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The Epidemiological, Clinical and Radiological (Echography, Mammography) Characteristics of Breast Pathologies at the Diagnostic Imaging Center (C.I.D) “Teriya” in Bamako

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Open Journal of Medical Imaging 2023年第1期13卷 30-39页

作者： Ilias Guindo Souleymane Sanogo Mamadou N’diaye Mody Abdoulaye Camara Adama Dao Youssouf Goita Amadou Sow Mohamed Malinke Salia Coulibaly Mahamadou Diallo Medical Imaging department CHU Pr BSS of Kati Kati Mali Medical Imaging department CHU Gabriel Touré Bamako Mali Medical Imaging department Luxembourg Mother-Child Hospital Bamako Mali Imaging Service Bamako Infirmary Central Directorate of Armed Forces Health Services (DCSSA) Bamako Mali Medical Imaging department Mali Hospital Bamako Mali TERIYA Diagnostic Imaging Center Bamako Mali

Breast pathology is varied, bringing together tumor and non-tumor lesions. Objective: To study the contribution of the ultrasound-mammography pair in the diagnosis of breast pathologies. Materials and Method: This was a retrospective descriptive study, carried out over a period of 3 years (from January 2018 to December 2020) at the Diagnostic Imaging Center (C.I.D) “TERIYA” in BAMAKO. It concerned all patients who came for a mammogram/ultrasound examination of the breast. All women admitted for mammogram or breast ultrasound who were diagnosed with a breast injury during the study period were included. Incomplete records and radiological checks were not included. The variables analyzed were age, sex, clinical data, and ultrasound and mammography aspects. The devices used are: a Voluson 730 PRO ultrasound machine and a G 600T type mammography machine. Results: At the end of our study, we collected 254 breast pathologies on a number of 382 women, i.e. a frequency of 66.49%. The average age of our patients was 41 years old. The dominant clinical data were mastodynia (41.88%) and mammary nodule (21.70%). On imaging (mammo-ultrasound) the lesions predominated on the left in 36% of cases, bilateral in 28% of cases and in the upper-outer quadrants in 31.5% of cases. Tumor pathologies represented 66.54% of which 45.27% were benign mainly composed of fibro-adenoma (20.88%) and cyst (18.50%), 11.8% of suspected cases and 9.45% of cancers. Non-tumor pathologies represented 33.46%, mainly mastitis (16.14%), galactophoric dilations (11.02%) and abscesses (5.51%). These pathologies were classified in 50.3% in ACR2, 17.75% in ACR3 and 4, and in 14.20% in ACR5. Lymphadenopathy was present in 73.21% of cases.

关键词： Breast Pathologies Ultrasound-Mammography Pair Diagnostic Imaging Center Bamako

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Surgical Management of Recent Traumatic Epiphyseal Fractures-Detachments of the Distal Femur at Gabriel TouréUniversity Hospital

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Surgical Science 2023年第2期14卷 61-71页

作者： Mahamadou Diallo Abdoul Kadri Moussa Layes Toure Kalifa Coulibaly Mamadou Bassirou Traoré Cheick Oumar Sanogo Terna Traoré Mamadou Diallo Amadou Maiga Adégné Togo Service d’Orthopédie-Traumatologie CHU Gabriel Touré Bamako Mali Service d’Orthopédie-Traumatologie Etablissement Hospitalier Publique Sikasso Sikasso Mali Service d’orthopédie traumatologie CHU de Kati Kati Mali Service de Neurochirurgie CHU Gabriel Touré Bamako Mali Service de chirurgie générale CHU Gabriel Touré Bamako Mali

