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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">mvjr</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский вестник Юга России</journal-title><trans-title-group xml:lang="en"><trans-title>Medical Herald of the South of Russia</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2219-8075</issn><issn pub-type="epub">2618-7876</issn><publisher><publisher-name>The Rostov State Medical University</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21886/2219-8075-2022-13-3-7-12</article-id><article-id custom-type="elpub" pub-id-type="custom">mvjr-1533</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ПСИХИАТРИЯ И НАРКОЛОГИЯ. «ДИСКУССИОННЫЕ ВОПРОСЫ ПОЛОВОЙ ИДЕНТИФИКАЦИИ»</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>PSYCHIATRY AND NARCOLOGY. «CONTROVERSIAL ISSUES OF GENDER IDENTITY»</subject></subj-group></article-categories><title-group><article-title>Гендерная неконформность как проблема ментализации</article-title><trans-title-group xml:lang="en"><trans-title>Gender nonconformity as a problem of mentalization</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0803-8797</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Виноградова</surname><given-names>К. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Vinogradova</surname><given-names>K. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Виноградова Ксения Сергеевна - аспирант кафедры истории, философии и психологии.</p><p>Краснодар.</p><p>SPIN: 4703-2868</p></bio><bio xml:lang="en"><p>Kseniya S. Vinogradova - postgraduate student, the Department of History, Philosophy and Psychology, Kuban State Techonological University.</p><p>Krasnodar.</p><p>SPIN: 4703-2868</p></bio><email xlink:type="simple">fassa87@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Кубанский государственный технологический университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Kuban State Techonological University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2022</year></pub-date><pub-date pub-type="epub"><day>30</day><month>09</month><year>2022</year></pub-date><volume>13</volume><issue>3</issue><fpage>7</fpage><lpage>12</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Виноградова К.С., 2022</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="ru">Виноградова К.С.</copyright-holder><copyright-holder xml:lang="en">Vinogradova K.S.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.medicalherald.ru/jour/article/view/1533">https://www.medicalherald.ru/jour/article/view/1533</self-uri><abstract><p>Цель — изучить и проанализировать тенденции, имеющиеся сегодня среди западных ученых и специалистов по психическому здоровью, касающиеся вопросов гендерной идентичности; изучить данные зарубежных и отечественных исследований, касающихся проблем гендерного несоответствия, гендерной дисфории и их коморбидности с психическими расстройствами, расстройствами личности, в особенности с расстройствами шизофренического и аутистического спектра; выявить перспективные направления научного поиска в указанном направлении. Поиск литературы в электронных базах данных проводился преимущественно за последние пять лет по зарубежным и русскоязычным публикациям, включая системы Web of science, Researchgate.net, Google Scholar, Elibrary, Cyberleninka, по таким словосочетаниям, как gender identity disorder, gender identity disorder comorbidity, gender identity disorder schizophrenia, gender identity disorder autism, gender nonconformity, mentalization personality disorder. В статье представлены данные современных публикаций и исследований, показывающие с одной стороны тенденцию западных специалистов депатологизировать гендерное несоответствие, способствовать гендерному переходу, с другой — активное исследование взаимосвязи явления с расстройствами аутистического и шизофренического спектра, расстройствами личности. По данным представленных исследований выявляется влияние особенностей ментализации на наличие психических расстройств и гендерного несоответствия.