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  1. Article ; Online: Predicting Suboptimal Bowel Preparation: Taking It Up a PEG.

    Sahebally, Shaheel M

    Digestive diseases and sciences

    2017  Volume 62, Issue 2, Page(s) 289–291

    MeSH term(s) Cathartics ; Colonoscopy ; Humans ; Polyethylene Glycols
    Chemical Substances Cathartics ; Polyethylene Glycols (30IQX730WE)
    Language English
    Publishing date 2017
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 304250-9
    ISSN 1573-2568 ; 0163-2116
    ISSN (online) 1573-2568
    ISSN 0163-2116
    DOI 10.1007/s10620-016-4385-x
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    Ui V Zs.35: Show issues Location:
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  2. Article ; Online: A meta-analysis of carbon dioxide versus room air insufflation on patient comfort and key performance indicators at colonoscopy.

    Rogers, Ailín C / Van De Hoef, Dayna / Sahebally, Shaheel M / Winter, Des C

    International journal of colorectal disease

    2020  Volume 35, Issue 3, Page(s) 455–464

    Abstract: Background: Carbon dioxide (CO: Methods: This meta-analysis was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Pubmed, Pubmed Central, Embase and Cochrane Library were searched for ... ...

    Abstract Background: Carbon dioxide (CO
    Methods: This meta-analysis was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Pubmed, Pubmed Central, Embase and Cochrane Library were searched for randomized studies from 2004 to 2019, reporting outcomes for patients undergoing colonoscopy with air or CO
    Results: Of 3586 citations, 23 studies comprising 3217 patients were analysed. Patients undergoing colonoscopy with air insufflation had 30% higher intraprocedural pain scores than those receiving CO
    Conclusions: CO
    MeSH term(s) Air ; Carbon Dioxide/pharmacology ; Colonoscopy/adverse effects ; Female ; Humans ; Insufflation ; Male ; Middle Aged ; Pain Measurement ; Pain, Postoperative/etiology ; Patient Comfort ; Publication Bias ; Risk
    Chemical Substances Carbon Dioxide (142M471B3J)
    Language English
    Publishing date 2020-01-03
    Publishing country Germany
    Document type Comparative Study ; Journal Article ; Meta-Analysis
    ZDB-ID 84975-3
    ISSN 1432-1262 ; 0179-1958
    ISSN (online) 1432-1262
    ISSN 0179-1958
    DOI 10.1007/s00384-019-03470-4
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    Zs.A 2121: Show issues Location:
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  3. Article ; Online: Prophylactic mesh placement at index permanent end colostomy creation to prevent parastomal hernia-an updated meta-analysis.

    Sahebally, Shaheel M / Lim, Titus Z / Azmir, Alisha A / Lu, Cu Tai / Doudle, Mark / Naik, Arun / Nolan, Gregory / Papen, Michael Von

    International journal of colorectal disease

    2021  Volume 36, Issue 9, Page(s) 2007–2016

    Abstract: Background: Debate persists regarding the efficacy of prophylactic mesh insertion (PMI) at index permanent stoma creation to reduce the rate of parastomal hernia (PSH). This meta-analysis aimed to appraise all the latest evidence from newly published ... ...

