Cette étude passe en revue les interventions destinées aux femmes ayant survécu à un cancer et relatives à la santé sexuelle

Clinical Practice Strategies to Address Sexual Health in Female Cancer Survivors

Noël Arring ; Debra L. Barton ; Jennifer B. Reese

PURPOSE: The objectives of this narrative review are to describe (1) the evidence for interventions addressing four key issues affecting female sexual health in cancer populations (ie, low sexual desire, vulvovaginal symptoms, negative body image, and sexual partner relationships) that are ready or nearly ready for integration into practice and (2) the current state of patient-provider sexual health communication related to female sexual health as these findings could have implications for [...]

Menée par enquête dans 7 pays auprès de 467 patientes atteintes d'un cancer du sein HR+ HER2+ de stade avancé et auprès de 502 professionnels de santé, cette étude analyse leurs points de vue concernant l'importance des discussions autour de la toxicité des traitements anticancéreux et de la qualité de vie

Quality of Life and Treatment-Related Side Effects in Patients With HR+/HER2− Advanced Breast Cancer: Findings From a Multicountry Survey

Cardoso, Fatima ; Rihani, Julie ; Harmer, Victoria ; Harbeck, Nadia ; Casas, Ana ; Rugo, Hope S ; Fasching, Peter A ; Moore, Adam ; de Courcy, Joanna ; Pathak, Purnima ; Haftchenary, Sina ; Aubel, Dawn ; Schumacher-Wulf, Eva

Quality of life (QOL) is a critical factor in decision-making for advanced breast cancer (ABC). There is a need to improve how QOL and treatment-related side effects (SEs) that impact it are clinically assessed. We examined healthcare professionals’ (HCPs’) and patients’ perspectives on the importance of QOL discussions and the impact of SEs on QOL in clinical settings. A cross-sectional online survey was conducted (7/2020-5/2021) among oncologists, nurses, and patients with HR+/HER2− ABC in 7 [...]

A partir d'une revue systématique de la littérature (20 études), cette étude analyse l'intérêt des applications de e-santé (sur appareils mobiles) proposant des soins de support aux patientes atteintes d'un cancer du sein

Evaluating the Effectiveness of Mobile Health in Breast Cancer Care: A Systematic Review

Flaucher, Madeleine ; Zakreuskaya, Anastasiya ; Nissen, Michael ; Mocker, Alexander ; Fasching, Peter A ; Beckmann, Matthias W ; Eskofier, Bjoern M ; Leutheuser, Heike

Breast cancer is affecting millions of people worldwide. If not appropriately handled, the side effects of different modalities of cancer treatment can negatively impact patients’ quality of life and cause treatment interruptions. In recent years, mobile health (mHealth) interventions have shown promising opportunities to support breast cancer care. Numerous studies implemented mobile health interventions aiming to support patients with breast cancer, for example, through physical activity [...]

Menée dans un contexte de vie réelle à partir de données portant sur des patientes atteintes d'un cancer du sein de stade localement avancé ou métastatique, cette étude de cohorte prospective analyse l'incidence, la sévérité et le délai avant résolution d'une neuropathie périphérique induite par l'éribuline

Incidence and Resolution of Eribulin-Induced Peripheral Neuropathy (IRENE) in Locally Advanced or Metastatic Breast Cancer: Prospective Cohort Study

Lück, Hans-Joachim ; Schmidt, Marcus ; Hesse, Tobias ; Hoffmann, Oliver ; Heinrich, Bernhard J ; Park-Simon, Tjoung-Won ; Grischke, Eva-Maria ; Weide, Rudolf ; Müller-Huesmann, Harald ; Lüdtke-Heckenkamp, Kerstin ; Fischer, Dorothea ; Zemlin, Cosima ; Kögel, Matthias ; Wu, Jane ; Schmitz, Helga ; Engelbrecht, Christian ; Jackisch, Christian

Eribulin, a halichondrin-class microtubule dynamics inhibitor, is a preferred treatment option for patients with advanced breast cancer who have been pretreated with an anthracycline and a taxane. Peripheral neuropathy (PN) is a common side effect of chemotherapies for breast cancer and other tumors. The Incidence and Resolution of Eribulin-Induced Peripheral Neuropathy (IRENE) noninterventional postauthorization safety study assessed the incidence and severity of PN in patients with breast [...]

