Service Patterns Research Articles

Scale effects of spatial patterns of ecosystem services in the Tarim River Basin in Central Asia.

Determining the effects of different scales on the geographical distribution of ecosystem services and validating the underlying driving mechanisms have been considered to be the keys to the sustainable management of ecosystem services. Our goal was to look at the Tarim River Basin's sub-watershed and county level trade-offs, synergistic linkages, and driving forces among habitat quality, soil conservation, and carbon storage. Variations in ecosystem services in the scenarios of natural land use and farmland preservation in 2030 under the influence of precipitation. The findings indicate the following: (1) The northern mountainous region has the majority of the high-value ecosystem service areas. Woodland contains highly valuable carbon reserves. (2) Correlations between different ecosystem services can vary across scale. The strength of synergistic relationship in sub-basins is higher than the county scale. Ecosystem services exhibit both synergistic and trade-off relationships in space on the two scales, with low-low agglomeration being the primary type of synergistic association. (3) Precipitation is the driver that affects ecosystem services the most. At the sub-basin level, precipitation and habitat quality are traded off with carbon storage. (4) By 2030, agricultural conservation scenarios and ecosystem services in natural scenarios will work in concert. Furthermore, synergistic are ecosystem services and precipitation.

Receipt and Timeliness of Mental Health Assessment, Treatment, and Acute Services Following Foster Care Entry.

Children often enter foster care (FC) with mental health (MH) concerns. Failure or delay in initiating treatment may result in overreliance on acute MH services. This report leverages 2010-2019 linked administrative child welfare and healthcare claims data for 13,562 Wisconsin children entering FC at ages 3-16 years to describe patterns of MH services during FC and examine how MH service use varies by demographic characteristics and maltreatment, FC, and MH histories. Two-thirds of children received MH assessment or treatment during FC, of whom 61% initiated services within 3months of entry. Younger age, kinship care, and absence of MH history were negatively associated with onset of assessment and treatment. One in 7 children used acute MH services, with higher rates for Black children, adolescents, and youth in non-family settings. Timely MH assessment and treatment is important for foster children's wellbeing, but current guidelines may lack accountability and monitoring mechanisms.

Improving Teacher Competence in The Implementation of The Merdeka Curriculum: an Intensive Mentoring Approach in Madrasah

The purpose of this community service activity is to provide training to teachers at Madrasah under the auspices of the Yayasan Pendidikan Ridlol Walidain (YPRW) Nahdlatul Wathan Diniah Islamiyah (NWDI) Batu Bangka in implementing the Merdeka Curriculum. The methods of implementing the mentoring that will be carried out are as follows: 1) a Workshop on compiling the madrasah unit curriculum, 2) a Workshop on compiling learning objectives, learning objective flows, and teaching modules, and 3) a Workshop on compiling projects to strengthen the profile of Pancasila students. In addition to the workshop, a mentoring program for the implementation of the three workshops was also carried out. The evaluation results of this community service activity are as follows: 1) 90% of teachers stated that this activity was very satisfied with this community service pattern, 2) the quality of the curriculum products produced was classified as very good, 3) 75% of teachers were able to produce products in the form of TP, ATP, and teaching modules, and 4) the P5 team was able to produce P5 modules with a very good category. From the evaluation results, it can be said that this madrasa could be an example of implementing the Merdeka curriculum.

Diverse Care Needs Assessment for Older Adults in China: A Latent Profile Analysis Study.

Grasping the nuanced needs of older adults is paramount for the efficacious provision of day-care services. Our study sought to identify the demand patterns for day-care services in China and to explore the underlying factors. This study aims to offer useful evidence that can refine nursing care strategies and guide policy development within day-care settings. We implemented a comprehensive electronic survey comprising 46 questions targeting older adults across nine day-care centers in Nanjing, China. Employing latent profile analysis (LPA), we systematically examined and categorized the demand characteristics for day-care services. This analysis was conducted using Mplus version 8.3 and SPSS version 26.0 software, ensuring a rigorous and precise methodological approach. Our study involved a comprehensive survey of 1016 older adults. The participants were categorized into three groups based on their demand for day-care services: high demand (n = 127), medium demand (n = 197), and low demand (n = 692). The low-demand group exhibited higher levels of social support and better activities of daily living (ADL) scores compared to their counterparts. Multivariate regression analysis indicated that older adults characterized by male gender, advanced age, higher levels of education, receipt of support from a child, presence of chronic diseases, and lower social support and ADL scores exhibited a statistically significant inclination towards moderate to high demand for day-care services (p <0.05). The demand for day-care services for older adults in China is intricately influenced by a complex array of interrelated factors. Tailoring service offerings to meet the varied physical and emotional needs of older adults is essential, with a particular focus on health and wellness management in day-care centers.

