Citation: Sharma Pankaj, Mittal Veena, Chhabra Mala, Roop Kumari, Priyanka Singh, Dipesh Bhattacharya, Srinivas Venkatesh, Arvind Rai. Molecular characterization of DENV-3 circulating during the post-monsoon period of 2013-14 in Delhi, India .VIROLOGICA SINICA, 2015, 30(6) : 464-469.  http://dx.doi.org/10.1007/s12250-015-3649-5

Molecular characterization of DENV-3 circulating during the post-monsoon period of 2013-14 in Delhi, India

  • Corresponding author: Mittal Veena, veena_m12@yahoo.com, ORCID: 0000-0001-9362-8064
  • Published Date: 14 December 2015
    Available online: 01 December 2015
  • The present study characterizes the recently circulating DENV-3 strain in the metropolitan city of Delhi during post monsoon period of 2013-14. Partial molecular characterization of 12 DENV3 isolates was carried out on the basis of envelope (E) and non-structural 1 (NS1) gene regions. Phylogenetic analysis showed all these 12 isolates grouped under lineage III of genotype III with recent isolates from China and Pakistan. The point mutation L430I in the Env region appears to be the unique molecular signature for the 2013 strains. Another unique substitution, I167V in NS1 protein was observed in a single isolate among those 12 samples. The study describing the molecular characterization could be significant if these unique substitutions cause the poor B cell responses.

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    1. Afreen N, Deeba F, Naqvi I, et al. 2014. PLoS Curr. Doi: 10.1371/currents.outbreaks.0411252a8b82aa933f6540abb54a855f.

    2. Akey DL, Brown WC, Dutta S, et al. 2014. Science, 343: 881-885.
        doi: 10.1126/science.1247749

    3. Barnes MR. 2007. 2nd edn. Chichester, England; Hoboken, NJ: Wiley.

    4. Chao DY, King CC, Wang WK, et al. 2005. Virol J, 2: 72.
        doi: 10.1186/1743-422X-2-72

    5. Dar L, Broor S, Sengupta S, et al. 1999. Emerg Infect Dis, 5: 589-590.
        doi: 10.3201/eid0504.990427

    6. Koo C, Nasir A, Hapuarachchi HC, et al. 2013. Virol J, 10: 275.
        doi: 10.1186/1743-422X-10-275

    7. Kukreti H, Chaudhary A, Rautela RS, et al. 2008. Int J Infect Dis, 12: 542-549.
        doi: 10.1016/j.ijid.2008.02.009

    8. Lanciotti RS, Lewis JG, Gubler DJ, et al. 1994. J Gen Virol, 75: 65-75.
        doi: 10.1099/0022-1317-75-1-65

    9. Muller DA, Young PR. 2013. Antiviral Res, 98: 192-208.
        doi: 10.1016/j.antiviral.2013.03.008

    10. Sharma P, Mittal V, Chhabra M, et al. 2014. J Virol Retrovirol, 1: 104.

    11. Sharma S, Dash PK, Agarwal S, et al. 2011. J Gen Virol, 92: 1595-1600.
        doi: 10.1099/vir.0.030437-0

    12. Singh P, Mittal V, Rizvi MM, et al. 2012. Epidemiol Infect, 140: 1337-1342.
        doi: 10.1017/S0950268811001671

    13. Wang T, Wang M, Shu B, et al. 2015. PLoS Negl Trop Dis, 9: e0003677.
        doi: 10.1371/journal.pntd.0003677

    14. World Health Organization (WHO). 2015. Dengue and severe dengue. Available: http://www.who.int/mediacentre/factsheets/fs117/en/.

    15. Zhang W, Chipman PR, Corver J, et al. 2003. Nat Struct Biol, 10: 907-912.
        doi: 10.1038/nsb990

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    Molecular characterization of DENV-3 circulating during the post-monsoon period of 2013-14 in Delhi, India

      Corresponding author: Mittal Veena, veena_m12@yahoo.com
    • 1. Division of Zoonosis, National Centre for Disease Control, Delhi 110054, India
    • 2. Centre for Medical Entomology and Vector Management, National Centre for Disease Control, Delhi 110054, India
    • 3. Division of Biotechnology, National Centre for Disease Control, Delhi 110054, India

    Abstract: The present study characterizes the recently circulating DENV-3 strain in the metropolitan city of Delhi during post monsoon period of 2013-14. Partial molecular characterization of 12 DENV3 isolates was carried out on the basis of envelope (E) and non-structural 1 (NS1) gene regions. Phylogenetic analysis showed all these 12 isolates grouped under lineage III of genotype III with recent isolates from China and Pakistan. The point mutation L430I in the Env region appears to be the unique molecular signature for the 2013 strains. Another unique substitution, I167V in NS1 protein was observed in a single isolate among those 12 samples. The study describing the molecular characterization could be significant if these unique substitutions cause the poor B cell responses.