Traumatic epiphyseal detachment fractures of the distal end of the femur are a rare lesion whose severity is linked to disabling sequelae such as limb length inequality or most often axial deviation. In this report, surgical treatment aims to reconstruct the anatomy of the distal femur, to avoid secondary displacements and to allow early mobilization of the knee. Surgery carried out mainly by the technique of plugging in or screwing, opened or better still closed, can be a source of complications including migration of pins, infections, knee stiffness, and growth disorders. The aim of this work was to describe their epidemiological, anatomo-clinical, therapeutic and evolutionary aspects in the department of Orthopedics-Traumatology at the chu Gabriel TOURE. It was a retrospective study over 30 months from July 2019 to December 2021. In fact, it concerned 42 patients with traumatic epiphyseal detachment of the distal femur occurring within 21 days or less, on a healthy knee with cartilage fertile treated surgically and followed in the department. However, the diagnosis of traumatic epiphyseal detachment of the distal femur was retained thanks to the clinical examination and supplemented by radiographic images of the knee from the front and from the side. The treatment was surgical. The functional results were evaluated according to the functional criteria of the Eastern Orthopedic Traumatology Society (SOTEST). Forty-two patients included 32 boys and 10 girls of average age of 12 years with extremes of 8 years and 16 years. The lesions were classified according to the Salter Harris classification. We noted 24% type I (n = 10), type II 71% (n = 30), type III 2% (n = 1), type IV 2% (n = 1). Union was achieved in all patients within an average of 6 weeks with extremes of 4 and 12 weeks. The functional result was considered good in 20% of cases and very good in 80%. Traumatic epiphyseal detachment fractures of the distal end of the femur are a rare lesion whose severity

关键词： Epiphyseal Detachment Distal Femur Treatment Surgical

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Feasibility of Scanopelvimetry in the Medical Imaging department of the University Hospital of Point “G”.

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Open Journal of Medical Imaging 2022年第3期12卷 157-164页

作者： Abdoulaye Koné Moussa Konaté Youssouf Koné Moussa Traore Youssouf Diawara Ibrahima Coulibaly Ouncoumba Diarra Fatoumata Kalapo Amadou Doumbia Kassim Sidibe Cheick Oumar Touré Oumar Aba Ata Mody A. Camara Mamadou Sima Coulibaly Salia Mahamadou Diallo Adama Diaman Keita Siaka Sidibé Faculty of Medicine and Odontostomatology Bamako Mali Medical Imaging department of the University Hospital of Point G Bamako Mali Radiology department of the Jacques Boutard Hospital Saint-Yrieix-la-Perche France Medical Imaging department of GABRIEL TOURE Hospital Bamako Mali Radiology department of CSREF Commune III Bamako Mali Medical Imaging Service Health Center of Ref Commune VI Bamako Mali DCSSA Kati Mali Medical Imaging Service Health Center of Ref Commune IV Bamako Mali Medical Imaging Service of the Mali Hospital Bamako Mali. Surgery of gynecology-obstetrics chu Point G Bamako Mali Medical Imaging department CHU BSS Kati Mali

Purpose: The purpose of our study was to describe the technique of scanopelvimetry used in the radiology department of the Point G University Hospital, to specify the indications of scanopelvimetry in the department and to evaluate the cost of radiopelvimetry. Patients and Method: This was a prospective, cross-sectional study that took place over a 12-month period from January 1 to December 31, 2018. It focused on pregnant women in whom scanopelvimetry was performed in the medical imaging department of Point G University Hospital during the study period. Results: Out of 8615 CT examinations performed in the radiology department, we collected 65 cases of scanopelvimetry, i.e., 0.7% of the CT examinations. Primigravida and paucigravida dominated the study (40% each). In 60% of the pregnant women the height was less than 150 cm. The most frequent indication for CT scanning was clinical pelvic narrowing (50%). In 80% of the cases, the scanopelvimetry was performed after 37 weeks of amenorrhea. A predominance of narrowing of the superior strait was noted (40%). 4.6% of the pregnant women had a Magnin index of less than 20. CT scanopelvimetry is a feasible examination in our context but the level of demand is low because of the high cost of the examination (49500 fca). Conclusion: In light of the results obtained, we can say that CT pelvimetry allows us to predict the probable route of delivery and thus we can reduce the risk of fetomaternal morbidity and mortality to improve maternal and child health.

