Das C, Rathinam D, Manchanda S, Srivastava D. Endovascular uterine artery interventions. A Physical functioning, B physical role, C bodily pain, D general health, E vitality, F social functioning, G emotional role, H mental health. Eligible patients are symptomatic premenopausal women without the desire to conceive and who have symptomatic magnetic resonance imaging (MRI)-confirmed pure adenomyosis or dominant adenomyosis accompanied by fibroids. The type of hysterectomy was categorized as either open surgery (i.e., AH) or LH. These studies have reported sensitivity between 70 and 93% and specificities between 86 and 93%. Bilhim T, Pisco JM, Duarte M, Oliveira AG. Janda M, Gebski V, Brand A, Hogg R, Jobling TW, Land R, et al. By using this website, you agree to our Important factors to be included in classification systems would be the site and location of pathology, configuration, and size/volume relative to the total myometrial thickness [31]. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). statement and Tan J, Moriarty S, Taskin O, et al. A prospective randomized comparison between laparoscopic and laparotomic approaches in women with early stage endometrial cancer: a focus on the quality of life. It has started since November 2015, and its primary outcomes are expected by May 2020 . Uterine artery embolization versus hysterectomy in the - ResearchGate The symptomatology of adenomyosis. However, no reports to date have assessed the postoperative QOL for benign diseases. This site needs JavaScript to work properly. Adenomyosis, Uterine artery embolization, Hysterectomy. Several theories have been introduced, including traumatic, immunological, hormonal, metaplastic, and stem cell [25]. J Clin Epidemiol. The Uterine Artery Embolization (UAE) versus Hysterectomy for Uterine Fibroids trial (EMMY; ClinicalTrials.gov number, NCT00100191) was a multicenter, randomized trial in which uterine fibroid . official website and that any information you provide is encrypted Outcomes in adenomyosis treated with uterine artery embolization are associated with lesion vascularity: a long-term follow-up study of 252 cases. 1998;51:104553. doi: 10.1002/14651858.CD005073.pub2. Prevalence of adenomyosis varies widely from 5 to 70% [47] with recent studies showing about 20% prevalence [810] among which the majority were premenopausal. The LH group had higher scores in physical functioning on postoperative day 3 and week 2; physical role on day 3 and week 1; bodily pain on day 3 and week 1; general health on day 3, weeks 1, 2, and 4, and month 6; social functioning on day 3; and emotional (mental) role on day 3 and week 1. Introduction: A description is given of the quality of life (QOL) of women who were treated with peripartum embolization or hysterectomy for major obstetric hemorrhage (MOH). Adenomyosis: a clinical review of a challenging gynecologic condition. Mailli L, Patel S, Das R, Chun JY, Renani S, Das S, Ratnam L. CVIR Endovasc. Excisional adenomyomectomy involves the complete removal of focal lesions (adenomyomas), while myometrectomy is the surgical debulking of diffuse adenomyosis. This multicenter non-blinded randomized controlled trial is currently ongoing in the Netherlands. Uterine artery embolization vs hysterectomy in the treatment of Aromatase inhibitors or gonadotropin-releasing hormone agonists for the management of uterine adenomyosis: a randomized controlled trial. Pontis A, DAlterio MN, Pirarba S, de Angelis C, Tinelli R, Angioni S. Adenomyosis: a systematic review of medical treatment. BMC Women's Health 21, 219 (2021). Habiba M, Benagiano G, Brosens I. In the past 15years, UAE has been considerably studied for the treatment of symptomatic adenomyosis [107]. Matsumoto Y, Iwasaka T, Yamasaki F, Sugimori H. Apoptosis and Ki-67 expression in adenomyotic lesions and in the corresponding eutopic endometrium. showed 75% symptom relief on short-term follow-ups [77]. The technique for UAE in adenomyosis is similar to that used in fibroids. Suginami H, Tokushige M, Taniguchi F. Surgical treatment of adenomyosis. Patients who underwent LH scored significantly higher on physical functioning on postoperative day 3 and week 2; physical role and bodily pain on day 3 and week 1; general health on postoperative day 3, weeks 1, 2, and 4, and month 6; social functioning on day 3; and emotional role on day 3 and week 1. High-intensity focused ultrasound (HIFU) for adenomyosis: two-year follow-up results. 