Research on coordination mechanism between agricultural green and land ecosystem in Yellow River Basin

The Yellow River Basin is China’s grain production base and ecological barrier, with an important strategic position. Therefore, it is of great significance to analyze spatiotemporal pattern of ecosystem services and agricultural green, and further exploring the driving mechanism of coordination using the GTWR model to examine how the Yellow River Basin’s agriculture evolve sustainably. The results indicate that: (1) In 2011–2021, the Yellow River Basin’s ecosystem service value showed a state of growth first and then decline, indicating that the decrease trend cannot be ignored; the Yellow River Basin has seen a steady rise in agricultural green level, with regional disparities progressively disappearing. (2) Although the Yellow River Basin’s agriculture and ecosystem has tended towards coordinated development, it was still in the primary stage of coordination; the tendency of downstream > midstream > upstream was seen in the notable geographical disparities, and the gap was continuously closing. (3) The harmonization of ecosystem service value and agricultural green development is driven by multiple factors. The influence of social factors has undergone a transition from negative influence to positive influence; economic factors generally had a positive impact, but there existed a certain amount of instability; the overall state of natural factors was relatively stable, with little change in areas with positive coefficients. In areas with negative coefficients, their negative effects gradually decreased and showed a trend towards positive development. In light of the finding above, some recommendations are put forth to promote sustainable agricultural production.

Changing patterns of general practice services during a period of public sector investment in Britain.

Given the importance of GP care to the public's health, it is important that we understand how patterns of service use change as levels of investment change. This study investigated GP use in Britain in conjunction with use of outpatient services during a period of investment and during a period of austerity. The study used data from the British Household Panel Survey (BHPS) that included service use, morbidity (as an indicator of need) and socio-demographic characteristics (e.g., employment, age, education, and sex). Data for 2000, 2004, and 2008, were specifically chosen for comparison with data from 2015, 2016 and 2017. Service use and respondent characteristics were described using measures of central tendency and dispersion. Multivariable analyses were undertaken using recursive bivariate probit (RBVP) and probit analyses separately for each study year. All analyses were adjusted for cross-sectional weighting. BHPS respondents who used outpatient services or GP services had higher morbidity compared to survey participants who did not. Older people, people with lower educational attainment and employed people had higher mean morbidity indices in each study year as did females. Morbidity among service users tended to decline slightly over time. RBVP analyses revealed a significant positive correlation in residuals between outpatient and GP functions in 2000 and 2004 but not 2008. GP consultations and outpatient use remained largely unrelated to socio-economic factors in each year. Survey participants who reported hearing or vision impairment conditions were consistently less likely to use GP or outpatient services in 2000 and 2004, in 2008. The results are broadly indicative of stable relationships in service use during a period of healthcare investment but change during austerity. Those who reported, vision, hearing, and skin conditions were consistently less likely to report use of GP or outpatient services, controlling for other aspects of health.

Research on Urban Sustainability Based on Neural Network Models and GIS Methods

Ecologically sustainable urban design plays a pivotal role in mitigating climate change. This study develops an indicator group consisting of urban ecological emergy, land use change, population density, ecological services, habitat quality, enhanced vegetation index, carbon emissions, and carbon storage to assess urban sustainability. By leveraging a dataset from 2000 to 2020, we employ a neural network to predict emergy sustainability indicators over a time series, projecting the sustainable status of Xuzhou City from 2020 to 2050. The findings indicate that urbanization has led to significant changes in land use, population distribution, ecological service patterns, habitat quality degradation, vegetation fragmentation, and fluctuating carbon dynamics. Cropland constitutes the predominant land type (90.6%), followed by built-up land (8.49%). The neural network predictions suggest that Xuzhou City’s sustainable status is subject to volatility (15–20%), with stability expected only as the city matures into a developed urban area. This research introduces a novel approach to urban sustainability analysis and provides insights for policy development aimed at fostering sustainable urban growth.

