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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">zabmedvestnik</journal-id><journal-title-group><journal-title xml:lang="ru">Забайкальский медицинский вестник</journal-title><trans-title-group xml:lang="en"><trans-title>Transbaikalian Medical Bulletin</trans-title></trans-title-group></journal-title-group><issn pub-type="epub">1998-6173</issn><publisher><publisher-name>Читинская государственная медицинская академия</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.52485/19986173_2025_1_89</article-id><article-id custom-type="elpub" pub-id-type="custom">zabmedvestnik-293</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL RESEARCH</subject></subj-group></article-categories><title-group><article-title>Динамика уровня эндогенной интоксикации при стимуляции остеогенеза постоянным электрическим током</article-title><trans-title-group xml:lang="en"><trans-title>Dynamics of the level of endogenous intoxication during stimulation of osteogenesis by direct electric current</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5595-1706</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Овчинников</surname><given-names>Е. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Ovchinnikov</surname><given-names>E. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Овчинников Евгений Николаевич - канд. биол. наук, заместитель директора по научной работе.</p><p>640021, Курган, ул. М. Ульяновой, 6</p><p>Researcher ID L-5439-2015, Author ID РИНЦ 149879, Author ID Scopus 57194208169</p></bio><bio xml:lang="en"><p>Evgeniy N. Ovchinnikov - Candidate of Biological Sciences, Deputy director for scientific work of the National Ilizarov Medical Scientific Centre of Traumatology and Orthopaedics.</p><p>6, M. Ulyanova st., Kurgan, 640014</p><p>Researcher ID L-5439-2015, Author ID РИНЦ 149879, Author ID Scopus 57194208169</p></bio><email xlink:type="simple">omu00@list.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8516-8571</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Стогов</surname><given-names>М. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Stogov</surname><given-names>M. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Стогов Максим Валерьевич - д-р. биол. наук, доцент, руководитель отдела доклинических и лабораторных исследований.</p><p>640021, Курган, ул. М. Ульяновой, 6</p><p>Researcher ID N-5847-2018, Author ID РИНЦ 130371, Author ID Scopus 26024482600</p></bio><bio xml:lang="en"><p>Maksim V. Stogov - Doctor of Biological Sciences, Associate Proffesor, Head of Preclinical and Laboratory Research Department of the National Ilizarov Medical Scientific Centre for Traumatology and Orthopaedics.</p><p>6, M. Ulyanova st., Kurgan, 640014</p><p>Researcher ID N-5847-2018, Author ID РИНЦ 130371, Author ID Scopus 26024482600</p></bio><email xlink:type="simple">stogo_off@list.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9974-2204</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Дюрягина</surname><given-names>О. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Diuriagina</surname><given-names>O. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Дюрягина Ольга Владимировна - канд. ветеринар. наук, заведующая экспериментальной лабораторией.</p><p>640021, Курган, ул. М. Ульяновой, 6</p><p>Researcher ID ABG-5719-2021, Author ID РИНЦ 163524, Author ID Scopus 65105040400</p></bio><bio xml:lang="en"><p>Olga V. Diuriagina - Candidate of Veterinary Sciences, Head of the Experimental Laboratory of the National Ilizarov Medical Research Centre for Traumatology and Ortopaedics.</p><p>6, M. Ulyanova st., Kurgan, 640014</p><p>Researcher ID ABG-5719-2021, Author ID РИНЦ 163524, Author ID Scopus 65105040400</p></bio><email xlink:type="simple">diuriagina@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1006-5217</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Киреева</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Kireeva</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Киреева Елена Анатольевна - канд. биол. наук, ведущий научный сотрудник отдела доклинических и лабораторных исследований.</p><p>640021, Курган, ул. М. Ульяновой, 6</p><p>Researcher ID G-9986-2018, Author ID РИНЦ 162361, Author ID Scopus 56716612200</p></bio><bio xml:lang="en"><p>Elena A. Kireeva - Candidate of Biological Sciences, Leading Researcher of the Department of Preclinical and Laboratory Research, National Ilizarov Medical Research Centre for Traumatology and Ortopaedics.</p><p>6, M. Ulyanova st., Kurgan, 640014</p><p>Researcher ID G-9986-2018, Author ID РИНЦ 162361, Author ID Scopus 56716612200</p></bio><email xlink:type="simple">ea_tkachuk@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1322-608X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Тушина</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Tushina</surname><given-names>N. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Тушина Наталья Владимировна - канд. биол. наук, старший научный сотрудник отдела доклинических и лабораторных исследований.</p><p>640021, Курган, ул. М. Ульяновой, 6</p><p>Researcher ID AAF-1375-2020, Author ID РИНЦ 162360, Author ID Scopus 44062153800</p></bio><bio xml:lang="en"><p>Natalia V. Tushina - Candidate of Biological Sciences, Senior Researcher of the Department of Preclinical and Laboratory Research, National Ilizarov Medical Research Centre for Traumatology and Ortopaedics.</p><p>6, M. Ulyanova st., Kurgan, 640014</p><p>Researcher ID AAF-1375-2020, Author ID РИНЦ 162360, Author ID Scopus 44062153800</p></bio><email xlink:type="simple">ntushina76@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБУ «Национальный медицинский исследовательский центр травматологии и ортопедии имени академика Г.А. Илизарова» Министерства здравоохранения РФ</institution><country>Россия</country></aff><aff xml:lang="en"><institution>National Ilizarov Medical Scientific Centre for Traumatology and Orthopaedics</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>08</day><month>05</month><year>2025</year></pub-date><volume>0</volume><issue>1</issue><fpage>89</fpage><lpage>97</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Овчинников Е.Н., Стогов М.В., Дюрягина О.В., Киреева Е.А., Тушина Н.В., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Овчинников Е.Н., Стогов М.В., Дюрягина О.В., Киреева Е.А., Тушина Н.В.</copyright-holder><copyright-holder xml:lang="en">Ovchinnikov E.N., Stogov M.V., Diuriagina O.V., Kireeva E.A., Tushina N.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.zabmedvestnik.ru/jour/article/view/293">https://www.zabmedvestnik.ru/jour/article/view/293</self-uri><abstract><sec><title>Цель исследования</title><p>Цель исследования: изучить динамику изменения продуктов эндогенной интоксикации в сыворотке крови кроликов при удлинении голени по Илизарову в условиях воздействия на зону регенерата постоянного электрического тока.</p></sec><sec><title>Материалы и методы</title><p>Материалы и методы. Исследование выполнено на 49 кроликах-самцах, которым проводили удлинение большеберцовой кости по Илизарову. В обеих опытных группах процедуру электровоздействия на кость осуществляли шесть раз, повторяя ее через 48 часов. Сила тока составляла 150 мкА. Время воздействия – 60 секунд. В первой группе анод (+) прибора присоединяли к спицам-электродам дистальнее зоны остеотомии, катод (-) – проксимальнее остеотомии. Во второй группе анод (+) присоединяли к спицам-электродам проксимальнее остеотомии, катод (-) – дистальнее зоны остеотомии. Внутри групп животные были разделены на подгруппы в зависимости от времени начала электровоздействия: сразу после операции (подгруппа 1.1, n = 11; подгруппа 2.1, n = 9) и с 10 суток после операции (подгруппа 1.2, n = 10; подгруппа 2.2, n = 8). В контрольной группе (n = 11) электровоздействие не проводили. Эндогенную интоксикацию оценивали по уровню олигопептидов и веществ низкой и средней молекулярной массы (ВНСММ) в сыворотке крови.</p></sec><sec><title>Результаты</title><p>Результаты. Достоверный рост ВНСММ в ходе эксперимента обнаружен только у кроликов контрольной группы. Процент катаболического пула среди ВНСММ в ходе эксперимента был значимо повышен у животных группы 1.1 на 5-е сутки дистракции, для группы 1.2 – с 15-х по 20-е сутки дистракции; в группе 2.1 – на 10-е сутки дистракции; в группе 2.2 – в конце фиксации. Во всех группах с электровоздействием, в отличие от контроля, отмечалось снижение уровня олигипептидов в период фиксации и до 30 суток после снятия аппарата.</p></sec><sec><title>Заключение</title><p>Заключение. Воздействие на дистракционный регенерат постоянного электрического тока не вызывало существенного роста продуктов эндогенной интоксикации в крови лабораторных животных при изученных режимах применения.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>The aim of the study</title><p>The aim of the study. To study the dynamics of changes in endogenous intoxication products in the blood serum of rabbits during leg bone lengthening according to Ilizarov under the influence of direct electric current on the regenerate zone.