Multidisciplinary Perspective Research Articles

Perception of the Sustainable Development Goals among university students: A multidisciplinary perspective

This study explores the variations in perceptions and understanding of the Sustainable Development Goals (SDGs) among university students, influenced by their field of study and gender. To this end, we introduced the 17 SDGs across various academic disciplines. Students participated in a concise educational initiative, with data being gathered to evaluate their baseline awareness and comprehension (before the initiative) as well as their ensuing empowerment (after participating in the initiative, which equipped them with essential knowledge pertaining to the various SDGs). Additionally, the satisfaction levels associated with the initiative was assessed. The findings unveil that, generally, Spanish university students possess a restricted grasp of the SDGs. However, students immersed in Social-Legal (S-L) sciences exhibit a significantly heightened acquaintance with these objectives compared to their counterparts. Students perceive the impact of the SDGs on their lives as moderate to high and anticipate that their individual contributions can facilitate moderate progress towards the realization of these goals, with S-L science students manifesting a greater sense of empowerment. Moreover, the study underscores a pronounced interest among university students in engaging with the SDGs. Gender appeared to have a minimal effect on the evaluated variables, with the exception of satisfaction levels concerning the educational initiative.

Clinician perspectives and practices related to sexual and reproductive care provision for males with cystic fibrosis

BackgroundMales with cystic fibrosis (MwCF) have unique sexual and reproductive health (SRH) concerns. This study investigates multidisciplinary CF clinician perspectives related to SRH for MwCF in the current era of CF care. MethodsWe surveyed multidisciplinary clinicians exploring attitudes, practices, and preferences toward male CF SRH care. We compared responses across groups by population served (pediatric vs. adult vs. both pediatric and adult MwCF) using chi square/Fisher's exact tests. ResultsA total of 297 clinicians completed the survey (41 % pediatric, 36 % adult, 23 % both; 27 % physicians, 24 % social workers, 11 % nurses, 41 % other). Nearly all (98 %) believed the CF team had a role in SRH care with 75 % believing they should be primarily responsible. Pediatric clinicians were less likely to deem SRH topics important and less likely to report annual discussions compared to adult colleagues (all p<0.05). Pediatric clinicians reported less comfort in their SRH knowledge than adult colleagues (p<0.001) and in their ability to provide SRH care (p<0.05). Common barriers endorsed by respondents included lack of SRH knowledge (75 %) and presence of family/partners in exam room (64 %). A majority rated SRH screening tools (91 %), partnerships with SRH specialists (90 %), clinician training (83 %), and management algorithms (83 %) as potential facilitators. ConclusionMultidisciplinary CF clinicians perceive SRH for MwCF as important but report suboptimal SRH discussions. Pediatric clinicians report significantly less comfort and skill in discussing and managing male SRH. Identified barriers and facilitators should be used to improve SRH care for MwCF.

Applicability of clinical genetic testing for deep brain stimulation treatment in monogenic Parkinson's disease and monogenic dystonia: a multidisciplinary team perspective.

In this perspective article, we highlight the possible applicability of genetic testing in Parkinson's disease and dystonia patients treated with deep brain stimulation (DBS). DBS, a neuromodulatory technique employing electrical stimulation, has historically targeted motor symptoms in advanced PD and dystonia, yet its precise mechanisms remain elusive. Genetic insights have emerged as potential determinants of DBS efficacy. Known PD genes such as GBA, SNCA, LRRK2, and PRKN are most studied, even though further studies are required to make firm conclusions. Variable outcomes depending on genotype is present in genetic dystonia, as DYT-TOR1A, NBIA/DYTPANK2, DYT-SCGE and X-linked dystonia-parkinsonism have demonstrated promising outcomes following GPi-DBS, while varying outcomes have been documented in DYT-THAP1. We present two clinical vignettes that illustrate the applicability of genetics in clinical practice, with one PD patient with compound GBA mutations and one GNAL dystonia patient. Integrating genetic testing into clinical practice is pivotal, particularly with advancements in next-generation sequencing. However, there is a clear need for further research, especially in rarer monogenic forms. Our perspective is that applying genetics in PD and dystonia is possible today, and despite challenges, it has the potential to refine patient selection and enhance treatment outcomes.