Pengaruh Pandemi COVID-19 Terhadap Kondisi Finansial Rumah Sakit

The COVID-19 pandemic has put great pressure on hospitals, affecting clinical and non-clinical aspects such as patient care, resource management, and finances. This research analyzes the challenges faced by hospitals through crisis management theory and open systems, with a focus on financial pressures, staff shortages, and digital transformation. The purpose of this writing is to provide insight into hospital strategies in overcoming pandemic challenges, which is expected to improve hospital readiness in the future. Article search was conducted through international databases using the terms PICO and MeSH: P: "COVID-19"; I: "Financial Strategy"; O: "Stability", "Profitability", "Impact". Article selection follows PRISMA guidelines, starting with article identification, duplicate checking, and screening based on inclusion criteria (English articles, original, published 2019-2024) and exclusion (systematic review, literature review, meta-analysis). The COVID-19 pandemic has had a major impact on hospital operations and finances in various countries, including declining revenues, increased operating costs, and pressure on resources. Some hospitals managed to recover through efficiency strategies and government support, while others faced challenges related to regulatory changes and uncertainty. Research shows the importance of adaptive and optimal managerial mitigation strategies to address similar crises in the future. The COVID-19 pandemic has had a major impact on the operations and finances of the global health system, requiring an optimal management strategy. The main challenges facing healthcare providers include financial pressures, changing service patterns, and the importance of effective mitigation strategies to deal with the crisis.

Music is Boundless but License Has Boundaries: Research on License of Streaming Music Services and the Differences Between the United States and China

This paper examines the licensing patterns of music streaming services, focusing on the challenges and opportunities presented by this rapidly growing sector. It analyzes the current statutory framework and commercial practices in the US and China, highlighting the differences in economic, political, and cultural contexts. The paper argues that the current licensing model is insufficient and unfair, particularly for artists who lack negotiation power. It proposes a more voluntary and less compulsory licensing pattern to encourage fair competition and provide artists with greater control over their work. The paper also explores the evolution of music dissemination from traditional ownership models to access-based streaming, and the impact of this shift on copyright holders, music platforms, and consumers.

Demographics of Ophthalmology and Optometry Practices and Changes in Utilization Patterns of Procedures and Services Following Private Equity Acquisition.

To characterize private equity (PE) acquisition of ophthalmology and optometry practices and compare procedural utilization before and after acquisition. Ophthalmologists and optometrists in practices acquired from 2012 to 2016 were identified and characterized using an internet archive with an additional search in 2017 to characterize doctor turnover. United States Census Bureau and Internal Revenue Service Data were used to determine population health insurance and adjusted gross income (AGI). Healthcare Common Procedure Coding System codes were drawn from the Medicare database. Six platform companies acquired 36 practices between 2012 and 2016, including 518 optometrists and 136 ophthalmologists with a net doctor decrease of 3% and 7%, respectively (years 2016 to 2017). PE firm-owned practices were primarily located in metropolitan core areas with above-average AGI and insurance coverage. Diagnostic procedures, total encounters, cataract surgery, and yttrium aluminum garnet (YAG) capsulotomy volume increased per physician 1-year post-acquisition. In adjusted difference-in-difference comparisons, cataract surgery (13.3% relative increase, P<0.001) and YAG capsulotomy (35.6% relative increase, P<0.001) remained significant. PE practices demonstrated an increase in cataract surgery procedures (28,813/platform pre-acquisition to 33,930/platform post-acquisition, P=0.015). PE acquisitions of ophthalmology and optometry practices were centered in metropolitan core areas with above-average AGI and insurance coverage. PE acquisition led to less optometrists and ophthalmologists employed at the practice. Overall, they exhibited doctor turnover with a net doctor decrease. When compared to non-PE doctors, PE-acquired doctors demonstrated an increase in cataract surgery and YAG capsulotomy volume. Overall, cataract surgery volume increased among PE practices after acquisition.

Employment Outcomes Among Clients With Stroke Utilizing Public Vocational Rehabilitation Services in the United States.