</p></sec><sec><title>Materials and methods</title><p>Materials and methods. The study was performed on 49 male rabbits, which underwent leg bone lengthening according to Ilizarov. In both experimental groups, the procedure of electrical action on the bone was performed six times, repeating it after 48 hours. The current strength was 150 μA. The exposure time was 60 seconds. In the first group, the anode (+) of the device was connected to the spokes-electrodes distal to the osteotomy zone, the cathode (-) – proximal to the osteotomy. In the second group, the anode (+) was attached to the spokes-electrodes proximal to the osteotomy, the cathode (-) – distal to the osteotomy zone. Within the groups, the animals were divided into subgroups depending on the time of the onset of electrical exposure: immediately after surgery (subgroup 1.1, n = 11; subgroup 2.1, n = 9) and from 10 days after surgery (subgroup 1.2, n = 10; subgroup 2.2, n = 8). In the control group (n = 11), no electrical exposure was performed. Endogenous intoxication was assessed by the level of oligopeptides and substances of low and medium molecular weight (SLMM) in the blood serum.</p></sec><sec><title>Results</title><p>Results. A significant increase in SLMM during the experiment was found only in the rabbits of the control group. The percentage of the catabolic pool among SLMM during the experiment was significantly increased in the animals of group 1.1 on the 5th day of distraction, for group 1.2 – from the 15th to the 20th day of distraction; in group 2.1 – on the 10th day of distraction; in group 2.2 – at the end of fixation. In all groups with electrical exposure, in contrast to the control, a decrease in the level of oligopeptides was noted during the period of fixation and up to 30 days after the removal of the device.</p></sec><sec><title>Conclusion</title><p>Conclusion. The effect of direct electric current on the distraction regenerate did not cause a significant increase in the products of endogenous intoxication in the blood of laboratory animals under the studied application modes.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>остеогенез</kwd><kwd>метод Илизарова</kwd><kwd>стимуляция</kwd><kwd>электрический ток</kwd><kwd>эндогенная интоксикация</kwd></kwd-group><kwd-group xml:lang="en"><kwd>osteogenesis</kwd><kwd>Ilizarov method</kwd><kwd>stimulation</kwd><kwd>electric current</kwd><kwd>endogenous intoxication</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Работа выполнена в рамках государственного задания на научные исследования и разработки ФГБУ «НМИЦ ТО имени академика Г.А. Илизарова» Минздрава России.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Aifantis I.D., Ampadiotaki M.M., Pallis D., et al. Biophysical Enhancement in Fracture Healing: A Review of the Literature. Cureus. 2023. 15 (4). e37704. doi: 10.7759/cureus.37704.</mixed-citation><mixed-citation xml:lang="en">Aifantis I.D., Ampadiotaki M.M., Pallis D., et al. Biophysical Enhancement in Fracture Healing: A Review of the Literature. Cureus. 2023. 15(4). e37704. doi: 10.7759/cureus.37704</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Ding N., Zhou F., Li G., et al. Quantum dots for bone tissue engineering. Mater Today Bio. 2024. 28. 101167. doi: 10.1016/j.mtbio.2024.101167.</mixed-citation><mixed-citation xml:lang="en">Ding N., Zhou F., Li G., et al. Quantum dots for bone tissue engineering. Mater Today Bio. 2024. 28. 101167. doi: 10.1016/j.mtbio.2024.101167</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Ibrahim A., Gupton M., Schroeder F. Regenerative Medicine in Orthopedic Surgery: Expanding Our Toolbox. Cureus. 2024. 16 (9). e68487. doi: 10.7759/cureus.68487.</mixed-citation><mixed-citation xml:lang="en">Ibrahim A., Gupton M., Schroeder F. Regenerative Medicine in Orthopedic Surgery: Expanding Our Toolbox. Cureus. 2024. 16(9). e68487. doi: 10.7759/cureus.68487</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Овчинников Е.Н., Стогов М.В. Стимуляция остеогенеза постоянным электрическим током (обзор литературы). Травматология и ортопедия России. 2019. 3. 185–191. doi: 10.21823/2311-2905-2019-25-3-185-191.</mixed-citation><mixed-citation xml:lang="en">Ovchinnikov E.N., Stogov M.V. Stimulation of osteogenesis by direct electric current (review). Travmatologiya i ortopediya Rossii. 2019. 3. 185-191. doi: 10.21823/2311-2905-2019-25-3-185-191. in Russian.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Flatscher J., Pavez Loriè E., Mittermayr R., et al. Pulsed Electromagnetic Fields (PEMF)-Physiological Response and Its Potential in Trauma Treatment. Int J Mol Sci. 2023. 24 (14). 11239. doi: 10.3390/ijms241411239.</mixed-citation><mixed-citation xml:lang="en">Flatscher J., Pavez Loriè E., Mittermayr R., et al. Pulsed Electromagnetic Fields (PEMF)-Physiological Response and Its Potential in Trauma Treatment. Int J Mol Sci. 2023. 24(14). 11239. doi: 10.3390/ijms241411239</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Luo S., Zhang C., Xiong W., et al. Advances in electroactive biomaterials: Through the lens of electrical stimulation promoting bone regeneration strategy. J Orthop Translat. 2024. 47. 191–206. doi: 10.1016/j.jot.2024.06.009.