Compassion in World Farming Conference – March 2005 CIWF Paper fin3.doc 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 Onset of sentience: the potential for suffering in fetal and newborn farm animals David J Mellor and Tamara J Diesch Animal Welfare Science and Bioethics Centre, Massey University, Palmerston North, New Zealand Abstract Sentience and consciousness are prerequisites of suffering. Thus, animals must have sufficiently sophisticated neural mechanisms to receive sensory information and to transduce this information into sensations, and they must also be conscious to be able to perceive those sensations. Moreover, those sensations must be sufficiently noxious or aversive to cause suffering. The neural apparatus of embryos and fetuses of farm animals is inadequate to support sentience for at least the first half of pregnancy, but the required structures and mechanisms do develop by the time of birth. Thus, although one of the preconditions for suffering is satisfied shortly before birth, the embryo and fetus are apparently never conscious for the following reasons. The embryo-fetus initially does not have brain structures that are functionally capable of supporting consciousness, and subsequently, when the fetal brain might have that capability, it displays electrical activity indicating a continuous state of sleep and therefore unconsciousness. Furthermore, the fetus is apparently actively maintained in sleep-like states by several endogenous neuroinhibitory mechanisms which involve adenosine (a potent neuroinhibitory and sleep inducing agent), allopregnanolone and pregnanolone (two neurosteroidal anaesthetics), prostaglandin D2 (a potent sleep-inducing hormone), a placental neural inhibitor, warmth, buoyancy and cushioned tactile stimulation. Consciousness evidently appears for the first time only after birth. This results from a substantial withdrawal of the neuroinhibitors, especially adenosine, and the involvement of neuroactivators including 17β-oestradiol (a potent neuroactive steroid with widespread excitatory effects in the brain), noradrenaline (released from excitatory locus coeruleus nerves that extend throughout the brain), and a barrage of novel sensory information associated with the newborn’s first exposure to air, gravity, hard surfaces, unlimited space and, usually, to cold ambient conditions. We conclude that the embryo and fetus cannot suffer before or during birth. Furthermore, we conclude that suffering can only occur in the newborn when the onset of breathing oxygenates its tissues sufficiently to substantially reduce the dominant adenosine inhibition of brain electrical activity. The implications of these observations for managing fetuses and newborns in ways that minimise suffering are considered briefly. Corresponding author: Professor David J Mellor Phone +64 6 350 4807 Fax +64 6 350 5657 1 Compassion in World Farming Conference – March 2005 CIWF Paper fin3.doc 48 Email D.J.Mellor@massey.ac.nz 2 Compassion in World Farming Conference – March 2005 CIWF Paper fin3.doc 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 Introduction An animal must be both sentient and conscious for suffering to occur. The first prerequisite, therefore, is that the required neural apparatus for sentience must be in place and operational. Internal and environmental stimuli must be able to elicit impulse transmission along nerves from sensory receptors to the animal’s brain, and its brain stuctures must be operationally sophisticated enough to tranduce those nerve impulses into perceived sensations. The second requirement is that the brain must be in a functional state that allows the animal to perceive sensations; it must be in a state that supports consciousness, as unconsciousness nullifies perception. Third, for a conscious animal to suffer, and for its welfare thereby to be compromised (Mellor and Stafford, 2001; Mellor and Reid, 1994), the character, intensity and/or duration of the sensations it perceives must result in significantly noxious or aversive experiences. Although it is not clear whether there is a distinct place delineating those animals in the phylogenetic hierarchy that are and are not sentient or whether sentience exhibits different levels (Mellor, 1998; Kirkwood, 2005), it is generally accepted that mammals are sentient. However, this generalisation requires some qualification because it does not allow for different phases of development. Adult and autonomous young mammals are evidently sentient, as are neurologically mature young very soon after birth (Mellor and Gregory, 2003; Mellor and Stafford, 2004), but the situation in neurologically immature newborns and in mammalian young before birth is