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Ding C, Lv H, Huang S, Hu M, Liao Y, Meng X, Gao M, Chen H, Feng X, Wu Z. The Application Progress of Nonthermal Plasma Technology in the Modification of Bone Implant Materials. ACS Biomater Sci Eng 2024; 10:5893-5914. [PMID: 39227180 DOI: 10.1021/acsbiomaterials.4c00081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2024]
Abstract
With the accelerating trend of global aging, bone damage caused by orthopedic diseases, such as osteoporosis and fractures, has become a shared international event. Traffic accidents, high-altitude falls, and other incidents are increasing daily, and the demand for bone implant treatment is also growing. Although extensive research has been conducted in the past decade to develop medical implants for bone regeneration and healing of body tissues, due to their low biocompatibility, weak bone integration ability, and high postoperative infection rates, pure titanium alloys, such as Ti-6A1-4V and Ti-6A1-7Nb, although widely used in clinical practice, have poor induction of phosphate deposition and wear resistance, and Ti-Zr alloy exhibits a lack of mechanical stability and processing complexity. In contrast, the Ti-Ni alloy exhibits toxicity and low thermal conductivity. Nonthermal plasma (NTP) has aroused widespread interest in synthesizing and modifying implanted materials. More and more researchers are using plasma to modify target catalysts such as changing the dispersion of active sites, adjusting electronic properties, enhancing metal carrier interactions, and changing their morphology. NTP provides an alternative option for catalysts in the modification processes of oxidation, reduction, etching, coating, and doping, especially for materials that cannot tolerate thermodynamic or thermosensitive reactions. This review will focus on applying NTP technology in bone implant material modification and analyze the overall performance of three common types of bone implant materials, including metals, ceramics, and polymers. The challenges faced by NTP material modification are also discussed.
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Affiliation(s)
- Chengbiao Ding
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China
| | - Hao Lv
- Department of Orthopedics, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230602, China
| | - Suoni Huang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China
| | - Mengxuan Hu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China
| | - Yanxinyue Liao
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China
| | - Xinyue Meng
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China
| | - Ming Gao
- Department of Emergency Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China
| | - Hemu Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China
| | - Xiaojun Feng
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China
| | - Zhengwei Wu
- School of Nuclear Science and Technology, University of Science and Technology of China, Hefei, Anhui 230026, China
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Huang H, Liu X, Wang J, Suo M, Zhang J, Sun T, Wang H, Liu C, Li Z. Strategies to improve the performance of polyetheretherketone (PEEK) as orthopedic implants: from surface modification to addition of bioactive materials. J Mater Chem B 2024; 12:4533-4552. [PMID: 38477504 DOI: 10.1039/d3tb02740f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
Polyetheretherketone (PEEK), as a high-performance polymer, is widely used for bone defect repair due to its homogeneous modulus of elasticity of human bone, good biocompatibility, excellent chemical stability and projectability. However, the highly hydrophobic surface of PEEK is biologically inert, which makes it difficult for cells and proteins to attach, and is accompanied by the development of infections that ultimately lead to failure of PEEK implants. In order to further enhance the potential of PEEK as an orthopedic implant, researchers have explored modification methods such as surface modification by physical and chemical means and the addition of bioactive substances to PEEK-based materials to enhance the mechanical properties, osteogenic activity and antimicrobial properties of PEEK. However, these current modification methods still have obvious shortcomings in terms of cost, maneuverability, stability and cytotoxicity, which still need to be explored by researchers. This paper reviews some of the modification methods that have been used to improve the performance of PEEK over the last three years in anticipation of the need for researchers to design PEEK orthopedic implants that better meet clinical needs.
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Affiliation(s)
- Huagui Huang
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China.
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, People's Republic of China
- Division of Energy Materials (DNL22), Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, China.
| | - Xin Liu
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China.
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, People's Republic of China
| | - Jinzuo Wang
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China.
