{"id":5467,"date":"2017-11-23T08:00:02","date_gmt":"2017-11-23T07:00:02","guid":{"rendered":"https:\/\/asscat-hepatitis.org\/?p=5467"},"modified":"2018-07-17T11:18:31","modified_gmt":"2018-07-17T09:18:31","slug":"realitzacio-de-proves-dhepatitis-c-i-reduccio-del-consum-dopioides","status":"publish","type":"post","link":"https:\/\/asscat-hepatitis.org\/ca\/realitzacio-de-proves-dhepatitis-c-i-reduccio-del-consum-dopioides\/","title":{"rendered":"Realitzaci\u00f3 de proves d\u2019hepatitis C i reducci\u00f3 del consum d\u2019opioides"},"content":{"rendered":"<p>[et_pb_section bb_built=&#8221;1&#8243; disabled_on=&#8221;off|off|off&#8221; _builder_version=&#8221;3.0.106&#8243; custom_margin=&#8221;|||&#8221; custom_padding=&#8221;0px||0px|&#8221; next_background_color=&#8221;#000000&#8243;][et_pb_row custom_padding=&#8221;0px||0px|&#8221; _builder_version=&#8221;3.0.106&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221;][et_pb_column type=&#8221;4_4&#8243;][et_pb_post_title author=&#8221;off&#8221; date_format=&#8221;d\/m\/Y&#8221; comments=&#8221;off&#8221; featured_placement=&#8221;background&#8221; text_background=&#8221;on&#8221; text_bg_color=&#8221;#ffffff&#8221; module_class=&#8221;ac-post-title-section-0&#8243; _builder_version=&#8221;3.0.106&#8243; title_font=&#8221;Montserrat|600|||||||&#8221; title_text_color=&#8221;#2d2d2d&#8221; title_letter_spacing=&#8221;-1px&#8221; title_line_height=&#8221;1.2em&#8221; meta_font=&#8221;Open Sans||||||||&#8221; meta_text_color=&#8221;rgba(45,45,45,0.5)&#8221; text_orientation=&#8221;center&#8221; custom_margin=&#8221;|||&#8221; custom_padding=&#8221;|20px|20px|20px&#8221; title_text_align=&#8221;center&#8221; meta_font_size=&#8221;13px&#8221; meta_text_align=&#8221;center&#8221;]<br \/>\n[\/et_pb_post_title][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section bb_built=&#8221;1&#8243; specialty=&#8221;on&#8221; _builder_version=&#8221;3.0.106&#8243; custom_padding=&#8221;0px|||&#8221; prev_background_color=&#8221;#000000&#8243; next_background_color=&#8221;#000000&#8243;][et_pb_column type=&#8221;2_3&#8243; specialty_columns=&#8221;2&#8243;][et_pb_row_inner admin_label=&#8221;Fila&#8221; _builder_version=&#8221;3.0.106&#8243;][et_pb_column_inner type=&#8221;4_4&#8243; saved_specialty_column_type=&#8221;2_3&#8243;][et_pb_text admin_label=&#8221;Contenido Entrada 1&#8243; ul_type=&#8221;square&#8221; module_class=&#8221;ac-posts-content&#8221; _builder_version=&#8221;3.0.106&#8243; text_orientation=&#8221;justified&#8221; background_layout=&#8221;light&#8221;]<\/p>\n<h3>El virus de la hepatitis C (VHC) por transmetre\u2019s amb facilitat a trav\u00e9s de l\u2019\u00fas compartit d\u2019agulles i les persones usu\u00e0ries de drogues intravenoses presenten unes elevades taxes d\u2019incid\u00e8ncia del VHC (noves infeccions) i prevalen\u00e7a (total d\u2019infeccions existents).<\/h3>\n<p>La prevenci\u00f3 i el tractament del VHC en el cas dels usuaris de drogues (en actiu o que les van consumir en el passat) va constituir un tema central en el Congr\u00e9s de l\u2019Associaci\u00f3 Americana per a l\u2019Estudi del Fetge (AASLD, en les seves sigles en angl\u00e8s), que va tenir lloc del 20 al 24 d\u2019octubre a Washington DC (Estats Units), especialment en el context del creixement de les epid\u00e8mies de consum d\u2019opioides a l\u2019Am\u00e8rica del Nord i d\u2019altres llocs del m\u00f3n.<\/p>\n<p>Fer-se <strong>la prova del virus de l\u2019hepatitis C (VHC) es va associar amb una reducci\u00f3 en el consum de drogues<\/strong>. Aix\u00ed, sotmetre\u2019s a una prova del VHC es va relacionar amb una reducci\u00f3 del consum de drogues, sobretot en el cas de les persones que van donar un resultat positiu. No obstant, tamb\u00e9 es va observar certa reducci\u00f3 fins i tot entre les persones que van donar negatiu a la prova, segons els resultats de l\u2019estudi presentats a \u2018The Liver Meeting 2017\u2019.