Framework for understanding quantum computing use cases from a multidisciplinary perspective and future research directions

Recently, there has been increasing awareness of the tremendous opportunities inherent in quantum computing (QC). Specifically, the speed and efficiency of QC will significantly impact the Internet of Things, cryptography, finance, and marketing. Accordingly, there has been increased QC research funding from national and regional governments and private firms. However, critical concerns regarding legal, political, and business-related policies germane to QC adoption exist. A few relevant studies are currently available, and those few focus heavily on the technical side of QC. Thus, this study offers a multidisciplinary review of QC, drawing on the expertize of scholars from a wide range of disciplines whose insights coalesce into a framework that simplifies the understanding of QC. This study offers a timely contribution to both practitioners and academia, as it explores use cases in business, addresses fundamental legal and political issues undermining QC’s adoption, identify possible areas of market disruption, and highlights several research gaps critical to advancing knowledge within the field, including definition of 52 Research Questions that are critical for forecasting, planning, and strategically positioning QC for accelerated diffusion.

LAND USE CHARACTERISTICS ON THE COASTS OF IZMIT BAY

The 21st century draws attention as a century in which environmental destruction continues, on the one hand, and efforts are made to prevent these destructions with holistic and sustainable approaches. Rapid and unplanned population growth, industrialization, informatics and industry 4.0 revolution, carbon emissions, ecosystem destruction, environmental pollution, global climate changes continue unabated. On the other hand, many institutions and organizations, especially the United Nations, are taking steps and setting goals to slow down this trend. The shores of Izmit Bay were examined in this study in terms of holistic and sustainable spatial use. In this field, where demands and usage needs are high but resources and potential are limited, it is clear that optimal and correct use is imperative, considering the future and future generations and environments. In the study, land use characteristics were determined and evaluations were made in terms of sustainable holistic basin management. Correct and sustainable use, as the most basic application subject of Geographical Science, which deals with the interaction between natural and human elements in a place, has been evaluated from a multidisciplinary perspective. KEY WORDS: Izmit Gulf, Spatial, Land Use, Sustainability, Planning, Management

The return of comparative economic systems: An extension of János Kornai's contribution

AbstractKornai profoundly contributed to place the system to the centre of economic analysis. His multidisciplinary system paradigm is fundamental for understanding and analysing the variety of economic solutions and its consequences. The strong scientific foundation of Kornai's approach provides a fruitful opportunity to further develop and apply it to the most fundamental economic issues, such as explaining the different performance and strength of different economies and societies. The inclusion of a multidisciplinary perspective has the significant advantage of keeping under control non-economic factors that influence economic activities and performance and allows to account for the real behaviour and evolution of economies and societies. It can also contribute to explain the resilience of economic and social systems and economies. The paper takes stock of the importance of Kornai's analysis and method and applies them to better understanding the nature and working of the European Union and its difficulties. Based on Kornai's approach, the paper considers how the European Union should evolve to make itself workable and resilient in front of a threatening international environment.

Provider perspectives on radiation oncology quality practices in peer review.

411 Background: Radiation oncology peer review involves presentation of new cases including pertinent patient history and case-specific qualitative treatment planning decisions. Yet implementation of peer recommendations is inconsistent. Thus, we sought to understand multidisciplinary perspectives on peer review to identify factors affecting stakeholder engagement. Methods: Participants in radiation oncology peer review completed semi-structured interviews and Likert surveys to explore the perceived value in peer review and its influence on their clinical practice and plan changes. Interviews were audio-recorded and transcribed, and two independent coders utilized a grounded theory approach to extract dominant themes. ANOVA and students t-test were used to analyze Likert scores. Results: Participants included 6 academic and 3 community radiation oncologists, 2 radiation oncology residents, 2 medical physicist, 2 radiation therapists, 4 dosimetrists and 1 industry representative. Analysis of interviews regarding perceived priorities of peer review revealed the following themes: understanding the clinical background to inform decision-making, detection of rare errors not found in other quality assurance processes, coherence in practice within an organization, and education on new techniques. Key facilitators included pre-planning communication between multidisciplinary teams, particularly for replanning and reirradiation scenarios. Barriers to adaptation of recommendations included resource limitations and lack of supporting data. Likert surveys (0=no importance, 10=highest importance) assigned a high value to the overall process (mean score: 8.3), reducing variation in practice (8.0), conformity of plans with institutional guidelines (7.8), and participant education (7.6), with a lower value placed on the detection of medical errors (7.4) and reduction of treatment incidents (6.9). When comparing Likert scores by provider, non-physicians rated overall importance of peer review (mean: 9.8 vs 6.5, p=0.03) and education (9.0 vs 6.7, p=0.02) significantly higher than physicians. There was no significant difference in Likert scores by academic vs community practice. Conclusions: All participants agreed peer review is an important process in radiation oncology quality assurance that may catch rare errors. However, there was significant variation in the perceived benefits of peer review, and a higher value was placed on alignment of clinical practice and non-physician participant education. Future processes to improve communication between multi-disciplinary teams was identified as beneficial to peer review discussions.

