Database : MEDLINE
Search on : endometrial and ablation and techniques [Words]
References found : 830 [refine]
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[PMID]: 28796898
[Au] Autor:Louie M; Spencer J; Wheeler S; Ellis V; Toubia T; Schiff LD; Siedhoff MT; Moulder JK
[Ad] Address:Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
[Ti] Title:Comparison of the levonorgestrel-releasing intrauterine system, hysterectomy, and endometrial ablation for heavy menstrual bleeding in a decision analysis model.
[So] Source:Int J Gynaecol Obstet;139(2):121-129, 2017 Nov.
[Is] ISSN:1879-3479
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: A better understanding of the relative risks and benefits of common treatment options for abnormal uterine bleeding (AUB) can help providers and patients to make balanced, evidence-based decisions. OBJECTIVES: To provide comparative estimates of clinical outcomes after placement of levonorgestrel-releasing intrauterine system (LNG-IUS), ablation, or hysterectomy for AUB. SEARCH STRATEGY: A PubMED search was done using combinations of search terms related to abnormal uterine bleeding, LNG-IUS, hysterectomy, endometrial ablation, cost-benefit analysis, cost-effectiveness, and quality-adjusted life years. SELECTION CRITERIA: Full articles published in 2006-2016 available in English comparing at least two treatment modalities of interest among women of reproductive age with AUB were included. DATA COLLECTION AND ANALYSIS: A decision tree was generated to compare clinical outcomes in a hypothetical cohort of 100 000 premenopausal women with nonmalignant AUB. We evaluated complications, mortality, and treatment outcomes over a 5-year period, calculated cumulative quality-adjusted life years (QALYs), and conducted probabilistic sensitivity analysis. MAIN RESULTS: Levonorgestrel-releasing intrauterine system had the highest number of QALYs (406 920), followed by hysterectomy (403 466), non-resectoscopic ablation (399 244), and resectoscopic ablation (395 827). Ablation had more treatment failures and complications than LNG-IUS and hysterectomy. Findings were robust in probabilistic sensitivity analysis. CONCLUSIONS: Levonorgestrel-releasing intrauterine system and hysterectomy outperformed endometrial ablation for treatment of AUB.
[Mh] MeSH terms primary: Decision Support Techniques
Menorrhagia/therapy
Models, Theoretical
[Mh] MeSH terms secundary: Endometrial Ablation Techniques
Female
Humans
Hysterectomy
Levonorgestrel/administration & dosage
Menorrhagia/surgery
Treatment Outcome
[Pt] Publication type:COMPARATIVE STUDY; JOURNAL ARTICLE; REVIEW
[Nm] Name of substance:5W7SIA7YZW (Levonorgestrel)
[Em] Entry month:1710
[Cu] Class update date: 171030
[Lr] Last revision date:171030
[Js] Journal subset:IM
[Da] Date of entry for processing:170810
[St] Status:MEDLINE
[do] DOI:10.1002/ijgo.12293

  2 / 830 MEDLINE  
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[PMID]: 29046244
[Au] Autor:Leathersich SJ; McGurgan PM
[Ad] Address:King Edward Memorial Hospital for Women, 374 Bagot Road, Subiaco, WA 6008, Australia. Electronic address: sebastian.leathersich@health.wa.gov.au.
[Ti] Title:Endometrial resection and global ablation in the normal uterus.
[So] Source:Best Pract Res Clin Obstet Gynaecol;, 2017 Sep 28.
[Is] ISSN:1532-1932
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:There are various methods that can be used to destroy the endometrium as a treatment for menorrhagia. This chapter reviews the history, rationale, evidence, indications and long-term safety and efficacy of the current techniques. It also discusses endometrial ablation in the context of its clinical utility in comparison with existing alternative treatments.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1710
[Cu] Class update date: 171019
[Lr] Last revision date:171019
[St] Status:Publisher

