Special Experience Research Articles

Biopsychosocial Effects of Donor Traits on Heart Transplant Recipients.

BACKGROUND Psychological function after transplantation has garnered increased attention, and the relationship between recipients and corresponding donors has been investigated in medical research. Here, we investigated potential qualitative and quantitative psychological and lifestyle changes among recipients after heart transplantation and their correlation with donors. MATERIAL AND METHODS Transplant recipients, their families, and the donor's families were interviewed. The interview was semi-structured, featuring open-ended questions related to 5 domains: preference, emotions and temperament, memory, self-identity, and social identity. Qualitative data were analyzed by triangulation and deductive content analysis. Quantitative data were collected using the Big Five Inventory-19 (BFI-19) questionnaire, to complement the domain of emotions and temperament. RESULTS Overall, 20 recipients, 15 recipients' families, and 13 corresponding donors' families were interviewed (5 recipients' families and 7 donors' families refused to participate) between October 2020 and July 2021. The data were matched to 13 groups, each including at least 1 recipient and the corresponding donor. Finally, 13 recipients, 9 corresponding recipients' families, and 13 corresponding donors' families were identified. Similarities between recipients' psychological and lifestyle changes and the corresponding donors' traits were primarily identified in the aspects of diet, emotions and temperament, and special experiences other than dreams. The BFI-19 data showed no significant correlations between recipients and the corresponding donors' families. CONCLUSIONS Our findings indicate significant psychological and lifestyle changes in recipients before and after heart transplantation, with 38% exhibiting characteristics partly similar to those of their donors. Further investigation is needed to explore the psychobiological correlation between recipients and donors.

Balancing between reality, ideality, and equity: critical reflections from recruiting key informants for qualitative health research.

Key informant interviews (KII) are a widely used method in qualitative health research to gain in-depth insights from individuals with specialized knowledge, experience, or access that is crucial to the research topic. However, there is growing criticism regarding how the selection of key informants is insufficiently described in research. This opacity is problematic as the authority and knowledge of key informants may be given undue weight in research findings, potentially overshadowing other non-expert samples. The resulting imbalance in representation can lead to favoring certain viewpoints while marginalizing others, and thereby reinforcing existing inequities. Using our KII study as an example, we demonstrate how we initially composed an ideal sample based on theoretical considerations and subsequently operationalized it in the field. We employed a selective recruitment strategy informed by intersectional theory, targeting physicians with migration backgrounds from Middle Eastern countries for a study on cancer prevention and screening. Our recruitment process combined direct methods, including database searches and email outreach, with indirect methods like snowball sampling and engagement with multipliers. The recruitment strategy was iterative, allowing for ongoing assessment and adaptation to ensure a diverse and representative sample. The KII study successfully recruited 21 physicians with diverse social categories, including different genders, migration backgrounds, language skills, and medical specialties. Direct recruitment was more effective than indirect methods and allowed for greater control in reaching out to specific subsamples. It highlights the importance of flexible and persistent recruitment strategies to achieve the desired sample. This KII study underscores the interplay between methodological ideals and the practical realities of recruiting a diverse, carefully composed sample of key informants in health research. Our intersectional approach aimed to ensure equitable representation by considering power dynamics and refining recruitment strategies, while balancing the challenges of real-world fieldwork-such as engaging busy physicians with specific recruitment criteria-with practical adaptability. Our KII study emphasizes the need for ongoing reflexivity to balance ideality and equity with practical feasibility.

The Development of Learning Achievement in Military Theory Course Through Integrated Learning Activities of the Sophomore at Guang Zhon Huashang Vocational College