<\/p>\n<p><em>\u201cEl simple acte de fer-se la prova pot tenir un efecte important sobre el comportament de risc\u201d<\/em>, va explicar Hooman Farhang Zangneh, de l\u2019Hospital General de Toronto (Canad\u00e0), en una confer\u00e8ncia de premsa de l\u2019AASLD.<\/p>\n<p><strong>El VHC es transmet f\u00e0cilment a trav\u00e9s d\u2019agulles compartides i les persones que s\u2019injecten drogues tenen altes taxes d\u2019incid\u00e8ncia de VHC (noves infeccions) o prevalen\u00e7a (infeccions totals existents)<\/strong>.<\/p>\n<p>Les persones usu\u00e0ries de drogues intravenoses conformen una important proporci\u00f3 del total de persones que viuen amb hepatitis C (i, en conseq\u00fc\u00e8ncia, d\u2019aquelles que necessitaran rebre tractament per poder eliminar l\u2019amena\u00e7a per a la salut p\u00fablica que suposa el VHC). No obstant, moltes d\u2019aquestes persones no s\u2019han sotm\u00e8s a una prova i desconeixen si tenen el VHC. <strong>Els programes de tractament d\u2019addiccions (com aquells que brinden ter\u00e0pia de substituci\u00f3 d\u2019opioides amb metadona o buprenorfina) ofereixen un possible punt d\u2019acc\u00e9s als serveis d\u2019atenci\u00f3 de l\u2019hepatitis C<\/strong>.<\/p>\n<p>Zangneh i els seus col\u00b7legues van realitzar una an\u00e0lisi retrospectiva per avaluar l\u2019efecte del diagn\u00f2stic de VHC sobre el comportament de l\u2019\u00fas de subst\u00e0ncies, emprant registres electr\u00f2nics de salut d\u2019una xarxa de 47 cl\u00edniques de tractament d\u2019addiccions a Ont\u00e0rio de 2007 a 2013. Ont\u00e0rio t\u00e9 m\u00e9s de 50.000 persones que reben ter\u00e0pies de substituci\u00f3 d\u2019opioides (OST, en les seves sigles en angl\u00e8s), amb una prevalen\u00e7a de VHC propera al 65% entre aquells que s\u2019injecten opiacis, va indicar Zangneh com a antecedents.<\/p>\n<p>Els investigadors van identificar a 2.406 persones que es van sotmetre a proves de detecci\u00f3 d\u2019infecci\u00f3 pel VHC durant el per\u00edode d\u2019estudi i van tenir resultats de proves d\u2019orina disponibles per fer monitoreig de l\u2019\u00fas de drogues. Poc m\u00e9s del 60% eren homes i l\u2019edat mitjana va ser d\u2019aproximadament 40 anys. Un 85% residia en ciutats i al voltant del 15% en \u00e0rees rurals. Entre els participants seleccionats, 527 (22%) van donar positiu en anticossos contra el VHC.<\/p>\n<p>L\u2019equip de Zangneh va analitzar la proporci\u00f3 de mostres d\u2019orina amb resultats positius pel consum de drogues en l\u2019any posterior a la prova del VHC en comparaci\u00f3 amb l\u2019any anterior a la prova. Els participants de l\u2019estudi diagnosticats amb el VHC van tenir una reducci\u00f3 estad\u00edsticament significativa del 8,1% a les mostres d\u2019orina que van mostrar l\u2019\u00fas d\u2019opioides sense recepta. Els que van ser VHC-negatius van tenir una disminuci\u00f3 m\u00e9s petita per\u00f2 encara significativa del 6,7%.<\/p>\n<p>L\u2019an\u00e0lisi multivariable, on es van tenir en compte diversos factors, va reflectir que <strong>les persones que van donar positiu al VHC van ser un 33% m\u00e9s propenses a reduir el consum d\u2019opioides sense recepta<\/strong>, en comparaci\u00f3 amb les que van donar negatiu en la prova diagn\u00f2stica de l\u2019hepatitis C. <strong>Les persones diagnosticades del VHC tamb\u00e9 van ser aproximadament un 50% m\u00e9s propenses a reduir el seu consum de benzodiazepines i coca\u00efna<\/strong>.