Intrauterine Device (IUD) migration is a medical condition where the IUD, a long-acting reversible contraceptive device placed inside the uterus, moves from its original position. Normally, an IUD is designed to remain in the uterus, with the vertical strings attached to it trailing down through the cervix into the vagina, allowing for easy removal or checking of its position.

IUD migration refers to the unintended movement of the device, either partially or completely, outside the uterine cavity. This may occur due to various reasons such as a weakened uterus, infection, or anatomical abnormalities. The migration can lead to complications like perforation of the uterus, damage to nearby organs, and difficulty in removing or locating the IUD. Regular check-ups with healthcare providers are essential to ensure that the IUD remains in its proper place and to address any potential issues early on.

An Intrauterine Device (IUD) is a long-acting, reversible contraceptive device that is inserted into the uterus to prevent pregnancy. It is a small T-shaped piece of flexible plastic with strings attached to it for removal. There are two types of IUDs available: hormonal and copper. Hormonal IUDs release progestin, which thickens cervical mucus and thins the lining of the uterus, preventing sperm from reaching and fertilizing an egg. Copper IUDs, on the other hand, produce an inflammatory reaction in the uterus that is toxic to sperm and eggs, preventing fertilization.

IUDs are more than 99% effective at preventing pregnancy and can remain in place for several years, depending on the type. They are easily removable by a healthcare provider if a woman wants to become pregnant or choose another form of contraception. IUDs do not protect against sexually transmitted infections (STIs), so it is important to use condoms in addition to an IUD for protection against STIs.

In summary, Intrauterine Devices are small, T-shaped plastic devices that are inserted into the uterus to prevent pregnancy. They come in two types: hormonal and copper, both of which work by preventing fertilization. IUDs are highly effective, long-acting, and reversible forms of contraception.

An Intrauterine Device (IUD) is a small, T-shaped device that is inserted into the uterus to prevent pregnancy. The copper IUD is a type of long-acting reversible contraception (LARC) that releases copper ions, which are toxic to sperm and egg, preventing fertilization. It is one of the most effective forms of birth control available, with a failure rate of less than 1%.

The copper IUD can be used by women who have previously given birth as well as those who have not. It can be inserted up to five days after unprotected intercourse as emergency contraception to prevent pregnancy. Once inserted, the copper IUD can remain in place for up to ten years, although it can be removed at any time if a woman wants to become pregnant or for other reasons.

Copper IUDs are also used as an effective treatment for heavy menstrual bleeding and can be used to manage endometriosis-associated pain. Common side effects of copper IUDs include heavier and longer menstrual periods, cramping during insertion, and irregular periods during the first few months after insertion. However, these side effects usually subside over time.

It is important to note that while copper IUDs are highly effective at preventing pregnancy, they do not protect against sexually transmitted infections (STIs). Therefore, it is still recommended to use condoms or other barrier methods of protection during sexual activity to reduce the risk of STIs.

Foreign-body migration is a medical condition that occurs when a foreign object, such as a surgical implant, tissue graft, or trauma-induced fragment, moves from its original position within the body to a different location. This displacement can cause various complications and symptoms depending on the type of foreign body, the location it migrated to, and the individual's specific physiological response.

Foreign-body migration may result from insufficient fixation or anchoring of the object during implantation, inadequate wound healing, infection, or an inflammatory reaction. Symptoms can include pain, swelling, redness, or infection at the new location, as well as potential damage to surrounding tissues and organs. Diagnosis typically involves imaging techniques like X-rays, CT scans, or MRIs to locate the foreign body, followed by a surgical procedure to remove it and address any resulting complications.

An intrauterine device (IUD) is a small, T-shaped birth control device that is inserted into the uterus to prevent pregnancy. A medicated IUD is a type of IUD that contains hormones, which are released slowly over time to provide additional benefits beyond just contraception.

There are two types of medicated IUDs available in the US market: levonorgestrel-releasing intrauterine system (LNG-IUS) and the copper intrauterine device (Cu-IUD). The LNG-IUS releases a progestin hormone called levonorgestrel, which thickens cervical mucus to prevent sperm from reaching the egg, thins the lining of the uterus to make it less likely for a fertilized egg to implant, and can also inhibit ovulation in some women. The Cu-IUD is non-hormonal and works by releasing copper ions that create a toxic environment for sperm, preventing them from reaching the egg.