  3 / 830 MEDLINE  
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[PMID]: 28843713
[Au] Autor:Cramer SF; Heller DS
[Ad] Address:Department of Pathology, Rochester General Hospital, University of Rochester School of Medicine, Rochester, 14621, NY.
[Ti] Title:Postablation neuroma of the myometrium-a report of 5 cases.
[So] Source:Hum Pathol;67:211-216, 2017 Sep.
[Is] ISSN:1532-8392
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:When hysterectomy is performed for chronic pelvic pain, routine pathology examination often provides no explanation. However, analysis of small uterine nerves using immunostains may help to address this deficiency. Small uterine nerves tend to be sparse or absent in wide areas of normal myometrium. Some studies of uterine nerves have suggested that endometriosis, adenomyosis, and fibroids are not inherently painful, with increased small nerves in the inner uterine wall associated with the history of pelvic pain. Although such areas may appear normal on hematoxylin and eosin (H&E), we have found a subtle inner wall lesion termed inner myometrial elastosis, best detected with trichrome or elastic stains, which may be a reaction to microscopic tears of inner myometrium. Such tears may induce increased inner wall innervation via the generation of nerve growth factor in granulation tissue. In the course of studying uterine nerves with immunostains, we found 5 cases with florid nerve proliferation, after deep endometrial ablation for abnormal uterine bleeding led to increased pelvic pain. We suggest that immunostains for postablation neuromas should be done in hysterectomies when pelvic pain increases after endometrial ablation. This may offer gynecologists and their patients an objective finding with a rational, scientific explanation for the pelvic pain.
[Mh] MeSH terms primary: Endometrial Ablation Techniques/adverse effects
Endometrial Neoplasms/etiology
Myometrium/surgery
Neuroma/etiology
Neurons/pathology
Uterine Hemorrhage/surgery
[Mh] MeSH terms secundary: Adult
Biopsy
Chronic Pain/etiology
Chronic Pain/surgery
Endometrial Neoplasms/pathology
Endometrial Neoplasms/surgery
Female
Humans
Hysterectomy
Immunohistochemistry
Middle Aged
Myometrium/innervation
Neuroma/pathology
Neuroma/surgery
Neurons/chemistry
Pain, Postoperative/etiology
Pain, Postoperative/surgery
Pelvic Pain/etiology
Pelvic Pain/surgery
Treatment Outcome
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171016
[Lr] Last revision date:171016
[Js] Journal subset:IM
[Da] Date of entry for processing:170827
[St] Status:MEDLINE

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[PMID]: 28888699
[Au] Autor:Famuyide A
[Ad] Address:Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota. Electronic address: famuyide.abimbola@mayo.edu.
[Ti] Title:Endometrial Ablation.
[So] Source:J Minim Invasive Gynecol;, 2017 Sep 06.
[Is] ISSN:1553-4669
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:The destruction of the endometrium in women with heavy menstrual bleeding has been used for well over a century, and the various techniques of delivering forms of thermal energy have been modified over the years to ensure a safe and effective treatment approach. Today, 6 nonresectoscopic devices are approved for use in the United States in addition to resectoscopic techniques that rely on the skillful use of the operative hysteroscope. Regardless of the technique used, endometrial ablation uniformly reduces menstrual blood loss, improves general and menstrual-related quality of life, and prevents hysterectomy in 4 of 5 women who undergo the procedure. When patients are appropriately selected, outcomes are optimized, and risks of serious complications are minimized. This article reviews the literature with singular reference to nonresectoscopic endometrial ablation procedures including historical background, appropriate patient selection, clinical outcomes data, complications, and special or unique considerations.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1709
[Cu] Class update date: 171009
[Lr] Last revision date:171009
[St] Status:Publisher

  5 / 830 MEDLINE  
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[PMID]: 28696501
[Au] Autor:Kalampokas E; McRobbie S; Payne F; Parkin DE
[Ad] Address:Department of Gynecologic Oncology, Aberdeen Royal Infirmary, Aberdeen, UK.
[Ti] Title:Long-term incidence of hysterectomy following endometrial resection or endometrial ablation for heavy menstrual bleeding.
[So] Source:Int J Gynaecol Obstet;139(1):61-64, 2017 Oct.
[Is] ISSN:1879-3479
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To estimate the incidence of hysterectomy following endometrial resection or endometrial ablation (ERA). METHODS: The present retrospective study enrolled women who underwent ERA for benign heavy menstrual bleeding (HMB) at Aberdeen Royal Infirmary, UK, between February 1, 1990, and December 31, 1997; follow-up data to the end of 2015 were included from the pathology laboratory report system from the single pathology laboratory in the region. Data were compared between patients who did or did not require a hysterectomy after ERA. RESULTS: There were 901 patients who underwent ERA for HMB during the study period. The mean age of patients was 42.3 ± 5.7 years; of the patients included, 206 (22.9%) women underwent hysterectomy and these patients had a mean age of 40.1 years. Of the patients who had hysterectomies, 155 (75.2%) did so in the first 5 years following ERA, 31 (15.0%) did within 6-10 years, 11 (5.3%) did within 11-15 years, and 9 (4.4%) did within 16-20 years. In total, 51 (24.8%) of these patients had hysterectomies within 6-25 years of ERA. CONCLUSIONS: A significant majority of women who underwent ERA for HMB did not require hysterectomy up to 25 years after the procedure.
[Mh] MeSH terms primary: Endometrial Ablation Techniques/utilization
Endometrium/surgery
Hysterectomy/statistics & numerical data
Menorrhagia/epidemiology
[Mh] MeSH terms secundary: Adult
Cohort Studies
Female
Humans
Incidence
Menorrhagia/surgery
Retrospective Studies
Scotland/epidemiology
Women's Health Services
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171006
[Lr] Last revision date:171006
[Js] Journal subset:IM
[Da] Date of entry for processing:170711
[St] Status:MEDLINE
[do] DOI:10.1002/ijgo.12259