Pediatric Neuroendocrine Neoplasia of the Parathyroid Glands: Delving into Primary Hyperparathyroidism.

Our objective was to overview the most recent data on primary hyperparathyroidism (PHP) in children and teenagers from a multidisciplinary perspective. Methods: narrative review based on full-length, English-language papers (from PubMed, between January 2020 and July 2023). Results: 48 papers (14 studies of ≥10 subjects/study, and 34 case reports/series of <10 patients/study). Study-sample-based analysis: except for one case-control study, all of the studies were retrospective, representing both multicenter (n = 5) and single-center (n = 7) studies, and cohort sizes varied from small (N = 10 to 19), to medium-sized (N = 23 to 36) and large (N = 63 to 83); in total, the reviewed studies covered 493 individuals with PHP. Case reports/series (n = 34, N = 41): the mean ages studied varied from 10.2 to 14 years in case reports, and the mean age was 17 years in case series. No clear female predominance was identified, unlike that observed in the adult population. Concerning the assessments, there were four major types of endpoints: imaging data collection, such as ultrasound, 99mTc Sestamibi, or dual-phase computed tomography (CT); gene testing/familial syndrome identification; preoperative findings; and exposure to surgical outcome/preoperative drugs, like cinacalcet, over a 2.2-year median (plus two case reports of denosumab used as an off-label calcium-lowering agent). Single-gland cases (representing 85% of sporadic cases and 19% of genetic PHP cases) showed 100% sensitivity for neck ultrasounds, with 98% concordance with 99mTc Sestamibi, as well as a 91% sensitivity for dual-phase CT, with 25% of the lesions being ectopic parathyroids (mostly mediastinal intra-thymic). Case reports included another 9/41 patients with ectopic parathyroid adenomas, 3/41 with parathyroid carcinomas, and 8/41 subjects with brown tumors. Genetic PHP (which has a prevalence of 5-26.9%) mostly involved MEN1, followed by CDC73, CASR, RET, and CDKN1B, as well as one case of VHL. Symptomatic PHP: 70-100% of all cases. Asymptomatic PHP: 60% of genetic PHP cases. Renal involvement: 10.5% of a cohort with genetic PHP, 71% of sporadic PHP cases; 50% (in a cohort with a mean age of 16.7), 29% (in a cohort with a mean age of 15.2); 0% (in infancy) to 50-62% (in teenagers). Bone anomalies: 83% of the children in one study and 62% of those in two other studies. Gastrointestinal issues: 40% of one cohort, but the data are heterogeneous. Cure rate through parathyroidectomy: 97-98%. Recurrent PHP: 2% of sporadic PHP cases and 38% of familial PHP cases. Hungry bone syndrome: maximum rate of 34-40%. Case reports identified another 7/41 subjects with the same post-parathyroidectomy condition; a potential connection with ectopic presentation or brown tumors is suggested, but there are limited data. Minimally invasive thoracoscopic approaches for ectopic tumors seemed safe. The current level of statistical evidence on pediatric PHP qualifies our study- and case-sample-based analysis (n = 48, N = 534) as one of the largest of its kind. Awareness of PHP is the key factor to benefit our young patients.