    • Dear Editor,

      Dengue infection is one of the emerging concerns for public health on a global scale. Over the past few years, dengue transmission has increased in the Americas, the western Pacific and southeast Asia. The magnitude, distribution, and clinical severity of dengue outbreaks have been an alarming signal in the southeast Asia region. Major outbreaks have been reported in countries in this region, including in Sri Lanka, Nepal, Bangladesh, Pakistan, and China(Koo et al., 2013; Wang et al., 2015). Recent reports have indicated an increasing trend in the number of cases in the People's Republic of China, Fiji, Malaysia, The Cook Islands, and Vanuatu, with DENV-3 affecting the Pacific Island countries after a lapse of nearly 10 years(WHO, 2015).

      In the past two decades, major dengue outbreaks have been reported in Delhi, the national capital of India. All four serotypes of DENV circulate in Delhi, but only three(DENV-1, 2, and 3)have been reported as the main etiological agent in different outbreaks(Dar et al., 1999; Kukreti et al., 2008; Singh et al., 2012). The recent outbreak of dengue in 2013 was predominantly caused by DENV-2; however, DENV-1 and DENV-3 were also reported in 19% and 8% of cases, respectively(Afreen et al., 2014). In 2012, a downward shift in pre-dominance of DENV-1 and an upward shift in dominance of DENV-2 and DENV-3 were recorded(Sharma et al., 2014). This shift probably resulted in the DENV-2 outbreak in 2013. The possibility of an outbreak predominated by DENV-3 cannot now be ruled out.

      The aim of the present study was to characterize the DENV-3 currently circulating in the capital. For this purpose, envelope(E) and non-structural 1(NS1)gene regions were sequenced and analyzed. Acute phase serum samples with confirmed DENV-3 serotype were included in the study. Samples from different geographical locations of Delhi were referred to the National Centre for Disease Control for diagnosis during the post-monsoon period of 2013 and 2014.

      Viral RNA was isolated from serum, using QIAmp Viral RNA Mini Kit(Qiagen, Hilden, Germany)following the manufacturer's protocol. The E gene of DENV-3 was amplified using the primers, P1259A and CDC2503B described by Chao et al.(Chao et al., 2005). The cDNA was synthesized by reverse primer(CDC2503B)using GoScriptTM Reverse Trancription System(Promega, Madison, USA). For cDNA amplification, GoTaq® Green Master Mix(Promega, USA)was applied, using 1 µL cDNA as a template. Initial denaturation was performed at 95 ℃ for 2 min, followed by 35 cycles of denaturation(95 ℃ for 30 s), annealing(54 ℃ for 50 s) and extension(72 ℃ for 1.5 min), with a final extension step at 72 ℃ for 10 min. The amplified PCR products(~1244bp)were visualized on 1% agarose gel stained with ethidium bromide.

      For amplification of NS1 gene, a new set of primer(D3NS1F, nt 2407-2434, 5′-TGAATTCGACATGGGGTGTGTCATAAAC-3′; D3NS1R, nt 3456-3478, 5′-TGCGGCCGCCGCTGAGACTAAAG-3′)was designed using the software Gene Runner(version 3.05)according to the DENV-3 reference sequence(NC_0014 75.2). Reverse transcription polymerase chain reaction(RT-PCR)was carried out in a 25 µL reaction volume using the QIAGEN OneStep RT-PCR Kit(Qiagen). The thermal profile of RT-PCR was an RT step at 50 ℃ for 30 min, followed by the PCR step of initial denaturation at 95 ℃ for 15 min, followed by 35 cycles of denaturation at 94 ℃ for 50 s, annealing at 54 ℃ for 50 s, extension at 72 ℃ for 1 min and final extension at 72 ℃ for 10 min. Amplified PCR products(~1072 bp)were separated in 1% agarose gel and visualized with ethidium bromide.