  6 / 830 MEDLINE  
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[PMID]: 28209456
[Au] Autor:Mendez LC; Leung E; Cheung P; Barbera L
[Ad] Address:Department of Radiation Oncology, Sunnybrook Health Science Centre, University of Toronto, Toronto, Ontario, Canada.
[Ti] Title:The Role of Stereotactic Ablative Body Radiotherapy in Gynaecological Cancers: A Systematic Review.
[So] Source:Clin Oncol (R Coll Radiol);29(6):378-384, 2017 Jun.
[Is] ISSN:1433-2981
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:AIMS: To summarise and evaluate the current literature in gynaecological tumours treated with stereotactic ablative body radiotherapy (SABR) through a systematic review using the Preferred Reported Items for Systematic Reviews and Meta-analysis (PRISMA) guideline. MATERIALS AND METHODS: A literature search through Medline, EMBASE and Cochrane databases resulted in 22 pertinent manuscripts. Selected studies evaluated the locoregional role of SABR in gynaecological tumours, regardless of SABR clinical indication. Data on local control, toxicity and SABR dose and technique were extracted by at least two investigators. RESULTS: In total, 330 patients received locoregional SABR for gynaecological tumour and had measurable clinical outcomes. Six different clinical scenarios were identified: (i) boost to external beam radiotherapy (EBRT) for cervical cancer as radical treatment; (ii) boost to EBRT for non-operable endometrial cancer; (iii) treatment for pelvic and/or para-aortic node metastases; (iv) adjuvant treatment after surgery in uterine/cervix cancers; (v) salvage of non-nodal pelvic recurrences and (vi) vulvar or vaginal malignancies. Except for SABR as a boost for non-operable endometrial cancer, local control over 80% was found in a range of median follow-up of 4-132 months. Local control in non-operable endometrial tumours receiving SABR was 53%. In salvage treatments for non-nodal pelvic relapses, SABR was associated with about a 20% grade 3-4 gastrointestinal toxicity. CONCLUSION: There is no clear consensus or evidence on the defined role of SABR in gynaecological tumours. Local control and toxicity associated with SABR seems reasonable for most clinical indications found by this review with a short median follow-up. When used for salvage of non-nodal pelvic recurrences, SABR may be associated with high rates of grade 3-4 late gastrointestinal toxicity.
[Mh] MeSH terms primary: Genital Neoplasms, Female/radiotherapy
Radiosurgery
[Mh] MeSH terms secundary: Ablation Techniques
Female
Genital Neoplasms, Female/surgery
Humans
Lymph Nodes/pathology
Lymphatic Metastasis
Radiosurgery/adverse effects
Radiotherapy, Adjuvant
Salvage Therapy
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1709
[Cu] Class update date: 170912
[Lr] Last revision date:170912
[Js] Journal subset:IM
[Da] Date of entry for processing:170217
[St] Status:MEDLINE