Medicated IUDs are highly effective at preventing pregnancy, with typical use failure rates of less than 1% per year. They can remain in place for several years, depending on the brand, and can be removed at any time by a healthcare provider if a woman wants to become pregnant or experience side effects. Common side effects of medicated IUDs may include irregular menstrual bleeding, cramping, and spotting between periods, although these tend to improve over time.

Intrauterine Device (IUD) expulsion is a medical condition that refers to the unintentional and partial or complete removal of an IUD from the uterus after its initial insertion. This can occur spontaneously or as a result of manipulation, and it may happen soon after insertion or even several months or years later.

IUD expulsion is more common in women who have not previously given birth, and it can increase the risk of unintended pregnancy and other complications. Symptoms of IUD expulsion may include irregular menstrual bleeding, pelvic pain, or the absence of the IUD strings in the vagina. If a woman suspects that her IUD has been expelled, she should contact her healthcare provider for further evaluation and management.

Uterine perforation is a medical condition that refers to the piercing or puncturing of the uterine wall. This can occur during various medical procedures such as dilatation and curettage (D&C), insertion of an intrauterine device (IUD), or during childbirth. It can also be caused by trauma or infection. Uterine perforation can lead to serious complications, such as bleeding, infection, and damage to surrounding organs. If left untreated, it can be life-threatening. Symptoms of uterine perforation may include severe abdominal pain, heavy vaginal bleeding, fever, and signs of shock. Immediate medical attention is required for proper diagnosis and treatment.

Contraceptive agents, female, are medications or devices specifically designed to prevent pregnancy in women. They work by interfering with the normal process of ovulation, fertilization, or implantation of a fertilized egg in the uterus. Some common examples of female contraceptive agents include:

1. Hormonal methods: These include combined oral contraceptives (COCs), progestin-only pills, patches, vaginal rings, and hormonal implants. They contain synthetic forms of the female hormones estrogen and/or progesterone, which work by preventing ovulation, thickening cervical mucus to make it harder for sperm to reach the egg, or thinning the lining of the uterus to prevent implantation of a fertilized egg.
2. Intrauterine devices (IUDs): These are small, T-shaped devices made of plastic or copper that are inserted into the uterus by a healthcare provider. They release hormones or copper ions that interfere with sperm movement and prevent fertilization or implantation.
3. Barrier methods: These include condoms, diaphragms, cervical caps, and sponges. They work by physically preventing sperm from reaching the egg.
4. Emergency contraception: This includes medications such as Plan B or Ella, which can be taken up to 5 days after unprotected sex to prevent pregnancy. They work by delaying ovulation or preventing fertilization of the egg.
5. Fertility awareness-based methods (FABMs): These involve tracking a woman's menstrual cycle and avoiding sexual intercourse during her fertile window. Some FABMs also involve using barrier methods during this time.

It is important to note that different contraceptive agents have varying levels of effectiveness, side effects, and risks. Women should consult with their healthcare provider to determine the best method for their individual needs and circumstances.

Levonorgestrel is a synthetic form of the natural hormone progesterone, which is used in various forms of birth control and emergency contraceptives. It works by preventing ovulation (the release of an egg from the ovaries), thickening cervical mucus to make it harder for sperm to reach the egg, and thinning the lining of the uterus to make it less likely for a fertilized egg to implant.

Medically, Levonorgestrel is classified as a progestin and is available in various forms, including oral tablets, intrauterine devices (IUDs), and emergency contraceptive pills. It may also be used to treat endometriosis, irregular menstrual cycles, and heavy menstrual bleeding.

It's important to note that while Levonorgestrel is a highly effective form of birth control when used correctly, it does not protect against sexually transmitted infections (STIs). Therefore, condoms should still be used during sexual activity if there is any risk of STI transmission.

A blood vessel prosthesis is a medical device that is used as a substitute for a damaged or diseased natural blood vessel. It is typically made of synthetic materials such as polyester, Dacron, or ePTFE (expanded polytetrafluoroethylene) and is designed to mimic the function of a native blood vessel by allowing the flow of blood through it.

Blood vessel prostheses are used in various surgical procedures, including coronary artery bypass grafting, peripheral arterial reconstruction, and the creation of arteriovenous fistulas for dialysis access. The choice of material and size of the prosthesis depends on several factors, such as the location and diameter of the vessel being replaced, the patient's age and overall health status, and the surgeon's preference.