    Abstract Background: Debate persists regarding the efficacy of prophylactic mesh insertion (PMI) at index permanent stoma creation to reduce the rate of parastomal hernia (PSH). This meta-analysis aimed to appraise all the latest evidence from newly published randomized controlled trials (RCTs) on PMI for PSH prevention.
    Methods: PubMed, EMBASE, and Cochrane databases were searched for relevant articles from inception until November 2020. All RCTs that reported on PMI at end colostomy creation with ≥ 12 months follow-up were included. The primary objective was the rate of clinical and radiological PSH while secondary objectives included number of PSH requiring repair and stoma (or mesh)-related complications. Random effects models were used to calculate pooled effect size estimates. Sensitivity analyses were also performed.
    Results: Eleven RCTs were included capturing 1097 patients. The mean (SD) age was 67.9 (±9.4) years. On random effects analysis, prophylactic mesh appeared to reduce the rate of both clinical (OR = 0.27, 95% CI = 0.12 to 0.61, p = 0.002) and radiological (OR = 0.39, 95% CI = 0.24 to 0.65, p = 0.0002) PSH. However, there was no difference in number of PSH requiring repair or stoma-related complications. On sensitivity analysis, when focusing on low-risk of bias studies, the benefit of prophylactic mesh in the retrorectus space was lost for both clinical (OR = 0.97, 95% CI = 0.62 to 1.51, p = 0.89) and radiological PSH (OR = 0.74, 95% CI = 0.46 to 1.18, p = 0.20).
    Conclusion: PMI may reduce the rate of subsequent PSH. However, further studies are required to confirm these findings and to establish the optimal mesh position and shape before definite recommendations can be made.
    MeSH term(s) Aged ; Colostomy/adverse effects ; Hernia, Ventral ; Humans ; Incisional Hernia/etiology ; Incisional Hernia/prevention & control ; Middle Aged ; Surgical Mesh/adverse effects ; Surgical Stomas/adverse effects
    Language English
    Publishing date 2021-04-20
    Publishing country Germany
    Document type Journal Article ; Meta-Analysis ; Review
    ZDB-ID 84975-3
    ISSN 1432-1262 ; 0179-1958
    ISSN (online) 1432-1262
    ISSN 0179-1958
    DOI 10.1007/s00384-021-03924-8
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    Zs.A 2121: Show issues Location:
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  4. Article ; Online: Outcomes After Colonic Self-Expanding Metal Stent Insertion Without Fluoroscopy: A Surgeon-Led 10-Year Experience.

    Connelly, Tara M / Ryan, Jessica / Foley, Niamh M / Earley, Helen / Sahebally, Shaheel M / O'Brien, Carl / McCullough, Peter / Neary, Peter / Cooke, Fiachra

    The Journal of surgical research

    2022  Volume 281, Page(s) 275–281

    Abstract: Introduction: Colonic self-expanding metal stents (SEMS) can be used to relieve malignant and benign large bowel obstruction (LBO) as a bridge to surgery (BTS) and for palliation. Guidelines suggest the use of fluoroscopic guidance for deployment. This ... ...

    Abstract Introduction: Colonic self-expanding metal stents (SEMS) can be used to relieve malignant and benign large bowel obstruction (LBO) as a bridge to surgery (BTS) and for palliation. Guidelines suggest the use of fluoroscopic guidance for deployment. This may be difficult to obtain after hours and in certain centers. We aimed to determine the outcomes of stenting under endoscopic guidance alone.
    Methods: All patients who underwent SEMS insertion in our tertiary referral center between August 2010 and June 2021 were identified from a prospectively maintained database. Patient demographics (age/gender), disease characteristics (benign versus malignant/location/stage), stenting intent (BTS versus palliative), and outcomes (technical success/stoma/time from stenting to resection/death/study end) were analyzed.
    Results: Fifty-three (n = 39, 73.6% male) patients underwent SEMS insertion. Indications included colorectal carcinoma (n = 48, 90.6%), diverticular stricture (n = 3), and gynecological malignancy (n = 2). In five (9.4%) patients (four BTS and one palliative), SEMSs deployment was not completed because of the inability to pass the guidewire. All underwent emergency surgery. In the BTS cohort (n = 29, median 70.4 [range 40.3-91.8] years), 10 patients underwent neoadjuvant chemoradiotherapy. The permanent stoma rate was 20.7% (n = 6). There was no 30- or 90-d mortality. In the palliative cohort (n = 24, median age 77.1 [range 54.4-91.9]), 16 (66.7%) were deceased at the study end. The median time from stenting to death was 5.2 (2.3-7.9) months.
    Conclusions: SEMS placed under endoscopic visualization alone, palliatively and as a BTS, had acceptable stoma, morbidity, and mortality rates. These results show that SEMS insertion can be safely performed without fluoroscopy.
    MeSH term(s) Humans ; Male ; Aged ; Female ; Treatment Outcome ; Retrospective Studies ; Intestinal Obstruction/etiology ; Intestinal Obstruction/surgery ; Stents/adverse effects ; Colorectal Neoplasms/pathology ; Palliative Care/methods ; Fluoroscopy/adverse effects ; Surgeons ; Colonic Diseases/etiology ; Colonic Diseases/surgery
    Language English
    Publishing date 2022-10-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80170-7
    ISSN 1095-8673 ; 0022-4804
    ISSN (online) 1095-8673
    ISSN 0022-4804
    DOI 10.1016/j.jss.2022.08.043
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    Zs.A 178: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
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  5. Article: Aspirin in the primary prophylaxis of venous thromboembolism in surgical patients.