8600 Rockville Pike Their study tracked the QOL of cancer patients in the short and long term over a 1-year postoperative period, finding laparoscopic surgery to be advantageous compared with open surgery. The examination of studies resulted in inclusion of 30 observational trials and yielded follow-up data from 1,049 patients with adenomyosis (pure and combined) on improvement of symptoms and After obtaining informed consent, patients will be randomly allocated to treatment in a 2:1 UAE versus hysterectomy ratio. Digital subtraction angiography (DSA) images (of the same patient in Fig. Ability to preserve fertility will be one of the main factors determining whether UAE can replace hysterectomy in treatment of adenomyosis, but further randomized controlled trials are needed. Yasushi Kotani. Tamai K, Togashi K, Ito T, Morisawa N, Fujiwara T, Koyama T. MR imaging findings of adenomyosis: correlation with histopathologic features and diagnostic pitfalls. Thus, no consensus has been reached on the postoperative QOL in gynecological malignancies. Short-term QOL for laparoscopy was significantly superior, but this difference disappeared after 6months and later for most of the items [9]. In the latest systematic review and meta-analysis by de Bruijn et al., patients were divided into four groups to report short- and long-term outcomes. However, randomized controlled trials are lacking. Surgery in adenomyosis. An official website of the United States government. The purpose of this study is to clarify its minimal invasive features using a patient questionnaire on the postoperative quality of life (QOL) over various time periods following either laparoscopic hysterectomy (LH) or abdominal hysterectomy (AH) and to compare the results. Because it removes the uterus completely, a hysterectomy is a definitive cure for adenomyosis. Zullo F, Palomba S, Russo T, Falbo A, Costantino M, Tolino A, et al. For more than a century, diagnosis was dependent on histopathologic examination of post-hysterectomy specimens till the introduction of noninvasive ultrasound and MR techniques [13]. Patient enrollment started November 2015. On the other hand, Kindai University Hospital treats approximately all total hysterectomies for uterine fibroids and adenomyosis via LH. Int J Gen Med. A Correction to this paper has been published: https://doi.org/10.1186/s12905-021-01382-6, The Functional Assessment of Cancer Therapy-General. Cheung VYT. The purpose of this study is to clarify its minimal invasive features using a patient questionnaire on the postoperative quality of life (QOL) over various time periods following either laparoscopic hysterectomy (LH) or abdominal hysterectomy (AH) and to compare the results. Bookshelf @article{osti_21608522, title = {Uterine Artery Embolization versus Myomectomy: Impact on Quality of Life-Results of the FUME (Fibroids of the Uterus: Myomectomy versus Embolization) Trial}, author = {Manyonda, Isaac T., E-mail: imanyond@sgul.ac.uk and Bratby, Mark and Horst, Jessica S and Banu, Nassera and Gorti, Maha and Belli, Anna-Maria}, abstractNote = {Purpose: This study was designed to . GMS Interdiscip Plast Reconstr Surg DGPW. The .gov means its official. Takeuchi H, Kitade M, Kikuchi I, Kumakiri J, Kuroda K, Jinushi M. Diagnosis, laparoscopic management, and histopathologic findings of juvenile cystic adenomyoma: a review of nine cases. [8] studied the QOL of postoperative patients with endometrial cancer using the SF-36 and reported an overall advantage for laparoscopic surgery in QOL for up to 6months postoperatively. Younes G, Tulandi T. Conservative surgery for adenomyosis and results: a systematic review. To report the diagnostic accuracy of TVS in adenomyosis, several meta-analyses have been published [17, 4446]. Wallwiener M, Taran F-A, Rothmund R, et al. Uterine Artery Embolization with Small-Sized Particles for the YK, KM and NM were major contributors in writing the article. and transmitted securely. Most recent ultrasound and MR classification and reporting systems have been developed by Van den Bosch et al. Despite being less operator dependent, MRI needs more reader experience and optimization of imaging technique to achieve higher diagnostic accuracy [36]. This work was supported in part by Akaeda Medical Research Foundation in Japan. Hou Y, Qin Z, Fan K, Xu Y, Huang X. Europe PMC is an archive of life sciences journal