It is important to note that while blood vessel prostheses can be effective in restoring blood flow, they may also carry risks such as infection, thrombosis (blood clot formation), and graft failure over time. Therefore, careful patient selection, surgical technique, and postoperative management are crucial for the success of these procedures.

An abdominal aortic aneurysm (AAA) is a localized dilatation or bulging of the abdominal aorta, which is the largest artery in the body that supplies oxygenated blood to the trunk and lower extremities. Normally, the diameter of the abdominal aorta measures about 2 centimeters (cm) in adults. However, when the diameter of the aorta exceeds 3 cm, it is considered an aneurysm.

AAA can occur anywhere along the length of the abdominal aorta, but it most commonly occurs below the renal arteries and above the iliac bifurcation. The exact cause of AAA remains unclear, but several risk factors have been identified, including smoking, hypertension, advanced age, male gender, family history, and certain genetic disorders such as Marfan syndrome and Ehlers-Danlos syndrome.

The main concern with AAA is the risk of rupture, which can lead to life-threatening internal bleeding. The larger the aneurysm, the greater the risk of rupture. Symptoms of AAA may include abdominal or back pain, a pulsating mass in the abdomen, or symptoms related to compression of surrounding structures such as the kidneys, ureters, or nerves. However, many AAAs are asymptomatic and are discovered incidentally during imaging studies performed for other reasons.

Diagnosis of AAA typically involves imaging tests such as ultrasound, computed tomography (CT) scan, or magnetic resonance imaging (MRI). Treatment options depend on the size and location of the aneurysm, as well as the patient's overall health status. Small AAAs that are not causing symptoms may be monitored with regular imaging studies to assess for growth. Larger AAAs or those that are growing rapidly may require surgical repair, either through open surgery or endovascular repair using a stent graft.

Contraception is the use of various devices, methods, or medications to prevent pregnancy. The term is derived from the Latin words "contra" meaning "against" and "conceptio" meaning "conception." Contraceptive methods can be broadly categorized into temporary and permanent methods. Temporary methods include barriers such as condoms, diaphragms, cervical caps, and sponges; hormonal methods like the pill, patch, ring, injection, and emergency contraception; and fertility awareness-based methods that involve tracking ovulation and avoiding intercourse during fertile periods. Permanent methods include surgical procedures such as tubal ligation for women and vasectomy for men.

The primary goal of contraception is to prevent the sperm from reaching and fertilizing the egg, thereby preventing pregnancy. However, some contraceptive methods also offer additional benefits such as reducing the risk of sexually transmitted infections (STIs) and regulating menstrual cycles. It's important to note that while contraception can prevent pregnancy, it does not protect against STIs, so using condoms is still recommended for individuals who are at risk of contracting STIs.

When choosing a contraceptive method, it's essential to consider factors such as effectiveness, safety, ease of use, cost, and personal preferences. It's also important to consult with a healthcare provider to determine the most appropriate method based on individual health history and needs.

Blood vessel prosthesis implantation is a surgical procedure in which an artificial blood vessel, also known as a vascular graft or prosthetic graft, is inserted into the body to replace a damaged or diseased native blood vessel. The prosthetic graft can be made from various materials such as Dacron (polyester), PTFE (polytetrafluoroethylene), or bovine/human tissue.

The implantation of a blood vessel prosthesis is typically performed to treat conditions that cause narrowing or blockage of the blood vessels, such as atherosclerosis, aneurysms, or traumatic injuries. The procedure may be used to bypass blocked arteries in the legs (peripheral artery disease), heart (coronary artery bypass surgery), or neck (carotid endarterectomy). It can also be used to replace damaged veins for hemodialysis access in patients with kidney failure.

The success of blood vessel prosthesis implantation depends on various factors, including the patient's overall health, the location and extent of the vascular disease, and the type of graft material used. Possible complications include infection, bleeding, graft thrombosis (clotting), and graft failure, which may require further surgical intervention or endovascular treatments.