Background and Aims: In the current educational environment, military theory classes have always been regarded as a special learning experience. Guangzhou Huashang Vocational College offers military theory courses for sophomore students, aiming to improve students' military accomplishment and national defense awareness through systematic theoretical study and practical operation. However, there are several issues concerning the setting and implementation of this curriculum that are worth exploring in depth. For example, does military theory have an impact on the academic success of sophomore students? Is the effect positive or negative? How satisfied are students with the course? Based on the concern of these problems, this study takes the sophomore students of Guangzhou Huashang Vocational College as the research object, analyzes the teaching practice of military theory courses, and discusses the influence of military theory courses on academic achievement. The objectives of this research were 1) To compare academic achievement in Development of Learning Military Theory Course subjects before and after the blended learning. 2) Study on students' satisfaction towards integrated learning activities. 3) Study students' interest in interactive games in integrated learning activities. Methodology: The research tools include 1) A blended by traditional learning management plans, a total of 6 plans. 2) Academic achievement with multiple choice test before class - after class total of 30 items.3) A questionnaire on students' satisfaction towards integrated learning activities totals 10 items.4）A questionnaire on students' interest in interactive games in integrated learning activities totals 5 items. Results: The results of the research found that 1) Academic achievement after the blended learning arrangement was higher than before with statistical significance at the.05 level.2) Students were satisfied with the integrated teaching and learning arrangement. at a high level 3) Students' interest in interactive games in integrated learning activities at a high. Conclusion: The study discovered that the use of blended learning greatly increased academic achievement and that students expressed great satisfaction with both the integrated teaching strategy and the interactive games incorporated into the learning activities.

Comparison of the Effects of Sanyinjiao Point (SP6) Acupressure with Combined SP6 and LI4 Acupressure on Labor Pain Intensity in Primiparous Women: A Randomized Controlled Trial

Background: Childbirth is an important event and special experience in women's lives. Labor pain is the most severe pain that women undergo in their lives. Pain management during labor is crucial for the well-being of the mother and fetus. Objective: This study aimed to compare the effect of combined LI4 and SP6 acupressure with SP6 acupressure on reducing labor pain. Methods: A total of 108 primiparous women who participated in the study were randomized into three groups, combining LI4 and SP6 acupressure, SP6 acupressure, and a control group. Pain intensity was evaluated before, immediately, 1 and 2 hours after the intervention and the second stage of labor by visual analogue scale (VAS). Results: Although the pain intensity immediately after the intervention was lower in the combined SP6 and LI4 acupressure group than in the other groups, the differences were not significant between the three groups (p = 0.147). The pain intensity 1 hour after the intervention and in the second stage of labor had a statistically significant difference between the three groups (p =0.006, p =0.001). The pain intensity 2 hours after the intervention was lower in the combined SP6 and LI4 acupressure group than the other groups, but it was not statistically significantly different (p= 0.05). The pain intensity 1 hour after the intervention was not statistically different between the SP6 group and the control group (p= 0.095). The pain intensity 2 hours after the intervention was lower in the combined SP6 and LI4 acupressure group compared to the control group, but it was not significant (p=0.06). The pain intensity in the second stage of labor was lower in the combined SP6 and LI4 acupressure group and SP6 acupressure group compared to the control group (p =0.001, p = 0.017), but there was no significant difference between the SP6 acupressure group and combined SP6 and LI4 acupressure group (p=1.000). Conclusion: The obtained results revealed that combination intervention is a safe, effective, noninvasive and economical method in alleviating labor pain intensity. Healthcare providers are expected to master the acupressure technique as an alternative, complementary therapy, which can be used as an alternative or additional therapy.

Vocal cord anomaly detection based on Local Fine-Grained Contour Features

Laryngoscopy is a popular examination for vocal cord disease diagnosis. The conventional screening of laryngoscopic images is labor-intensive and depends heavily on the experience of the medical specialists. Automatic detection of vocal cord diseases from laryngoscopic images is highly sought to assist regular image reading. In laryngoscopic images, the symptoms of vocal cord diseases are concentrated in the inner vocal cord contour, which is often characterized as vegetation and small protuberances. The existing classification methods pay little, if any, attention to the role of vocal cord contour in the diagnosis of vocal cord diseases and fail to effectively capture the fine-grained features. In this paper, we propose a novel Local Fine-grained Contour Feature extraction method for vocal cord anomaly detection. Our proposed method consists of four stages: image segmentation to obtain the overall vocal cord contour, inner vocal cord contour isolation to obtain the inner contour curve by comparing the changes of adjacent pixel values, extraction of the latent feature in the inner vocal cord contour by taking the tangent inclination angle of each point on the contour as the latent feature, and the classification module. Our experimental results demonstrate that the proposed method improves the detection performance of vocal cord anomaly and achieves an accuracy of 97.21%.