  7 / 830 MEDLINE  
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[PMID]: 28852646
[Au] Autor:Di Spiezio Sardo A; Calagna G; Santangelo F; Zizolfi B; Tanos V; Perino A; De Wilde RL
[Ad] Address:Department of Public Health, School of Medicine, University of Naples "Federico II", Naples, Italy.
[Ti] Title:The Role of Hysteroscopy in the Diagnosis and Treatment of Adenomyosis.
[So] Source:Biomed Res Int;2017:2518396, 2017.
[Is] ISSN:2314-6141
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Uterine adenomyosis is a common gynecologic disorder in women of reproductive age, characterized by the presence of ectopic endometrial glands and stroma within the myometrium. Dysmenorrhea, abnormal uterine bleeding, chronic pelvic pain, and deep dyspareunia are common symptoms of this pathological condition. However, adenomyosis is often an incidental finding in specimens obtained from hysterectomy or uterine biopsies. The recent evolution of diagnostic imaging techniques, such as transvaginal sonography, hysterosalpingography, and magnetic resonance imaging, has contributed to improving accuracy in the identification of this pathology. Hysteroscopy offers the advantage of direct visualization of the uterine cavity while giving the option of collecting histological biopsy samples under visual control. Hysteroscopy is not a first-line treatment approach for adenomyosis and it represents a viable option only in selected cases of focal or diffuse "superficial" forms. During office hysteroscopy, it is possible to enucleate superficial focal adenomyomas or to evacuate cystic haemorrhagic lesions of less than 1.5 cm in diameter. Instead, resectoscopic treatment is indicated in cases of superficial adenomyotic nodules > 1.5 cm in size and for diffuse superficial adenomyosis. Finally, endometrial ablation may be performed with the additional removal of the underlying myometrium.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1708
[Cu] Class update date: 170902
[Lr] Last revision date:170902
[St] Status:In-Process
[do] DOI:10.1155/2017/2518396

  8 / 830 MEDLINE  
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[PMID]: 28246921
[Au] Autor:Barral M; Placé V; Dautry R; Bendavid S; Cornelis F; Foucher R; Guerrache Y; Soyer P
[Ad] Address:Sorbonne Paris Cité, Hôpital Lariboisière, Université Paris Diderot, Paris, France. matthiasbarral@gmail.com.
[Ti] Title:Magnetic resonance imaging features of uterine sarcoma and mimickers.
[So] Source:Abdom Radiol (NY);42(6):1762-1772, 2017 Jun.
[Is] ISSN:2366-0058
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Uterine myometrial tumors are predominantly benign conditions that affect one-third of women and represent the main indication for hysterectomy. Preoperative imaging is of utmost importance for characterization and for precise mapping of myometrial tumors to best guide therapeutic strategy. New minimally invasive therapeutic strategies including morcellation, myolysis, uterine artery embolization and image-guided radiofrequency or focused ultrasound ablation have been developed for the treatment of uterine leiomyoma. However, preoperative differentiation between atypical leiomyomas and leiomyosarcomas is critical on imaging as uterine sarcoma requires a specific surgical technique to prevent dissemination. A single, rapidly growing uterine tumor, associated with endometrial thickening and ascites, in post-menopausal women is suspicious of uterine endometrial stromal sarcoma and carcinosarcoma. Suggestive magnetic resonance imaging features have been described, but overlap in imaging appearance between uterine leiomyosarcomas and cellular leiomyomas makes it challenging to ascertain the diagnosis. This review aims to illustrate the imaging features of uterine sarcomas and potential mimickers to make the reader more familiar with this serious condition which needs special consideration.
[Mh] MeSH terms primary: Magnetic Resonance Imaging/methods
Uterine Neoplasms/diagnostic imaging
[Mh] MeSH terms secundary: Carcinosarcoma/diagnostic imaging
Diagnosis, Differential
Female
Humans
Leiomyoma/diagnostic imaging
Leiomyosarcoma/diagnostic imaging
Sarcoma, Endometrial Stromal/diagnostic imaging
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1708
[Cu] Class update date: 170825
[Lr] Last revision date:170825
[Js] Journal subset:IM
[Da] Date of entry for processing:170301
[St] Status:MEDLINE
[do] DOI:10.1007/s00261-017-1076-9