<\/p>\n<p><em>\u201cEls pacients diagnosticats amb el VHC van reduir el seu consum de drogues sense recepta, incloses les benzodiazepines i la coca\u00efna, en l\u2019any seg\u00fcent al diagn\u00f2stic\u201d<\/em>, van concloure els investigadors. <em>\u201cAix\u00f2 ressalta la import\u00e0ncia d\u2019avaluar als individus en ter\u00e0pia de substituci\u00f3 d\u2019opioides pel VHC, ja que aix\u00f2 nom\u00e9s pot tenir un impacte positiu en la seva activitat de consum de drogues\u201d<\/em>.<\/p>\n<p>Ampliar la realitzaci\u00f3 de proves del VHC a persones que s\u2019injecten drogues <strong><em>\u201cpot reduir les conseq\u00fc\u00e8ncies per a la salut de l\u2019individu i reduir la transmissi\u00f3 en la comunitat\u201d<\/em><\/strong>, va afirmar Zangneh als periodistes. En aquest sentit, va suggerir que es realitzi m\u00e9s investigaci\u00f3 per veure si l\u2019efecte de les proves sobre el comportament del consum de drogues s\u2019est\u00e9n a d\u2019altres malalties infeccioses.<\/p>\n<p>&nbsp;<\/p>\n<h6>Font:\u00a0<a href=\"http:\/\/www.infohep.org\/page\/3184340\/?utm_source=NAM-Email-Promotion&amp;utm_medium=conference-bulletin&amp;utm_campaign=English\">infohep.org<\/a><strong><em>\u00a0<\/em><\/strong><\/h6>\n<h6>Refer\u00e8ncia:\u00a0Zangneh FH et al.\u00a0<em>The impact of hepatitis C diagnosis on substance-use behaviors in patients engaged in opioid substitution therapy.\u00a0<\/em>The Liver Meeting, abstract 125, 2017.<\/h6>\n<h6>Not\u00edcia tradu\u00efda per l&#8217;ASSCAT<\/h6>\n<p>[\/et_pb_text][\/et_pb_column_inner][\/et_pb_row_inner][et_pb_row_inner admin_label=&#8221;Fila&#8221; custom_padding=&#8221;0px|||&#8221; _builder_version=&#8221;3.0.105&#8243; custom_margin=&#8221;|||&#8221;][et_pb_column_inner type=&#8221;4_4&#8243; saved_specialty_column_type=&#8221;2_3&#8243;][et_pb_post_title admin_label=&#8221;Metadatos &#8211; Fecha \u00daltima actualizaci\u00f3n&#8221; title=&#8221;off&#8221; author=&#8221;off&#8221; date_format=&#8221;d\/m\/Y&#8221; categories=&#8221;off&#8221; comments=&#8221;off&#8221; featured_image=&#8221;off&#8221; _builder_version=&#8221;3.0.106&#8243; title_text_align=&#8221;left&#8221; meta_font=&#8221;Open Sans||||||||&#8221; meta_text_align=&#8221;left&#8221; meta_font_size=&#8221;13px&#8221; meta_text_color=&#8221;#0082ca&#8221; border_width_top=&#8221;1px&#8221; border_color_top=&#8221;#cccccc&#8221; custom_margin=&#8221;50px|||&#8221; custom_padding=&#8221;10px|||&#8221; custom_css_before=&#8221;content:%22\u00daltima actualizaci\u00f3n:%22;&#8221; global_module=&#8221;3449&#8243; saved_tabs=&#8221;all&#8221;]<br \/>\n[\/et_pb_post_title][\/et_pb_column_inner][\/et_pb_row_inner][\/et_pb_column][et_pb_column type=&#8221;1_3&#8243;][et_pb_sidebar orientation=&#8221;right&#8221; area=&#8221;et_pb_widget_area_8&#8243; module_class=&#8221;ac-posts-sidebar&#8221; _builder_version=&#8221;3.0.106&#8243; global_module=&#8221;3198&#8243; saved_tabs=&#8221;all&#8221;]<br \/>\n[\/et_pb_sidebar][\/et_pb_column][\/et_pb_section][et_pb_section bb_built=&#8221;1&#8243; _builder_version=&#8221;3.0.106&#8243; custom_padding=&#8221;||0px|&#8221; prev_background_color=&#8221;#000000&#8243; module_class=&#8221;ac-post-section-share-rrss&#8221;][et_pb_row custom_padding=&#8221;||0px|&#8221; custom_margin=&#8221;|||&#8221; _builder_version=&#8221;3.0.105&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221;][et_pb_column type=&#8221;4_4&#8243;][et_pb_text _builder_version=&#8221;3.0.106&#8243; text_font=&#8221;Montserrat||||||||&#8221; text_text_color=&#8221;#e20611&#8243; text_orientation=&#8221;center&#8221; custom_margin=&#8221;||0px|&#8221; custom_padding=&#8221;|||&#8221; background_layout=&#8221;light&#8221;]<\/p>\n<h5>Desde aqu\u00ed puedes compartir esta publicaci\u00f3n. \u00a1Gracias!