    Sahebally, Shaheel M / Healy, Donagh / Walsh, Stewart R

    The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

    2015  Volume 13, Issue 6, Page(s) 348–358

    Abstract: Introduction: Venous thromboembolism (VTE) is a common complication in surgical patients, especially those undergoing lower limb orthopaedic procedures as well as oncological resectional surgery. Numerous studies have evaluated the role of ... ...

    Abstract Introduction: Venous thromboembolism (VTE) is a common complication in surgical patients, especially those undergoing lower limb orthopaedic procedures as well as oncological resectional surgery. Numerous studies have evaluated the role of acetylsalicylic acid (ASA, aspirin) in primary VTE prevention, with contradictory results reflected in divergent guidelines. We reviewed current evidence for ASA as primary VTE prophylaxis.
    Methods: English language studies meeting our inclusion criteria were retrieved from PubMed, EMBASE and Cochrane databases. Six studies (3 meta-analyses and 3 randomized trials) comparing ASA with placebo and 7 studies (1 meta-analysis, 5 randomized trials, and 1 prospective) comparing ASA with other anticoagulants were included in the final analysis. Retrospective studies and case reports were excluded.
    Results: ASA is more effective than placebo in primary VTE prevention. Although there is clinical equipoise when ASA is compared with other anticoagulants, studies specific to orthopaedic surgery suggest that ASA appears as effective as low molecular weight heparin (LMWH) and may reduce bleeding risk. Extended prophylaxis up to 4 weeks post surgery reduces VTE episodes.
    Conclusions: ASA may be considered as a potential strategy in primary VTE prophylaxis in orthopaedic patients at high-risk of bleeding complications. Further studies comparing ASA with LMWH/oral anticoagulants in primary thromboprophylaxis following non-orthopaedic surgery are warranted.
    MeSH term(s) Aspirin/therapeutic use ; Fibrinolytic Agents/therapeutic use ; Global Health ; Humans ; Incidence ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/prevention & control ; Primary Prevention/methods ; Risk Factors ; Time Factors ; Venous Thromboembolism/epidemiology ; Venous Thromboembolism/etiology ; Venous Thromboembolism/prevention & control
    Chemical Substances Fibrinolytic Agents ; Aspirin (R16CO5Y76E)
    Language English
    Publishing date 2015-12
    Publishing country Scotland
    Document type Journal Article ; Review
    ZDB-ID 2102927-1
    ISSN 1479-666X
    ISSN 1479-666X
    DOI 10.1016/j.surge.2015.05.001
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    Zs.A 5756: Show issues Location:
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  6. Article ; Online: Twenty years of restorative proctocolectomy with ileal pouch anal anastomosis in Beaumont Hospital.

    McKevitt, Kevin / Ryan, Paul C / Sahebally, Shaheel M / McNamara, Deborah A / Deasy, Joseph / Burke, John P

    Irish journal of medical science

    2020  Volume 190, Issue 1, Page(s) 275–280

    Abstract: Introduction: An ileal pouch anal anastomosis (IPAA) is the treatment of choice in selected patients to restore intestinal continuity following proctocolectomy. Data on IPAA in the Republic of Ireland is lacking, and surgery for IPAA has evolved over ... ...