  9 / 830 MEDLINE  
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[PMID]: 28437003
[Au] Autor:Zhang L; Rao F; Setzen R
[Ad] Address:State Key Laboratory of Ultrasound Engineering in Medicine, Chongqing Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China.
[Ti] Title:High intensity focused ultrasound for the treatment of adenomyosis: selection criteria, efficacy, safety and fertility.
[So] Source:Acta Obstet Gynecol Scand;96(6):707-714, 2017 Jun.
[Is] ISSN:1600-0412
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Adenomyosis is a disorder of uterus in which endometrial glands and stroma are present within the uterine musculature. The main clinical manifestations are dysmenorrhea and menorrhagia. Adenomyosis has a great impact on both the quality of life and fertility of women. The treatment of adenomyosis remains an immense challenge. Relevant articles were searched through MEDLINE and PubMed between 2000 and March 2017. The search terms of adenomyosis, magnetic resonance imaging (MRI) features of adenomyosis, high intensity focused ultrasound (HIFU), ultrasound-guided HIFU and MRgFUS were used. There were no language restrictions. HIFU is a non-invasive local thermal ablation technique which has been used in the treatment of both focal and diffuse adenomyosis. Several case studies have demonstrated that HIFU presents low rate of minor and/or major complications and, at the same time, a long symptom-relief period. Multiple factors such as the enhancement type of the adenomyotic lesion, volume of the adenomyotic lesions, number of hyperintense foci on T2WI, location of the uterus, location of adenomyotic lesions, thickness of the abdominal wall and distance from the skin to the adenomyotic lesions contribute to the efficacy of HIFU. Consequently, based on these contributing factors, specific and strict selection criteria have been used to achieve higher efficacy. Thus, patients with pelvic endometriosis, adhesions between the bowel and the uterus, or an abdominal surgical scar wider than 10 mm, are not suitable for HIFU treatment. Moreover, HIFU-treated patients with adenomyosis, who wished to conceive, showed high conception and live birth rates. HIFU is a new and promising treatment option for patients with adenomyosis, but its efficacy, safety, cost-effectiveness and fertility outcome must be evaluated by randomized controlled trials.
[Mh] MeSH terms primary: Adenomyosis/surgery
Dysmenorrhea/surgery
High-Intensity Focused Ultrasound Ablation/methods
Infertility, Female/prevention & control
Menorrhagia/surgery
Ultrasonography, Interventional/methods
[Mh] MeSH terms secundary: Adenomyosis/complications
Dysmenorrhea/etiology
Female
Humans
Infertility, Female/etiology
Magnetic Resonance Imaging/methods
Menorrhagia/etiology
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1708
[Cu] Class update date: 170815
[Lr] Last revision date:170815
[Js] Journal subset:IM
[Da] Date of entry for processing:170424
[St] Status:MEDLINE
[do] DOI:10.1111/aogs.13159

  10 / 830 MEDLINE  
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[PMID]: 28186620
[Au] Autor:Cranney R; Condous G; Reid S
[Ad] Address:Department of Obstetrics and Gynecology, John Hunter Hospital, New Lambton Heights, NSW, Australia.
[Ti] Title:An update on the diagnosis, surgical management, and fertility outcomes for women with endometrioma.
[So] Source:Acta Obstet Gynecol Scand;96(6):633-643, 2017 Jun.
[Is] ISSN:1600-0412
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Endometriosis is estimated to affect up to 50% of infertile women, and severity of endometriosis stage appears to correlate with reduced fertility. Ovarian endometriomas are found in up to 44% of women with endometriosis, and are significantly associated with the presence of pelvic deep infiltrating endometriosis, ovarian adhesions, and pouch of Douglas obliteration. Through the use of MEDLINE and PubMed databases, we conducted a literature review of all available research related to the diagnosis, surgical management and fertility outcomes for women with endometrioma. The evolving use of specialized transvaginal ultrasound for the diagnosis of endometrioma and related endometriotic pathologies can allow for preoperative mapping/staging of the disease, as well as appropriate surgical planning and fertility counseling. Surgical management of endometriomas appears to reduce markers of ovarian reserve, such as anti-Mullerian hormone, prompting concern of reduced fertility following surgery. Ovarian cystectomy appears to be superior to ablation in terms of endometrioma recurrence, pain symptoms and increased spontaneous conception rate among subfertile patients. Research is inconclusive as to which surgical method least damages ovarian reserve in the long term; however, bipolar hemostasis appears to be the most damaging technique and should be avoided. Surgical management should be individualized for women with endometrioma, and strong consideration should be given to the preoperative ovarian reserve status prior to performing ovarian cystectomy. Current evidence suggests that ovarian cystectomy does not improve reproductive outcomes for women with endometrioma undergoing assisted reproductive technology; however, the majority of studies have been performed retrospectively and more prospective studies are needed.
[Mh] MeSH terms primary: Endometriosis/diagnosis
Endometriosis/surgery
Endometrium/surgery
Fertility Preservation/methods
[Mh] MeSH terms secundary: Anti-Mullerian Hormone/blood
Endometrial Ablation Techniques
Endometriosis/metabolism
Female
Gynecologic Surgical Procedures
Humans
Infertility, Female/etiology
Infertility, Female/prevention & control
Ovarian Diseases/diagnosis
Ovarian Diseases/surgery
Women's Health
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Nm] Name of substance:80497-65-0 (Anti-Mullerian Hormone)
[Em] Entry month:1708
[Cu] Class update date: 170815
[Lr] Last revision date:170815
[Js] Journal subset:IM
[Da] Date of entry for processing:170210
[St] Status:MEDLINE
[do] DOI:10.1111/aogs.13114


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