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Zhao Z, Yang X, Miao J, Dorn S, Barcellos SH, Fletcher JM, Lu Q. Controlling for polygenic genetic confounding in epidemiologic association studies. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.02.12.579913. [PMID: 38405812 PMCID: PMC10888957 DOI: 10.1101/2024.02.12.579913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Epidemiologic associations estimated from observational data are often confounded by genetics due to pervasive pleiotropy among complex traits. Many studies either neglect genetic confounding altogether or rely on adjusting for polygenic scores (PGS) in regression analysis. In this study, we unveil that the commonly employed PGS approach is inadequate for removing genetic confounding due to measurement error and model misspecification. To tackle this challenge, we introduce PENGUIN, a principled framework for polygenic genetic confounding control based on variance component estimation. In addition, we present extensions of this approach that can estimate genetically-unconfounded associations using GWAS summary statistics alone as input and between multiple generations of study samples. Through simulations, we demonstrate superior statistical properties of PENGUIN compared to the existing approaches. Applying our method to multiple population cohorts, we reveal and remove substantial genetic confounding in the associations of educational attainment with various complex traits and between parental and offspring education. Our results show that PENGUIN is an effective solution for genetic confounding control in observational data analysis with broad applications in future epidemiologic association studies.
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Affiliation(s)
- Zijie Zhao
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI
| | - Xiaoyu Yang
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI
| | - Jiacheng Miao
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI
| | - Stephen Dorn
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI
| | - Silvia H. Barcellos
- Center for Economic and Social Research (CESR), University of Southern California, Los Angeles, CA
- Department of Economics, University of Southern California, Los Angeles, CA
| | - Jason M. Fletcher
- La Follette School of Public Affairs, University of Wisconsin-Madison, Madison, WI
| | - Qiongshi Lu
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI
- Department of Statistics, University of Wisconsin-Madison, Madison, WI
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Persaud H, Overton JP. Factors associated with prostate cancer screening among Indo-Guyanese men. J Natl Med Assoc 2023; 115:46-52. [PMID: 36543621 DOI: 10.1016/j.jnma.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/28/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Health screening is considered a vital intervention in public health practices. Despite the strong emphasis on the need for preventative health screenings, little attention is focused on many immigrant populations. Indo-Guyanese immigrants are one of the ethnically minoritized populations facing these challenges. This study aims to identify factors associated with the likelihood that Indo-Guyanese men will undergo screening for prostate cancer. METHODS This study is guided by a mixed-method approach incorporating both quantitative and qualitative analyses. A total of 20 participants were recruited via a snowball technique. Correlation between variables was conducted using IBM SPSS Statistics Version 27, while the qualitative data underwent a rigorous process of analysis and interpretation. RESULTS Education, income, understanding of risk factors, and considering self at risk were positively correlated with screening. Knowledge of prostate cancer and knowledge of the screening process was negatively correlated with screening. CONCLUSION Immigrant health has a significant impact on the U.S. public health system. Timely identification of potential barriers and providing culturally competent solutions and services will ensure a safe and healthy nation.
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Affiliation(s)
- Harrynauth Persaud
- Physician Assistant Program - CUNY York College, 94-20 Guy R. Brewer Blvd, Jamaica, New York 11451, USA.
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Hajizadeh M, Whelan A, Johnston GM, Urquhart R. Socioeconomic Gradients in Prostate Cancer Incidence Among Canadian Males: A Trend Analysis From 1992 to 2010. Cancer Control 2021; 28:10732748211055272. [PMID: 34889129 PMCID: PMC8669872 DOI: 10.1177/10732748211055272] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Understanding the effects of socioeconomic status on cancer incidence and their trends over time will help inform public health interventions for cancer control. This study sought to investigate trends in socioeconomic inequalities in prostate cancer incidence among Canadian males. Methods Using a census division level dataset (n = 280) constructed from the Canadian Cancer Registry, Canadian Census of Population (1992, 1996, 2001, 2006) and 2011 National Household Survey, we examined the effect of socioeconomic status on prostate cancer incidence among Canadian males between 1992 and 2010. The age-adjusted concentration index was used to quantify education/income-related inequalities in prostate cancer incidence. Results The crude prostate cancer incidence increased from 115 to 137 per 100 000 males in Canada from 1992 to 2010 with a peak in 2007. The rate increased significantly in all but three of four western provinces. The age-adjusted concentration index showed a higher concentration of prostate cancer diagnoses among males living in high-income neighbourhoods in Canada in particular from 1996 to 2005. In contrast, the index was higher among males living in less-educated neighbourhoods in the most recent study years (2006–2010). Conclusions The concentration of new prostate cancer cases among high-income populations in Canada may be explained by the rise of opportunistic screening of asymptomatic males; however, this should be studied in further detail. Since we found a higher incidence rate of prostate cancer among less-educated males in Canada in recent years, risk-benefit investigation of primary prevention and opportunistic screening for less-educated males is advised.