To examine the correlations between individual characteristics among clients with stroke within public vocational rehabilitation (VR) and the employment outcome, as well as the utilization of VR services and their employment outcomes after VR services. Observational cohort study. Nationwide VR data from the Rehabilitation Service Administration Case Service Report for fiscal year 2022. Individuals with stroke as primary cause of disability. Not applicable. Employment status and VR service types. Of those with stroke who received VR services (n=1793), 653 (36.4%) achieved a competitive employment outcome. Black clients were less likely to be competitively employed at closure than White clients, odds ratio (OR, 0.72; 95% CI, 0.56-0.92). Clients whose primary disability was auditory or communicative disabilities were more likely to be competitively employed at closure (OR, 2.25; 95% CI, 1.22-4.17). Regarding VR services, receiving distinct types of VR services significantly was associated with the competitive employment outcome for clients. Clients who received short-term job support services were 6.36 times more likely to be competitively employed at closure than those who did not receive the service (OR, 6.36; 95% CI, 4.28-9.46). Our results found that race, types of primary disability, level of education, receipt of Supplemental Security Income/Social Security Disability Insurance and the length of the VR services were associated with obtaining or regaining employment among clients with stroke who received public VR services. In terms of VR service patterns, job support services, job placement assistance, rehabilitation technology supports, maintenance services, other services, and VR counseling and guidance were associated with competitive employment outcomes among individuals with stroke.

Ecological Network Construction Based on Ecosystem Services and Landscape Pattern Indices in the Tabu River Basin

Unsustainable human activities threaten the ecological security of arid and semi-arid watersheds. However, improving the connectivity of ecological networks can enhance ecosystem services and preserve biodiversity in these fragile environments. In this study, we aimed to identify ecological sources of the Tabu River Basin by quantifying five key ecosystem services and using a morphological spatial pattern analysis model. We further optimized resistance surfaces using landscape pattern indices, constructed an ecological network, and provided recommendations for sustainable management. The results obtained were as follows: (1) Ecosystem services in the Tabu River Basin exhibit clear spatial heterogeneity, with significant increases in water yield, food supply, and carbon sequestration over the past two decades. (2) Landscape pattern indices, such as the aggregation index, patch cohesion index, and Shannon’s diversity index, showed declines, indicating heightened landscape fragmentation and reduced connectivity. (3) Over the study period, the number of ecological sources increased from 6 to 17, although the total area of these sources decreased. The number of corridors expanded from 9 to 36, with a total length increase of 362.47 km, whereas pinch points increased from 27 to 40. (4) After optimization, one additional corridor and 24 new pinch points were identified, alongside a marked reduction in resistance in the northern and central-western regions. These results provide a robust scientific basis for optimizing land-use planning and reinforcing ecological security in the Tabu River Basin.

Analysis of Blood Utilization Practices and Quality Indicators in a South Indian Teaching Hospital in Puducherry, India

Abstract Introduction: The transfusion of donated blood is the mainstay of treatment for medical or surgical conditions. It is the primary responsibility of blood transfusion services to provide a safe, sufficient, and timely supply of blood products. It is recommended to conduct regular audits to know usage trends. This study aims to analyze the utilization pattern and quality indicators of transfusion services. Materials and Methods: This is a retrospective study conducted in the blood center of a tertiary care teaching hospital in Puducherry, India. We collected and analyzed data on the request and utilization of blood and its products from January 2023 to December 2023. The department-wise utilization of blood and its components, crossmatch to transfusion ratio (C: T ratio), transfusion probability (T%), and transfusion index (TI), were calculated. Results: Packed red blood cells (PRBCs) were the most utilized blood product. The intensive care unit ward received the highest blood supply, followed by obstetrics/gynecology and orthopedics. Patients with anemia, followed by surgery and pregnancy, required a majority of PRBCs. The CT ratio, TI, and TP% were 2.7%, 0.42%, and 0.37%, respectively. Conclusions: The overall transfusion indicators, namely C/T ratio, TI, and TP, were near optimal compared to standard values. However, the majority of the cross-matched blood remained unused. It is crucial to conduct a periodic review of the blood component usage in a hospital.

Time-Critical Emergencies in Suburban Parks and Outdoor Recreation Spaces.