A multidisciplinary perspective on the relationship between sustainable built environment and user perception: a bibliometric analysis

The study of the relationship between sustainable built environment and user perception has often taken a single perspective, displaying neither a holistic view of the relationship nor a systematic and refined grasp of the research content previously. This has resulted in a biased understanding of the two research objects and their respective measurement methods and made it difficult to develop synergies. In this context, this paper summarises the current research hotspots and trends in the relationship between sustainable built environment and user perception through CiteSpace quantitative analyses such as keyword co-occurrence networks, emergent word detection, and disciplinary re-clustering, and takes a multidisciplinary perspective to focus on relevant research in public health, environmental science, and architecture and urban design, such as the progress of research between sustainable built environment and users in physical activity, environmental cognition, and image perception. The results show that in the environmental science field, environmental cognition is the core, based on the study of users’ direct perception of sustainable built environment and its externalisation in the expression of behaviours. The public health field and the architecture and urban design field are dominated by the study of perceptual outcomes. There is a trend towards big data as a measurement tool for research subjects in all fields with a multidisciplinary perspective and the inclusion of more disciplines can produce more meaningful research results. The study provides a framework for research into the relationship between the two from a broader perspective and provides guidance for future multidisciplinary research, with implications for the construction of high-quality human-centred urban spatial environments.

Economic assessment of multiple energy community participation

Energy Communities (ECs) have been introduced as a solution to address energy system development from a multidisciplinary perspective, with energy-related, environmental, and social targets as main pillars. While some countries still struggle with implementing basic rules for ECs, others, such as Austria, already go one step further and address the topic of allowing to participate in multiple ECs at the same time. The scientific literature to date lacks of studies that investigate whether it is profitable for a new participant to join multiple ECs instead of joining only one, and, which effect this would have on the existing ECs. Thus, this paper introduces a mathematical framework to optimally allocate a new participant within an existing set of ECs. The proposed economic-based decision making problem is formulated as a Mixed Integer Linear Programming (MILP) problem. While the model determines the economically optimal solution for a new participant, it is ensured that the initial situation of the existing ECs does not worsen. Results are provided for a set of ECs with different availability of resources and located in different settlement patterns, applying current Austrian legislation. Result shows that having multiple possibilities to share energy surplus and to satisfy energy demand can result in additional revenues of 6%, making multiple participation a valuable option to be considered by policy makers.

«Como son obligados de inmemorial tiempo a esta parte»: Una historia de larga duración de los comunales en las aldeas de Casaio y Lardeira (siglos X-XVIII)

Since Elinor Ostrom's seminal works in the 90s the analysis on the common lands has had a great development, which have favored complex historical approaches and, more recently, archaeological ones. However, fewer are the studies which tackle the long duration of these common lands, addressing not only their historical origins but also their transformation regarding different historical contexts. In this paper, from a multidisciplinary perspective that includes the analyses of the documentary, archaeological and ethnographical evidence, we will delve into the history of the common lands at the villages of Casaio and Lardeira (Ourense, Galicia). Hence the social, economic and political factors which have influenced the configuration of these spaces as well as the uses and practices exerted on them will be explored. In conclusion, we will value the analyses of conflicts and agencies as the best path to understand the complexities of common lands from a long duration perspective.

The Climatology, Vulnerability, and Public Perceptions Associated with Overlapping Tornado and Flash Flood Warnings in a Portion of the Southeast United States

Abstract Simultaneous and overlapping tornadoes and flash floods are a meteorological hazard with complex societal implications as, when issued at the same time, tornado and flash flood warnings provide conflicting public safety advice. This work assessed potential tornado and flash flood (TORFF) events in a portion of the Southeast from an interdisciplinary perspective with a focus on the climatology, vulnerability, and public perceptions surrounding these hazards. Our results suggest that, in addition to the conflicting warning advice, TORFFs present a challenge to the public because they can occur at night or in cool seasons when they are least expected, though they are most common in spring. Also, the storms causing TORFFs are often not clearly organized, causing a forecast and communication challenge. The public responding to the tornado and flash flood warnings in our study area is more vulnerable to TORFFs than those in other areas and may lack vehicles and structures to respond safely to one or both hazard threats. Administered survey results suggest that many believe they know what protective actions to take in a TORFF, though they may not believe they are likely in their area. Those that believe they are likely are also more likely to feel prepared to respond. Many climatology and vulnerability characteristics vary between, and at times within, NWS county warning areas, highlighting the different communication and preparation needs across the region. Approximately a quarter of flash flood and tornado warnings overlap in the region for an average of 31 min. The frequency of TORFFs and their associated public safety challenges warrant continued investigation. Significance Statement The purpose of this work is to increase our understanding of overlapping tornado and flash flood events by studying them from a multidisciplinary perspective. We found that residents in the southeastern United States are especially vulnerable to overlapping tornado and flash floods. This vulnerability is heightened by the climatology of overlapping tornado and flash floods because they can occur when they are unexpected, for example, at night or in the winter, and the public perceptions of overlapping tornado and flash floods, which is that they may not be likely in their area. These findings are important because much of the Southeast includes a population vulnerable to overlapping tornado and flash floods who may be underestimating their risk, and therefore may be unprepared for an event that requires critical decision-making.