</p></abstract><trans-abstract xml:lang="en"><p>Objective — to study and analyze the current trends among Western scientists and mental health professionals regarding issues of gender identity; to study the data of foreign and domestic studies concerning the problems of gender incongruence, gender dysphoria and their comorbidity with mental disorders, personality disorders, especially with schizophrenia and autism spectrum disorders; to identify promising areas of scientific research in this direction. Source search in electronic databases was carried out mainly for the past 5 years among foreign and russian publications, including Web of science, Researchgate.net, Google Scholar, Elibrary, Cyberleninka systems, using phrases such as gender identity disorder, gender identity disorder comorbidity, gender identity disorder schizophrenia, gender identity disorder autism, gender nonconformity, mentalization personality disorder. The article presents the data of modern publications and studies, showing, on the one hand, the tendency of Western experts to depathologize gender incongruence, promote gender transition, on the other hand, an active study of the relationship between this phenomenon with autism and schizophrenia spectrum disorders, personality disorders. According to the presented studies, the influence of mentalization features on the presence of mental disorders and gender incongruence is revealed.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>обзор</kwd><kwd>гендерная идентичность</kwd><kwd>гендерная дисфория</kwd><kwd>гендерное несоответствие</kwd><kwd>ментализация</kwd><kwd>расстройства шизофренического спектра</kwd></kwd-group><kwd-group xml:lang="en"><kwd>review</kwd><kwd>gender identity</kwd><kwd>gender dysphoria</kwd><kwd>gender incongruence</kwd><kwd>mentalization</kwd><kwd>schizophrenia spectrum disorders</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Менделевич В.Д. Почему транссексуализм не является психическим расстройством, или как сделать психиатрическую классификацию научной. Неврологический вестник. 2018;50(3):5-10. DOI: 10.17816/nb14115</mixed-citation><mixed-citation xml:lang="en">Mendelevich V.D. Why transssexualism isn't a mental disorder or how to make psychiatric classification evidence-based. Neurology bulletin. 2018;50(3):5-10. (In Russ.). DOI: 10.17816/nb14115</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Littman L. Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria. PLoS One. 2018;13(8):e0202330. DOI: 10.1371/journal.pone.0202330. Erratum in: PLoS One. 201914(3):e0214157.</mixed-citation><mixed-citation xml:lang="en">Littman L. Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria. PLoS One. 2018;13(8):e0202330. DOI: 10.1371/journal.pone.0202330. Erratum in: PLoS One. 201914(3):e0214157.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Дьяченко А. В., Солдаткин В. А., Бухановская О. А., Переход А. Я. Расстройства половой идентификации у детей и подростков в психиатрической практике. Социальная и клиническая психиатрия. 2021;31(2):69-78. eLIBRARY ID: 46413359</mixed-citation><mixed-citation xml:lang="en">Dyachenko A.V., Soldatkin V.A., Bukhanovskaya O.A., Perekhov A.Y. Gender identity disorders in children and adolescents psychiatric practice. Social'naja i klinicheskaja psihiatrija. 2021;31(2):69-78. (In Russ.). eLIBRARY ID: 46413359</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Bewley S, Clifford D, McCartney M, Byng R. Gender incongruence in children, adolescents, and adults. Br J Gen Pract. 2019;69(681):170-171. DOI: 10.3399/bjgp19X701909.</mixed-citation><mixed-citation xml:lang="en">Bewley S, Clifford D, McCartney M, Byng R. Gender incongruence in children, adolescents, and adults. Br J Gen Pract. 2019;69(681):170-171. DOI: 10.3399/bjgp19X701909.