<\/h5>\n<p>[\/et_pb_text][et_pb_divider color=&#8221;#e20611&#8243; show_divider=&#8221;on&#8221; divider_style=&#8221;ridge&#8221; _builder_version=&#8221;3.0.106&#8243; \/][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n<!-- Begin Yuzo --><div class='yuzo_related_post style-1'  data-version='5.12.77'><!-- without result --><div class='yuzo_clearfixed yuzo__title yuzo__title'><h3>Related Post<\/h3><\/div>\n\t\t\t\t\t\t  <div class=\"relatedthumb \" style=\"width:125px;float:left;overflow:hidden;\">  \n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  <a  href=\"https:\/\/asscat-hepatitis.org\/ca\/coneixes-la-cirurgia-bariatrica-tajudara-a-controlar-el-teu-pes\/\"  >\n\t\t\t\t\t\t\t\t\t  <div class=\"yuzo-img-wrap \" style=\"width: 125px;height:90px;\">\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"yuzo-img\" style=\"background:url('https:\/\/asscat-hepatitis.org\/wp-content\/uploads\/CB-150x150.jpg') 50% 50% no-repeat;width: 125px;height:90px;margin-bottom: 5px;background-size: cover; \"><\/div>\n\t\t\t\t\t\t\t\t\t  <\/div>\n\t\t\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t\t   <span class=\"yuzo__text--title\" style=\"font-size:13px;\">Coneixes la cirurgia bari\u00e0trica? T\u2019ajudar\u00e0 a contr...<\/span>\n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  <\/a>\n\n\t\t\t\t\t\t  <\/div>\n\t\t\t\t\t\t  <div class=\"relatedthumb \" style=\"width:125px;float:left;overflow:hidden;\">  \n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  <a  href=\"https:\/\/asscat-hepatitis.org\/ca\/consum-excessiu-dalcohol-i-tabaquisme-factors-desencadenants-dosteoporosi-masculina\/\"  >\n\t\t\t\t\t\t\t\t\t  <div class=\"yuzo-img-wrap \" style=\"width: 125px;height:90px;\">\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"yuzo-img\" style=\"background:url('https:\/\/asscat-hepatitis.org\/wp-content\/uploads\/osteoporosis-150x150.jpeg') 50% 50% no-repeat;width: 125px;height:90px;margin-bottom: 5px;background-size: cover; \"><\/div>\n\t\t\t\t\t\t\t\t\t  <\/div>\n\t\t\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t\t   <span class=\"yuzo__text--title\" style=\"font-size:13px;\">Consum excessiu d\u2019alcohol i tabaquisme: factors de...<\/span>\n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  <\/a>\n\n\t\t\t\t\t\t  <\/div>\n\t\t\t\t\t\t  <div class=\"relatedthumb \" style=\"width:125px;float:left;overflow:hidden;\">  \n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  <a  href=\"https:\/\/asscat-hepatitis.org\/ca\/curar-lhepatitis-c-pot-reduir-la-inflamacio-en-persones-amb-vih\/\"  >\n\t\t\t\t\t\t\t\t\t  <div class=\"yuzo-img-wrap \" style=\"width: 125px;height:90px;\">\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"yuzo-img\" style=\"background:url('https:\/\/asscat-hepatitis.org\/wp-content\/uploads\/hep-C-6-150x150.jpeg') 50% 50% no-repeat;width: 125px;height:90px;margin-bottom: 5px;background-size: cover; \"><\/div>\n\t\t\t\t\t\t\t\t\t  <\/div>\n\t\t\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t\t   <span class=\"yuzo__text--title\" style=\"font-size:13px;\">Curar l\u2019hepatitis C pot reduir la inflamaci\u00f3 en pe...<\/span>\n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  <\/a>\n\n\t\t\t\t\t\t  <\/div>\n\t\t\t\t\t\t  <div class=\"relatedthumb \" style=\"width:125px;float:left;overflow:hidden;\">  \n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  <a  href=\"https:\/\/asscat-hepatitis.org\/ca\/reactivacio-de-lhepatitis-b-en-pacients-amb-artritis-cronica-i-tractament-immunosupressor-2\/\"  >\n\t\t\t\t\t\t\t\t\t  <div class=\"yuzo-img-wrap \" style=\"width: 125px;height:90px;\">\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t<div class=\"yuzo-img\" style=\"background:url('https:\/\/asscat-hepatitis.org\/wp-content\/uploads\/hep-B-14-150x150.jpg') 50% 50% no-repeat;width: 125px;height:90px;margin-bottom: 5px;background-size: cover; \"><\/div>\n\t\t\t\t\t\t\t\t\t  <\/div>\n\t\t\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t\t   <span class=\"yuzo__text--title\" style=\"font-size:13px;\">Reactivaci\u00f3 de l\u2019hepatitis B en pacients amb artri...