the Immunodeficiency Centre, said: "This infection was burbling along, but with his [weakened] immune system it was just not enough to kick off a response sufficient to clear it. "So the vaccine really made a huge difference, in antibodies and T-cells, and utilised and squeezed every last drop out of what his immune system could do." Read full story Source: BBC News, 21 March 2022
  13. Content Article
    Get information on waiting times for treatment at NHS Trusts in England. This data is sourced from NHS England, and is published two months in arrears. Please note that some data may not be available. This could be because a) the Trust does not provide treatment for the selected condition, b) data has not been submitted, or c) some services (e.g. mental health) are not covered in the source data.
  14. Content Article
    Healthcare professionals need clearer guidance on responding to racism in paediatric settings, argue Zeshan Qureshi and colleagues.
  15. News Article
    The only NHS gender identity service for children in England and Wales is under unsustainable pressure as the demand for the service outstrips capacity, a review has found. The interim report of the Cass Review, commissioned by NHS England in 2020, recommends that a network of regional hubs be created to provide care and support to young people with gender incongruence or dysphoria, arguing their care is “everyone’s business”. Led by the paediatrician Hilary Cass, the interim report explains that the significant rise in referrals to the Gender Identity Development Service (GIDS) at the Tavistock and Portman NHS foundation trust in London has resulted in overwhelmed staff and waiting lists of up to two years that leave young people “at considerable risk” of distress and deteriorating mental health. Last spring, the Care Quality Commission demanded monthly updates on numbers on waiting lists and actions to reduce them in a highly critical report on GIDS. Differing views and lack of open discussion about the nature of gender incongruence in childhood and adolescence – and whether transition is always the best option – means that patients can experience a “clinician lottery”, says the new review, which carried out extensive interviews with professionals and those with lived experience. It notes that the clinical approach used by GIDS “has not been subjected to some of the usual control measures” typically applied with new treatments. Another significant issue raised with the review team was that of “diagnostic overshadowing”, whereby once a young person is identified as having gender-related distress, other complex needs – such as neurodiversity or a mental health problem that would normally be managed by local services – can be overlooked. Read full story Source: The Guardian, 10 March 2022
  16. News Article
    Patients whose operations have been delayed will be able to shop online for hospitals with the shortest waiting times in the public and private sector, under plans being announced by the health secretary this week reports The Times. Sajid Javid will unveil a three-point plan to transform the NHS as part of efforts to tackle a record backlog of more than six million people. Under the proposals, patients referred for hospital care will be able to go online to look up the waiting time at their local hospital, and compare it with times at any hospital in the country, including those in the private sector. The website will allow patients to book their treatment at any unit in the country and there are plans to make the service available on the NHS app. The proposals will be set out in a speech on Tuesday. Javid said: “The NHS constitution says already that you as a patient have the right to ask for an alternative provider for your treatment." However, is this just a distraction? writes Roy Lilley in his latest newsletter. Shopping on-line for treatment depends on getting a website organised that can collect real-time data from all Trusts, for every specialty, that can take into account staffing, rota-gaps and clinical priorities. Software might be able to cope but has the potential to throw the NHS into chaos. People arriving from ‘out of area’ will need video-out-patient consultations, some way of doing blood, imaging and other tests. And post-op? The same again for out-patients and physio, OT, aids, adaptations, pharmacy and social care support... ... to say nothing of the stress on patients and their families. None of this is impossible but the NHS is nowhere near geared up for it. Sources: The Times, 6 March 2022 (paywalled) Roy Lilley's newsletter, 7 March 2022
  17. News Article
    Two leading medical organisations have told the BBC that GPs are not getting the right support to treat eating disorders. The Royal College of General Practitioners (RCGP) and the British Medical Association (BMA) say doctors need more time with patients and more specialist units. Beat Eating Disorders asked nearly 1,700 people about their experience of trying to get a diagnosis from their GP. Over 92% asked thought their GP needed more training with eating disorders. Out of those questioned, 69% also said they felt their GP didn't know how to help them. The survey has been released to coincide with Eating Disorder Awareness Week. Jess Griffiths had an eating disorder between the ages of 11 and 21 and, now in full recovery, she works as a consultant to NHS England and with her local eating disorder service in Dorset. She tells the BBC that when she first went to her GP to try to get help, she wasn't entirely transparent about what she was struggling with. "I was presenting at a low weight and not having periods, so the GP put me on the pill, but I went there hoping he would ask me the questions [about a potential eating disorder]" she says. "But it's really hard for people with eating disorders to - in a really pressurised situation with a doctor - say how they really feel." Dr Richard Van Mellaerts is part of the BMA's GP committee and has told the BBC the results of the survey are "deeply saddening". "People with eating disorders should never feel that GPs are a barrier to accessing care, so it is vital that medical education and training supports doctors to identify eating disorders and support their treatment," he says. But he adds that there is "poor provision of specialist care", which has left GPs "frustrated up and down the country". Read full story Source: BBC News, 3 March 2022 Read hub blog from Dr Joanna Silver on the challenges the pandemic has brought to patients with eating disorders
  18. Content Article
    To mark Rare Disease Day 2022, the Department of Health and Social Care has published England’s first Rare Diseases Action Plan.