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, People's Republic of China
| | - Moran Suo
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China.
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, People's Republic of China
| | - Jing Zhang
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China.
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, People's Republic of China
| | - Tianze Sun
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China.
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, People's Republic of China
| | - Honghua Wang
- Division of Energy Materials (DNL22), Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, China.
| | - Chengde Liu
- Department of Polymer Science & Materials, Dalian University of Technology, Dalian, People's Republic of China.
| | - Zhonghai Li
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China.
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Liaoning Province, People's Republic of China
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Chen J, Xiao J, Han X, Sima X, Guo W. An HA/PEEK scaffold with modified crystallinity via 3D-bioprinting for multiple applications in hard tissue engineering. Biomed Mater 2023; 18:065021. [PMID: 37852224 DOI: 10.1088/1748-605x/ad0476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 10/18/2023] [Indexed: 10/20/2023]
Abstract
Hard tissues, especially teeth and bones, are highly mineralized and the large-scale defect or total loss of them is irreversible. There is still no ideal strategy for the reconstruction of various hard tissue defects that can achieve the balance between biological and mechanical properties. Polyether ether ketone (PEEK) has the potential to substitute for natural hard tissue in defect areas but is limited by its biological inertness. The addition of hydroxyapatite (HA) can significantly improve the osteogenic properties and osteointegration of PEEK materials. But the mechanical properties of HA/PEEK scaffolds are far from satisfaction making scaffolds easy to fracture. We put forward a strategy to balance the mechanical and biological properties of HA/PEEK scaffolds via the regulation of the inner crystallinity and HA mixing ratio and we systematically evaluated the modified HA/PEEK scaffolds through material characterization,in vitroandin vivoexperiments. And we found that the 20%HA/PEEK scaffolds with low crystallinity achieved the required strength and elasticity, and exhibited the characteristics of promoting the proliferation, migration and osteogenic differentiation of bone marrow mesenchymal stem cells. The results of the implantation of beagles' teeth, mandible and rib showed that the 20%HA/PEEK scaffold with low crystallinity could well withstand the local complex force in the defect area and combine well with natural bone tissue, which made it a candidate for a practical versatile hard tissue engineering scaffold.
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Affiliation(s)
- Jiahao Chen
- State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
- National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
- Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
- Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
| | - Jingyi Xiao
- State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
- National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
- Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
- Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
| | - Xue Han
- State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
- National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
- Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
- Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
| | - Xiutian Sima
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, People's Republic of China
| | - Weihua Guo
- State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
- National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
- Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
- Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu, People's Republic of China
- Yunnan Key Laboratory of Stomatology, Affiliated Hospital of Stomatology, School of Stomatology, Kunming Medical University, Kunming, People's Republic of China
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Wang J, Lei J, Hu Y, Meng L, Li W, Zhu F, Xie B, Wang Y, Yang C, Wu Q. Calcium Silicate Whiskers-Enforced Poly(Ether-Ether-Ketone) Composites with Improved Mechanical Properties and Biological Activities for Bearing Bone Reconstruction. Macromol Biosci 2022; 22:e2200321. [PMID: 36057971 DOI: 10.1002/mabi.202200321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/23/2022] [Indexed: 01/15/2023]
Abstract
Poly (ether-ether-ketone) (PEEK) displays promising potential application in bone tissue repair and orthopedic surgery due to its good biocompatibility and chemical stability. However, the bio-inertness and poor mechanical strength of PEEK greatly limit its application in load-bearing bones. In this study, calcium silicate whiskers (CSws) are synthesized and then compounded with PEEK to fabricate the PEEK/CSw composites with excellent mechanical properties, biological activity. Compared with PEEK, the PEEK/CSw composites exhibited higher hydrophilicity and ability to deposit hydroxyapatite on the surface. CSws are evenly dispersed in the PEEK matrix at 10 wt% content and the mechanical strength of the PEEK/CSw composite is ≈96.9 ± 2.4 MPa, 136.3 ± 2.4 MPa, and 266.0 ± 3.2 MPa, corresponding to tensile strength, compressive strength, and bending strength, respectively, which is 20%, 18%, and 52% higher than that of pure PEEK. The composites improve the adhesion, proliferation, and osteogenic differentiation of BMSCs. Furthermore, PEEK/CSw composite remarkably improves bone formation and osteointegration, which has higher bone repair capacity than PEEK. These results demonstrate that the PEEK/CSw scaffolds display superior abilities to integrate with the host bone and promising potential in the field of load bearing bone repair.