Objective Prior studies have described the patterns of emergency medical service (EMS) activations in national parks in the United States. However, little data existsregarding EMSactivations in local and regional outdoor recreational locations. We performed a retrospective analysis of EMS activations originating from parks and recreational areas in suburban Howard County, Maryland, to characterize those activations determined to be time-critical emergencies. Methods EMS activations originating from outdoor recreational areas and parks in Howard County, Maryland, between December 2018 and December 2022, were extracted from the Howard County Department of Fire and Rescue Services (HCDFRS) electronic medical records database. Patient complaints were categorized into medical or traumatic etiologies and then determined to be "time-critical" or "non-time-critical" by two emergency physician reviewers with a tie-breaker reviewer to resolve discrepancies. Results A total of 396 EMS activations in county parks and recreational areas were recorded during the study period, with 61 (15.40%) determined to be time-critical. The most commonly occurring time-critical calls were cardiac arrest (7; 11.48%), drug/alcohol-related complaints (5; 8.20%), and altered mental status (5; 4.92%). Most EMS activations were for male patients (273; 68.94%). Pediatric patients (<18 years old) constituted 161 (40.66%) time-critical traumatic injury activations, and these numbers decreased as patient age increased. The most commonly occurring time-critical medical activations (11; 2.78%), occurred in 40-64-year-olds. The highest number of total EMS activations occurred in October, with 57 calls (14.39%), and the greatest volume of time-critical activations occurred during June, with nine calls (14.75%). Conclusion Within a suburban county's EMS system, 15.4% of the total EMS activations to parks and outdoor recreational locations were found to be time-critical, significantly higher than in other places. Patients aged 0-18 experienced the highest number of time-critical trauma-related activations, whereas those aged 40-64 had the highest number of time-critical medical activations. EMS agencies should review their activation rates in these locations to determine the need to enhance education and operational readiness for response to time-critical activations for pediatric trauma and adult medical emergencies.

The impact of tobacco consumption on household catastrophic health expenditure in Türkiye.

Understanding the financial burden of smoking on households is crucial for developing effective strategies and policies to reduce smoking and mitigate its impact on household health. To investigate the relationship between smoking and catastrophic health expenditure in Türkiye. This cross-sectional study used microdata from household budget surveys conducted by the Turkish Statistical Institute in 2015 and 2019. The data included the socioeconomic characteristics, income levels and consumption patterns of various goods and services by individuals and households. We used the pooled logit model to analyse the factors influencing household catastrophic health expenditure, focusing on the smoking status of households. The presence of a smoker in a household, an uninsured person, a disabled or ill member, and members with higher education were significant positive predictors of catastrophic health expenditure, while being poor, working and having school-aged children were significant negative predictors. Smokers within the household were the foremost contributors to the probability of catastrophic health expenditure, with a coefficient of 0.4101 and marginal effect of 7.94%. This study highlights the need for comprehensive tobacco control measures that analyse and use critical information from the interactions between public health and economic stability to reduce tobacco consumption and the associated financial burdens on households.

Increasing awareness of sexually transmitted infections (STI) testing and addressing stigma may improve STI testing in Aboriginal and Torres Strait Islander youth: Evidence from the Next Generation Youth Wellbeing Study

To quantify the prevalence of sexually transmitted infections (STI) testing in relation to sociodemographic, behavioural, and health related factors, and patterns in sexual health service (SHS) use and non-use among Aboriginal and Torres Strait Islander (hereafter Aboriginal) youth. The analyses included N=198 sexually active 16-24-year-olds from Central Australia, Western Australia, and New South Wales participating in the Next Generation Youth Wellbeing Study. Modified Poisson regression estimated age-sex-adjusted prevalence ratios (PRs) for ever testing for STIs. Approximately 55% of the participants ever tested for STIs. Over 44% of the participants ever accessed SHS; perceived irrelevance (50%) and embarrassment (15%) were the main reasons for not accessing SHS. STI testing was higher among: 21-24-year-olds (68.75% vs 37.04% among 16-17-year-olds, PR: 1.82; confidence interval 1.23-2.67); those with high/very-high psychological distress (63.39% vs 44.55% among low/moderate group, 1.50;1.16-1.94); and those who lived in ≥3 houses in the past five years (65.43% vs 48.11% among those who lived in 1-2 houses, 1.33;1.04-1.70). STI testing should be offered to sexually active Aboriginal youth at every opportunity. Sexual health messages should further promote the benefit of regular STI testing and where to access free SHS among Aboriginal youth.

Patterns of Comorbidity, Disability, and Home Health Care Service for Older Adults With Physical Disability: A Latent Class Analysis and Visualized Illustration.