Menée à partir de données portant sur 171 patientes ayant survécu à un cancer du sein, cette étude analyse l'évolution de la quantité et de l'intensité d'une activité physique, 1 et 4 ans après le diagnostic de la maladie

Changes in amount and intensity of physical activity over time in breast cancer survivors

Marell, Paulina S ; Vierkant, Robert A ; Olson, Janet E ; Herrmann, Joerg ; Larson, Nicole ; Lebrasseur, Nathan K ; D'Andre, Stacy D ; Ehlers, Diane K ; Stan, Daniela L ; Cheville, Andrea L ; Barksdale, Toure ; Loprinzi, Charles L ; Couch, Fergus ; Ruddy, Kathryn J

Physical activity (PA) is associated with decreased breast cancer recurrence and mortality, as well as fewer treatment-related symptoms. Nevertheless, most breast cancer survivors do not meet PA guidelines. The purpose of this manuscript is to characterize PA trends over time in breast cancer survivors.Mayo Clinic Breast Disease Registry participants received surveys at baseline and at one and four years after diagnosis; breast cancer recurrence and/or metastatic disease were exclusion [...]

A partir d'une revue systématique de la littérature publiée jusqu'en décembre 2022 (3 essais randomisés contrôlés), cette étude évalue l'efficacité d'un pansement, le Mepitel film, pour prévenir et traiter une radiodermite aiguë chez les patientes atteintes d'un cancer du sein

Mepitel film for the prevention and treatment of acute radiation dermatitis in breast cancer: a systematic review and meta-analysis of randomized controlled trials

Shariati, Saba ; Behroozian, Tara ; Kennedy, Samantha ; Caini, Saverio ; Herst, Patries M. ; Zhang, Liying ; Ding, Keyue ; Karam, Irene ; van den Hurk, Corina ; Wolf, Julie Ryan ; Lee, Shing Fung ; Wong, Henry ; Chan, Adrian Wai ; Ogita, Mami ; Ye, Jason C. ; Chan, Raymond J. ; Gojsevic, Milena ; Rajeswaran, Thenugaa ; Bonomo, Pierluigi ; Chow, Edward

Purpose: This systematic review and meta-analysis aimed to evaluate the efficacy of Mepitel film in preventing or treating acute radiation dermatitis (RD) in patients with breast cancer in randomized controlled trials (RCTs). Methods: Embase, APA PsychInfo, Journals@Ovid Full Text, Ovid MEDLINE, PubMed, and Cochrane Trials were searched until December 12, 2022, to identify RCTs on the use of Mepitel film for preventing or treating acute RD from breast cancer radiotherapy. Per-protocol analysis [...]

A partir d'une revue systématique de la littérature publiée jusqu'en décembre 2022 (30 études), cette étude identifie les interventions de soins de support destinées aux hommes atteints d'un cancer urologique (prostate, vessie, rein et testicule)

Supportive care interventions for men with urological cancers: a scoping review

Saab, Mohamad M. ; McCarthy, Megan ; Murphy, Mike ; Medved, Katarina ; O’Malley, Maria ; Bambury, Richard M. ; Gleeson, Jack P. ; Noonan, Brendan

Purpose: To identify supportive care interventions for men with urological cancers. Methods: Experimental studies conducted among men with any urological cancer were eligible for inclusion. Academic Search Complete, CINAHL Plus with Full Text, MEDLINE, APA PsycArticles, APA PsycInfo, Social Sciences Full Text (H.W. Wilson), SocINDEX with Full Text, ERIC, Google Scholar and ClinicalTrials.gov were searched on 6 December 2022. No database limits were applied. The included studies were [...]

Menée aux Pays-Bas sur la période 1989-2021 à partir de données portant sur 47 014 patients (âge médian : 73 ans), cette étude de cohorte analyse l'évolution de l'incidence du cancer gastrique distal ainsi que l'évolution des traitements et de la survie

Incidence, Stage, Treatment, and Survival of Noncardia Gastric Cancer

van Velzen, Merel J. M. ; Braemer, Michelle ; Nieuwenhuijzen, Grard A. P. ; van Sandick, Johanna W. ; Siersema, Peter D. ; Ruurda, Jelle P. ; Verheij, Marcel ; Spaander, Manon C. W. ; Beerepoot, Laurens V. ; Haj Mohammad, Nadia ; van Laarhoven, Hanneke W. M. ; Verhoeven, Rob H. A.