      The PCR products of the amplified gene fragments were purified by using the QIAquick PCR purification kit(Qiagen). For sequencing, the BigDye Terminator Cycle Sequencing Kit(version 3.1; Applied Biosystems, Foster City, USA)was used, with an ABI 3130xl Genetic Analyzer(Applied Biosystems). Retrieved sequences were submitted to GenBank(http://www.ncbi.nlm. nih.gov/) and accession numbers were acquired(Table 1). A BLAST search(http://blast.ncbi.nlm.nih.gov/ Blast.cgi)was carried out to confirm the identity of the strains. For sequence comparison with previously reported Indian and other geographically diverse DENV-3 isolates(Supplementary Table S1), multiple sequence alignment was performed using the Clustal W multiple alignment tool available in BioEdit(version 7.0.5.3). To represent the three-dimensional structure of the proteins, Cn3D(version 4.3.1)was used(http://www.ncbi.nlm.nih.gov/Structure/CN3D/cn3d.shtml). Phylogenetic analysis was performed using MEGA(version 5.0). A Tamura Nei model of nucleotide substitution with a gamma distribution of between-site rate variation was employed to construct the neighbor-joining tree with 1000 bootstrap replicates. To calculate nucleotide diversity per site(Pi), Tajima's D-test statistics, and nucleotide-based statistics(Ks, Kst, Ks*, Kst*, Z, Z* and Snn), we used DnaSP(version 5.10). F statistics(Fst) and the N statistics(Nst)were also calculated by DnaSP(version 5.10)to estimate diversity and gene flow(Nm)among the phylogenetic lineages.

      Sample no.Isolate nameYearGenotypeAccession number
      E geneNS1 gene
      11/D3/Del/20132013KT250573KT250581
      22/D3/Del/20132013KT250574KT250582
      33/D3/Del/20132013KT250575KT250583
      44/D3/Del/20132013KT250576KT250584
      55/D3/Del/20132013KT250577KT250585
      66/D3/Del/20132013KT250578KT250586
      77/D3/Del/20132013KT250579KT250587
      88/D3/Del/20132013KT250580KT250588
      91/D3/Del/20142014KT250589KT250593
      102/D3/Del/20142014KT250590KT250594
      113/D3/Del/20142014KT250591KT250595
      124/D3/Del/20142014KT250592KT250596

      Table 1.  Details of DENV-3 isolates from India sequenced in the study.

      In our study, total 12 samples(eight from 2013 and four from 2014)were sequenced for both the E and NS1 gene regions. The 981 bp(from nucleotides 1418-2398)gene region of E was selected for multiple sequence alignment. All the 12 isolates sequenced revealed 0.00423 nucleotide diversity per site(Pi). These isolates showed sequence identity of 98.36%-99.67% with other Indian isolates. Sequence comparison with the prototype strain H87(M93130)revealed a few amino acid substitutions, which were also present in other previously reported Indian isolates(Supplementary Figure S1). In the phylogenetic analysis, all Indian and global isolates could be classified as five different genotypes of DENV-3(Figure 1A). The analysis revealed clustering of all Indian isolates within the same group(genotype Ⅲ)with recent isolates from China(GU363549, KF954945-KF954948) and Pakistan(KF041256, KF041258 and KF041259). Extensive analysis of the phylogenetic tree revealed the presence of the five lineages of genotype Ⅲ. Lineage Ⅰ isolates formed a separate clade in closeness to lineage Ⅱ, and was represented by the isolates from the Americas, including Brazil, Saint Lucia, Venezuela, Puerto Rico, Colombia, and Martinique. Lineage Ⅱ was represented by the isolates from Sri Lanka(GQ252674 and FJ882571) and Mozambique(FJ882575), and was found in close proximity to lineage Ⅲ. All the Indian isolates were categorized under lineage Ⅲ. Isolates from Sri Lanka, China's Taiwan, and Singapore clustered as lineage Ⅳ, while lineage Ⅴ was formed only by the three older isolates from Sri Lanka(FJ882572, FJ882574, and GQ199889). The nucleotide diversity per site(Pi)in all genotype Ⅲ sequences was recorded as 0.02345. Genetic differentiation between the five lineages was analyzed by Ks = 9.80970, Kst = 0.57351, Ks* = 2.22754, Kst* = 0.25983, Z = 428.15909, Z* = 5.73874, and Snn = 1.0. The statistical significance of nucleotide-based statistics was tested by the permutation test with 1000 replication value(P < 0.001). Nst and Fst recorded for the lineages were 0.67884 and 0.67537; χ2 = 284, P = 0.0013. Estimated gene flow(Nm)was 0.12. Tajima's D value(-1.02015, P > 0.10)showed a neutral evolutionary trend for all the DENV-3 isolates.