关键词： Scanopelvimetry Prognosis Magnin Index Delivery

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kati chu BSS External Genital Organ Delivery Syndrome: Inguinal Pedicle Flap Plasty

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Surgical Science 2021年第11期12卷 357-364页

作者： Koniba Keita Sidiki Keita Oulematou Coulibaly Abdoulaye Diarra Fodé Mory Keita Boubacar Kone Lassina Traoré Salia Coulibaly Amadou Traoré Assitan Kone Amadou Kassogué Issa Traoré Oumou Traoré Ismael Konaré Daouda Diallo Drissa Traoré Bacary T. Dembélé General Surgery department Hospital BSS Kati Mali General Surgery “A” department Hospital Point-G Bamako Mali Reference Health Centre of the Commune VI Bamako Mali Medical Imaging department Hospital BSS Kati Mali General Surgery department Hospital Gabriel Toure Bamako Mali Urology department Hospital BSS Kati Mali Anesthesia Resuscitation department Hospital BSS Kati Mali General Surgery “B” department Hospital Point-G Bamako Mali

Fournier’s syndrome is a poly microbial necrotizing fasciitis, of severe evolution of the perineum and external genitals. Objectives: We report the experience of the service in the management of Fournier gangrene of the external genital organs by inguinal flap pediculated in front of the loss of significant substances of the scrotum. Patients and method: This was a mono-centric retrospective study from January 2008 to August 2021 in the General Surgery Department of the Bocar Sidi Sall University Hospital (CHU BSS) in Kati. It focused on patients treated for Fournier gangrene of external genitals. The variables studied were age, sex, blood count, germs encountered, the antibiogram, duration of evolution, reconstruction of the scrotum by pedicle flap, and morbidity. Results: During the study period we collected 5 cases of Fournier gangrene of external genitals in the service. The average age was 57.6 years and all the patients were male. The average duration of evolution was 5 days for an average age of 57.6 years. All patients were male. Echerichia coli (E. coli)

关键词： Fournier’s Gangrene Scrotum Inguinal Pedicular Flap

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Echocardiographic Aspects of Type 2 Diabetics Patients Hospitalized in the Medicine and Endocrinology department of the Mali Hospital

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World Journal of Cardiovascular Diseases 2024年第3期14卷 129-139页

作者： Konaté Massama Mamadou Touré Mariam Sako Samba Sidibé Souleymane Mariko Djeneba Sylla Sow Elhaj Mahamane Maiga Coumba Adiaratou Thiam Youssouf Camara Hamidou Oumar Ba Asmao Keita Maiga Djenebou Traoré Zoumana Traoré Souleymane Coulibaly Bah Traoré Modibo Mariko Nouhoum Ouologuem Amadou Koné Ichaka Menta Faculty of Medicine and Dentistry Bamako USTTB Department of Medicine Hospital of Mali Bamako Mali department of Cardiology chu Gabriel TOURE Bamako Mali department of Cardiology chu Point G Bamako Mali department of Medicine Hospital of Timbuktu Bamako Mali department of Cardiology Hospital of kati Bamako Mali department of Cardiology chu Mother and Child Bamako Bamako Mali department of Internal Medicine chu Point G Bamako Mali

Introduction: Cardiovascular disease is the leading cause of death in diabetics. The objective of our study was to investigate the echocardiographic aspects of type 2 diabetics. Patients and Method: Descriptive and cross-sectional study of 12 months from June 2020 to June 2021. We included hospitalized type 2 diabetics who underwent transthoracic cardiac ultrasound in the department of Medicine and Endocrinology at the Mali Hospital. Results: We collected 128 type 2 diabetics. The predominance was male with a sex ratio of 1.2. The mean age of patients was 60.06 ± 11.54 years with extremes of 28 and 84 years. Echocardiographic abnormalities were dominated by abnormal relaxation of left ventricle in 62.5%, increased of left ventricle mass in 54.7% and left atrium dilation in 28.1%. Patients with type 2 diabetes mellitus and hypertension had more left atrium dilation with a p of 0.02. Disorders of global kinetics and systolic dysfunction were more prevalent in smoking patients with statistically significant associations, respectively, p = 0.02;p = 0.03. Dyslipidemia had a statistically significant association with segmental kinetic disorders with a p of 0.008. Duration of diabetes greater than 5 years was associated with left atrium dilation and p-value was 0.04. Conclusion: Diabetes is responsible for cardiovascular manifestations that can be identified with transthoracic echocardiography. Its performance in diabetic patients makes it possible to refine the patient’s management.