    Abstract Introduction: An ileal pouch anal anastomosis (IPAA) is the treatment of choice in selected patients to restore intestinal continuity following proctocolectomy. Data on IPAA in the Republic of Ireland is lacking, and surgery for IPAA has evolved over time. The aim of this retrospective study was to report our institutional outcomes from IPAA over a 20-year period.
    Methods: Data were retrospectively collated from consecutive primary IPAA cases between 1998 and 2017 at Beaumont Hospital. Patient demographics and operative approach were examined, and pouch failure was estimated using the Kaplan-Meier method.
    Results: Ninety-five patients underwent IPAA over the study period with a mean follow-up of 9.4 ± 5.6 years. The mean age at IPAA was 35.9 ± 10.0 years, and 58.9% were male. The majority were performed in 3 stages (78.9%), were performed to treat ulcerative colitis (66.3%), were of a J-pouch configuration (96.8%), and had a stapled anastomosis (70.5%). On follow-up, 28.4% reported experiencing at least 1 episode of pouchitis and the 10-year pouch failure rate was 14%. In the last decile of the study period, the mean number of IPAA performed per year increased to 10.5 ± 2.1 (P = 0.013), the age of IPAA formation reduced (P = 0.049), and the proportion completed in a minimally invasive manner increased (P < 0.001).
    Conclusions: Acceptable long-term outcomes were observed by our institution. A recent increase in institutional volume, reduction in patient age, and increase in the proportion of cases performed laparoscopically have been identified.
    MeSH term(s) Adult ; Anastomosis, Surgical/methods ; Female ; Hospitals ; Humans ; Ireland ; Male ; Proctocolectomy, Restorative/methods ; Retrospective Studies ; Time Factors ; Treatment Outcome
    Language English
    Publishing date 2020-07-08
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 390895-1
    ISSN 1863-4362 ; 0021-1265
    ISSN (online) 1863-4362
    ISSN 0021-1265
    DOI 10.1007/s11845-020-02297-1
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  7. Article: Classical Limberg versus classical Karydakis flaps for pilonidal disease- an updated systematic review and meta-analysis of randomized controlled trials.

    Sahebally, Shaheel M / McMahon, Gabriela / Walsh, Stewart R / Burke, John P

    The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

    2018  Volume 17, Issue 5, Page(s) 300–308

    Abstract: Introduction: Pilonidal disease (PD) is associated with significant disability culminating in time off work/school. Recurrence rates remain high following conventional surgical interventions. Flap-based techniques are postulated to decrease recurrence. ... ...

    Abstract Introduction: Pilonidal disease (PD) is associated with significant disability culminating in time off work/school. Recurrence rates remain high following conventional surgical interventions. Flap-based techniques are postulated to decrease recurrence. We performed a systematic review and meta-analysis to compare the effectiveness of the classical Limberg (LF) and Karydakis (KF) flaps in the treatment of PD.
    Methods: The online databases of Medline, CINAHL, EMBASE, Cochrane Central Register of Controlled Trials as well as Google Scholar were searched for relevant articles from inception until May 2017. All randomized studies that reported direct comparisons of classical LF and KF were included. Two independent reviewers performed data extraction. Random effects models were used to calculate pooled effect size estimates. A sensitivity analysis was also carried out.
    Results: Five randomized controlled trials describing 727 patients (367 in LF, 360 in KF) were examined. There was significant heterogeneity among studies. On overall random effects analysis, there was a lower rate of seroma formation associated with LF, and this approached statistical significance (OR = 0.47, 95% CI = 0.22 to 1.03, p = 0.06). However, there were no significant differences in recurrence (OR = 1.03, 95% CI = 0.48 to 2.21, p = 0.939), wound dehiscence (OR = 0.53, 95% CI = 0.09 to 2.85, p = 0.459), wound infection (OR = 0.59, 95% CI = 0.23 to 1.52, p = 0.278) or haematoma formation (OR = 2.08, 95% CI = 0.82 to 5.30, p = 0.124) between LF and KF. On sensitivity analysis, focusing only on primary and excluding recurrent PD, the results remained similar.
    Conclusions: LF and KF appear comparable in efficacy for primary PD, although LF is associated with less seroma formation.
    MeSH term(s) Chronic Disease ; Humans ; Pilonidal Sinus/complications ; Pilonidal Sinus/surgery ; Randomized Controlled Trials as Topic ; Surgical Flaps/adverse effects
    Language English
    Publishing date 2018-08-23
    Publishing country Scotland
    Document type Comparative Study ; Journal Article ; Meta-Analysis ; Systematic Review
    ZDB-ID 2102927-1
    ISSN 1479-666X
    ISSN 1479-666X
    DOI 10.1016/j.surge.2018.07.004
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    Zs.A 5756: Show issues Location:
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  8. Article ; Online: Short-term outcomes following the use of self-expanding metallic stents in acute malignant colonic obstruction--a single centre experience.