<\/span>\n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  \n\t\t\t\t\t\t\t  <\/a>\n\n\t\t\t\t\t\t  <\/div>\n<\/div> <style>\n\t\t\t\t\t\t\t\t.yuzo_related_post img{width:120px !important; height:110px !important;}\n\t\t\t\t\t\t\t\t.yuzo_related_post .relatedthumb{line-height:15px;background: !important;color:!important;}\n\t\t\t\t\t\t\t\t.yuzo_related_post .relatedthumb:hover{background:#fcfcf4 !important; -webkit-transition: background 0.2s linear; -moz-transition: background 0.2s linear; -o-transition: background 0.2s linear; transition: background 0.2s linear;;color:!important;}\n\t\t\t\t\t\t\t\t.yuzo_related_post .relatedthumb a{color:!important;}\n\t\t\t\t\t\t\t\t.yuzo_related_post .relatedthumb a:hover{ color:}!important;}\n\t\t\t\t\t\t\t\t.yuzo_related_post .relatedthumb:hover a{ color:!important;}\n\t\t\t\t\t\t\t\t.yuzo_related_post .yuzo_text {color:!important;}\n\t\t\t\t\t\t\t\t.yuzo_related_post .relatedthumb:hover .yuzo_text {color:!important;}\n\t\t\t\t\t\t\t\t.yuzo_related_post .relatedthumb{  margin: 0px  0px  0px  0px;   padding: 5px  5px  5px  5px;  }\n\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/style> <script>\n\t\t\t\t\t\t  jQuery(document).ready(function( $ ){\n\t\t\t\t\t\t\t\/\/jQuery('.yuzo_related_post').equalizer({ overflow : 'relatedthumb' });\n\t\t\t\t\t\t\tjQuery('.yuzo_related_post .yuzo_wraps').equalizer({ columns : '> div' });\n\t\t\t\t\t\t   })\n\t\t\t\t\t\t  <\/script> <!-- End Yuzo :) -->","protected":false},"excerpt":{"rendered":"<p>El VHC por transmetre\u2019s amb facilitat a trav\u00e9s de l\u2019\u00fas compartit d\u2019agulles i les persones usu\u00e0ries de drogues intravenoses presenten unes elevades taxes d\u2019incid\u00e8ncia del VHC i prevalen\u00e7a.<\/p>\n","protected":false},"author":9,"featured_media":7551,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_crdt_document":"","footnotes":""},"categories":[491],"tags":[811,1169,1257,1409,915,1410,1411,1408,511],"class_list":["post-5467","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-noticias-de-prensa-ca","tag-aasld-2017-ca","tag-estudi","tag-noves-infeccions","tag-persones-usuaries-de-drogues","tag-premsa","tag-taxes-dincidencia","tag-taxes-de-prevalenca","tag-transmissio","tag-vhc-ca"],"_links":{"self":[{"href":"https:\/\/asscat-hepatitis.org\/ca\/wp-json\/wp\/v2\/posts\/5467","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/asscat-hepatitis.org\/ca\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/asscat-hepatitis.org\/ca\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/asscat-hepatitis.org\/ca\/wp-json\/wp\/v2\/users\/9"}],"replies":[{"embeddable":true,"href":"https:\/\/asscat-hepatitis.org\/ca\/wp-json\/wp\/v2\/comments?post=5467"}],"version-history":[{"count":0,"href":"https:\/\/asscat-hepatitis.org\/ca\/wp-json\/wp\/v2\/posts\/5467\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/asscat-hepatitis.org\/ca\/wp-json\/wp\/v2\/media\/7551"}],"wp:attachment":[{"href":"https:\/\/asscat-hepatitis.org\/ca\/wp-json\/wp\/v2\/media?parent=5467"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/asscat-hepatitis.org\/ca\/wp-json\/wp\/v2\/categories?post=5467"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/asscat-hepatitis.org\/ca\/wp-json\/wp\/v2\/tags?post=5467"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}