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Affiliation(s)
- Mohammad Hajizadeh
- School of Health Administration, Faculty of Health, 3688Dalhousie University, Halifax, NS, Canada
| | - Ashley Whelan
- 12361Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Grace M Johnston
- Cancer Care Program, and School of Health Administration, 3688Dalhousie University, Halifax, NS, Canada
| | - Robin Urquhart
- Department of Community Health and Epidemiology, Faculty of Medicine, 3688Dalhousie University, Halifax, NS, Canada
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Wang M, Jian Z, Gao X, Yuan C, Jin X, Li H, Wang K. Causal Associations Between Educational Attainment and 14 Urological and Reproductive Health Outcomes: A Mendelian Randomization Study. Front Public Health 2021; 9:742952. [PMID: 34778177 PMCID: PMC8581244 DOI: 10.3389/fpubh.2021.742952] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 09/27/2021] [Indexed: 02/05/2023] Open
Abstract
Background: The impact of educational attainment (EA) on multiple urological and reproductive health outcomes has been explored in observational studies. Here we used Mendelian randomization (MR) to investigate whether EA has causal effects on 14 urological and reproductive health outcomes. Methods: We obtained summary statistics for EA and 14 urological and reproductive health outcomes from genome-wide association studies (GWAS). MR analyses were applied to explore the potential causal association between EA and them. Inverse variance weighted was the primary analytical method. Results: Genetically predicted one standard deviation (SD) increase in EA was causally associated with a higher risk of prostate cancer [odds ratio (OR) 1.14, 95% confidence interval (CI) 1.05–1.25, P = 0.003] and a reduced risk of kidney stone (OR 0.73, 95% CI 0.62–0.87, P < 0.001) and cystitis (OR 0.76, 95% CI 0.67–0.86, P < 0.001) after Bonferroni correction. EA was also suggestively correlated with a lower risk of prostatitis (OR 0.76, 95% CI 0.59–0.98, P = 0.037) and incontinence (OR 0.64, 95% CI 0.47–0.87, P = 0.004). For the bioavailable testosterone levels and infertility, sex-specific associations were observed, with genetically determined increased EA being related to higher levels of testosterone in men (β 0.07, 95% CI 0.04–0.10, P < 0.001), lower levels of testosterone in women (β −0.13, 95% CI−0.16 to−0.11, P < 0.001), and a lower risk of infertility in women (OR 0.74, 95% CI 0.64–0.86, P < 0.001) but was not related to male infertility (OR 0.79, 95% CI 0.52–1.20, P = 0.269) after Bonferroni correction. For bladder cancer, kidney cancer, testicular cancer, benign prostatic hyperplasia, and erectile dysfunction, no causal effects were observed. Conclusions: EA plays a vital role in urological diseases, especially in non-oncological outcomes and reproductive health. These findings should be verified in further studies when GWAS data are sufficient.
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Affiliation(s)
- Menghua Wang
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, China
| | - Zhongyu Jian
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, China.,West China Biomedical Big Data Center, Sichuan University, Chengdu, China
| | - Xiaoshuai Gao
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, China
| | - Chi Yuan
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, China
| | - Xi Jin
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, China
| | - Hong Li
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, China
| | - Kunjie Wang
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, China
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Hornung N, Frank M, Dragano N, Dürig J, Dührsen U, Moebus S, Erbel R, Stang A, Jöckel KH, Schmidt B. Monoclonal gammopathy of undetermined significance is associated with prostate cancer in a population-based cohort study. Sci Rep 2021; 11:19266. [PMID: 34588555 PMCID: PMC8481402 DOI: 10.1038/s41598-021-98803-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 09/06/2021] [Indexed: 11/30/2022] Open
Abstract
Register-based studies indicate a possible association of monoclonal gammopathy of undetermined significance (MGUS) and prostate cancer (PCa). Aim of the present study was to investigate the relationship between MGUS and PCa considering potentially shared risk factors. Data from the prospective population-based Heinz Nixdorf Recall cohort study of 2.385 men (age 45–85) were analyzed. MGUS was determined at three points in time; cases of cancer were assessed annually. Potentially shared risk factors were assessed at baseline. Hazard ratios (HR), adjusted for age and educational attainment, and corresponding 95%-confidence intervals (95%-CI) were calculated. 157 cases of MGUS and 143 incident cases of PCa were detected. Of 19 participants diagnosed with both, MGUS and incident PCa, only in one case MGUS did not clearly occur before PCa. MGUS was associated with PCa presenting a HR of 2.00 (95%-CI: 1.23–3.25). Stratified by isotype, IgM-MGUS showed the strongest association with PCa. There was no relevant change of the effect estimate when adjusting for potentially shared risk factors. We were able to give supporting evidence for an association between MGUS and PCa and pointed out its temporality. There was no indication that the observed association is due to shared risk factors. The present study indicated that different isotypes of MGUS differ in the strength of the effect on PCa-risk. Based on these findings, future studies investigating the pathophysiological background of the association will be needed.