National survey on Congenital Cytomegalovirus Awareness and Screening Practices among Healthcare Professionals

ObjectivesCongenital cytomegalovirus (CMV) infection, resulting from maternal-fetal transmission of CMV, poses a substantial risk to maternal and child health. It is the most prevalent congenital viral infection, and the prevention and management of this condition rely heavily on the knowledge and awareness of healthcare professionals. MethodsThis cross-sectional survey was conducted between March 1, 2023, and August 31, 2023, across multiple tertiary centers in various Saudi Arabian cities. It assessed the understanding and awareness of congenital CMV infection among 400 healthcare professionals from diverse specialties. The study utilized a structured questionnaire to evaluate knowledge levels, obtain demographic data, and identify factors influencing awareness. ResultsThe study revealed significant disparities in knowledge levels, with around 84 % of participants categorized as having “low" knowledge. Obstetricians and gynecologists exhibited better knowledge. Factors like specialization, age, and professional experience significantly affected knowledge levels. Additionally, many healthcare professionals perceived a lack of information and awareness regarding CMV among their peers. ConclusionCongenital CMV infection is a major public health concern with potential severe consequences. The study identified knowledge disparities, particularly among non-specialist healthcare practitioners, emphasizing the need for targeted educational programs and focused awareness initiatives. Key factors, such as expertise, age, and experience, underscore the importance of addressing ongoing knowledge gaps, highlighting the need for continuous efforts to mitigate challenges associated with CMV infection.

INCREASING THE HUMAN RESOURCES POTENTIAL OF STATE AUDIT BODIES AS A BASIS FOR IMPROVING THE EFFICIENCY AUDIT MECHANISM

Recent economic and financial scandals worldwide, the growth of the shadow economy, the increase in funds concealed from the budget, the rise of corruption, and insufficient adherence to financial discipline create very serious problems. The development of an audit system that creates a transparent and comprehensive informational environment for the government and the public, and plays a key role in economic regulation, is aimed at addressing these serious issues and improving the economic and managerial environment. The purpose of the paper is to explore how increasing the human resources potential of state audit bodies serves as a basis for improving the efficiency audit mechanism. The improvement of the functioning of the state audit system and the enhancement of the knowledge and expertise of personnel and specialists working in this field are based on the critical need to assess and refine the existing system. At the current stage of development, improving the mechanisms of state audit and financial control, as well as monitoring the effective use of budget expenditures, has become a priority. In this context, the concept of state budget policy has undergone changes and is now focused on results-based management. To achieve these goals, new approaches to assessing economic efficiency are being developed, with the improvement of the efficiency audit mechanism being the main focus. The development of auditing institutions plays an important role in accelerating the country's socio-economic development. As a result of these institutions' activities, it becomes possible to identify new financial and economic resources necessary for economic growth. Increasing transparency in society and strengthening financial discipline in economic activities are also closely linked to the work of these institutions. The paper examines the issues of enhancing the knowledge and experience of personnel and specialists, who play a key role in the development of the audit institute.

Критерии нуждаемости в постинтернатном патронате: разработка методологического подхода

<p style="text-align: justify;"><span lang="EN-US">The article is devoted to the analysis of the concepts of “independence”, “adaptation” and “socialization”, as well as to the identification of definitions of the need for post-institutional patronage of persons from among orphans and children left without parental care in normative legal acts and the formulation of conclusions about the criteria of need, taking into account the regional aspect. The article uses a comprehensive approach, including an analysis of theoretical sources, regulations of the Russian Federation and Moscow, as well as the practical experience of specialists. As a result of the study, it was found that “independence” is defined as a generalized personality quality manifested in initiative and responsibility for one’s actions, “adaptation” is considered as an individual’s ability to assimilate the requirements of the environment, whereas “socialization” is understood as the assimilation of social roles and norms. The analysis showed important dynamic aspects of socialization, including the dependence of its success on external factors and the compliance of social skills with age requirements. The article substantiates the introduction of the concept of “desocialization” and criteria for identifying the risk of desocialization in the context of determining the need for post-institutional patronage of this category of citizens.</span></p>

Determining the most rational method of automooring vessels in a navigation lock chamber