literature. Hehenkamp WJK, Volkers NA, Birnie E, Reekers JA, Ankum WM. Ultrasonography compared with magnetic resonance imaging for the diagnosis of adenomyosis: correlation with histopathology. Postoperative QOL in LH cases was improved on day 3 and week 1; however, no significant differences between the LH and AH groups were found in most categories at week 4 and month 6. Primary outcomes (quality of life) were measured at 6, 12, and 24months using a combination of World Health Organization Quality of Life Scale and Short Form-12 Questionnaires. Received 2018 Dec 15; Accepted 2019 Mar 14. Sign in | . -. Wang S, Meng X, Dong Y. 2022 Nov 25;96(1143):20220121. doi: 10.1259/bjr.20220121. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 01.03.2018. Ravina JH, Herbreteau D, Ciraru-Vigneron N, et al. This is the first report to investigate postoperative QOL using the SF-36 to compare LH and AH for uterine fibroids and adenomyosis. (These two hospitals are located in different geographical areas and have different medical specializations.). The results were compared between the two groups. Management of uterine adenomyosis: current trends and uterine artery embolization as a potential alternative to hysterectomy. Am J Obstet Gynecol. Uterine artery embolization for symptomatic adenomyosis: 7-year clinical follow-up using UFS-Qol questionnaire. Subsequently, both groups scores recovered over time to the national average baseline of 50 points for most variables, and no difference was observed in the long-term QOL between the LH and AH groups in most variables at week 4 and thereafter. 2023 BioMed Central Ltd unless otherwise stated. Transvaginal sonographic features of diffuse adenomyosis in 18-30-year-old nulligravid women without endometriosis: association with symptoms. Adenomyosis: Diagnosis and Management | AAFP This includes the temporary relieve of symptoms, and the common (i.e., menopausal symptoms, irregular bleeding, amenorrhea) and occasionally severe (i.e., thromboembolic) side effects of some drugs. Fukunishi H, Funaki K, Sawada K, Yamaguchi K, Maeda T, Kaji Y. Uterine artery embolization (UAE) in patients with symptomatic adenomyosis has demonstrated to reduce symptoms and improve quality of life. Adenomyosis is a challenging clinical condition that is commonly being diagnosed in women of reproductive age. Additionally, the study was conducted in two different facilities with different teams which may have created a bias due to the difference in the study environment of the two groups. Europe PMC Management of uterine adenomyosis: current trends and uterine artery embolization as a potential alternative to hysterectomy. Comparisons of the QOL between patients receiving AH or LH are shown in Fig. Currently, the RCT "Quality of Life after Embolization vs Hysterectomy in Adenomyosis" (QUESTA) trial is ongoing and results highly awaited. Uterine artery embolization is a well-documented and less invasive alternative to hysterectomy for symptomatic uterine fibroids on which eligible patients should be counseled. This study was aimed to compare serial long-term postoperative changes in quality-of-life (QoL) between photoselective-vaporization (PVP) using 120W-High-Performance-System and holmium-laser-enucleation (HoLEP) in benign-prostatic-hyperplasia (BPH) patients and to identify factors influencing the QoL improvement at the short-term, mid-term and long-term follow-up visits after surgery. Gupta JK, Sinha AS, Lumsden MA, Hickey M. Cochrane Database Syst Rev. Patient data includes the following questionnaires: Pictorial Blood Assessment Chart (PBAC), Numeric Pain, MeSH Our study revealed that both LH and AH reduce QOL in the immediate postoperative period. The evaluation of uterine artery embolization as a nonsurgical treatment option for adenomyosis. Table1 describes MRI features of adenomyosis as described in previous literature [1416, 35, 47]. Introduction Adenomyosis is defined as abnormal implantation of endometrial tissue into the myometrium associated with enlarging of the uterus [ 1 ]. Hysterectomy has historically been the golden standard for treatment as well as (postoperatively) diagnosis of the disease. The embolization was performed using small-sized polyvinyl alcohol particles (100 m and 300 m). Despite the absence of specific (pathognomonic) diagnostic features for uterine adenomyosis, typical symptoms include menorrhagia, chronic pelvic pain, and dysmenorrhea [11]. Ultrasound scan and magnetic resonance imaging for the diagnosis of adenomyosis: systematic review comparing test accuracy. Please enable it to take advantage of the complete set of features! Ota H, Hatazawa J, Igarashi S, Tanaka T. Is adenomyosis an immune disease? These findings suggest that laparoscopic surgery may be advantageous patients for in the short term regarding physical function and pain but without particular benefits for mental health. These symptoms are commonly encountered in other gynecological disorders including leiomyomas and endometriosis, often confounding the clinical diagnosis [12]. Patient data includes the following, Study flowchart. Edwards RD, Moss JG, Lumsden MA, et al. Magnetic resonance imaging (MRI) represents a second line, detailed imaging modality for the detection of adenomyosis (Fig. The .gov means its official. Embolization is usually performed using variable-sized permanent particulate agents [103, 104]. Observational studies have shown sustained improvements in quality of life, as measured with the use of the validated Uterine Fibroid Symptom and Quality of Life (UFS-QOL) questionnaire, 14-17 at . There was a significant median reduction of -37.4% after uterine fibroid embolization, but no correlations between uterine volume and quality of life scores were found before or after embolization. On the other hand, the Gynecologic Oncology Group (GOG) 2222 (LAP-2) study compared laparoscopic versus abdominal surgery using the FACT-G v. 3.0. and transmitted securely. Huang X, Huang Q, Chen S, et al. 2). Adenomyosis is defined by the abnormal location of endometrial tissue within the myometrium associated with hypertrophy or hyperplasia of the myometrial stroma [1, 2]. Cardiovasc Intervent Radiol. Bethesda, MD 20894, Web Policies Transvaginal sonographic criteria for the diagnosis of adenomyosis based on histopathologic correlation. Tinelli A, Malvasi A (2015, 2015) Uterine myoma, myomectomy and minimally invasive treatments. Thirty-eight patients who underwent total hysterectomy for uterine fibroids in 2012 (14 AH and 24 LH cases) were included. Even in this period, however, the QOL was significantly greater in the LH group compared with the AH group. The results demonstrate that QOL is increased with laparoscopy in the short postoperative term, improves thereafter in both procedures, and shows no inter-group differences in the long term. doi: 10.1016/j.diii.2012.10.012. Nabeshima H, Murakami T, Terada Y, Noda T, Yaegashi N, Okamura K. Total laparoscopic surgery of cystic adenomyoma under hydroultrasonographic monitoring. 1). Naftalin J, Hoo W, Pateman K, Mavrelos D, Foo X, Jurkovic D. Is adenomyosis associated with menorrhagia? Endovascular embolization of uterine myomas and adenomyomatosis is a safe and effective organ-sparing treatment for symptomatic patients based on a broad range of published evidence including randomized-controlled trials. [38]. 1989 Mar;16(1):22135. Prevalence and risk factors of adenomyosis at hysterectomy. Symptomatic uterine fibroids: treatment with uterine artery embolization or hysterectomyresults from the randomized clinical embolisation versus hysterectomy (EMMY) trial. Obstet Gynecol. Article Symptomatic adenomyosis-uterine artery embolization | IJGM Bird CC, McElin TW, Manalo-Estrella P. The elusive adenomyosis of the uterus--revisited. Eligibility criteria comprised patients diagnosed with uterine fibroids and adenomyosis on preoperative magnetic resonance imaging (MRI) who underwent total hysterectomy. Special attention is paid to visualization of the cervicovaginal and ovarian artery branches (Fig. Aarts JW, Nieboer TE, Johnson N, Tavender E, Garry R, Mol BW, et al. With the introduction and advancement of ultrasound and MR techniques, various criteria have been utilized in the noninvasive narrowing of the clinical differential [15, 35, 36], determining the depth of myometrial invasion and monitoring treatment response [37]. Lancet Oncol. Medical treatment is the first-line treatment option for adenomyosis aiming to relieve symptoms and maintain fertility with the least possible side effect. The authors declare that they have no competing interests. Springer International Publishing, pp 1281 10.1007/978-3-319-10305-1. Reinhold C, McCarthy S, Bret PM, et al. Can uterine artery embolization be an alternative to plastic and reconstructive uterus operation by minimally invasive surgery? 