</mixed-citation><mixed-citation xml:lang="en">Luo S., Zhang C., Xiong W., et al. Advances in electroactive biomaterials: Through the lens of electrical stimulation promoting bone regeneration strategy. J Orthop Translat. 2024. 47. 191-206. doi: 10.1016/j.jot.2024.06.009</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Klinder A., Möws F., Ziebart J., et al. Effects of electrical stimulation with alternating fields on the osseointegration of titanium implants in the rabbit tibia – a pilot study. Front Bioeng Biotechnol. 2024. 12. 1395715. doi: 10.3389/fbioe.2024.1395715.</mixed-citation><mixed-citation xml:lang="en">Klinder A., Möws F., Ziebart J., et al. Effects of electrical stimulation with alternating fields on the osseointegration of titanium implants in the rabbit tibia - a pilot study. Front Bioeng Biotechnol. 2024. 12. 1395715. doi: 10.3389/fbioe.2024.1395715</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Wang A., Ma X., Bian J., et al. Signalling pathways underlying pulsed electromagnetic fields in bone repair. Front Bioeng Biotechnol. 2024. 12. 1333566. doi: 10.3389/fbioe.2024.1333566.</mixed-citation><mixed-citation xml:lang="en">Wang A., Ma X., Bian J., et al. Signalling pathways underlying pulsed electromagnetic fields in bone repair. Front Bioeng Biotechnol. 2024. 12. 1333566. doi: 10.3389/fbioe.2024.1333566</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Pettersen E., Anderson J., Ortiz-Catalan M. Electrical stimulation to promote osseointegration of bone anchoring implants: a topical review. J Neuroeng Rehabil. 2022. 19 (1). 31. doi: 10.1186/s12984-022-01005-7.</mixed-citation><mixed-citation xml:lang="en">Pettersen E., Anderson J., Ortiz-Catalan M. Electrical stimulation to promote osseointegration of bone anchoring implants: a topical review. J Neuroeng Rehabil. 2022. 19(1). 31. doi: 10.1186/s12984-022-01005-7</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Dechent D., Emonds T., Stunder D., et al. Direct current electrical injuries: A systematic review of case reports and case series. Burns. 2020. 46 (2). 267-278. doi: 10.1016/j.burns.2018.11.020.</mixed-citation><mixed-citation xml:lang="en">Dechent D., Emonds T., Stunder D., et al. Direct current electrical injuries: A systematic review of case reports and case series. Burns. 2020. 46(2). 267-278. doi: 10.1016/j.burns.2018.11.020</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Ganse B. Methods to accelerate fracture healing – a narrative review from a clinical perspective. Front Immunol. 2024. 15. 1384783. doi: 10.3389/fimmu.2024.1384783.</mixed-citation><mixed-citation xml:lang="en">Ganse B. Methods to accelerate fracture healing - a narrative review from a clinical perspective. Front Immunol. 2024. 15. 1384783. doi: 10.3389/fimmu.2024.1384783</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Овчинников Е.Н., Филимонова Г.Н., Дюрягина О.В., Тушина Н.В., Киреева Е.А. Влияние различных режимов электровоздействия на скелетные мышцы удлиняемого сегмента при дистракции голени по Илизарову. Казанский медицинский журнал. 2024. 1. 73–83. doi: 10.17816/KMJ465709.</mixed-citation><mixed-citation xml:lang="en">Ovchinnikov E.N., Filimonova G.N., Dyuryagina O.V., Tushina N.V., Kireeva E.A. The effect of various modes of electrical influence on the skeletal muscles of the lengthened -segment during distraction of the lower leg according to Ilizarov. Kazanskiy meditsinskiy zhurnal. 2024. 1. 73-83. doi: 10.17816/KMJ465709. in Russian.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Справочник по лабораторным методам исследования. под ред. Л.А. Даниловой. СПб. Питер. 2003. 736 с.</mixed-citation><mixed-citation xml:lang="en">Danilova L.A. editors. Handbook of laboratory research methods. Saint Petersburg. Piter. 2003. in Russian.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Хрулев А.Е., Григорьева В.Н., Хрулев С.Е. Механизмы поражения и морфологические изменения нервной системы при электрической травме. Саратовский научно-медицинский журнал. 2010. 2. 374–377.</mixed-citation><mixed-citation xml:lang="en">Khrulev A.E., Grigor'eva V.N., Khrulev S.E. Mechanisms of the damage and morphological changes in nervous system in case of electrical trauma. Saratovskiy nauchno-meditsinskiy zhurnal. 2010. 2. 374-377. in Russian.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Рябых С.О., Силантьева Т.А., Дюрягина О.В., и соавт. Разработка пористых титановых имплантатов для межтелового спондилодеза. Гений ортопедии. 2021. 6. 773–781. doi: 10.18019/1028-4427-2021-27-6-773-781.</mixed-citation><mixed-citation xml:lang="en">Ryabykh S.O., Silant'eva T.A., Dyuryagina O.V., et al. Development of porous titanium implants for interbody fusion. Genij Ortopedii. 2021. 6. 773-781. doi: 10.18019/1028-4427-2021-27-6-773-781. in Russian.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