less obvious. The present paper explores the potential of fetuses and newborns to suffer by outlining the development of the neural apparatus required to support sentience and the functional state of that apparatus with respect to consciousness before and after birth. State changes at birth and the impact of other factors on the potential for suffering after birth are also considered. Although most reported observations relate to fetal and newborn sheep, the principles are considered to be generally applicable to farmed ungulates (e.g. sheep, goats, cattle, deer, horses and pigs). Prenatal development sentience of the neural apparatus required for Neural tissue begins to differentiate after fertilisation, progressing via sparsely connected rudimentary precursors of nerve tracts and brain structures in the embryo to the well-defined, complex, sophisticated and operationally effective, yet still maturing, structures that are present in the fetus just before birth (Mellor and Gregory, 2003). As part of this development, sensory and numerous other neurological structures need to mature sufficiently in utero to enable the newborn to use sight, hearing, smell, taste, touch, proprioception and thermal sensitivity to secure its survival during the critical first few minutes and hours after birth (Mellor and Gregory, 2003; Mellor and Stafford, 2004). The operation of such sensory 3 Compassion in World Farming Conference – March 2005 CIWF Paper fin3.doc 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 perception very soon after birth shows that the required structures are in place immediately before birth, and possibly earlier. Fetal sense organs therefore have the potential to operate in utero. The question is, do they? In fact, the sensory environment in utero is significant and varied, and the fetus in late pregnancy is responsive to stimulation in most of the modalities evident after birth (Bradley and Mistretta, 1975; Abrams et al., 1996; Bauer et al., 1997). Thus, fetal sense organs do operate, but this does not mean that the fetus perceives the associated sensory input. For that to occur, a fetal neural state that supports consciousness would need to be present. Functional state of the neural apparatus in the fetus The nervous system is evidently too immature to support any activity resembling consciousness during the embryonic stage of development and this immaturity apparently continues at least into the early fetal stage (Joseph, 2000). Indeed, the establishment of the necessary neural pathways and their connections to lower brain centres and then to the cerebral cortex, together with the evolution of mature fetal brain electrical activity (described briefly below) and cortical responses to somatic tactile stimulation (Bradley & Mistretta, 1975; Fitzgerald, 1999; Joseph, 2000; Mellor & Gregory, 2003), suggest that, even if the physiological environment of the brain permitted it, neural development could not support fetal consciousness until later in pregnancy. The electrical activity of the fetal cerebral cortex (EEG activity) provides apparently definitive evidence of the absence of consciousness in utero. Thus, from mid-pregnancy fetal EEG activity evolves from rudimentary and discontinuous patterns into two coherent, discrete states resembling rapid-eyemovement sleep and non-rapid-eye-movement sleep in postnatal animals (Harding et al 1981; Clewlow et al 1983; Szeto and Hinman, 1985; Berger et al 1986; Dawes 1988). By late pregnancy these two sleep-like states occupy 95% of fetal EEG activity during each day, the other 5% representing transitions between the two sleep-like states (Mellor et al., 2005). Accordingly, the embryo-fetus initially does not have brain structures which are functionally capable of supporting consciousness, and subsequently, when the brain might have that capability, the fetus displays EEG activity indicating that it is continuously asleep and therefore unconscious. Maintenance of fetal sleep-like states The above conclusion is further strengthened by an increasing body of evidence which shows that there are several suppressors in utero which act to inhibit neural activity in the fetus. Thus, the uterus plays a key role in providing the chemical and physical factors that together help to keep the fetus continuously asleep. We propose that this is achieved, among other things, through the combined neuroinhibitory actions of a powerful EEG suppressor and sleep inducing agent (adenosine), two neurosteroidal anaesthetics (allopregnanolone, 4 Compassion in World Farming Conference – March 2005 CIWF Paper fin3.doc 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 pregnanolone) and a potent sleep-inducing hormone (prostaglandin D2), acting together with a possible peptide inhibitor produced by the placenta, further supported by the warmth, buoyancy and cushioned tactile stimulation of the uterine environment (Mellor & Gregory, 2003; Mellor et al., 2005). Adenosine is a potent neural inhibitor which promotes sleep and/or unconsciousness and is produced by placental and fetal tissues in quantities that maintain its circulating concentrations two- to four-fold higher in the fetus than in the mother (Ball et al., 1995, 1996; Dunwiddie & Masino, 2001). Superimposed on these high background concentrations are variations due to changes in fetal oxygen status, such that hypoxaemia (oxygen shortage) elevates and hyperoxaemia (experimentally induced oxygen abundance) reduces adenosine concentrations, which in turn lead, respectively, to suppressive and activating effects on fetal EEG, breathing and behavioural activities (Szeto and Hinman, 1985; Szeto and Umans, 1985; Koos and Matsuda 1990; Sawa et al., 1991; Avital et al., 1993; Kubonoya and Power, 1997; Koos et al., 2001). Allopregnanolone and pregnanolone are neuroactive steroids with wellestablished anaesthetic, sedative/hypnotic and analgesic effects (Majewska, 1992; Paul and Purdy, 1992; Miller, 1998). They are produced from cholesterol or progesterone by the placenta and the fetal brain, exhibit high circulating concentrations in the fetus and have suppressive effects on fetal EEG, eye movements, breathing movements and postural changes (Crossley et al., 1997: Nicol et al., 1997, 1998, 1999, 2001; Hirst et al., 2000). Prostaglandin D2, a potent sleep-inducing agent in adult mammals (Hayaishi and Urade, 2002), is evidently active as a suppressor of eye, breathing and postural muscle movements, and associated EEG activity, in the late gestation fetus (Lee et al., 2002). Likewise, a possible placental peptide inhibitor, warmth, cushioned tactile stimulation and buoyancy are also considered to contribute to the maintenance of sleep-like EEG activity in the fetus until birth (Mellor and Gregory, 2003). It appears, therefore, that the above factors, and others (Mellor et al 2005), contribute to actively maintaining the continuous sleep-like state of the fetus (indicated by its EEG) throughout the last one-third to one-half of pregnancy. Changes in the functional state of the brain at birth Suppressors of brain function and their removal As labour approaches there is a progression towards fetal EEG activity indicating a predominance of deeper sleep-like states (Berger et al 1986; Shinozuka and Nathanielsz 1998), and during labour fetal motor systems, including the respiratory system, are largely quiescent (Berger et al 1986; Fraser and Broom 1990; Hasan and Rigaux 1991). Moreover, hypoxaemia-induced elevations in 5 Compassion in World Farming Conference – March 2005 CIWF Paper fin3.doc 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 adenosine concentrations transiently inhibit fetal EEG activity during strong labour contractions and, if the hypoxaemia is severe and protracted enough, EEG activity may be almost completely suppressed (indicated by an isoelectric trace), an effect which is usually rapidly reversed if fetal normoxaemia is restored between contractions (Mallard et al., 1992; Hunter et al., 2003). Likewise, with loss of placental oxygen supply due to severance of the umbilical cord immediately after birth, the EEG of the newborn would progress towards an isoelectric state, reached after 60 to 90 seconds (Mallard et al., 1992; Hunter et al., 2003), and this would usually be reversed only when successful breathing begins. Although an isoelectric EEG trace indicates very marked suppression of activity in the cerebral cortex, the normal functions of which are required for consciousness to occur, brain stem function supporting the reflexes involved in the initiation of breathing (among other functions) is safeguarded, even during protracted periods of hypoxaemia (Jensen et al., 1987). Thus, severance of the umbilical cord and the associated fall in oxygen and rise in carbon dioxide tensions in the newborn’s blood stimulate gasping, and if the respiratory system is mature enough, this leads to successful inflation of the lungs, the onset of breathing and a rapid elevation in oxygen tensions which eventually rise to well above maximum fetal levels (Mellor and Gregory, 2003). This oxygenation of the newborn, together with the loss of the placental source of adenosine, would result in a very rapid decrease in circulating and cerebral adenosine concentrations and a decrease in adenosine suppression of the cerebral cortex. We consider this to be critical for the onset of consciousness after birth. Loss at birth