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">de Graaf NM, Giovanardi G, Zitz C, Carmichael P. Sex Ratio in Children and Adolescents Referred to the Gender Identity Development Service in the UK (2009-2016). Arch Sex Behav. 2018;47(5):1301-1304. DOI: 10.1007/s10508-018-1204-9.</mixed-citation><mixed-citation xml:lang="en">de Graaf NM, Giovanardi G, Zitz C, Carmichael P. Sex Ratio in Children and Adolescents Referred to the Gender Identity Development Service in the UK (2009-2016). Arch Sex Behav. 2018;47(5):1301-1304. DOI: 10.1007/s10508-018-1204-9.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Kaltiala-Heino R, Bergman H, Tyolajarvi M, Frisen L. Gender dysphoria in adolescence: current perspectives. Adolesc Health Med Th er. 2018;9:31-41. DOI: 10.2147/AHMT.S135432.</mixed-citation><mixed-citation xml:lang="en">Kaltiala-Heino R, Bergman H, Tyolajarvi M, Frisen L. Gender dysphoria in adolescence: current perspectives. Adolesc Health Med Th er. 2018;9:31-41. DOI: 10.2147/AHMT.S135432.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Zucker K.J. The myth of persistence: Response to “A criti- 7. cal commentary on follow-up studies and ‘desistance' theories about transgender and gender non-conforming children” by Temple Newhook et al. International Journal of Transgenderism. 2018;19(2):231-245. DOI: 10.1080/15532739.2018.1468293</mixed-citation><mixed-citation xml:lang="en">Zucker K.J. The myth of persistence: Response to “A critical commentary on follow-up studies and ‘desistance' theories about transgender and gender non-conforming children” by Temple Newhook et al. International Journal of Transgenderism. 2018;19(2):231-245. DOI: 10.1080/15532739.2018.1468293</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">D'Angelo R, Syrulnik E, Ayad S, Marchiano L, Kenny 8. DT, Clarke P. One Size Does Not Fit All: In Support of Psychotherapy for Gender Dysphoria. Arch Sex Behav. 2021;50(1):7-16. DOI: 10.1007/s10508-020-01844-2.</mixed-citation><mixed-citation xml:lang="en">D'Angelo R, Syrulnik E, Ayad S, Marchiano L, Kenny DT, Clarke P. One Size Does Not Fit All: In Support of Psychotherapy for Gender Dysphoria. Arch Sex Behav. 2021;50(1):7-16. DOI: 10.1007/s10508-020-01844-2.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Turban JL, Beckwith N, Reisner SL, Keuroghlian AS. As- 9. sociation Between Recalled Exposure to Gender Identity Conversion Efforts and Psychological Distress and Suicide Attempts Among Transgender Adults. JAMA Psychiatry. 2020;77(1):68-76. DOI: 10.1001/jamapsychiatry.2019.2285.</mixed-citation><mixed-citation xml:lang="en">Turban JL, Beckwith N, Reisner SL, Keuroghlian AS. Association Between Recalled Exposure to Gender Identity Conversion Efforts and Psychological Distress and Suicide Attempts Among Transgender Adults. JAMA Psychiatry. 2020;77(1):68-76. DOI: 10.1001/jamapsychiatry.2019.2285.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Furlong Y, Janca A. Epidemiology of personality disorders 10. in individuals with gender dysphoria. Curr Opin Psychiatry. 2022;35(1):78-82. DOI: 10.1097/YCO.0000000000000757.</mixed-citation><mixed-citation xml:lang="en">Furlong Y, Janca A. Epidemiology of personality disorders in individuals with gender dysphoria. Curr Opin Psychiatry. 2022;35(1):78-82. DOI: 10.1097/YCO.0000000000000757.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Perrotta G. Etiological factors and comorbidities associated 11. with the “Gender Dysphoria”: Definition, clinical contexts, differential diagnosis and clinical treatments. Int J Sex Reprod Health Care. 2021;4(1):001-005. DOI: 10.17352/ijsrhc.000018</mixed-citation><mixed-citation xml:lang="en">Perrotta G. Etiological factors and comorbidities associated with the “Gender Dysphoria”: Definition, clinical contexts, differential diagnosis and clinical treatments. Int J Sex Reprod Health Care. 2021;4(1):001-005. DOI: 10.17352/ijsrhc.000018</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Rajkumar RP. Gender identity disorder and schizophrenia: 12. neurodevelopmental disorders with common causal mechanisms? Schizophr Res Treatment. 