    Sahebally, Shaheel M / Sarwar, Azhar / Cooke, Fiachra

    International journal of surgery (London, England)

    2014  Volume 12, Issue 11, Page(s) 1198–1202

    Abstract: Background: Colonic self-expanding metallic stents (SEMS) may provide prompt relief of acute malignant colorectal obstruction (AMCO) and are increasingly used either palliatively or as a bridge to surgery (BTS) in patients in whom a definitive surgical ... ...

    Abstract Background: Colonic self-expanding metallic stents (SEMS) may provide prompt relief of acute malignant colorectal obstruction (AMCO) and are increasingly used either palliatively or as a bridge to surgery (BTS) in patients in whom a definitive surgical approach is unsuitable. We evaluated short-term outcomes of malignant colorectal obstructive patients who underwent SEMS insertion in our institution over a 3-year period.
    Methods: A prospectively maintained database was reviewed to identify all patients who presented to our institution with AMCO between August 2010 and 2013 and who were treated with a SEMS either temporarily or permanently. Additional data was retrieved from chart reviews and operation notes.
    Results: Sixteen patients (12 males, 4 females) each had a single stent inserted during the study period, either palliatively (n = 11) or as a BTS (n = 5). The technical and clinical success rates were both 87.5% (14/16). The two unsuccessful stenting cases both had disseminated disease and required emergency surgery while five patients with curable disease proceeded to elective resections. There was no procedure-related mortality or stent-related perforations. The mean (standard deviation) length of stay post acute surgery was longer than elective surgery [45 ± 21.2 vs. 15.8 ± 4.0, days]. All patients in the BTS group were stoma-free post-operatively, while both patients who had emergency surgery ended up with permanent stomas. Finally, the stent complication rate was 6.2% (1/16), secondary to migration.
    Conclusions: Although limited by a small sample size, the study shows that SEMS have favourable short-term outcomes. Further adequately powered trials are needed to confirm those findings.
    MeSH term(s) Aged ; Aged, 80 and over ; Colorectal Neoplasms/pathology ; Colorectal Neoplasms/surgery ; Endoscopy ; Equipment Design ; Female ; Humans ; Intestinal Obstruction/etiology ; Intestinal Obstruction/surgery ; Length of Stay ; Male ; Middle Aged ; Retrospective Studies ; Stents ; Time Factors ; Treatment Outcome
    Language English
    Publishing date 2014-11
    Publishing country England
    Document type Journal Article
    ZDB-ID 2212038-5
    ISSN 1743-9159 ; 1743-9191
    ISSN (online) 1743-9159
    ISSN 1743-9191
    DOI 10.1016/j.ijsu.2014.09.010
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  9. Article ; Online: Systemic Molecular Mediators of Inflammation Differentiate Between Crohn's Disease and Ulcerative Colitis, Implicating Threshold Levels of IL-10 and Relative Ratios of Pro-inflammatory Cytokines in Therapy.

    Kiernan, Miranda G / Coffey, J Calvin / Sahebally, Shaheel M / Tibbitts, Paul / Lyons, Emma M / O'leary, Eimear / Owolabi, Funke / Dunne, Colum P

    Journal of Crohn's & colitis

    2019  Volume 14, Issue 1, Page(s) 118–129

    Abstract: Background and aims: Faecal diversion is associated with improvements in Crohn's disease but not ulcerative colitis, indicating that differing mechanisms mediate the diseases. This study aimed to investigate levels of systemic mediators of inflammation, ...