of the placental source of allopregnanolone and pregnanolone (and/or of their precursors) and loss of the placental peptide inhibitor would also contribute to the onset of consciousness in the newborn, but cerebral pregnanolone (and presumably allopregnanolone) concentrations do not apparently change much during labour (Nguyen et al., 2003). Accordingly, these particular neuroactive steriods presumably continue to exert some suppressive effects on the EEG even after birth. However, a number of EEG activators begin to operate just before and during labour, especially during the final delivery stage, and immediately after birth (Mellor and Gregory, 2003). In view of the apprearance of consciousness in newborn farm animals shortly after birth (Mellor and Gregory, 2003; Mellor and Stafford, 2004), the combined stimulatiory effects of these activators are evidently sufficient to overcome any marked residual effects of the suppressors noted above. Activators of brain function The principal activators briefly considered here are 17β-oestradiol, noradrenaline and a barrage of sensory input associated with birth and entry into the postnatal environment. 17β-oestradiol is a neuroactive steroid, which, in contrast to allopregnanolone and pregnanolone, has rapid-onset excitatory effects widely within the brain (Wong et al. 1996; Woolley, 1999; McEwen, 2002). When injected into the fetus or 6 Compassion in World Farming Conference – March 2005 CIWF Paper fin3.doc 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 premature newborn it stimulates arousal behaviour and breathing activity (Mellor and Gregory, 2003). As its fetal plasma concentrations rise progressively during labour (Challis & Patrick, 1981), 17β-oestradiol presumably contributes to preparing the brain to support the increase in behavioural activity and the onset of breathing, which usually occur immediately after birth (Mellor and Gregory, 2003), and the subsequent appearance of consciousness. The locus coeruleus extends noradrenaline-releasing nerves widely within the brain from the cerebral cortex to the brain stem and has major roles in stimulating arousal and alert vigilance, as reflected in specific EEG states (Svensson, 1987; Berridge & Waterhouse, 2003). The locus coeruleusnoradrenaline system is particularly responsive to painful stimuli and to hypoxaemia and hypercapnia (elevated blood carbon dioxide tensions), and is present and operational, although not particularly active, in the fetus before labour (Joseph & Walker, 1990). However, strong tactile stimulation (including pain receptor input) associated with head and body compression during labour, and especially during the final stage before delivery (Mellor & Gregory, 2003), and the transient episodes of hypoxaemia/hypercapnia associated with labour contractions and, after birth, with severance of the umbilical cord before breathing starts (see above), are potent stimuli to the locus coeruleus brain activating effects. These presumably also prime the brain for the onset of arousal and consciousness very soon after birth. Immediately after birth the newborn is exposed to air, gravity, hard surfaces, unlimited space and, usually, to cold challenge for the first time (Mellor and Gregory, 2003), and this will be associated with a barrage of novel sensory information which is likely to be arousing. Cold stimulation of skin thermoreceptors in particular is a potent stimulus to both fetal and newborn arousal and breathing, and tactile stimulation of the head and ears either by maternal licking or manually by farm staff apparently also has activating effects (Mellor and Gregory, 2003). Integrated summary of suppression and consciousness in the fetus and newborn activation of The above analysis suggests that fetuses subjected to normal in utero sensory input remain in sleep-like (unconscious) states and that awareness appears for the first time only after birth. Suppression of fetal consciousness-related EEG activity is evidently achieved by the combined effects of a high brain adenosine, allopregnanolone/pregnanolone and PGD2 status acting together with a placental inhibitor (a peptide), warmth, buoyancy and cushioned tactile stimulation. This suppression continues during labour despite marked rises in the circulating concentrations of 17β-oestradiol and locus coeruleus-induced noradrenaline release, both of which are putative activators of behavioural arousal and consciousness. The 17β-oestradiol surge 7 Compassion in World Farming Conference – March 2005 CIWF Paper fin3.doc 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326 327 328 329 330 331 332 333 results from the progressive switch in placental steroidogenesis away from