1. Pathogenesis of adenomyosis: an update on molecular mechanisms. Important factors to be considered and discussed with patients are age, symptom severity, desire for future conception, and associated comorbidities [32, 54, 55]. Diffuse adenomyosis: comparison of endovaginal US and MR imaging with histopathologic correlation. Shui L, Mao S, Wu Q, et al. Uterine Artery Embolization for Symptomatic Adenomyosis: 7-Year Rates of menorrhagia, dysmenorrhea, and uterine volume reduction varied widely from 12.4 to 44.8%, 25 to 100%, and 12.7 to 54% respectively, increasing gradually overtime (from 1 to 24months). Imaging outcomes were also determined to identify potential predictive parameters for therapy effect using specific TVUS criteria (uterine size/fibroid volume reduction in case of associated fibroids, vascular index by 3D power Doppler) at baseline, 6weeks, and 6months and MRI criteria (uterine size/fibroid volume reduction in case of associated fibroids, junctional zone reduction, infarction rate, and presence of endometriosis) at baseline and at 6months postprocedure [101]. 2021. Department of Obstetrics and Gynecology, Kindai University Faculty of Medicine, 377-2 Ohno-higashi, Osaka-sayama, Osaka, 589-8511, Japan, Yasushi Kotani,Kosuke Murakami,Risa Fujishima,Akiko Kanto,Hisamitsu Takaya,Masao Shimaoka,Hidekatsu Nakai&Noriomi Matsumura, You can also search for this author in Kim MD, Kim YM, Kim HC, et al. Table1 describes ultrasound features of adenomyosis as described in previous literature [14, 16, 3843]. Google Scholar. Togashi K, Konishi I, Itoh H, Nishimura K, Fujisawa IOH. Patients with written informed consents were randomly allocated (in a 2:1 ratio) between both experimental intervention (UAE) and standard care control groups (hysterectomy), while patients refusing randomization are given the standard of care (hysterectomy) [101]. Issues related to QOL are routinely cited by cancer survivors as among their greatest concerns. The main indication for operative management is the presence of symptoms that impairs the patient's quality of life. Uterine adenomyosis: endovaginal US and MR imaging features with histopathologic correlation. The use of complex imaging techniques has revealed various subtypes of adenomyosis, often associated with histopathologic variation in glandular and muscular components [31]. Pathogenesis of uterine adenomyosis: invagination or metaplasia? The retrospective nature of our study is another limitation; future large-scale prospective studies are encouraged. Uterine artery embolization versus hysterectomy in the treatment of symptomatic adenomyosis: protocol for the randomized questa trial. QUESTA trial: QUality of life after Embolization vs. hySTerectomy in Adenomyosis. A hysterectomy is a treatment option for adenomyosis, a condition where the inner lining of the uterus (endometrium) breaks through the muscle wall of the uterus. Peric H, Fraser IS. Written informed consent was obtained from all participating respondents (R24-036, R24-058). Ultrasound features of adenomyosis can be divided into direct or indirect features (Fig. The authors declare that they have no competing interests. Adenomyosis remains an underdiagnosed condition. Quality of Life After Hysterectomy (AdenoQOL) - CheckOrphan In: Nahum H, editor. Am J Obstet Gynecol. LH leads to superior short-term QOL early in the postoperative period relative to AH. Uterine Artery Embolization Versus Hysterectomy in the - PubMed Am J Obstet Gynecol. A prospective study of prevalence using transvaginal ultrasound in a gynaecology clinic. Online ahead of print. Patient background (age, number of menstrual cycles, body mass index, preoperative symptoms, and rate of previous abdominal surgery) and surgical outcomes (operative time, blood loss, uterine weight removed, postoperative hospital stay, and rate of operative complications) were examined for both AH and LH. Transvaginal ultrasound (TVS) represents a cost-effective initial screening modality for adenomyosis. Hysteroscopic resection/ablation is a combined treatment method involving the dissection and or coagulation of cystic adenomyotic lesions and crypts [7882]. Recent studies estimate a prevalence of adenomyosis among females younger than 40years to be about 2030%, while in the rest of the patients, diagnosis is usually established in the fourth or fifth decade [5557]. Patient data includes the following questionnaires: Pictorial