      Figure 1.  (A) Phylogenetic tree of DENV-3 based on 981 bp (nucleotide 1418 to 2398) E gene region generated by the neighbor-joining (NJ) method (1000 Bootstrap replications). Each sequence is denoted by serotype, country of origin, followed by the last two digits of the year of isolation and GenBank accession number. Isolates sequenced in the study are shown in bold (symbol with ▲). (B) Phylogenetic tree of DENV-3 based on 823 bp (nucleotide 2498 to 3320) NS1 gene region generated by the NJ method (1000 bootstrap replications). Each sequence is denoted by serotype and country of origin, followed by the last two digits of year of isolation and the GenBank accession number. Isolates sequenced in the study are shown in bold (symbol with ●). (C) 3D representation using Cn3D. C-1: The position of the L430I substitution inferred from the three-dimensional (3D) structure of the E protein (PDB sequence; 3J6S_A). C-2: The position of I167V substitution inferred from the 3D structure of the NS1 protein (PDB sequence; 406B_A).

      The phylogenetic analysis based on the 823 bp gene region(nucleotides 2498-3320)of NS1 also revealed a similar segregation of sequences, as shown by the tree based on the E gene region(Figure 1B). A few sequences were removed from the analysis because of unavailability of sequence for the NS1 gene region. All sequenced isolates had sequence identity of 96.35%-100% to other Indian isolates from previous years. Recent isolates from China(KF954945-KF954948)also showed close identity(99.02%-99.63%)to these isolates. Sequence identity of 99.27%-99.78% to Pakistan isolates(KF041256, KF041258, and KF041259)was observed. The nucleotide diversity per site(Pi)for all sequences isolated was found to be 0.00171. Genetic differentiation between the five lineages for the NS1 gene region was analyzed by Ks = 8.47947, Kst = 0.61084, Ks* = 1.97655, and Kst = 0.32173 and Snn = 1.0. In permutation testing with 1000 replication values, P < 0.001 showed statistical significance of nucleotide-based statistics. Nst and Fst for the lineages were recorded as 0.68635 and 0.68296, respectively(χ2 = 260, P = 0.0004). Gene flow(Nm)was estimated as 0.12. Tajima's D test, applied to all the DENV-3 sequences for the NS1 gene region, showed a neutral evolutionary trend(Tajima's D value = -1.18983, P > 0.10).

      All the 12 isolates sequenced clustered within lineage Ⅲ of genotype Ⅲ. This lineage was formed by recent strains prevalent in India, China, and Pakistan. The presence of different lineages has been explained in an earlier study on the basis of the complete nucleotide sequence of the DENV-3 genome.(Sharma et al., 2011). The nucleotide-based statistics, F statistics, N statistics, and gene flow analysis for both the E and NS1 gene regions advocated genetic differentiation between the phylogenetic lineages. Sequence comparison with prototype strain H87 revealed the presence of a few amino acid substitutions that were also present in other Indian isolates.

      A unique amino acid substitution(L430I)in the E protein was observed in 83.33%(10/12)isolates(Supplementary Figure 1). This substitution falls within the α helix of the stem region(Figure 1C-1). The substitution at this site has also been reported in an earlier isolate from Samoa in 1986(L11435)(Lanciotti et al., 1994). This site is located within the stem–anchor region adjacent to the putative receptor-binding domain(domain Ⅲ)in E protein. The stem and anchor regions are both predicted to have two α-helices each. Secondary structure prediction of the stem region has suggested that the two consecutive, mostly amphipathic, α-helices are half-buried in the outer lipid leaflet of the viral membrane(Zhang et al., 2003). Their interactions with the lipid phosphate groups are probably affected by the pH changes, contributing to the forces that cause conformational rearrangements during the time of fusion(Zhang et al., 2003). The substitution L430I is present in the α-helix in the stem region. The presence of a neutral, non-polar, amino acid residue at this site may be essential for such conformational rearrangements. The E protein is a major antigenic determinant. The substitution L430I lies in the MHC complex(epitope I.D 59137)(http://www.iedb.org/refId/1000409) and may have an important role in the host immune response.