Importance : Gastric cancer is the fifth most common cancer worldwide, and investigating its incidence, characteristics, treatment, and outcomes over the past decades can help in selecting clinical strategies and future research directions. Objective : To analyze the trends in incidence, staging, and treatment of gastric cancer. Design, Setting, and Participants : This nationwide, population-based cohort study included patients diagnosed with noncardia gastric cancer (NCGC) between 1989 and [...]

Menée en France à partir de données portant sur 976 patients ayant survécu au moins 5 ans à un cancer pédiatrique et présentant un risque élevé de cardiomyopathie (âge : 36-49 ans), cette étude analyse leur adhésion aux recommandations de surveillance cardiaque

Surveillance after childhood cancer: are survivors with an increased risk for cardiomyopathy regularly followed-up?

Bougas, Nicolas ; Allodji, Rodrigue S. ; Fayech, Chiraz ; Haddy, Nadia ; Mansouri, Imene ; Journy, Neige ; Demoor, Charlotte ; Allard, Julie ; Thebault, Eric ; Surun, Aurore ; Pacquement, Hélène ; Pluchart, Claire ; Bondiau, Pierre-Yves ; Berchery, Delphine ; Laprie, Anne ; Boussac, Marjorie ; Jackson, Angela ; Souchard, Vincent ; Vu-Bezin, Giao ; Dufour, Christelle ; Valteau-Couanet, Dominique ; de Vathaire, Florent ; Fresneau, Brice ; Dumas, Agnès

Background: We aimed to study adherence to cardiac screening in long-term childhood cancer survivors (CCS) at high risk of cardiomyopathy. Methods: This study involved 976 5-year CCS at high risk for cardiomyopathy from the French Childhood Cancer Survivor Study. Determinants of adherence to recommended surveillance were studied using multivariable logistic regression models. Association of attendance to a long-term follow-up (LTFU) visit with completion of an echocardiogram was estimated using [...]

Menée à partir de données 2000-2019 des registres américains des cancers, cette étude analyse les disparités ethniques et socioéconomiques dans l'évolution de l'incidence des cancers pédiatriques (âge au diagnostic : 0-19 ans)

Racial/ethnic and Socioeconomic Disparities in Childhood Cancer Incidence Trends in the United States, 2000-2019

Monterroso, Pablo S ; Li, Zhaoheng ; Domingues, Allison M ; Sample, Jeannette M ; Marcotte, Erin L

Population-based surveillance of pediatric cancer incidence trends is critical to determine high-risk populations, drive hypothesis generation, and uncover etiologic heterogeneity. We provide a comprehensive update to the current understanding of pediatric cancer incidence trends by sex, race/ethnicity, and socioeconomic status (SES).The Surveillance, Epidemiology, and End Results 22 data (2000-2019) was used to summarize age-adjusted incidence rates for children and adolescents aged 0 [...]

Menée en Nouvelle-Zélande sur la période 2010-2019, cette étude estime l'incidence des cancers pédiatriques et la survie des patients (1 522 cas)

Childhood cancer incidence and survival in Aotearoa, New Zealand 2010–2019

Pugh, G. ; Bradbeer, P. ; Wood, A. ; Hunter, S. ; Cross, S. ; Denton, K. ; Copeland, K. ; Laughton, S.

Objective: To provide updated estimates of childhood cancer incidence and survival in Aotearoa, New Zealand. Method: Registrations for children under the age of 15 years diagnosed with cancer between 2010 and 2019 were extracted from the New Zealand Children’s Cancer Registry. Cases were stratified by age, sex, prioritised ethnicity (Māori, Pacific peoples, and non-Māori) and cancer type. Age-standardised incidence rates (ASRs) per million person years and observed survival rates were [...]

