Interactive Text Research Articles

Factors Influencing Undergraduate Nursing Students’ Perception of Educational Quality

Context: Quality education is a contemporary concern. Students' evaluations of teaching (SET) are universal measures and applied in almost every higher educational system in the world.
 Aim: The present study aims to explore student perception of factors that influence educational quality among undergraduate nursing students.
 Methods: A survey research design was utilized to achieve the aim of this study. The study conducted at obstetrics and gynecology classroom. Faculty of Nursing, El-Minia University. The subjects of the study consisted of all 3rd year nursing students (male & female) who registered in Obstetrics & Gynecological course (total number was 125 students) during the academic year 2017- 2018. Three tools were used to achieve the aim of this study; they are student achievement record, student’s evaluation of educational quality scale, and factor affecting educational quality scale (FAEQS).
 Results: The results of this study revealed that students’ perception to the components of educational quality named learning experience, instructor rapport, enthusiasm, and tests grading, organization and clarity, theoretical breadth coverage, group interaction, and course texts and reading materials. The students also ranked course organization, examination system, student communication and group dynamics, availability of course materials, instructor performance, and academic values as top factors that could affect their educational quality.
 Conclusions: Obstetrics and gynecology students perceive factors which affected the provision of quality education were explored incorporating four categories named the organization, student, instructor, and course-related factors. The study recommended that all institutions and departments should use self-evaluation as an essential tool in striving to educational quality, and also should consider the students’ perception of factors that might affect their educational quality. Further researches are expected to shed light in the number of higher-order factors that could affect educational quality

Effects of an expanded Uber-like transport system on access to and use of maternal and newborn health services: findings of a prospective cohort study in Homa Bay, Kenya

IntroductionKenya’s progress towards reducing maternal and neonatal deaths is at present ‘insufficient’. These deaths could be prevented if the three delays, that is, in deciding to seek healthcare (delay 1),...

A Two-Way Interactive Text Messaging Application for Low-Income Patients with Chronic Medical Conditions: Design-Thinking Development Approach.

BackgroundTwo-way interactive text messaging between patient and community health workers (CHWs) through mobile phone SMS (short message service) text messaging is a form of digital health that can potentially enhance patient engagement in young adults and families that have a child with chronic medical conditions such as diabetes mellitus, sickle cell disease, and asthma. These patients have complex needs, and a user-centered way can be useful for designing a tool to address their needs.ObjectiveThe aim of this study was to utilize the user-centered approach of design thinking to develop a two-way interactive communication SMS text messaging tool for communication between patients or caregivers and CHWs.MethodsWe applied a design thinking methodology for development of the SMS text messaging tool. We collected qualitative data from 127 patients/caregivers and 13 CHWs, health care professionals, and experts. In total, 4 iterative phases were used to design the final prototype.ResultsThe design thinking process led to the final SMS text messaging tool that was transformed from a one-dimensional, template-driven prototype (phases 1 and 2) into a dynamic, interactive, and individually tailored tool (phases 3 and 4). The individualized components consider social factors that influence patients’ ability to engage such as transportation issues and appointment reminders. SMS text messaging components also include operational factors to support staff such as patient contact lists, SMS text messaging templates, and technology chat support.ConclusionsDesign thinking can develop a tool to meet the engagement needs of patients with complex health care needs and be user-friendly for health care staff.

From aseptic processing to enrichment of virus-specific Tcells: nationwide children's hospital and the ohio state university are increasing cGMP training efficacy through a competency-based learning management system for cell processing specialists