关键词： Diabetes Echocardiography Mali Hospital

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Stranched Internal Hernia Revealed by Occlusion of the Large Libra: A Propos of a Case

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Case Reports in Clinical Medicine 2024年第1期13卷 37-42页

作者： Abdoulaye Kanté Mamady Almami Kéita Idrissa Tounkara Drissa Ouattara Bréhima Bengaly Souleymane Sanogo Bréhima Togola Drissa Traoré Nouhoum Ongoiba General Surgery department of The kati-Mali Reference Health Center Koulikoro Mali Service of Surgery “B” of The chu Du Point G Faculty of Medicine and Odontostomatology Bamako Mali

The left para-duodenal internal hernia, whose origin is generally embryological, is a rare etiology of intestinal obstruction found mainly in young adults. We report here the case of acute intestinal obstruction by left para-duodenal internal hernia in a 36-year-old young man. It was a patient who consulted urgently for occlusive syndrome with cessation of materials and gases. Abdominal percussion noted abdominal tympanism and pre-hepatic dullness was preserved. The flow and icicle signs were negative. Palpation did not objectify hepatosplenomegaly and did not find any organomegaly either. On the other hand, she found an epigastric defense. The abdominal X-ray without preparation showed water levels that were wider than high, hail-like. We performed a median above and below umbilical laparotomy and intraoperatively, it was an internal hernia with incarceration of small loops in a voluminous left paraduodenal sac of 12 cm. They were not necrotic and quickly recolored after extrication. We resected the hernial sac and closed the hernial orifice with separate stitches with absorbable suture 0. The postoperative course was simple. The patient was discharged from the hospital on the 4th postoperative day. After 18 months of hindsight, he is doing well.

关键词： Paraduodenal Internal Hernia Occlusion Laparotomy

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Deafness: Epidemiological, Clinical and Therapeutic Aspects in 15 Year Olds and over at the University Hospital Center Gabriel Toure of Bamako

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International Journal of Otolaryngology and Head & Neck Surgery 2022年第4期11卷 202-210页

作者： Kassim Diarra N’faly Konaté Yaya Dembele Ismael Berthé Drissa Kaloga Bagayoko Boubacary Guindo Fatogoma Issa Koné Siaka Soumaoro Doumbia Kadidiatou Singare Mohamed Amadou Keita ENT and Head and Neck Surgery department university hospital Gabriel Toure Bamako Mali Armies Polyclinic of the kati Bamako Mali department of Anesthesia Resuscitation chu Mother-Child “Luxembourg” Bamako Mali

Objective: To study the epidemiological, clinical and therapeutic aspects of hearing loss in 15-year-olds and over at the chu GT of Bamako. Materials and Method: This is a longitudinal prospective study carried out in the ENT department of the University hospital Gabriel Toure in Bamako over 13 months (from September 2018 to September 2019). We carried out an exhaustive sampling of all the patients who consulted in the department for hearing loss and whose deafness was confirmed at pure tone audiometry with age greater than or equal to 15 years. The exclusion criteria were all patients under the age of 15 as well as a hearing loss related to earwax or foreign bodies and refusals to participate in the study. Results: Two hundred and thirty (230) patients were collected during the study. Dominated by the male sex with a sex ratio of 1.5 or 3 men for 2 women, with an average age of 38.16 ± 19 years with extremes ranging from 15 to 86 years. Among our patients, 37.40% had unilateral deafness, progressive installation evolving more than 12 weeks with a rate of cases had headaches 41% and had a history of chronic otitis media (CMO) 27%. There were a few cases of mixed type deafness, 30% had mild deafness, 22% moderate deafness and 40% severe deafness, according to the BIAP classification. Among our patients, 22.16% had conductive hearing loss, and those with sensorineural hearing loss accounted for 15.24%. Conclusion: Pure tone audiometry remains essential in the diagnosis of deafness. It not only makes it possible to confirm or invalidate the deafness, but also to define the type of deafness and especially to classify the deafness according to the degree of the average hearing loss established by the BIAP.