  19. News Article
    Sickle cell patients have begun receiving the first new treatment for the blood disorder in over 20 years. The inherited condition can cause severe pain and organ failure, often requiring hospital admissions. Crizanlizumab is given as a monthly infusion and is thought to cut visits to A&E by 40%. Loury Mooruth, 62, received the treatment at Birmingham City Hospital, having suffered repeated periods of intense pain for decades. During a crisis, patients often need powerful opioid painkillers but Loury, like many others, has faced suspicion when at A&E. "You know the protocol when you go in, which needles and so on. They think straight away you are a drug addict - they don't believe you," she says. She has refused to go to hospital during a crisis for the past two years because of her negative experiences. A report from MPs last year found "serious failings" in sickle cell care with some evidence of discrimination against patients. Dr Shivan Pancham, a consultant haematologist at Birmingham City Hospital, told the BBC: "Our patients often find the experience in emergency departments challenging with a lack of understanding of the severity of pain. "It is hoped with these new therapies if we reduce the likelihood of attending emergency departments, ultimately this will be much better for the patients." Read full story Source: BBC News, 24 February 2022
  20. News Article
    The government of Mexico City handed out nearly 200 000 “ivermectin based kits” last year to people who had tested positive for Covid-19, without telling them they were subjects in an experiment on the drug’s effectiveness. The results of that experiment were then written up by public officials in an article placed on popular US preprint server SocArXiv. It became one of site’s most viewed articles, claiming that ivermectin had reduced hospital admissions by 52-76%. But those officials have been under fire at home since SocArXiv withdrew the paper earlier this month, calling it “either very poor quality or else deliberately false and misleading.” Opposition deputies in Mexico City’s Congress demanded hearings and said they would bring legal action against the paper’s lead author, José Merino, head of the city’s Digital Agency for Public Innovation. Explaining the decision to withdraw the article—the first to be taken down by SocArXiv—the site’s steering committee wrote that it had responded “to a community groundswell beseeching us to act” in order “to prevent the paper from causing additional harm.” The committee wrote, “The paper is spreading misinformation, promoting an unproved medical treatment in the midst of a global pandemic. The paper is part of, and justification for, a government programme that unethically dispenses (or did dispense) unproven medication apparently without proper consent or appropriate ethical protections.” Read full story Source: BMJ, 22 February 2022
  21. Event
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    CVDPREVENT will provide a foundation for professionally-led quality improvement in individual GP practices across Primary Care Networks (PCNs). It will support primary care in understanding how many patients with CVD and/or the six main high-risk conditions are potentially undiagnosed, or under or over treated. These include atrial fibrillation, high blood pressure, high cholesterol, diabetes, non-diabetic hyperglycaemia and chronic kidney disease. The audit will provide data to highlight gaps, identify inequalities, and opportunities for improvement. This event will be the first publicised presentation of the CVD publication, being presented live by Dr Pete Green, Clinical Lead CVD Prevent & Chair, Heart UK. This event has been sponsored by Daiichi Sankyo UK. This webinar is for Govconnect registered members who are UK healthcare professionals and allied personnel in commissioning, AHSN and health policy only. Speakers: Dr Yassir Javaid, Clinical Advisor for Cardiology, Royal College of GPs Dr Pete Green, Clinical Lead CVD Prevent & Chair, Heart UK Vishal Mashru, Head of Medicines & Research, Cross Counties & North Blaby PCN Dr Ravi Pawa, Country Medical Director, Daiichi Sankyo Register
  22. News Article
    The numbers of cancer patients facing delays in seeing a specialist for the first time and starting their treatment have hit record highs in England, amid fears that overstretched NHS services can no longer provide prompt care. The disclosure comes as a new row over how quickly hospitals can clear the record 6 million-strong NHS backlog has forced ministers to delay publication of the long-awaited plan to tackle it. Half a million people in England with suspected cancer will have to wait longer than the supposed two-week maximum to see an oncologist this year, an analysis for the House of Commons library reveals. The number of patients confirmed to have the disease who are unable to start treatment such as surgery or chemotherapy within the 31 or 62 days that hospitals try to guarantee is expected to exceed 75,000 for the first time. Experts, who claim significant shortages in the NHS cancer workforce are to blame, fear delays in getting diagnosed and starting care could reduce a patient’s chances of survival. Cancer charities highlighted the “unimaginable distress and anxiety” they induce in patients. “Cancer care is in crisis,” the shadow health secretary, Wes Streeting, said. “As this new analysis shows, terrifyingly large numbers of people are waiting longer than they should to receive vital cancer care and treatment with the insecurity of not knowing.” Read full story Source: The Guardian, 6 February 2022