Menée à partir de données portant sur un total de 309 932 travailleurs de l'industrie nucléaire en France, au Royaume-Uni et aux Etats-Unis (période de suivi : 10,7 millions de personnes-années), cette étude de cohorte estime la mortalité par cancer en lien avec une exposition à de faibles doses de rayonnements ionisants (103 553 décès dont 28 089 décès par tumeur solide)

Cancer mortality after low dose exposure to ionising radiation in workers in France, the United Kingdom, and the United States (INWORKS): cohort study

Richardson, David B ; Leuraud, Klervi ; Laurier, Dominique ; Gillies, Michael ; Haylock, Richard ; Kelly-Reif, Kaitlin ; Bertke, Stephen ; Daniels, Robert D ; Thierry-Chef, Isabelle ; Moissonnier, Monika ; Kesminiene, Ausrele ; Schubauer-Berigan, Mary K

Objective: To evaluate the effect of protracted low dose, low dose rate exposure to ionising radiation on the risk of cancer. Design: Multinational cohort study. Setting: Cohorts of workers in the nuclear industry in France, the UK, and the US included in a major update to the International Nuclear Workers Study (INWORKS).Participants 309 932 workers with individual monitoring data for external exposure to ionising radiation and a total follow-up of 10.7 million person years. Main outcome [...]

Menée à partir des données des registres américains des cancers portant sur 230 370 patients atteints d'un second cancer primitif, cette étude de cohorte rétrospective analyse les disparités ethniques dans la survie

Racial and Ethnic Disparities in Survival Among People With Second Primary Cancer in the US

Sung, Hyuna ; Nisotel, Lauren ; Sedeta, Ephrem ; Islami, Farhad ; Jemal, Ahmedin

Importance : Comprehensive data for racial and ethnic disparities after second primary cancers (SPCs) are lacking despite the growing burden of SPCs. Objective : To quantify racial and ethnic disparities in survival among persons with SPCs. Design, Setting, and Participants : This population-based, retrospective cohort study used data from 18 Surveillance, Epidemiology, and End Results registries in the US for persons diagnosed with the most common SPCs at age 20 years or older from January 1, [...]

Menée au Canada à partir de données portant sur 10 299 patients atteints d'un lymphome diffus à grandes cellules B (âge médian : 67 ans), cette étude analyse l'association entre la présence de troubles psychiatriques, antérieurs ou postérieurs au diagnostic de cancer, et la mortalité

Mortality among patients with diffuse large B-cell lymphoma with mental disorders: a population-based study

Gong, Inna ; Cheung, Matthew C ; Chan, Kelvin K W ; Arya, Sumedha ; Faught, Neil ; Calzavara, Andrew ; Liu, Ning ; Odejide, Oreofe O ; Abel, Gregory ; Kurdyak, Paul ; Raphael, Michael J ; Kuczmarski, Thomas ; Prica, Anca ; Mozessohn, Lee

Background: While mental disorders have been reported in patients with diffuse large B-cell lymphoma (DLBCL), studies examining their association with mortality are lacking. Methods: We conducted a population-based study using linked administrative healthcare databases from Ontario, Canada. All patients with DLBCL aged ≥18 years treated with rituximab-based therapy between January 1st, 2005 and December 31st, 2017 were identified and followed until March 1, 2020. Mental disorders were defined [...]

A partir d'une revue systématique publiée entre janvier 1995 et juin 2022 (65 études issues de 35 pays), cette méta-analyse estime pour 5 régions du monde (Afrique sub-saharienne, Amérique latine et Caraïbes, Amérique du Nord, Asie de l'Est et du Sud-Est, Europe) la prévalence chez les hommes d'une infection génitale par le papillomavirus humain

Global and regional estimates of genital human papillomavirus prevalence among men: a systematic review and meta-analysis

Bruni, Laia ; Albero, Ginesa ; Rowley, Jane ; Alemany, Laia ; Arbyn, Marc ; Giuliano, Anna R. ; Markowitz, Lauri E. ; Broutet, Nathalie ; Taylor, Melanie

Background : The epidemiology of human papillomavirus (HPV) in women has been well documented. Less is known about the epidemiology of HPV in men. We aim to provide updated global and regional pooled overall, type-specific, and age-specific prevalence estimates of genital HPV infection in men. Methods : We conducted a systematic review and meta-analysis to assess the prevalence of genital HPV infection in the general male population. We searched Embase, Ovid MEDLINE, and the Global Index [...]