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Affiliation(s)
- Jin Wang
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Biomedical Material and Engineering Center of Hubei Province, Wuhan University of Technology, Wuhan, 430070, P. R. China
| | - Jie Lei
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, P. R. China
| | - Yanru Hu
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Biomedical Material and Engineering Center of Hubei Province, Wuhan University of Technology, Wuhan, 430070, P. R. China
| | - Lihui Meng
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Biomedical Material and Engineering Center of Hubei Province, Wuhan University of Technology, Wuhan, 430070, P. R. China
| | - Wenchao Li
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Biomedical Material and Engineering Center of Hubei Province, Wuhan University of Technology, Wuhan, 430070, P. R. China
| | - Fang Zhu
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Biomedical Material and Engineering Center of Hubei Province, Wuhan University of Technology, Wuhan, 430070, P. R. China
| | - Bing Xie
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Biomedical Material and Engineering Center of Hubei Province, Wuhan University of Technology, Wuhan, 430070, P. R. China
| | - Youfa Wang
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Biomedical Material and Engineering Center of Hubei Province, Wuhan University of Technology, Wuhan, 430070, P. R. China
| | - Cao Yang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, P. R. China
| | - Qingzhi Wu
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Biomedical Material and Engineering Center of Hubei Province, Wuhan University of Technology, Wuhan, 430070, P. R. China
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Javaid S, Dey M, Matzke C, Gupta S. Synthesis and characterization of engineered
PEEK
‐based composites for enhanced tribological and mechanical performance. J Appl Polym Sci 2022. [DOI: 10.1002/app.52886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Sabah Javaid
- Department of Mechanical Engineering University of North Dakota Grand Forks North Dakota USA
| | - Maharshi Dey
- Department of Mechanical Engineering University of North Dakota Grand Forks North Dakota USA
| | - Caleb Matzke
- Department of Mechanical Engineering University of North Dakota Grand Forks North Dakota USA
| | - Surojit Gupta
- Department of Mechanical Engineering University of North Dakota Grand Forks North Dakota USA
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The Single-Step Fabrication of a Poly (Sodium Vinylsulfonate)-Grafted Polyetheretherketone Surface to Ameliorate Its Osteogenic Activity. COATINGS 2022. [DOI: 10.3390/coatings12060868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Polyetheretherketone (PEEK) is considered a potential material for replacing traditional biomedical metals used in orthopedic implants because of its similar elastic modulus to human bone. However, the poor osteogenic activity of PEEK itself hinders its clinical application. In this study, a PEEK surface was grafted with poly (sodium vinylsulfonate) through a single-step ultraviolet-initiated graft polymerization method to ameliorate its osteogenic activity. X-ray photoelectron spectroscopy and water contact angle measurements confirmed that different amounts of poly (sodium vinylsulfonate) were grafted onto the PEEK surface upon varying the ultraviolet irradiation time. Atomic force microscopy revealed that the surface topography and roughness of PEEK before and after surface grafting did not change significantly. The in vitro results showed that grafting with poly (sodium vinylsulfonate) rendered the PEEK surface with improved MC3T3-E1 osteoblast compatibility and osteogenic activity. Moreover, a PEEK surface with a higher grafting amount of poly (sodium vinylsulfonate) was observed to be more beneficial to the proliferation and osteogenic differentiation of MC3T3-E1 osteoblasts. Collectively, by employing this simple and one-step method, the osteogenic activity of PEEK can be enhanced, paving the way for the clinical application of PEEK in orthopedic implants.