Understanding the relationships between comorbidity, disability, and home health-care services aids in user-centered care design. This study identifies patterns of these factors among older adults with physical disability living at home and explores their associations. This cross-sectional study included community-dwelling older adults assessed for Long-term Care Insurance from September 1 to December 31, 2018, in Yiwu, Zhejiang, China. We analyzed deidentified data on sociodemographics, physical disability, chronic conditions, and care plans for 1882 participants using latent class analysis and multinomial logistic regression. Five comorbidity patterns (other sporadic diseases, cancer comorbidity, other sporadic comorbidities, coronary atherosclerotic heart disease, and fracture) and four home health-care service patterns (assistance & facilitation of elimination, bedridden assistance & stoma care, bedside assistance & stoma care, and assistance & tube feeding) were identified. Four disability patterns emerged (bedridden without incontinence, bedridden & with upper limb mobility, off-bed & ADLs limited, and bedridden with incontinence). Complex associations between these patterns were observed. The study highlights the heterogeneity and complexity of the above patterns, emphasizing the importance of person-centered home health-care services and technology-supported care strategies.

Spatio-temporal Patterns Evolution of Coupling Coordination of Ecosystem Services and New Urbanization in the Beijing-Tianjin-Hebei Region

Clarifying the coupling coordination relationship between ecosystem services and new urbanization is of great significance for promoting high-quality and sustainable development in the region. In this study, 197 county administrative units in the Beijing-Tianjin-Hebei region were selected as the study area, and the ecosystem service value index and new urbanization level from 2005 to 2020 were calculated respectively. The coupling coordination degree model was used to analyze the spatial-temporal correlation pattern evolution of the coupling coordination degree between the two. Results show that: ① The ecosystem service value index in the Beijing-Tianjin-Hebei region first decreased and then increased, showing an overall upward trend, manifested as a spatial pattern of "high in the north and low in the south, high in the west and low in the east", with different spatial distribution patterns of sub ecosystem services; ② The overall level of new urbanization is showing a continuous upward trend, manifested by a spatial pattern from "high in the north and low in the south" to "high in the north and south, low in the middle". ③ The coupling coordination degree shows a steady upward trend, but overall it is in a stage of mild imbalance, manifested as a spatial pattern of "high in the north and low in the south".

How does shared mobility impact metro-based urban commercial travel accessibility and Equity?

How does shared mobility impact metro-based urban commercial travel accessibility and Equity?

Ecological compensation based on multiscale ecosystem carbon sequestration service flow

Scientific assessments of the supply, demand and flow of ecosystem services and the formulation of ecological compensation policies are important for the promotion of sustainable regional development. Based on the supply-demand ratio model, breakpoint model, field strength model, geographic information system spatial analysis and statistical methods, we assessed the supply, demand and supply-demand relationships of carbon sequestration services on the Loess Plateau for 2000, 2010 and 2020. We also analyzed the interregional flow of carbon sequestration services at multiple scales and accounted for horizontal ecological compensation. The results revealed that from 2000 to 2020, both the supply and demand of carbon sequestration services increased, with a greater increase in demand. The high-supply areas were mostly in the central and northwestern parts of the Loess Plateau, and the high-demand areas were mostly in areas other than the central part. The supply-demand ratio for carbon sequestration services declined, with a large increase in the number of deficit counties and surplus counties, mostly in the central and western parts of the study area. The flow rates of carbon sequestration services within the Loess Plateau increased. The intercounty flow rates within the same city were the highest but decreased. Decreasing intercity flow rates appeared within the same province although they initially increased. Finally, interprovincial flow rates were the lowest, but they were increasing. The outflow of carbon sequestration services from the Loess Plateau to external regions was greater than the inflow from external regions, but the outflow decreased in 2020 compared with 2010, while the inflow from external regions increased. Most cities actually received or paid less ecological compensation than that accounted for based on the basis of flow rates after considering willingness to pay and ability to pay. Moreover, the number and total compensation of cities receiving ecological compensation were greater than the number and total compensation of payers in the 44 cities within the Loess Plateau. This study provides a theoretical basis for not only understanding the spatial transfer patterns of ecosystem services at multiple scales but also formulating ecological compensation policies, thereby promoting the realization of regional sustainable development.