2014;2014:463757. DOI: 10.1155/2014/463757.</mixed-citation><mixed-citation xml:lang="en">Rajkumar RP. Gender identity disorder and schizophrenia: neurodevelopmental disorders with common causal mechanisms? Schizophr Res Treatment. 2014;2014:463757. DOI: 10.1155/2014/463757.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Дьяченко А.В., Бухановская О.А., Солдаткин В.А., 13. Перехов А.Я. Кто обращается к психиатру с запросом на изменение пола: результаты 30-летнего исследования. Психиатрия. 2020;18(3):32-41. DOI: 10.30629/2618-6667-2020-18-3-32-41</mixed-citation><mixed-citation xml:lang="en">Dyachenko A.V., Bukhanovskaya O.A., Soldatkin V.A., Perek-hov A.Y. Who Submits a Request to the Psychiatrist for a Gender Change: Results of a 30-Year Study. Psikhiatriya. 2020;18(3):32-41. (In Russ.) DOI: 10.30629/2618-6667-2020-18-3-32-41</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Warrier V, Greenberg DM, Weir E, Buckingham C, Smith P, 14. et al. Elevated rates of autism, other neurodevelopmental and psychiatric diagnoses, and autistic traits in transgender and gender-diverse individuals. Nat Commun. 2020;11(1):3959. DOI: 10.1038/s41467-020-17794-1.</mixed-citation><mixed-citation xml:lang="en">Warrier V, Greenberg DM, Weir E, Buckingham C, Smith P, et al. Elevated rates of autism, other neurodevelopmental and psychiatric diagnoses, and autistic traits in transgender and gender-diverse individuals. Nat Commun. 2020;11(1):3959. DOI: 10.1038/s41467-020-17794-1.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Van Der Miesen AI, Hurley H, De Vries AL. Gen- 15. der dysphoria and autism spectrum disorder: A narrative review. Int Rev Psychiatry. 2016;28(1):70-80. DOI: 10.3109/09540261.2015.1111199.</mixed-citation><mixed-citation xml:lang="en">Van Der Miesen AI, Hurley H, De Vries AL. Gender dysphoria and autism spectrum disorder: A narrative review. Int Rev Psychiatry. 2016;28(1):70-80. DOI: 10.3109/09540261.2015.1111199.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Glidden D, Bouman WP, Jones BA, Arcelus J. Gender 16. Dysphoria and Autism Spectrum Disorder: A Systematic Review of the Literature. Sex Med Rev. 2016;4(1):3-14. DOI: 10.1016/j.sxmr.2015.10.003.</mixed-citation><mixed-citation xml:lang="en">Glidden D, Bouman WP, Jones BA, Arcelus J. Gender Dysphoria and Autism Spectrum Disorder: A Systematic Review of the Literature. Sex Med Rev. 2016;4(1):3-14. DOI: 10.1016/j.sxmr.2015.10.003.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Kallitsounaki A, Williams D. Mentalising Moderates the 17. Link between Autism Traits and Current Gender Dysphoric Features in Primarily Non-autistic, Cisgender Individuals. J Autism Dev Disord. 2020;50(11):4148-4157. DOI: 10.1007/s10803-020-04478-4.</mixed-citation><mixed-citation xml:lang="en">Kallitsounaki A, Williams D. Mentalising Moderates the Link between Autism Traits and Current Gender Dysphoric Features in Primarily Non-autistic, Cisgender Individuals. J Autism Dev Disord. 2020;50(11):4148-4157. DOI: 10.1007/s10803-020-04478-4.</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Zupanic S, Kruljac I, Sostaric Zvonar M, Drobnic Radobul- 18. jac M. Case Report: Adolescent With Autism and Gender Dysphoria. Front Psychiatry. 2021;12:671448. DOI: 10.3389/fpsyt.2021.671448.</mixed-citation><mixed-citation xml:lang="en">Zupanic S, Kruljac I, Sostaric Zvonar M, Drobnic Radobuljac M. Case Report: Adolescent With Autism and Gender Dysphoria. Front Psychiatry. 2021;12:671448. DOI: 10.3389/fpsyt.2021.671448.</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Kallitsounaki A, Williams DM, Lind SE. Links Between 19. Autistic Traits, Feelings of Gender Dysphoria, and Mentalising Ability: Replication and Extension of Previous Findings from the General Population. J Autism Dev Disord. 