Menée à partir de données portant sur 592 patientes afro-américaines atteintes d'un cancer épithélial de l'ovaire de stade invasif, cette étude de cohorte analyse l'association entre une exposition à des facteurs liés à une inflammation (notamment une alimentation pro-inflammatoire) et la survie

Association of inflammation-related exposures and ovarian cancer survival in a multi-site cohort study of Black women

Johnson, Courtney E. ; Alberg, Anthony J. ; Bandera, Elisa V. ; Peres, Lauren C. ; Akonde, Maxwell ; Collin, Lindsay J. ; Coté, Michele L. ; Hastert, Theresa A. ; Hebert, James R. ; Peters, Edward S. ; Qin, Bonnie ; Terry, Paul ; Schwartz, Ann G. ; Bondy, Melissa ; Epstein, Michael P. ; Mandle, Hannah B. ; Marks, Jeffrey R. ; Lawson, Andrew B. ; Schildkraut, Joellen M.

Background: An association was observed between an inflammation-related risk score (IRRS) and worse overall survival (OS) among a cohort of mostly White women with invasive epithelial ovarian cancer (EOC). Herein, we evaluated the association between the IRRS and OS among Black women with EOC, a population with higher frequencies of pro-inflammatory exposures and worse survival. Methods: The analysis included 592 Black women diagnosed with EOC from the African American Cancer Epidemiology Study [...]

Menée en Australie à partir de données portant sur 886 patientes atteintes d'un cancer de l'ovaire, cette étude de cohorte prospective analyse l'association entre le niveau sérique de vitamine D, mesuré pendant et après les traitements anticancéreux, et la survie

Vitamin D status during and after treatment and ovarian cancer survival

Ross, Tanya L. ; Neale, Rachel E. ; Na, Renhua ; Webb, Penelope M. ; for the, Opal Study Group

Purpose: Five-year relative survival for ovarian cancer remains below 50%. Strategies to improve outcomes are needed. Higher serum 25-hydroxyvitamin D [25(OH)D] concentrations [measure of vitamin D status] at and before diagnosis have been associated with longer survival in cancer patients; however, data for ovarian cancer are limited. We aimed to determine if 25(OH)D concentrations during and after primary treatment were associated with ovarian cancer-specific survival. Methods: We used data [...]

Menée à une échelle internationale à partir de données 1993-2012 issues de 42 pays, cette étude analyse l'évolution de l'incidence du cancer de l'oropharynx

Global Epidemiologic Patterns of Oropharyngeal Cancer Incidence Trends

Zumsteg, Zachary S ; Luu, Michael ; Rosenberg, Philip S ; Elrod, Julia K ; Bray, Freddie ; Vaccarella, Salvatore ; Gay, Christopher ; Lu, Diana J ; Chen, Michelle M ; Chaturvedi, Anil K ; Goodman, Marc T

The emergence of HPV-positive oropharyngeal cancer (OPC) and evolving tobacco use patterns have changed the landscape of head and neck cancer epidemiology internationally. We investigated updated trends in OPC incidence worldwide.We analyzed cancer incidence data during 1993-2012 from 42 countries using the Cancer Incidence in Five Continents database Volumes V-XI. Trends in OPC incidence were compared to oral cavity cancers (OCC) and lung squamous cell carcinoma (SCC) using log-linear [...]

Menée aux Etats-Unis par entretien auprès de 80 participants, cette étude qualitative identifie les facteurs facilitant ou entravant la mise en oeuvre d'une alliance thérapeutique entre les adolescents et jeunes adultes atteints d'un cancer de stade avancé, les soignants et les aidants

Patient, Caregiver, and Clinician Perspectives on Core Components of Therapeutic Alliance for Adolescents and Young Adults With Advanced Cancer: A Qualitative Study

Mastropolo, Rosemarie ; Altschuler, Andrea ; Brock, Katharine E. ; Casperson, Mallory ; Chao, Chun R. ; Fisher, Lauren ; Greenzang, Katie A. ; Kushi, Lawrence H. ; Lakin, Joshua R. ; Lefebvre, Anna ; Schwartz, Corey M. ; Shalman, Dov M. ; Wall, Catherine B. ; Wiener, Lori ; Mack, Jennifer W.

Importance : The patient-clinician therapeutic alliance is an important aspect of high-quality cancer care. However, components of the therapeutic alliance in adolescents and young adults (AYAs, aged 12-39 years) with cancer have not been defined. Objective : To identify components of and barriers to the therapeutic alliance between AYAs, caregivers, and clinicians from the perspective of all key stakeholders. Design, Setting, and Participants : In this qualitative study, semistructured [...]