Actinomycosis is a type of infection caused by bacteria that are normally found in the mouth, intestines, and female genital tract. These bacteria can cause abscesses or chronic inflammation if they infect body tissues, often after trauma or surgery. The infection typically affects the face, neck, or chest, and can spread to other parts of the body over time. Symptoms may include swelling, redness, pain, and the formation of pus-filled abscesses that may discharge a characteristic yellowish granular material called "sulfur granules." Treatment typically involves long-term antibiotic therapy, often requiring high doses and intravenous administration. Surgical drainage or removal of infected tissue may also be necessary in some cases.

Contraceptive devices for females refer to medical products designed to prevent pregnancy by blocking or interfering with the sperm's ability to reach and fertilize an egg. Some common examples of female contraceptive devices include:

1. Diaphragm: A shallow, flexible dome made of silicone that is inserted into the vagina before sexual intercourse to cover the cervix and prevent sperm from entering the uterus.
2. Cervical Cap: Similar to a diaphragm but smaller in size, the cervical cap fits over the cervix and creates a barrier to sperm entry.
3. Intrauterine Device (IUD): A small, T-shaped device made of plastic or copper that is inserted into the uterus by a healthcare professional. IUDs can prevent pregnancy for several years and work by changing the chemistry of the cervical mucus and uterine lining to inhibit sperm movement and implantation of a fertilized egg.
4. Contraceptive Sponge: A soft, round sponge made of polyurethane foam that contains spermicide. The sponge is inserted into the vagina before sexual intercourse and covers the cervix to prevent sperm from entering the uterus.
5. Female Condom: A thin, flexible pouch made of polyurethane or nitrile that is inserted into the vagina before sexual intercourse. The female condom creates a barrier between the sperm and the cervix, preventing pregnancy and reducing the risk of sexually transmitted infections (STIs).
6. Vaginal Ring: A flexible ring made of plastic that is inserted into the vagina for three weeks at a time to release hormones that prevent ovulation, thicken cervical mucus, and thin the lining of the uterus.
7. Contraceptive Implant: A small, flexible rod made of plastic that is implanted under the skin of the upper arm by a healthcare professional. The implant releases hormones that prevent ovulation and thicken cervical mucus to prevent pregnancy for up to three years.

It's important to note that while these contraceptive devices can be highly effective at preventing pregnancy, they do not protect against STIs. Using condoms in addition to other forms of contraception is recommended to reduce the risk of both pregnancy and STIs.

Pelvic Inflammatory Disease (PID) is a medical condition characterized by inflammation of the reproductive organs in women, specifically the uterus, fallopian tubes, and/or ovaries. It is often caused by an infection that ascends from the cervix or vagina into the upper genital tract. The infectious agents are usually sexually transmitted bacteria such as Neisseria gonorrhoeae and Chlamydia trachomatis, but other organisms can also be responsible.

Symptoms of PID may include lower abdominal pain, irregular menstrual bleeding, vaginal discharge with an unpleasant odor, fever, painful sexual intercourse, or pain in the lower back. However, some women with PID may not experience any symptoms at all. If left untreated, PID can lead to serious complications such as infertility, ectopic pregnancy, and chronic pelvic pain.

Diagnosis of PID is typically based on a combination of clinical findings, physical examination, and laboratory tests. Treatment usually involves antibiotics to eradicate the infection and may also include pain management and other supportive measures. In some cases, hospitalization may be necessary for more intensive treatment or if complications arise.

"Device Removal" in a medical context generally refers to the surgical or nonsurgical removal of a medical device that has been previously implanted in a patient's body. The purpose of removing the device may vary, depending on the individual case. Some common reasons for device removal include infection, malfunction, rejection, or when the device is no longer needed.

Examples of medical devices that may require removal include pacemakers, implantable cardioverter-defibrillators (ICDs), artificial joints, orthopedic hardware, breast implants, cochlear implants, and intrauterine devices (IUDs). The procedure for device removal will depend on the type of device, its location in the body, and the reason for its removal.

It is important to note that device removal carries certain risks, such as bleeding, infection, damage to surrounding tissues, or complications related to anesthesia. Therefore, the decision to remove a medical device should be made carefully, considering both the potential benefits and risks of the procedure.