  23. News Article
    Several drug companies have been fined £35 million for colluding to raise the cost of an anti-nausea drug used by cancer patients, taking the total fines stemming from a Times investigation to £400 million. The price paid by the NHS for prochlorperazine 3mg dissolvable tablets rose by 700%, from £6.49 a packet to more than £51, between December 2013 and December 2017, costing the NHS an extra £5 million a year. The Competition and Markets Authority (CMA) has ruled that several companies broke the law by fixing the market and agreeing not to produce a rival version of the drug, which is used to treat nausea and dizziness and can be prescribed to patients having chemotherapy. Andrea Coscelli, chief executive of the CMA, said: “The size of the fines reflects the seriousness of this breach. These firms conspired to stifle competition in the supply of this important medication, so that the NHS — the main buyer of the drugs — lost the opportunity for increased choice and lower prices.” He said the CMA would not “hesitate to take action like this against any businesses that collude at the expense of the NHS”. Read full story (paywalled) Source: The Times, 3 February 2022
  24. News Article
    Growing numbers of adults and children in England are surviving for longer after being diagnosed with cancer, with increases in lifespan seen in almost all types of the disease. Survival for one year and five years rose among adults diagnosed between 2015 and 2019 compared with those whose illness was identified between 2006 and 2010, NHS Digital reported. Survival is highest in adults who have melanoma of the skin, one of the main forms of skin cancer. Nine out of 10 men now survive for five years, as do almost 95% of women. However, survival remains stubbornly low for other forms of the disease, including pancreatic cancer and mesothelioma, which is mainly caused by prolonged exposure to asbestos. Just 6.3% of men and 7.8% of women who develop mesothelioma are still alive five years later. NHS Digital found that “in England one-year non-standardised net survival has improved, with patients diagnosed between 2015 and 2019 having a higher one-year survival than patients diagnosed between 2006 and 2010. “This trend was seen for all cancers and both genders except for bladder cancer. The largest improvement was 1.6 percentage points on average per year for lung cancer in females.” Greater survival after five years “was seen for all cancers and both genders except for bladder cancer and colon cancer,” the NHS’s statistical arm added. “The largest improvement was myeloma in females, [which was up] 1.4 percentage points on average per year.” However, Anna Jewell, the chair of the Less Survivable Cancers Taskforce, warned that the chances of survival remained low for people with a number of some forms of the disease. “Although overall cancer survival rates have generally increased in the past decades, we are not seeing the same improvements in prognosis for patients diagnosed with less survivable cancers, including those of the lung, liver, brain, oesophagus, pancreas and stomach.” Read full story Source: The Guardian, 4 February 2022
  25. News Article
    Improving cancer care will be a huge challenge, ministers are being warned as they promise a new 10-year strategy for England. Figures suggest there have been 34,000 fewer diagnoses since Covid hit - 50,000 if you include the whole UK. It risks an increasing number of late diagnoses which reduces the chances of survival, cancer charities said. It comes as the government is promising to invest in new technologies and equipment to spot cancer quicker. Health Secretary Sajid Javid said the new "war on cancer" strategy will be published later this year. "It will take a far-reaching look at how we want cancer care to be in 2032. Looking at all stages from prevention, to diagnosis, treatment and vaccines," he said. Mr Javid pointed out the NHS was already taking steps, including evaluating new blood tests to spot cancers early and opening a network of testing centres. Lynda Thomas, of Macmillan Cancer Support, said given the impact of the pandemic people with cancer needed "support more than ever". "We have been sounding the alarm for a long time," she added. But she said while improving diagnosis and treatment was crucial, it was like "building sandcastles while the tide comes" without extra staff to tackle the backlogs and demand for care. Read full story Source: BBC News, 4 February 2022
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