关键词： Pure Tone Audiometry Deafness BIAP

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Maternal and Perinatal Prognosis of the Cesarean at chu Point G, Bamako, Mali

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Open Journal of obstetrics and gynecology 2021年第11期11卷 1461-1469页

作者： Coulibaly Ahmadou Seydou Z. Dao Cissouma Assétou Sima Mamadou Kanté Ibrahim Ousmane Mamadou S. Traoré Koné Konimba Diarra Drissa Sissoko Hamadi Théra Thiounkani Traore Youssouf Obstetric gynecology department of the University Hospital Center (chu) Point G Bamako Mali Obstetric gynecology department of the Reference Health Center of Commune II Bamako Mali Pediatric department of Sikasso Hospital Sikasso Mali Obstetric gynecology Service of the Reference Health Center of Commune III Bamako Mali Obstetric gynecology department of the University Hospital (chu) Gabriel Touré Bamako Mali

Objective: In light of numerous obstetric evacuations to the Point G University Hospital and taking into account the practice of cesarean section for many years in the service, it seemed necessary to us to make our contribution to the study of cesarean section by putting emphasis on maternal and perinatal prognosis in the Obstetric Gynecology Department of the Point G university hospital. Method and materials: We conducted a retrospective cross-sectional study in the Gynecology and Obstetrics Department of the Point G University Hospital, from January 01, 2018 to December 31, 2018. The Point G University Hospital is a 3rd level center of reference in the field of obstetrics in Mali. There is no neonatal ward. The study included all women who gave birth in the gynecology and obstetrics department during the study period. All prophylactic and emergency Caesarean section records during the period in which management took place in the ward were included. The records of patients who had a prophylactic or emergency cesarean section in other health facilities and non-usable records were not included. Data were collected using a pre-established survey form. The variables analyzed were socio-epidemiological, clinical and prognostic. Data were analyzed using IBM SPSS software version 16.00. The Chi2 test and Fischer’s exact test were used to highlight risk factors. The significance level retained was p

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Epidemiological and Therapeutic Aspects of Proctological Pathologies in Pregnant and Postpartum Women at the Reference Health Center of Commune IV of Bamako District

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Open Journal of obstetrics and gynecology 2023年第4期13卷 752-766页

作者： Seydou Mariko Amaguiré Saye Dessé Diarra Sirima Diarra Mariam Tangara Brahima Dembélé Fanta Doumbia Moussa Samaké Abdou Guiré Yéli Dianessi Abdoul Razakou Dicko Amadou Bocoum Youssouf Traoré Adégné Togo gynecology department of Mali Bamako Hospital Bamako Mali department of gynecology and obstetrics Reference Health Center of Commune IV Bamako Mali department of General Surgery Centre de Santé de Référence de la commune IV Bamako Mali department of Public Health Centre de Santé de Référence de la commune IV Bamako Mali department of gynecology and obstetrics Center Hospitalier Universitaire (CHU) Gabriel TOURE Bamako Bamako Mali