A partir d'une revue systématique de la littérature publiée jusqu'en juin 2022 (72 études, 31 740 patients), cette méta-analyse évalue l'association entre la peur de la récidive de la maladie et des symptômes d'anxiété et de dépression chez des patients ayant survécu à un cancer

Fear of cancer recurrence and mental health: A comprehensive meta-analysis

Podina, Ioana R. ; Todea, Diana ; Fodor, Liviu-Andrei

Objective: This study aimed to examine the relationship between fear of cancer recurrence (FCR) and symptoms of anxiety, depression, and emotional distress in cancer survivors. Additionally, potential effect modifiers of this link were investigated. Methods: A systematic search was conducted in PsychInfo, PubMed/Medline, Web of Science, and the Cochrane Central Register of Controlled Trials until June 2022. Studies reporting the association between FCR and mental health indices in adolescent [...]

Menée à partir de données collectées dans 6 pays européeens et portant sur 660 patients atteints d'un cancer colorectal ou pulmonaire de stade avancé (âge moyen : 66 ans), cette étude identifie les facteurs associés à un sentiment d'auto-efficacité pour participer à la prise de décision thérapeutique

Self-efficacy of advanced cancer patients for participation in treatment-related decision-making in six European countries: the ACTION study

Yildiz, Berivan ; Korfage, Ida J. ; Deliens, Luc ; Preston, Nancy J. ; Miccinesi, Guido ; Kodba-Ceh, Hana ; Pollock, Kristian ; Johnsen, Anna Thit ; van Delden, Johannes J. M. ; Rietjens, Judith A. C. ; van der Heide, Agnes

Purpose: Many patients prefer an active role in making decisions about their care and treatment, but participating in such decision-making is challenging. The aim of this study was to explore whether patient-reported outcomes (quality of life and patient satisfaction), patients’ coping strategies, and sociodemographic and clinical characteristics were associated with self-efficacy for participation in decision-making among patients with advanced cancer. Methods: We used baseline data from the [...]

Menée à partir de données portant sur 389 patients ayant survécu à un cancer de l'oropharynx ou de la cavité buccale, cette étude analyse les facteurs associés à la peur de la récidive de la maladie

Prevalence and correlates of fear of recurrence among oral and oropharyngeal cancer survivors

Manne, Sharon L. ; Hudson, Shawna V. ; Preacher, Kristopher J. ; Imanguli, Matin ; Pesanelli, Morgan ; Frederick, Sara ; Singh, Neetu ; Schaefer, Alexis ; Van Cleave, Janet H.

Purpose: Fear of recurrence (FoR) is a prevalent and difficult experience among cancer patients. Most research has focused on FoR among breast cancer patients, with less attention paid to characterizing levels and correlates of FoR among oral and oropharyngeal cancer survivors. The purpose was to characterize FoR with a measure assessing both global fears and the nature of specific worries as well as evaluate the role of sociodemographic and clinical factors, survivorship care transition [...]

Cette étude présente les recommandations de la "Society for Integrative Oncology" et de l'"American Society of Clinical Oncology" concernant les médecines complémentaires et alternatives pour la prise en charge des symptômes de dépression et d'anxiété des patients adultes atteints d'un cancer

Integrative Oncology Care of Symptoms of Anxiety and Depression in Adults With Cancer: Society for Integrative Oncology–ASCO Guideline

Linda E. Carlson ; Nofisat Ismaila ; Elizabeth L. Addington ; Gary N. Asher ; Chloe Atreya ; Lynda G. Balneaves ; Joke Bradt ; Nina Fuller-Shavel ; Joseph Goodman ; Caroline J. Hoffman ; Alissa Huston ; Ashwin Mehta ; Channing J. Paller ; Kimberly Richardson ; Dugald Seely ; Chelsea J. Siwik ; Jennifer S. Temel ; Julia H. Rowland

PURPOSE: To provide evidence-based recommendations to health care providers on integrative approaches to managing anxiety and depression symptoms in adults living with cancer. METHODS: The Society for Integrative Oncology and ASCO convened an expert panel of integrative oncology, medical oncology, radiation oncology, surgical oncology, palliative oncology, social sciences, mind-body medicine, nursing, methodology, and patient advocacy representatives. The literature search included systematic [...]