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Affiliation(s)
- Nicola Hornung
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University of Duisburg-Essen, Hufelandstraße 55, 45122, Essen, Germany
| | - Mirjam Frank
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University of Duisburg-Essen, Hufelandstraße 55, 45122, Essen, Germany
| | - Nico Dragano
- Department of Medical Sociology, University Clinic Düsseldorf, Düsseldorf, Germany
| | - Jan Dürig
- Department of Hematology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ulrich Dührsen
- Department of Hematology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Susanne Moebus
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University of Duisburg-Essen, Hufelandstraße 55, 45122, Essen, Germany
| | - Raimund Erbel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University of Duisburg-Essen, Hufelandstraße 55, 45122, Essen, Germany
| | - Andreas Stang
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University of Duisburg-Essen, Hufelandstraße 55, 45122, Essen, Germany
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University of Duisburg-Essen, Hufelandstraße 55, 45122, Essen, Germany
| | - Börge Schmidt
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University of Duisburg-Essen, Hufelandstraße 55, 45122, Essen, Germany.
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Sheehan CM. Education and Health Conditions among the Currently Incarcerated and the Non-Incarcerated Populations. POPULATION RESEARCH AND POLICY REVIEW 2019; 38:73-93. [PMID: 36860891 PMCID: PMC9974178 DOI: 10.1007/s11113-018-9496-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Previous research has found a strong link between educational attainment and health, where the highly educated live longer and healthier lives than those with lower levels of education. Because such research has relied on samples of the non-institutionalized population, previous research has not explored the association between education and specific chronic and infectious health conditions among the currently incarcerated. Analyzing the relationship between education and health conditions among the incarcerated, whom tend to be less healthy and for whom many of the intermediate mechanisms between education and health are held relatively constant in prison, may yield new insights. Using the 2002-2004 National Health Interview Study (N=74,881), the 2004 Survey of Inmates in State and Federal Correctional Facilities (N=17,553), and interaction terms from logistic regression models, I compared the strength of the association between educational attainment and the presence of chronic and infectious health conditions among the incarcerated and non-incarcerated populations. These models indicated generally stronger negative associations between educational attainment and chronic conditions among the non-incarcerated, while the negative relationship between education and hepatitis was stronger for the incarcerated. These results suggest that while education may play a lesser role for chronic conditions for the incarcerated, it can still important for avoiding risky health behaviors.
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Affiliation(s)
- Connor M Sheehan
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University
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DeRouen MC, Schupp CW, Yang J, Koo J, Hertz A, Shariff-Marco S, Cockburn M, Nelson DO, Ingles SA, Cheng I, John EM, Gomez SL. Impact of individual and neighborhood factors on socioeconomic disparities in localized and advanced prostate cancer risk. Cancer Causes Control 2018; 29:951-966. [PMID: 30136012 PMCID: PMC7493460 DOI: 10.1007/s10552-018-1071-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 08/08/2018] [Indexed: 01/07/2023]
Abstract
PURPOSE The reasons behind socio-economic disparities in prostate cancer incidence remain unclear. We tested the hypothesis that individual-level factors act jointly with neighborhood-level social and built environment factors to influence prostate cancer risk and that specific social and built environment factors contribute to socio-econmic differences in risk. METHODS We used multi-level data, combining individual-level data (including education and known prostate cancer risk factors) for prostate cancer cases (n = 775) and controls (n = 542) from the San Francisco Bay Area Prostate Cancer Study, a population-based case-control study, with contextual-level data on neighborhood socio-economic status (nSES) and specific social and built environment factors from the California Neighborhoods Data System. Multivariable logistic regression models were used to compute adjusted odds ratios separately for localized and advanced stage prostate cancer while controlling for neighborhood clustering. RESULTS We found a more than twofold increased risk of both localized and advanced prostate cancer with increasing levels of nSES, and decreased risk of advanced prostate cancer with increasing levels of education. For localized disease, the nSES association was largely explained by known prostate cancer risk factors and specific neighborhood environment factors; population density, crowding, and residential mobility. For advanced disease, associations with education and nSES were not fully explained by any available individual- or neighborhood-level factors. CONCLUSIONS These results demonstrate the importance of specific neighborhood social and built environment factors in understanding risk of localized prostate cancer. Further research is needed to understand the factors underpinning the associations between individual- and neighborhood-level SES and risk of advanced prostate cancer.