The article presents the results of a study to determine the most rational method of automatic mooring of vessels in a navigation lock chamber. The relevance of the study is due to updated regulatory requirements in the field of designing the specified shipping hydraulic structures, the need to improve the efficiency and safety of navigation, including ensuring the passage of unmanned vessels, as well as the lack of ready-made technical solutions for their installation on the structures in question. To solve this problem, the authors of the study used the method of expert assessments, which allows taking into account the opinions and experience of specialists in the field of shipping, which ensures a more objective and reasonable choice of the most rational method of automatic mooring. As a method of expert assessment, taking into account the issues under consideration, the method of point assessments was chosen. For this purpose, during the study, a survey was conducted among the involved experts, during which each of them gave his intuitionistic assessment. In this study, vacuum, electromagnetic and lever-andhinge devices are considered as methods of automatic mooring. The criteria considered include, among other things, the need to reconstruct the lock chamber, environmental friendliness, the ability to hold the vessel, the complexity of the device, and reliability indicators. As a result of collecting and processing the obtained data, it was found that the most preferable method of auto-mooring of vessels in the lock chamber is a vacuum device. The results obtained indicate the feasibility of developing and implementing vacuum auto-mooring devices on shipping hydraulic structures. The results of the study are of practical interest to specialists in the field of shipping and can be used in the design and reconstruction of navigation locks.

Identification of Urban Heat Island Potency in Janten Village area due to Aerotropolis Development

Abstract Special Region Yogyakarta Province experiences an increase in heat every year based on land surface temperature data in each region. This increase in heat is caused by the decreasing function of green land in rural areas over time, so that the land surface experiences increased exposure to sunlight due to reduced radiation barriers and heat absorption, and has the potential to give rise to an Urban Heat Island. The decline in rural areas as green areas is due to industrial development, one of which is the planning of the Aerotropolis area in Janten Village, Wates Regency, Kulon Progo, Yogyakarta. Aerotropolis is a regional development concept that makes airports the center of the economy, mobilization, transportation, and industry. This paper aims to analyze the magnitude of the potential arising from Land Use-Land Change (LULC) due to the Aerotropolis planning concept in Janten Village. The main data collection was carried out through direct measurements in the field using a Micro Weather Station (MWS) as a recorder of climate conditions and a thermal flir camera to capture surface temperatures. The data taken will be processed using experimental methods using the ENVI-Met application according to modeling of the existing conditions and microclimate of Janten Village.

Variability of thermal subthreshold retinal laser treatment plans

To investigate the variability in subthreshold laser treatment plans for patients with diabetic macular edema or central serous chorioretinopathy. Diagnostic images from 20 patients were utilized, and 25 retina specialists generated subthreshold treatment plans along with a self-rated experience level. Evaluation comprised of i) Area Variability (AV): quantifies the consensus regarding the covered area and is the difference between the areas planned by 75% and 25% of the participants ii) mean Centroid Distance (CD): level of agreement on the localization of a treatment. Subgroup analysis investigated the impact of participants’ experience levels, utilizing the Mann-Whitney-Wilcoxon test. The predominant plan style is a targeted treatment approach (92%) and avoidance of subfoveal region (89%). Mean CD is 71.0 ± 37.5 pixels (≈half disc diameter) and mean AV is 9.8%±8.9%. A slight difference is observed between the 50-75% areas, but a notable distinction exists between the 25-50% areas. Subgroup analysis revealed CD and AV value of 75.9 pixels and 24% in the lower experience level group as opposed to 55.9 pixels and 8.6% in the higher experience level group. There is significant variability in treatment planning which reduces with increased experience of retina specialists. While consensus is observed around focal points, differences in the surrounding extents persist.

Relationship of Cultural Intelligence and Global Citizenship Levels of Preservice Teachers in the Philippines

With the global developments, educational institutions play a vital role in fostering cultural intelligence and global citizenship among individuals, including preservice teachers. Despite the plethora of research on cultural intelligence and global citizenship in higher education abroad, little is known about these in the Philippines, let alone their correlation. Employing a quantitative descriptive correlational design, this study investigated the relationship between cultural intelligence and global citizenship levels of 316 Philippine preservice teachers using the Cultural Intelligence and Global Citizenship Scales. The results revealed that although their cognitive cultural intelligence necessitates further development, the preservice teachers are highly competent and confident in communicating and functioning effectively in multicultural contexts. However, they exhibit limited global citizenship attributes, particularly in social responsibility. Most ethnic groups they represented were also identified to have high cultural intelligence and average global citizenship levels. Additionally, while the preservice teachers’ specialization, year level, and overseas experience did not play significant roles in their cultural intelligence levels, the study found their year level to be the lone variable that affected their global citizenship levels substantially. Overall, a positive correlation between cultural intelligence and global citizenship was identified. Aside from implications for strengthening internationalization strategies, recommendations for further investigations were discussed.