    Abstract Background and aims: Faecal diversion is associated with improvements in Crohn's disease but not ulcerative colitis, indicating that differing mechanisms mediate the diseases. This study aimed to investigate levels of systemic mediators of inflammation, including fibrocytes and cytokines, [1] in patients with Crohn's disease and ulcerative colitis preoperatively compared with healthy controls and [2] in patients with Crohn's disease and ulcerative colitis prior to and following faecal diversion.
    Methods: Blood samples were obtained from healthy individuals and patients with Crohn's disease or ulcerative colitis. Levels of circulating fibrocytes were quantified using flow cytometric analysis and their potential relationship to risk factors of inflammatory bowel disease were determined. Levels of circulating cytokines involved in inflammation and fibrocyte recruitment and differentiation were investigated.
    Results: Circulating fibrocytes were elevated in Crohn's disease and ulcerative colitis patients when compared with healthy controls. Smoking, or a history of smoking, was associated with increases in circulating fibrocytes in Crohn's disease, but not ulcerative colitis. Cytokines involved in fibrocyte recruitment were increased in Crohn's disease patients, whereas patients with ulcerative colitis displayed increased levels of pro-inflammatory cytokines. Faecal diversion in Crohn's disease patients resulted in decreased circulating fibrocytes, pro-inflammatory cytokines, and TGF-β1, and increased IL-10, whereas the inverse was observed in ulcerative colitis patients.
    Conclusions: The clinical effect of faecal diversion in Crohn's disease and ulcerative colitis may be explained by differing circulating fibrocyte and cytokine responses. Such differences aid in understanding the disease mechanisms and suggest a new therapeutic strategy for inflammatory bowel disease.
    MeSH term(s) Adult ; Case-Control Studies ; Colitis, Ulcerative/blood ; Colitis, Ulcerative/surgery ; Crohn Disease/blood ; Crohn Disease/surgery ; Cytokines/blood ; Female ; Humans ; Ileostomy ; Inflammation Mediators/blood ; Interleukin-10/blood ; Male ; Middle Aged
    Chemical Substances Cytokines ; IL10 protein, human ; Inflammation Mediators ; Interleukin-10 (130068-27-8)
    Language English
    Publishing date 2019-06-25
    Publishing country England
    Document type Journal Article
    ZDB-ID 2390120-2
    ISSN 1876-4479 ; 1873-9946
    ISSN (online) 1876-4479
    ISSN 1873-9946
    DOI 10.1093/ecco-jcc/jjz117
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    Zs.A 6634: Show issues Location:
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  10. Article: Grading operative findings at laparoscopic cholecystectomy- a new scoring system.

    Sugrue, Michael / Sahebally, Shaheel M / Ansaloni, Luca / Zielinski, Martin D

    World journal of emergency surgery : WJES

    2015  Volume 10, Page(s) 14

    Abstract: Introduction: Variation in outcomes from surgery is a major challenge and defining surgical findings may help set benchmarks, which currently do not exist in laparoscopic cholecystectomy. This study outlines a new surgical scoring system incorporating ... ...

    Abstract Introduction: Variation in outcomes from surgery is a major challenge and defining surgical findings may help set benchmarks, which currently do not exist in laparoscopic cholecystectomy. This study outlines a new surgical scoring system incorporating key operative findings.
    Methods: English language studies (from January 1965 to July 2014) pertaining to severity scoring and predictors of difficult laparoscopic cholecystectomy were searched for in PubMed, Embase and Cochrane databases using the search terms 'Laparoscopic cholecystectomy or Lap chole' and/or 'Scoring Index or Grading system or Prediction of difficulty or Conversion to open' in various combinations. Cross-referencing from papers retrieved in the original search identified additional articles.
    Results: Sixteen published papers report a gallbladder (GB) scoring system, but all relate to pre-operative clinical and imaging findings, rather than operative findings. The current scoring system, using operative findings incorporates the appearance of the GB, presence of GB distension, ease of access, potential biliary complications and time taken to identify cystic duct and artery. A score of <2 would imply mild difficulty, 2-4 moderate, 5-7 severe and 8-10 extreme.
    Conclusion: This paper reports one of the first operative classifications of findings at laparoscopic cholecystectomy. It has the potential to allow benchmarks for international collaboration of operative and patient outcomes in patients undergoing laparoscopic cholecystectomy.
    Language English
    Publishing date 2015
    Publishing country England
    Document type Journal Article
    ISSN 1749-7922
    ISSN 1749-7922
    DOI 10.1186/s13017-015-0005-x
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    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

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