progesterone and begins some days before birth. The rise in locus coeruleusinduced noradrenaline release, which is apparently particularly marked in the final stage of labour, is due to stimulation of the locus coeruleus by head and body compression (and sometimes injury) during passage of the fetus through the cervix and vagina. It is also due to locus coeruleus responses to acute, usually transient, periods of fetal hypoxaemia/hypercapnia during uterine contractions. However, as the hypoxaemia would also lead to an increase in brain production of adenosine and its suppression of EEG activity, the two effects may nullify each other. After birth, during the period between severance of the umbilical cord and the onset of breathing, the newborn becomes progressively more hypoxaemic/hypercapnic and the adenosine concentrations of the brain would rise markedly, thereby further suppressing its electrical activity. Studies of umbilical cord occlusion in near-term fetal sheep show that if the onset of effective breathing after birth is delayed for about 60 to 90 seconds the EEG would become isoelectric (Mallard et al. 1992; Hunter et al. 2003), an effect which would be rapidly reversed with the onset of breathing. In fact, gasping as a prelude to regular breathing usually occurs in vigorous newborns within the first minute after birth. This, and the subsequent onset of regular breathing lead to a rapid rise in circulating, and therefore tissue, oxygen tensions to well above usual fetal levels (Mellor & Gregory, 2003). This, together with loss of placental adenosine input, would cause a speedy reduction in brain concentrations of adenosine and its suppressive effects on EEG activity. This rapid postnatal removal of what is evidently an overriding suppression by adenosine presumably then allows the brain activators to operate. High circulating 17β-oestradiol concentrations and strong stimulation of the locus coeruleus-noradrenaline system are present during labour and after birth. With the onset of breathing after birth, they presumably act together with cold stimulation of cutaneous thermoreceptors and with tactile stimulation through contact with hard surfaces and maternal licking to promote the first appearance of consciousness. Marked changes in auditory and visual inputs, which undoubtedly occur at birth (Mellor & Gregory, 2003), may also contribute. Although adenosine suppression evidently declines very rapidly after birth, some effects of pregnanolone (and presumably allopregnanolone) are likely to continue at least during the first day, despite loss of the placenta as a major source of it, because its circulating concentrations are still significant three days after birth (Nguyen et al. 2003). Likewise, the decline in the plasma concentrations of the placental peptide inhibitor, due to loss of the placenta after birth, would probably not be as rapid as withdrawal of adenosine suppression. It is likely, therefore, that the above noted activators are required to overcome residual suppression by allopregnanolone, pregnanonlone, the placental inhibitor and other agents as their suppressive effects wane after birth. 8 Compassion in World Farming Conference – March 2005 CIWF Paper fin3.doc 334 335 336 337 338 339 340 341 342 343 344 345 346 347 348 349 350 351 352 353 354 355 356 357 358 359 360 361 362 363 364 365 366 367 368 369 370 371 372 373 374 375 376 377 378 379 380 381 Implications for suffering in the fetus and newborn Prior to and during birth For any animal to suffer it must be both sentient and conscious (see above). The analysis provided here shows that neurological development is insufficient for sentience until at least half way through pregnancy, and that the capacity for sentience evident in neurologically mature farm animals after birth develops during the last half of pregnancy. Nevertheless, even when the capacity for sentience has developed the fetus remains unconscious, as indicated by its sleeplike EEG states and the demonstrated operation in utero of a range of neuroinhibitory mechanisms that actively maintain the fetus asleep. It follows that although one precondition for suffering, i.e. the capacity for sentience, is met during late pregnancy, the absence of the other precondition, i.e. consciousness, before birth means that the fetus, and the embryo before it, cannot perceive by the senses and therefore cannot suffer. However, there remains the possibility that the fetus might be arousable to a state of consciousness by noxious stimulation. Three examples will clarify this. First, surgical interventions in the naturally unconscious (i.e. sleeping) fetus in an anaesthetised dam usually impede placental gas exchange and thereby