Blood Assessment Chart (PBAC), Numeric Pain Rating Scale (NRS), Facet 1:Pain and discomfort WHOQOL-100, World Health Organization Quality Of Life-Bref (WHOQOL-Bref), Short Form-12 (SF-12), Facet 15: sexual activity domain WHOQOL-100, recovery (RI-10), Euro-QOL 5D (EQ-5D), patient preference (vignette), and patient satisfaction (Likert-scale). Mochimaru A, Aoki S, Oba MS, Kurasawa K, Takahashi T, Hirahara F. Adverse pregnancy outcomes associated with adenomyosis with uterine enlargement. Clipboard, Search History, and several other advanced features are temporarily unavailable. Following the procedure (UAE or hysterectomy), patients are followed up immediately, then at 6weeks, 3months, 6months, 12months, and 24months using an online questionnaire system. In this study, most of the cases were performed by physicians who were in their 10th year of practice for both LH and AH. Current and Prospective Treatment of Adenomyosis. Cardiovasc Intervent Radiol. Naftalin J, Hoo W, Pateman K, Mavrelos D, Holland T, Jurkovic D. How common is adenomyosis? Struble J, Reid S, Bedaiwy MA. The exact etiology of adenomyosis remains unclear with some theories suggesting invagination of the endometrium into the myometrium and others favoring metaplasia of stem cells [ 2 ]. adenomyosis; hysterectomy; quality of life; randomized trial; uterine artery embolization. Cezar C, Torres de la Roche LA, Hennefrnd J, Verhoeven HC, Devassy R, De Wilde RL; Working Group on Minimally Invasive Therapy in Benign Disease of the Uterine Wall (European Society of Gynecological Endoscopy, ESGE). This process can be guided and monitored through MRI or ultrasound [83]. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. Uterine artery embolization for symptomatic adenomyosis: a new technical development of the 1-2-3 protocol and predictive factors of MR imaging affecting outcomes. Andersen MH, Mathisen L, Veenstra M, Oyen O, Edwin B, Digernes R, et al. Would you like email updates of new search results? Kim KA, Yoon SW, Lee C, et al. eCollection 2021. HHS Vulnerability Disclosure, Help Obstet Gynecol Clin North Am. Secondary outcomes (clinical, symptom and quality of life, recovery related, cost utility analysis, laboratory, and pathology outcomes) were measured at 6weeks and 3, 6, 12, and 24months. Transplantation. This is mainly due to difficult diagnosis, the diffuse nature of the disease, and little evidence-based literature needed to standardize treatments [19]. Terms and Conditions, Levy G, Dehaene A, Laurent N, Lernout M, Collinet P, Lucot J, Lions C, Poncelet E. An update on adenomyosis. It has started since November 2015, and its primary outcomes are expected by May 2020 [101]. Caridi TM, Spies JB. 1Radiology Department, Faculty of Medicine, Zagazig University, Koliat Al Tob Street, Zagazig, 44519 Egypt, 2Radiology Department, Al-Ahrar Teaching Hospital, Zagazig, Egypt. doi: 10.3205/iprs000157. Vascular access is gained through a femoral or radial artery puncture using 46-French (F) arterial sheath for femoral [99, 101] and 4-F sheath for radial access [102]. Microbubbles are believed to improve the ablative effects of HIFU by changing the acoustic characteristics, thus increasing energy deposition in target tissues, while GnRH and metformin inhibit cellular proliferation and induce apoptosis [8587]. The https:// ensures that you are connecting to the http://linkinghub.elsevier.com/retrieve/pii/S2211-5684(12)00346-4, Genc M, Genc B, Cengiz H. Adenomyosis and accompanying gynecological pathologies. Management of uterine adenomyosis: current trends and uterine artery Bergholt T, Berendt N, Eriksen L, Jacobsen M, Hertz JB. Furthermore, initial studies have linked various imaging criteria to symptoms of adenomyosis [4951]. Uterine Artery Embolization for the Treatment of Adenomyosis: A In this review, we discuss current trends in the management of uterine adenomyosis with a special focus on uterine artery embolization as an alternative to hysterectomy. show up to 67% long-term (40month) treatment success and up to and 72% patient satisfaction rates respectively [24, 100]. -. Conclusions: Prevalence of adenomyosis in women undergoing surgery for endometriosis. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Transvaginal ultrasound for the diagnosis of adenomyosis: systematic review and meta-analysis. HHS Vulnerability Disclosure, Help Provided by the Springer Nature SharedIt content-sharing initiative.