Contraceptive devices are medical products or tools specifically designed to prevent pregnancy by blocking or interfering with the fertilization of an egg by sperm, or the implantation of a fertilized egg in the uterus. There are various types of contraceptive devices available, each with its own mechanism of action and efficacy rate. Here are some common examples:

1. Intrauterine Devices (IUDs): These are small, T-shaped devices made of plastic or copper that are inserted into the uterus by a healthcare professional. IUDs can prevent pregnancy for several years and work by affecting the movement of sperm and changing the lining of the uterus to make it less receptive to implantation.
2. Contraceptive Implants: These are small, flexible rods that are inserted under the skin of the upper arm by a healthcare professional. The implant releases hormones that prevent ovulation and thicken cervical mucus to block sperm from reaching the egg.
3. Diaphragms and Cervical Caps: These are flexible, dome-shaped devices made of silicone or rubber that are inserted into the vagina before sex. They cover the cervix and prevent sperm from entering the uterus.
4. Male and Female Condoms: These are thin sheaths made of latex, polyurethane, or other materials that are placed over the penis (male condom) or inside the vagina (female condom) during sex to prevent sperm from entering the body.
5. Spermicides: These are chemicals that kill or disable sperm and can be used alone or in combination with other contraceptive methods such as condoms, diaphragms, or cervical caps. They come in various forms, including foams, creams, gels, films, and suppositories.

It's important to note that while contraceptive devices are effective at preventing pregnancy, they do not protect against sexually transmitted infections (STIs). Using condoms is the best way to reduce the risk of STIs during sexual activity.

Family planning services refer to comprehensive healthcare programs and interventions that aim to help individuals and couples prevent or achieve pregnancies, according to their desired number and spacing of children. These services typically include:

1. Counseling and education: Providing information about various contraceptive methods, their effectiveness, side effects, and appropriate use. This may also include counseling on reproductive health, sexually transmitted infections (STIs), and preconception care.
2. Contraceptive services: Making a wide range of contraceptive options available to clients, including barrier methods (condoms, diaphragms), hormonal methods (pills, patches, injectables, implants), intrauterine devices (IUDs), and permanent methods (tubal ligation, vasectomy).
3. Screening and testing: Offering STI screening and testing, as well as cervical cancer screening for eligible clients.
4. Preconception care: Providing counseling and interventions to help women achieve optimal health before becoming pregnant, including folic acid supplementation, management of chronic conditions, and avoidance of harmful substances (tobacco, alcohol, drugs).
5. Fertility services: Addressing infertility issues through diagnostic testing, counseling, and medical or surgical treatments when appropriate.
6. Menstrual regulation: Providing manual vacuum aspiration or medication to safely and effectively manage incomplete miscarriages or unwanted pregnancies within the first trimester.
7. Pregnancy options counseling: Offering unbiased information and support to help individuals make informed decisions about their pregnancy, including parenting, adoption, or abortion.
8. Community outreach and education: Engaging in community-based initiatives to increase awareness of family planning services and promote reproductive health.
9. Advocacy: Working to remove barriers to accessing family planning services, such as policy changes, reducing stigma, and increasing funding for programs.

Family planning services are an essential component of sexual and reproductive healthcare and contribute significantly to improving maternal and child health outcomes, reducing unintended pregnancies, and empowering individuals to make informed choices about their reproductive lives.

Postcoital contraception, also known as emergency contraception, refers to methods used to prevent pregnancy after sexual intercourse has already occurred. These methods are typically used in situations where regular contraception has failed or was not used, such as in cases of condom breakage or forgotten birth control pills.

There are two main types of postcoital contraception:

1. Emergency contraceptive pill (ECP): Also known as the "morning-after pill," this is a hormonal medication that can be taken up to 5 days after unprotected sex, but it is most effective when taken within 72 hours. There are two types of ECPs available: progestin-only and combined estrogen-progestin. The progestin-only pill is preferred because it has fewer side effects and is just as effective as the combined pill.
2. Copper intrauterine device (IUD): This is a small, T-shaped device made of flexible plastic and copper that is inserted into the uterus by a healthcare provider. The IUD can be inserted up to 5 days after unprotected sex to prevent pregnancy. It is the most effective form of emergency contraception available, and it also provides ongoing protection against pregnancy for up to 10 years, depending on the type of IUD.

It's important to note that postcoital contraception should not be used as a regular method of contraception, but rather as a backup in case of emergencies. It is also not effective in preventing sexually transmitted infections (STIs). Regular contraceptive methods, such as condoms and hormonal birth control, are the best ways to prevent unintended pregnancies and STIs.