      Another unique substitution, I167V, in the NS1 protein was observed in a single isolate(KT250588). The substitution lies in the connector subdomain of NS1(Figure 1C-2), which links the "wing" domain to the central β-sheet through a disulfide linkage(Akey et al., 2014). The NS1 protein is a protective antigen, and is known to play an important role in viral RNA replication. It has also been suggested to play a role in structural support for providing stability for replication complex(Muller and Young, 2013). Both isoleucine and valine are hydrophobic in nature and prefer to be buried in the hydrophobic cores of protein(Barnes, 2007). It is possible that hydrophobicity at this site is necessary for the structural support and functionality of NS1. However, to confirm this, additional studies are required.

      Further analysis also revealed the close identity of the sequenced Delhi isolates to recent isolates(KF954945– KF954948)from China, which is an alarming signal for public health, as this strain has been associated with a dengue outbreak in China(Wang et al., 2015). To prevent the occurrence of such outbreaks and to observe the unique variations accumulating in virus, it is essential to continually monitor the spread of DENV-3 and characterize it at the genomic level.

    • The authors acknowledge partial financial support from Indian Council of Medical Research(ICMR), Delhi during the course of this study. The authors declare that they have no conflict of interest. The approval of the institutional ethical committee was obtained to carry out the present study. "Waiver of informed consent" was obtained from the committee on the basis of use of "leftover samples after clinical diagnosis" under the 2006 guidelines of the ICMR. This work was carried out in collabora-tion among all the authors. All authors read and approved the final manuscript.

      Supplementary figures/tables are available on the website of Virologica Sinica: www.virosin.org; link.springer.com/journal/ 12250.

