try getting rid of the the second "mod:" in the last line, so it reads "[mod:ctrl,alt]" or add a + "[mod:ctrl+alt]". When you set the icon for the macro leave it as "?". When you press each mod, the icon should change to whichever spell it will cast. That should help diagnose what works and what doesn't.
Not sure why the shift mod is not working. Do you have the spell? That's the only reason I can think of for it to not work as written.
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