cause various degrees of fetal hypoxaemia during and for some time after the surgery (Mellor and Gregory, 2003), and the associated rise in fetal cerebral adenosine concentrations would lead to even deeper states of unconsciousness, not arousal. Second, during slaughter of the dam, the rapid cessation of fetal oxygen supply and the linked rapid increase in fetal adenosine concentrations acting on the already unconscious fetus would lead to an isoelectric EEG within 60 to 90 seconds (Mallard et al. 1992; Hunter et al. 2003), not arousal to consciousness. This observation contributed to the development of principles for the humane slaughter of the fetuses of pregnant ruminants (Mellor, 2003). Third, vibroacoustic stimulation of the fetus of sufficient intensity to induce movement does not cause the EEG to change from a sleep-like to an aroused or conscious state (Leader et al., 1988; Abrams et al., 1996: Bauer et al., 1997; Schwab et al., 2000). These observations suggest that the fetus in utero is not arousable to a state of consciousness. Fetal unconsciousness persists throughout labour and may indeed become deeper, partly through changes that are not related to hypoxaemia (Berger et al 1986; Shinozuka and Nathanielsz 1998) and partly through repeated transient hypoxaemia-adenosine induced suppression of brain function during intense and/or protracted labour contractions (see above). Thus, although mechanical and pain receptor nerve pathways will be activated by the marked compression and, when it occurs, injury, which are associated with labour and delivery, the fetus is protected from suffering because of its unconscious state. This is reassuring for the conduct of fetotomy on those occasions when living fetuses need to be dismembered in utero in order to resolve intractable dystocia (Mellor and Gregory, 2003). 9 Compassion in World Farming Conference – March 2005 CIWF Paper fin3.doc 382 383 384 385 386 387 388 389 390 391 392 393 394 395 396 397 398 399 400 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 421 422 423 424 425 426 427 428 429 After birth The first appearance of consciousness after birth occurs only when breathing oxygenates the newborn sufficiently to remove the dominant adenosine inhibition of brain function. The newborn that never breathes will have an isoelectric EEG and will die without suffering. The newborn that does breathe, but not sufficiently to effect an oxygen-induced reduction in adenosine to levels compatible with consciousness, will remain unconscious and will die without suffering. On the other hand, most newborn farm animals become conscious within minutes of birth through the operation of the mechanisms outlined above. Once conscious, they have the potential to perceive noxious and other sensations and to suffer if the character, intensity and/or duration of those sensations are sufficiently noxious or aversive (Mellor and Stafford, 2004). In their evaluation of the welfare implications of mortality and morbidity in newborn farm animals Mellor and Stafford (2004) considered that the major noxious subjective experiences of animal welfare concern are breathlessness, hypothermia, hunger, sickness and pain. Reference to documented responses of farm animals and, where appropriate, to human experience, suggested that breathlessness and hypothermia usually represent less severe neonatal welfare insults than do hunger, sickness and pain. However, two or more of these experiences can overlap, sometimes with greater negative welfare consequences (e.g. sickness plus pain), and sometimes where one mitigates the effects of another (e.g. where hypothermia dulls consciousness in hungry or sick newborns). Fortunately, major science-based improvements in the management of pregnancy and birth have markedly reduced the overall amount of welfare compromise experienced by newborn farm animals (Mellor and Stafford, 2004) and further improvements may be expected as knowledge is refined and extended in the future. Acknowledgements We are particularly grateful to Associate Professors Laura Bennet and Alistair Gunn (Department of Physiology, University of Auckland), Dr David Walker, Department of Physiology, Monash University) and Dr David Bayvel (Animal Welfare Group, Ministry of Agriculture and Forestry - MAF) for helpful discussion on the topics covered here, and to the Agricultural and Marketing Research and Development Trust and MAF Science Policy for financial support for related research projects. References Abrams R.M., Schwab M., Gerhardt K.J., Bauer, R., Peters A.J.M., 1996. Vibroacoustic stimulation with a complex signal: effect on behavioral state in fetal sheep. Biol. 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