국내 대학의 창의·디자인 교양 교육 현황 및 방향성 연구

It is time to mention the importance of creative education at universities to foster future talents who will lead the fourth industrial revolution. This study identified the current status of creative and design courses currently opened at domestic universities for the purpose of pursuing the goals of creative and design education and the direction to cultivate creative capabilities, and conducted two types of experimental classes based on design theory and design thinking from 2019 to 2020. As a result of the study, each university is aware of the importance of creative education, but it seems that creative-related subjects are not providing a wide range of courses to students due to lack of diversity. As a long-term goal, it is necessary to expand continuous and systematic programs that can cultivate students' integrated thinking skills and creative thinking skills. The direction of creative and design education should be directed in the form of self-directed learning, focusing on convergence education to create new knowledge from a multidisciplinary perspective and an integrated thinking process in which aesthetic experiences are made according to creative activities.

Leadership and Challenges for Indonesia in the Future: Multidisciplinary Perspective Study

Leadership and Challenges for Indonesia in the Future: Multidisciplinary Perspective Study

The Italian School System's autonomy and learning

The present work aims to highlight the evolution of school autonomy policies in Italy since its inception. To do this, we analyze the premises and promises of autonomy in reference to new phenomena that have recently appeared in the universe of school. Finally, a comparison is made between autonomy and the performance of students that derive from it. This analysis is conducted in a multidisciplinary perspective, combining approaches ranging from educational policies to the sociology of education.

Toward a queered psychology of the self: Empathy and passibility from the margins to the center

ABSTRACT Beginning with Kohut’s classic 1959 paper on the subject, empathy has been conceptualized as a process of finding something in one’s self (introspection) that has resonance with one’s experience of the other. This paper, inspired by advances in queer studies, philosophy, psychoanalysis, and the Black American theater, identifies the limitations of this understanding. By putting Kohut’s ideas about empathy in dialogue with French philosopher Jean-François Lyotard, Black American playwrights Jeremy O. Harris, Michael R. Jackson, and James Ijames, and the author’s own clinical experience, a queered empathy is theorized that relies less on self-reference and more on passibility. The theoretical and clinical implications of this shift are explored, and the possibilities for a queered Psychology of the Self that contain a heightened possibility for responsiveness to marginalized experience are suggested. The hope of this paper is that the reader, from a multidisciplinary perspective, will be inspired to imagine a psychoanalysis and Self Psychology for all that has the potential to flourish for generations to come.

Current Management of Diaphyseal Long Bone Defects-A Multidisciplinary and International Perspective.

The treatment of defects of the long bones remains one of the biggest challenges in trauma and orthopedic surgery. The treatment path is usually very wearing for the patient, the patient's environment and the treating physician. The clinical or regional circumstances, the defect etiology and the patient´s condition and mental status define the treatment path chosen by the treating surgeon. Depending on the patient´s demands, the bony reconstruction has to be taken into consideration at a defect size of 2-3 cm, especially in the lower limbs. Below this defect size, acute shortening or bone grafting is usually preferred. A thorough assessment of the patient´s condition including comorbidities in a multidisciplinary manner and her or his personal demands must be taken into consideration. Several techniques are available to restore continuity of the long bone. In general, these techniques can be divided into repair techniques and reconstructive techniques. The aim of the repair techniques is anatomical restoration of the bone with differentiation of the cortex and marrow. Currently, classic, hybrid or all-internal distraction devices are technical options. However, they are all based on distraction osteogenesis. Reconstructive techniques restore long-bone continuity by replacing the defect zone with autologous bone, e.g., with a vascularized bone graft or with the technique described by Masquelet. Allografts for defect reconstruction in long bones might also be described as possible options. Due to limited access to allografts in many countries and the authors' opinion that allografts result in poorer outcomes, this review focuses on autologous techniques and gives an internationally aligned overview of the current concepts in repair or reconstruction techniques of segmental long-bone defects.