Pyometra is a medical condition that primarily affects female animals, including dogs and cats. It refers to an accumulation of pus in the uterus. This can occur as a result of hormonal changes that lead to the uterine lining becoming thickened and providing a favorable environment for bacterial growth.

The condition is often seen in older, intact (not spayed) females, and it can be caused by a variety of bacteria, with E. coli being one of the most common. If left untreated, pyometra can lead to serious complications, such as sepsis, peritonitis (inflammation of the lining of the abdominal cavity), and even death.

Symptoms of pyometra may include vaginal discharge, lethargy, loss of appetite, vomiting, increased thirst and urination, and abdominal pain or distension. Treatment typically involves surgical removal of the uterus (spaying), as well as supportive care such as fluid therapy and antibiotics to treat any resulting infections.

Unplanned pregnancy is a pregnancy that is not intended or expected by the woman or couple. It is also sometimes referred to as an "unintended" or "unwanted" pregnancy. This can occur when contraceptive methods fail or are not used, or when there is a lack of knowledge about or access to effective family planning resources. Unplanned pregnancies can present various physical, emotional, and social challenges for the individuals involved, and may also have implications for public health and societal well-being. It's important to note that unplanned pregnancies can still result in wanted and loved children, but the circumstances surrounding their conception may bring additional stressors and considerations.

Gynecology is a branch of medicine that deals with the health of the female reproductive system. It includes the diagnosis, treatment, and management of conditions related to the female reproductive organs such as the vagina, cervix, uterus, ovaries, and fallopian tubes.

Gynecologists provide routine care for women, including Pap tests, breast exams, and family planning advice. They also treat a wide range of gynecological issues, from menstrual disorders and sexually transmitted infections to reproductive system cancers and hormonal imbalances. In addition, many gynecologists also provide obstetric care, making them both ob-gyns.

It's important for women to establish a relationship with a trusted gynecologist to ensure they receive regular checkups and are able to address any concerns or issues related to their reproductive health.

Urinary bladder calculi, also known as bladder stones, refer to the formation of solid mineral deposits within the urinary bladder. These calculi develop when urine becomes concentrated, allowing minerals to crystallize and stick together, forming a stone. Bladder stones can vary in size, ranging from tiny sand-like particles to larger ones that can occupy a significant portion of the bladder's volume.

Bladder stones typically form as a result of underlying urinary tract issues, such as bladder infection, enlarged prostate, nerve damage, or urinary retention. Symptoms may include lower abdominal pain, difficulty urinating, frequent urination, blood in the urine, and sudden, strong urges to urinate. If left untreated, bladder stones can lead to complications like urinary tract infections and kidney damage. Treatment usually involves surgical removal of the stones or using other minimally invasive procedures to break them up and remove the fragments.

Uterine hemorrhage, also known as uterine bleeding or gynecological bleeding, is an abnormal loss of blood from the uterus. It can occur in various clinical settings such as menstruation (known as menorrhagia), postpartum period (postpartum hemorrhage), or in non-pregnant women (dysfunctional uterine bleeding). The bleeding may be light to heavy, intermittent or continuous, and can be accompanied by symptoms such as pain, dizziness, or fainting. Uterine hemorrhage is a common gynecological problem that can have various underlying causes, including hormonal imbalances, structural abnormalities, coagulopathies, and malignancies. It is important to seek medical attention if experiencing heavy or prolonged uterine bleeding to determine the cause and receive appropriate treatment.

Contraception behavior refers to the actions and decisions made by individuals or couples to prevent pregnancy. This can include the use of various contraceptive methods, such as hormonal birth control (e.g., pills, patches, rings), barrier methods (e.g., condoms, diaphragms), intrauterine devices (IUDs), and natural family planning techniques (e.g., fertility awareness-based methods).

Contraception behavior can be influenced by various factors, including personal beliefs, cultural norms, relationship dynamics, access to healthcare services, and knowledge about contraceptive options. It is an important aspect of sexual and reproductive health, as it allows individuals and couples to plan their families and make informed choices about whether and when to have children.

It's worth noting that while the term "contraception behavior" typically refers to actions taken specifically to prevent pregnancy, some contraceptive methods may also provide protection against sexually transmitted infections (STIs). For example, condoms are effective at preventing both pregnancy and STIs when used consistently and correctly.