2021;51(5):1458-1465. DOI: 10.1007/s10803-020-04626-w.</mixed-citation><mixed-citation xml:lang="en">Kallitsounaki A, Williams DM, Lind SE. Links Between Autistic Traits, Feelings of Gender Dysphoria, and Mentalising Ability: Replication and Extension of Previous Findings from the General Population. J Autism Dev Disord. 2021;51(5):1458-1465. DOI: 10.1007/s10803-020-04626-w.</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Lingiardi V, McWilliams N. The psychodynamic diagnostic manual - 2nd edition (PDM-2). World Psychiatry. 2015;14(2):237-9. DOI: 10.1002/wps.20233.</mixed-citation><mixed-citation xml:lang="en">Lingiardi V, McWilliams N. The psychodynamic diagnostic manual - 2nd edition (PDM-2). World Psychiatry. 2015;14(2):237-9. DOI: 10.1002/wps.20233.</mixed-citation></citation-alternatives></ref><ref id="cit21"><label>21</label><citation-alternatives><mixed-citation xml:lang="ru">Fonagy, P, Gergely, G., Jurist, E.L., Target, M. Affect regulation, mentalization and the development of the self. New York: Other Press; 2002.</mixed-citation><mixed-citation xml:lang="en">Fonagy, P., Gergely, G., Jurist, E.L., Target, M. Affect regulation, mentalization and the development of the self. New York: Other Press; 2002.</mixed-citation></citation-alternatives></ref><ref id="cit22"><label>22</label><citation-alternatives><mixed-citation xml:lang="ru">Соколова Е.Т. Нарушения ментализации в клинической и культурной парадигме Л.С. Выготского. Психологические исследования. 2017;10(56). DOI: 10.54359/ps.v10i56.343</mixed-citation><mixed-citation xml:lang="en">Sokolova E.T. Mentalization disorders in clinical and cultural Vygotsky’s paradigm. Psychological Studies. 2017;10(56). (In Russ.). DOI: 10.54359/ps.v10i56.343</mixed-citation></citation-alternatives></ref><ref id="cit23"><label>23</label><citation-alternatives><mixed-citation xml:lang="ru">Fonagy Р, Bateman A. The development of borderline personality disorder- a mentalizing model. Journal of Personality Disorders. 2008;22(1):4-21. DOI: 10.1521/pedi.2008.22.1.4</mixed-citation><mixed-citation xml:lang="en">Fonagy R, Bateman A. The development of borderline personality disorder- a mentalizing model. Journal of Personality Disorders. 2008;22(1):4-21. DOI: 10.1521/pedi.2008.22.1.4</mixed-citation></citation-alternatives></ref><ref id="cit24"><label>24</label><citation-alternatives><mixed-citation xml:lang="ru">Лэйнг Р. Д. Расколотое «Я»: пер. с англ. Спб.; 1995</mixed-citation><mixed-citation xml:lang="en">Laing R. D. The divided Self: per. s angl. Spb.; 1995. (In Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit25"><label>25</label><citation-alternatives><mixed-citation xml:lang="ru">Соколова Е.Т., Андреюк К.О. Особенности ментализации у пациентов с шизотипическими расстройствами. Психологические исследования. 2016;9(46). DOI:10.54359/ps.v9i46.485</mixed-citation><mixed-citation xml:lang="en">Sokolova E.T., Andrejuk K.O. Peculiarities of mentalization in patients with schizotypal disorders. Psychological Studies. 2016;9(46). (In Russ.). DOI: 10.54359/ps.v9i46.485</mixed-citation></citation-alternatives></ref><ref id="cit26"><label>26</label><citation-alternatives><mixed-citation xml:lang="ru">Ball Cooper E, Anderson JL, Sharp C, Langley HA, Venta A. Attachment, Mentalization, and Criterion B of the Alternative DSM-5 Model for Personality Disorders (AMPD). Borderline Personal Disord Emot Dysregul. 2021;8(1):23. DOI: 10.1186/s40479-021-00163-9.</mixed-citation><mixed-citation xml:lang="en">Ball Cooper E, Anderson JL, Sharp C, Langley HA, Venta A. Attachment, Mentalization, and Criterion B of the Alternative DSM-5 Model for Personality Disorders (AMPD). Borderline Personal Disord Emot Dysregul. 2021;8(1):23. DOI: 10.1186/s40479-021-00163-9.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