The value of multibeam bathymetry in marine spatial planning in South Africa: A review

Given a growing global population and shift to embrace the blue economy, a need for marine spatial planning (MSP) has emerged in South Africa to sustainably resolve the rising conflicts over the use of marine and seabed resources and services. A well-developed marine spatial plan yields numerous ecological, social and economic benefits. These are achieved through mediating between spatially conflicting economic drivers’ interests (e.g. commercial fishing, tourism, mining), preventing their activities from compromising thresholds of an environment’s sustainability. Within the MSP framework, high-resolution geospatial datasets are required to document and describe the seabed in the highest possible detail. At any scale, integrated analysis of seabed geomorphology and habitats is anticipated to greatly improve the understanding of ecosystem functioning from a multidisciplinary perspective, whilst improving MSP procedures and management of marine space. South Africa is the first of few African countries to have an approved and implemented MSP framework, but is still somewhat behind globally in implementing large-scale regional hydroacoustic surveys to cover the country’s vast offshore territory. The deficiency of hydroacoustic surveys is perhaps due to a relative lack of funds and poor communication about the value of multibeam echo-sounder (MBES) derived data, whilst marine geoscience remains a scarce skill in the country. This review paper presents a geological perspective of MSP and explores (1) the value that seabed mapping offers MSP specifically and (2) the need to increase seabed mapping with MBES, using a recently initiated project from the South African east coast as a case study. Significance: The collected MBES data (our case study) provides unprecedented seabed detail of the complex reef habitat and adjacent areas within specific management zones of the uThukela Banks Marine Protected Area. We reveal seabed features and their spatial distribution at a scale not possible using earlier (singlebeam) seabed mapping techniques. These high-resolution data will enable a better understanding of east coast marine habitats whilst contributing to improved spatial management of areas within and around the uThukela Banks Marine Protected Area.

Technical–Economic Evaluation of Water Reuse at the WWTP El Salitre (Bogotá, Colombia): Example of Circular Economy

Water resource management should be conducted from a multidisciplinary perspective. In this sense, the objective of this work is to analyze, from the perspective of the circular economy, the technical–economic feasibility of implementing different alternatives for the regeneration of wastewater for its subsequent reuse in industrial and sports companies located in Bogotá, Colombia. The development of the methodology is carried out through the method of economic cost–benefit analysis (ACB) and the technique of net present value (NPV). These methodologies facilitate decision making based on the economic feasibility of recovering the initial investment costs and the operating costs during the useful life of the WWTP. Establishing the cost and price of reclaimed water is essential to the efficient management of water resources; so far, the studies carried out only focus on the economic viability of the internal costs of the system, while the private impacts and the externalities are excluded and relegated to unsubstantiated statements about the advantages of water reuse. The economic feasibility incorporating the analysis of externalities presents a total profit that ranges between 6.52 EUR/m3 for the industrial sector and 2503 EUR/m3 for the irrigation of golf courses. This analysis demonstrates the technical and economic feasibility of carrying out a circular economy where the water already used returns as a new source of supply.

Early warning systems and end-user decision-making: A risk formalism tool to aid communication and understanding.

In this work, we introduce a formalism to highlight the role of decision-making implicit in the setup of early warning systems (EWSs) and its consequences with respect to loss avoidance for end users. The formalism, a close relative of the cost/loss approach, combines EWS verification scores with traditional expressions of risk from the point of view of the user. This formalism articulates in mathematical format many well-known issues surrounding EWS usage, offering a conceptual anchor for concepts that otherwise may seem to wobble among the multidisciplinary perspectives participating in the EWS chain. This decision model is visually represented in a variation of the popular "performance diagram" used in forecast and warning verification. Our diagram adds to this the perspective of a generic user, in an effort to gain insight into how choices made regarding EWS settings may determine which users benefit from warnings and which do not. Although these results are based on a conceptual model, they are useful to better understand the actual benefits experienced by users and to highlight aspects that may temper unrealistic expectations on EWSs. The recent United Nations initiative to extend EWSs for natural hazards to all nations within 5 years will make EWSs more common and more public. The approach proposed here can be a tool to promote greater transparency and improve the necessary dialog between warning issuers and users in order to reduce loss.