    • Sample
      no.
      Isolate nameCountry & RegionYearGenotypeAccession
      no.
      1.Sleman/78Indonesia1978AY648961
      2.InJ-16-82Indonesia1982DQ401690
      3.den3_88Indonesia1988AY858038
      4.PF89/27643French Polynesia1989AY744677
      5.PF90/3056French Polynesia1990AY744680
      6.PF94/136116French Polynesia1994AY744685
      7.PhMH-J1-97Philippines1997AY496879
      8.98902890 DF DV-3Indonesia1998AB189128
      9.KJ30iIndonesia2004AY858042
      10.D3/Hu/TL129NIID/2005East Timor2005AB214882
      11.DENV-3/TH/BID-V3360/1973Thailand1973GQ868593
      12.ThD3_0010_87Thailand1987AY676352
      13.C0360/94Thailand1994AY923865
      14.Singapore 8120/95Singapore1995AY766104
      15.98TW358China's Taiwan1998DQ675522
      16.DENV-3/TH/BID-V2329/2001Thailand2001FJ744740
      17.DENV-3/IPC/BID-V3809/2003Cambodia2003GU131906
      18.DENV-3/KH/BID-V2087/2005Cambodia2005GQ868629
      19.DENV-3/VN/BID-V1014/2006Vietnam2006EU482458
      20.DENV-3/KH/BID-V3829/2007Cambodia2007HM181935
      21.DENV-3/IPC/BID-V3808/2008Cambodia2008GU131905
      22.DENV-3/LK/BID-V2410/1983Sri Lanka1983GQ199889
      23.DENV-3/MZ/BID-V2418/1985Mozambique1985FJ882575
      24.DENV-3/LK/BID-V2414/1985Sri Lanka1985FJ882574
      25.DENV-3/LK/BID-V2412/1989Sri Lanka1989FJ882572
      26.DENV-3/LK/BID-V2411/1989Sri Lanka1989FJ882571
      27.DENV-3/LK/BID-V2413/1993Sri Lanka1993FJ882573
      28.BR DEN3 97-04Brazil1997EF629367
      29.DENV-3/LK/BID-V2409/1997Sri Lanka1997GQ252674
      30.DENV-3/US/BID-V1449/1998Puerto Rico1998EU726772
      31.99TW628China's Taiwan1999DQ675533
      32.DENV-3/US/BID-V1452/1999Puerto Rico1999EU781137
      33.D3/H/IMTSSA-MART/1999/1243Martinique1999AY099337
      34.DENV-3/VE/BID-V2175/2000Venezuela2000FJ639747
      35.DENV-3/US/BID-V2103/2000Puerto Rico2000FJ547071
      36.D3/H/IMTSSA-SRI/2000/1266Sri Lanka2000AY099336
      37.DENV-3/LC/BID-V3929/2001Saint Lucia2001GQ868616
      38.DENV-3/VE/BID-V911/2001Venezuela2001EU529691
      39.DENV-3/VE/BID-V913/2001Venezuela2001EU482614
      40.DENV-3/CO/BID-V3393/2002Colombia2002GQ868571
      41.BR74886/02Brazil2002AY679147
      42.DENV-3/CO/BID-V3398/2003Colombia2003GQ868574
      43.D3BR/RP1/2003Brazil2003EF643017
      44.DENV-3/US/BID-V1089/2003Puerto Rico2003EU529702
      45.GWL-25India2003AY770511
      46.DENV-3/VE/BID-V1590/2004Venezuela2004FJ373304
      47.DENV-3/US/BID-V1606/2004Puerto Rico2004FJ024465
      48.DENV-3/CO/BID-V3400/2004Colombia2004GQ868575
      49.D3/SG/SS710/2004Singapore2004EU081181
      50.D3/SG/05K2933DK1/2005Singapore2005EU081198
      51.DENV-3/US/BID-V1621/2005Puerto Rico2005FJ182011
      52.DENV-3/VE/BID-V1593/2005Venezuela2005EU854292
      53.NAaSingapore2005AY662691
      54.D3/SG/05K2918DK1/2005Singapore2005EU081197
      55.D3/SG/05K3316DK1/2005Singapore2005EU081202
      56.DENV-3/IND/59826/2005India2005JQ922557
      57.DENV-3/IND/58760/2005India2005JQ922556
      58.NIV_058760India2005JQ686078
      59.NIV_059826India2005JQ686077
      60.DENV-3/CO/BID-V3404/2006Colombia2006GU131954
      61.DENV-3/US/BID-V1080/2006Puerto Rico2006EU529699
      62.D3/Pakistan/43298/2006Pakistan2006KF041259
      63.D3/Pakistan/55709/2006Pakistan2006KF041256
      64.DENV-3/CO/BID-V3405/2007Colombia2007GQ868578
      65.DENV-3/BR/BID-V3615/2007Brazil2007GU131878
      66.DENV-3/VE/BID-V2483/2007Venezuela2007GQ868587
      67.ND-143India2007FJ644564
      68.RR-72India2008GQ466079
      69.DENV-3/NI/BID-V4743/2009Nicaragua2009HQ166034
      70.GZ1D3China2009GU363549
      71.D3/Pakistan/45251/2009Pakistan2009KF041258
      72.NIV_0948359India2009JQ686081
      73.NIV_1029582India2010JQ686080
      74.NIV_1030355India2010JQ686076
      75.D3/India/1008aTwIndia2010JF968097
      76.13GDZDVS30BChina2013KF954946
      77.13GDZDVS30CChina2013KF954947
      78.13GDZDVS30DChina2013KF954948
      79.13GDZDVS30EChina2013KF954949
      80.13GDZDVS30AChina2013KF954945
      81.Puerto Rico 1963Puerto Rico1963L11433
      82.Puerto Rico 1977Puerto Rico1977L11434
      83.H87Philippines1956M93130
      84.80-2China1980AF317645
      85.BR DEN3 RO1-02Brazil2002EF629370
      aNA, name of the isolate is not available in GenBank

      Table S1.  DENV-3 isolates of diverse geographic origin, used in the study.

      Figure S1.  Amino acid changes observed in E protein of DENV-3 isolates (lineage Ⅲ), compared with the prototype strain H87 (Accession number M93130).

    Figure (2)  Table (2) Reference (15) Relative (20)

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