A VERY RARE CASE: THE DEVELOPMENT OF TUBA-OVARİAN TORSİON İN ENDOMETRİOMA

Endometriosis is increasingly diagnosed in women of reproductive age and is estimated to affect up to 10% of women. Endometriomas are a common antithesis in patients of reproductive age and require special planning and experience for optimal treatment. Endometroma in rare cases occurs with an acute abdominal picture. However, adnexal torsion is very rare in these patients. Because endometriomas are often tightly adherent to neighboring structures, and therefore they seem less likely to cause adnexal torsion, although there is insufficient data on the torsion rate in these cysts. With this case report, we thought to contribute to the literature with the case of torsion in endometrioma.

Introduction to the Special Theme Religious Experience and Psychopathology

Introduction to the Special Theme Religious Experience and Psychopathology

Partisipasi Masyarakat dalam Pengembangan Kampoeng Cyber sebagai Destinasi Wisata Edukasi

Blitar City has various famous tourist destinations such as Bung Karno's Tomb, Kebon Rojo Park, Gebang Palace, and Ar-Rahman Mosque. However, there is one unique destination, Kampoeng Cyber, which offers a special educational tourism experience. Although the tourism sector in Blitar City is growing, the development of these destinations requires active participation from the community, not just the government. The main problem found is that community participation still varies, where most are only involved if they feel they will benefit directly. This study aims to examine how much community participation in the development of Kampoeng Cyber as an educational tourism destination, based on the theory of community participation according to Meronda (2021). This research uses descriptive qualitative methods with data collection techniques through observation, interviews, and documentation in Gedog Village, Sananwetan Subdistrict, Blitar City. The results showed that community participation in the development of Kampoeng Cyber is quite good, as seen from monthly meetings, local potential development programs, and regular evaluations. However, there are challenges in the form of pros and cons among the community. The main factor supporting this development is the great potential of Kampoeng Cyber in increasing community knowledge and awareness, while the obstacles are the differences in understanding and background among residents. Overall, the development of Kampoeng Cyber has had a positive impact both economically and socially, making it more widely recognized.

A qualitative and quantitative cross-sectional study on the past, present, and future of vaginal delivery: Turkey.

The current study focused on predicting future trends in obstetrics by examining obstetricians' approaches to specific challenging vaginal delivery that require special experience, such as breech presentation, macrosomic fetus, twin pregnancy, and vacuum use, compared with their residency training experience. The cross-sectional study was conducted in two phases. The first phase was qualitative and the second phase was quantitative. The "interview" and "survey" techniques served as data collection tools. In total, 20 obstetricians participated in the interviews, and 400 obstetricians took part in the survey. Data from the interviews were analyzed using the Maxqda 2020 qualitative data analysis program, and survey data were analyzed using SPSS version 25.0. Over the past 2 decades, there has been a gradual shift from vaginal deliveries to cesarean deliveries in cases involving breech presentation, macrosomic fetus, twin pregnancy, and vacuum use. While medicolegal concerns are undeniable, the prevalent belief among obstetricians that cesarean delivery is safer than vaginal delivery significantly influences this trend. Comparatively, young obstetricians often complete their residency training without acquiring sufficient knowledge and skills in vaginal delivery. Young obstetricians currently lack adequate experience in managing vaginal deliveries for breech presentation, macrosomic fetus, twin pregnancy, and vacuum use. This experience is at risk of disappearing entirely within the next decade as senior obstetricians retire. Policymakers should take this into consideration when shaping future healthcare policies.

Special education experiences and stress among Asian-American parents of children with intellectual and developmental disabilities

ABSTRACT Family involvement is an essential component of the special education process for youth with intellectual and developmental disabilities (IDD). In addition to the legal requirement that parents should be equal partners in the decision-making of the student’s individualized education program (IEP) program (IDEA, 2004), a bulk of empirical research demonstrates the positive impact of parent involvement on student outcomes. However, many families face barriers to participation in the special education process. Culturally and linguistically diverse (CLD), including Asian-American families, especially face systemic barriers when accessing services for their children with disabilities. Unfortunately, less research is known about how Asian-American families participate in their child’s IEP meeting. To these ends, individual interviews were conducted with eight Asian-American families of children with IDD to explore parental perceptions of stress in relation to IEP meetings, special education knowledge, and family-professional partnerships. Participants reported feeling stress before, during, and after the IEP meeting. Regardless of the nature (i.e. positive, negative, or neutral) relationship with the school, participants reported barriers (i.e. language and poor experiences with school personnel) to their family-school partnerships. Implications for research and practice are discussed.