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Yu D, Lei X, Zhu H. Modification of polyetheretherketone (PEEK) physical features to improve osteointegration. J Zhejiang Univ Sci B 2022; 23:189-203. [PMID: 35261215 DOI: 10.1631/jzus.b2100622] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Polyetheretherketone (PEEK) has been widely applied in orthopedics because of its excellent mechanical properties, radiolucency, and biocompatibility. However, the bioinertness and poor osteointegration of PEEK have greatly limited its further application. Growing evidence proves that physical factors of implants, including their architecture, surface morphology, stiffness, and mechanical stimulation, matter as much as the composition of their surface chemistry. This review focuses on the multiple strategies for the physical modification of PEEK implants through adjusting their architecture, surface morphology, and stiffness. Many research findings show that transforming the architecture and incorporating reinforcing fillers into PEEK can affect both its mechanical strength and cellular responses. Modified PEEK surfaces at the macro scale and micro/nano scale have positive effects on cell-substrate interactions. More investigations are necessary to reach consensus on the optimal design of PEEK implants and to explore the efficiency of various functional implant surfaces. Soft-tissue integration has been ignored, though evidence shows that physical modifications also improve the adhesion of soft tissue. In the future, ideal PEEK implants should have a desirable topological structure with better surface hydrophilicity and optimum surface chemistry.
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Affiliation(s)
- Dan Yu
- Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Xiaoyue Lei
- Department of Stomatology, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Huiyong Zhu
- Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
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Ding L, Lu W, Zhang J, Yang C, Wu G. Preparation and Performance Evaluation of Duotone 3D-Printed Polyetheretherketone as Oral Prosthetic Materials: A Proof-of-Concept Study. Polymers (Basel) 2021; 13:polym13121949. [PMID: 34208259 PMCID: PMC8230783 DOI: 10.3390/polym13121949] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/30/2021] [Accepted: 06/08/2021] [Indexed: 02/07/2023] Open
Abstract
Literature has reported the successful use of 3D printed polyetheretherketone (PEEK) to fabricate human body implants and oral prostheses. However, the current 3D printed PEEK (brown color) cannot mimic the vivid color of oral tissues and thus cannot meet the esthetical need for dental application. Therefore, titanium dioxide (TiO2) and ferric oxide (Fe2O3) were incorporated into PEEK to prepare a series of tooth-color and gingival-color PEEK composites in this study. Through color measurements and mechanical tests, the color value and mechanical performance of the 3D printed PEEK composites were evaluated. In addition, duotone PEEK specimens were printed by a double nozzle with an interface between tooth-color and gingival-color parts. The mechanical performance of duotone PEEK with two different interfaces (horizontal and vertical) was investigated. With the addition of TiO2 and Fe2O3, the colors of 3D printed PEEK composites become closer to that of dental shade guides. 3D printed PEEK composites generally demonstrated superior tensile and flexural properties and hence have great potential in the dental application. In addition, duotone 3D printed PEEK with a horizontal interfacial orientation presented better mechanical performance than that with a vertical one.
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Affiliation(s)
- Ling Ding
- Department of Prosthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210000, China; (L.D.); (W.L.); (J.Z.)
| | - Wei Lu
- Department of Prosthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210000, China; (L.D.); (W.L.); (J.Z.)
| | - Jiaqi Zhang
- Department of Prosthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210000, China; (L.D.); (W.L.); (J.Z.)
| | - Chuncheng Yang
- State Key Laboratory for Manufacturing Systems Engineering, Xi’an Jiaotong University, Xi’an 710000, China;
| | - Guofeng Wu
- Department of Prosthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210000, China; (L.D.); (W.L.); (J.Z.)
- Digital Engineering Center of Stomatology and Department of Prosthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210000, China
- Correspondence:
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