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Affiliation(s)
- Mindy C DeRouen
- Cancer Prevention Institute of California, Fremont, CA, USA.
- Department of Epidemiology and Biostatistics, University of California, San Francisco, Mission Hall, 550 16th Street, 2nd Floor, UCSF Box 0560, San Francisco, CA, 94143, USA.
- Greater Bay Area Cancer Registry, Fremont, CA, USA.
- UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.
| | | | - Juan Yang
- Cancer Prevention Institute of California, Fremont, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, Mission Hall, 550 16th Street, 2nd Floor, UCSF Box 0560, San Francisco, CA, 94143, USA
- Greater Bay Area Cancer Registry, Fremont, CA, USA
| | - Jocelyn Koo
- Cancer Prevention Institute of California, Fremont, CA, USA
| | - Andrew Hertz
- Cancer Prevention Institute of California, Fremont, CA, USA
| | - Salma Shariff-Marco
- Cancer Prevention Institute of California, Fremont, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, Mission Hall, 550 16th Street, 2nd Floor, UCSF Box 0560, San Francisco, CA, 94143, USA
- Greater Bay Area Cancer Registry, Fremont, CA, USA
- UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - Myles Cockburn
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - David O Nelson
- Cancer Prevention Institute of California, Fremont, CA, USA
| | - Sue A Ingles
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Iona Cheng
- Cancer Prevention Institute of California, Fremont, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, Mission Hall, 550 16th Street, 2nd Floor, UCSF Box 0560, San Francisco, CA, 94143, USA
- Greater Bay Area Cancer Registry, Fremont, CA, USA
- UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - Esther M John
- Cancer Prevention Institute of California, Fremont, CA, USA
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
- Department of Health Research Policy (Epidemiology), Stanford University School of Medicine, Stanford, CA, USA
| | - Scarlett L Gomez
- Cancer Prevention Institute of California, Fremont, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, Mission Hall, 550 16th Street, 2nd Floor, UCSF Box 0560, San Francisco, CA, 94143, USA
- Greater Bay Area Cancer Registry, Fremont, CA, USA
- UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
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Aucoin M, Cooley K, Knee C, Fritz H, Balneaves LG, Breau R, Fergusson D, Skidmore B, Wong R, Seely D. Fish-Derived Omega-3 Fatty Acids and Prostate Cancer: A Systematic Review. Integr Cancer Ther 2017; 16:32-62. [PMID: 27365385 PMCID: PMC5736071 DOI: 10.1177/1534735416656052] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 05/16/2016] [Accepted: 05/18/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The use of natural health products in prostate cancer (PrCa) is high despite a lack of evidence with respect to safety and efficacy. Fish-derived omega-3 fatty acids possess anti-inflammatory effects and preclinical data suggest a protective effect on PrCa incidence and progression; however, human studies have yielded conflicting results. METHODS A search of OVID MEDLINE, Pre-MEDLINE, Embase, and the Allied and Complementary Medicine Database (AMED) was completed for human interventional or observational data assessing the safety and efficacy of fish-derived omega-3 fatty acids in the incidence and progression of PrCa. RESULTS Of 1776 citations screened, 54 publications reporting on 44 studies were included for review and analysis: 4 reports of 3 randomized controlled trials, 1 nonrandomized clinical trial, 20 reports of 14 cohort studies, 26 reports of 23 case-control studies, and 3 case-cohort studies. The interventional studies using fish oil supplements in patients with PrCa showed no impact on prostate-specific antigen levels; however, 2 studies showed a decrease in inflammatory or other cancer markers. A small number of mild adverse events were reported and interactions with other interventions were not assessed. Cohort and case-control studies assessing the relationship between dietary fish intake and the risk of PrCa were equivocal. Cohort studies assessing the risk of PrCa mortality suggested an association between higher intake of fish and decreased risk of prostate cancer-related death. CONCLUSIONS Current evidence is insufficient to suggest a relationship between fish-derived omega-3 fatty acid and risk of PrCa. An association between higher omega-3 intake and decreased PrCa mortality may be present but more research is needed. More intervention trials or observational studies with precisely measured exposure are needed to assess the impact of fish oil supplements and dietary fish-derived omega-3 fatty acid intake on safety, PrCa incidence, treatment, and progression.
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Affiliation(s)
- Monique Aucoin
- Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada
| | - Kieran Cooley
- Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada
| | - Christopher Knee
- Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada
| | - Heidi Fritz
- Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada
| | | | - Rodney Breau
- Ottawa Hospital General Campus, Ottawa, Ontario, Canada
| | - Dean Fergusson
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Becky Skidmore
- Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada
| | | | - Dugald Seely
- Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Ottawa Integrative Cancer Centre, Ottawa, Ontario, Canada
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