Introduction: Painful proctological conditions that are far less pleasant can mar pregnancy and childbirth. In Mali, few studies have been carried out on proctological pathologies in pregnant women and in the postpartum period. Objective: To determine the frequency and identify the risk factors of anal pathologies during pregnancy and in the postpartum period in the obstetric gynecology department of the Centre de Santé de Référence de la comme IV du District de Bamako. Mali. Methods and Materials: Our observational study, a cross-sectional cohort survey over a period of nine (09) months from January 1, 2020 to September 30, 2020, was conducted in the obstetrics and gynecology department of the Health Center of Reference of Type IV of the District of Bamako. Results: The frequency of anal pathologies during pregnancy and in the post partum period was 24% (36/150). The different anal pathologies found were anal fissures, hemorrhoidal disease, anal incontinence and multiple anal pathologies with respectively 10%;6.67%;5.33%;2%. Chronic constipation (p = 0.003), a newborn weight > 3500 g (p = 0.000) to the occurrence of hemorrhoidal disease. For anal fissures, risk factors were noted such as (weight of the newborn > 3500 g (p = 0.002) and duration of fetal expulsion > 20 minutes (p = 0.000). Finally, a newborn weight > 3500 g (p = 0.000) and a maternal age of up to 30 years (p = 0.001) were associated with the occurrence of anal incontinence. Conclusion: Our study shows that anal pathologies affecting women's intimacy are frequent during pregnancy and in the postpartum period and are part of the many taboos difficult to address in our society.

关键词： Anal Pathologies Delivery Pregnancy

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Age and menopausal status are important factors influencing the serum human epididymis secretory protein 4 level:a prospective cross-sectional study in healthy Chinese people

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Chinese Medical Journal 2020年第11期133卷 1285-1291页

作者： Hong-Yan Cheng Lin Zeng Xue Ye Rui-Qiong M a Zhi-Jian Tang Hong-Ling chu Yi-M ing Zhao Li-Rong Zhu Yu-Nong Gao Xiao-Hong Chang Heng Cui Departm ent of obstetrics and gynecology Peking University Peoples HospitalBeijing 100044China Center of Gynecologic Oncology Peking University Peoples HospitalBeijing 100044China Clinical Epidemiology Research Center Peking University Third HospitalBeijing 100191China department of obstetrics and gynecology Peking University First HospitalBeijing 100034China department of gynecology Beijing Cancer HospitalBeijing 100036China

Background::Human epididymis secretory protein 4(HE4)is a new ovarian cancer *** factors influencing HE4 levels are not clear,and the reference data in China are ***,we aim to evaluate the effects of menopause and age on HE4 levels and to provide a possible reference value for HE4 in healthy Chinese ***::A total of 2493 healthy females aged 40 years or older were recruited from March 2013 to March 2017 with the cooperation of four medical institutions across Beijing,*** serum levels of HE4 and cancer antigen 125(CA125)were measured by enzyme-linked immunosorbent *** Wilcoxon rank-sum test of variance and a stratified analysis were used to analyze the relationships among age,menopausal status,and levels of HE4 or *** intervals(5%-95%)were determined for reference ranges in different ***::There was a statistically significant difference in median HE4 levels between the post-menopausal(n=2168)and premenopausal groups(n=325)(36.46 vs.24.04 pmol/L,Z=-14.41,P<0.001).HE4 increased significantly with age in the post-menopausal groups(H=408.18,P<0.001)but not in the pre-menopausal subjects(Z=-0.43,P=0.67).The upper 95th percentile of HE4 levels were 44.63 pmol/L for pre-menopausal women,78.17 pmol/L for post-menopausal women,and 73.3 pmol/L for all *** the post-menopausal population,the HE4 reference ranges were 13.15 to 47.31,14.31 to 58.04,17.06 to 73.51,24.50 to 115.25,and 35.71 to 212.37 pmol/L for different age groups from forty divided by *** CA125 level was affected mainly by menopausal status and not ***::Menopausal status and age were both important factors influencing the level of HE4,and age affected HE4 levels mainly in post-menopausal *** HE4 level was higher in the post-menopausal population than in the pre-menopausal population and increased with age.

关键词： Ovarian cancer Biomarker Human epididymis protein 4 Cancer antigen 125 Menopause status

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