Modelling of Steel Concrete Composite Elements Cross-Sections with Adhesive Connections

Abstract Nowadays, complex steel-concrete composite structures are widely used, which combine the advantages and eliminate the disadvantages of similar metal and rein-forced concrete structures. With the help of the LIRALAND software complex (automated design system), which is effectively used in the scientific and practical field of the construction industry of Ukraine, the article presents the study of composite cross-sections taking into account the modern experience of foreign specialists. Numerical modelling with the help of the “Section Designer” software module of “LIRA-SAPR” makes it possible to reliably assess the performance of structural elements, taking into account changes in a significant number of studied parameters.

A Quantitative Review of Certified Burn Therapist’s Involvement in the JBCR Publications and ABA Leadership

Abstract The Burn Therapist Certification (BT-C) was introduced in 2018 to acknowledge occupational therapists (OT) and physical therapists (PT) with specialized knowledge, skill, and experience in the promotion of quality burn rehabilitation. Currently, BT-Cs make up 11.7% of therapists working in burn rehabilitation (n = 39/333). The purpose of this review is to report on the contributions of BT-Cs to organizational leadership of the American Burn Association (ABA) and in the generation of new knowledge through peer-reviewed publications. Despite the small percentage of burn therapists who are certified, they have a disproportionately large involvement in leadership within the ABA and burn research in the Journal of Burn Care and Rehabilitation (JBCR). From 2018 to 2023, BT-Cs have contributed to nearly one-half (n = 26/56) of therapy authored publications in the JBCR and almost one-third (n = 65/202) of accepted abstracts at the ABA annual meeting. Certified burn therapists demonstrate substantial involvement throughout the ABA, including maintaining an 85% membership rate and, on average, serve in 53% (n = 31/59) of the therapy allotted committee positions. Therapist pursuit of certification can have a profound impact on the burn community through publication, leadership, and development of care standards. Although therapists have indicated a desire to pursue certification, barriers related to a lack of association and center support have been identified. The burn community has endorsed certification as a mark of excellence for nurses and physicians. Maximizing the value of a transdisciplinary approach to burn care is also dependent on the excellence of therapies. If the burn community desires improved engagement and contribution from therapies, it should support therapist certification.

SCIENTIFIC-RESEARCH COMPETENCE OF PROSPECTIVE ENGINEER: FORMS, EXPERIENCE, PERSPECTIVES

The article examines the issue of forming scientific-research competencies in prospective engineers as a component of the general professional competence of a prospective specialist of a technical sphere. The implementation of a competency-based approach is determined by the conceptual vector of modernizing the training of engineering specialists for their effective activity in industrial production at the level of world standards. Based on the analysis of the experience of training specialists in the technical field, the features and purpose of professional training of prospective engineers in institutions of higher technical education are established. The professional competence of a prospective specialist in the technical field is characterized by a creative thinking, scientific-research skills, initiative in solving production tasks, the ability to organize teamwork, and a conscious understanding of personal responsibility for work results. The humanitarian, engineering, project-technological, managerial, informational, scientific-research, economic, legal-economic, and ecological components of the professional competence of a prospective engineer are substantiated, which determine the professionalism of a modern specialist in the industry. Scientific-research competence is singled out as an important component of the professional competence of a specialist in the technical field. Scientific-research competence is defined as an integrated quality of the personality of a prospective engineer capable of purposeful scientific-research activity in the field of industrial production based on formed knowledge, skills, experience, and a valuable attitude towards the profession, colleagues, and state natural resources. The target, motivational, cognitive, activity, and reflexive aspects of the scientific-research competence of a prospective specialist in the technical field are characterized. The effectiveness of forming the scientific-research competence of prospective engineers is proved in order to prepare highly qualified technical specialists in institutions of higher technical education.