Background & Aim Our innovative technician training program provides a competency-based, blended-learning model that creates flexibility in pace, content, and place of learning while increasing accountability and standardization. The initial thirty training modules comprise the full training plan of a new cell processing technician. Examples of initial training modules include: aseptic technique to ensure the integrity, viability and sterility of cellular products, QC testing: cytotoxicity assay, PCR and endotoxin, CofA generation and product release. Additionally, there are ten specialized cell manipulation modules. Personalized learning pathways support the participants’ unique training needs and learning style preferences. The content of each module is developed by subject-matter experts. Modules include cGMP skills in a variety of formats: interactive simulations, video, text, and assessments. The consistency of content delivery increases the fidelity and efficiency of cGMP training. The anytime, anywhere learning design provides flexibility with staff allocation and learner engagement. Embedded assessments calibrate levels of mastery in each competency with alternative resources and additional remedial assessment opportunities. Mastery of a module results in a digital badge which is sharable social platforms. Methods, Results & Conclusion Here we present our initial specialized module: Expansion, Purification, and Functional Assessment of Human Peripheral Blood Natural Killer (NK) Cells. Limited ability to expand in vitro has restricted development of NK cell immunotherapy. This module describes a method to efficiently expand vast quantities of functional NK cells ex vivo using K562 cells expressing membrane-bound IL21, as an artificial antigen-presenting cell. This module will be deployed online via a Learning Management System March 2019. This process utilizes prerequisite cGMP module skills and is designed for cell technicians manufacturing NK therapeutics for early Phase I clinical trials. Nationwide Children's Hospital and The Ohio State University utilize the manufacturing process described in this module for multiple Phase I investigator initiated expanded NK cell clinical trials. Additional discussion of the process to identify the appropriate training components, define the learning outcomes, ensure an appropriate duration for each module, calibrate a reliable assessment component, and our lessons learned will be shared.

Data disaggregation and its discontents: discourses of civil rights, efficiency and ethnic registry

ABSTRACT This paper examines recent political debates surrounding data disaggregation in education policy in one US state, and analyses the discourses taken up by supporters and opponents of these policies. Analysis suggests how discourses move across time and space, and focuses on how these discourses are contextualized and entextualized in social media, interaction, and public texts. The paper contributes to our knowledge of a major, but understudied, US education policy movement, and provides insights into how similar discourses are variably taken up by political actors for divergent ends.

Emergent interactive features in websites: analysis of online editions of six Indian newspapers

Drawing on the theories of new media and Domingo’s typology of interactivity, this paper examines the presence of interactive and participatory features on the websites of six Indian national dailies. The analysis reveals that newspapers offered its readers/users a wide variety of interactive features to “digitally manage” their “news environment.” Presence of features such as interactive polling, voting and star-grading media text, commenting and flagging a comment for error and abuse inter alia enabled readers/users to annotate the news content and provide feedback. Online forums, blogs, comment threads and other interactive features present on the website are affordances that are capable of fostering dialogue between user-user, user-machine and user-journalist. However, interactive features facilitating citizen journalism was not as ubiquitous as other dimensions on the websites of the newspapers studied. Out of six, only one newspaper had a dedicated section where readers/citizens could submit news of their neighborhood.

An Interactive Voice Response and Text Message Intervention to Improve Blood Pressure Control Among Individuals With Hypertension Receiving Care at an Urban Indian Health Organization: Protocol and Baseline Characteristics of a Pragmatic Randomized Controlled Trial.

BackgroundEfficient and effective strategies for treating chronic health conditions such as hypertension are particularly needed for under-resourced clinics such as Urban Indian Health Organizations (UIHOs).ObjectiveThe objective of the Controlling Blood Pressure Trial is to assess the impact of an interactive voice response and text message (IVR-T) intervention compared with usual care among individuals with hypertension receiving care at a UIHO in Albuquerque, New Mexico. This manuscript presents the baseline characteristics of individuals enrolled in the trial and compares their characteristics with those in the hypertension registry who did not enroll in the trial.MethodsA hypertension registry developed from the clinic’s electronic health record was used for recruitment. Potentially eligible participants were contacted by letter and then by phone. Those who expressed interest completed an in-person baseline visit that included a baseline survey and blood pressure measurement using standardized procedures. Individuals randomized to the intervention group could opt to receive either automated text messages or automated phone calls in either English or Spanish. The messages include reminders of upcoming appointments at First Nations Community HealthSource, requests to reschedule recently missed appointments, monthly reminders to refill medications, and weekly motivational messages to encourage self-care, appointment keeping, and medication taking for hypertension. Individuals in the IVR-T arm could opt to nominate a care partner to also receive notices of upcoming and missed appointments. Individuals in the IVR-T arm were also offered a home blood pressure monitor. Follow-up visits will be conducted at 6 months and 12 months.ResultsOver a 9.5-month period from April 2017 to January 2018, 295 participants were enrolled from a recruitment list of 1497 individuals. The enrolled cohort had a mean age of 53 years, was 25.1% (74/295) American Indian or Alaska Native and 51.9% (153/295) Hispanic, and 39.0% (115/295) had a baseline blood pressure greater than or equal to 140/90 mmHg. Overall, the differences between those enrolled in the trial and patients with hypertension who were ineligible, those who could not be reached, or those who chose not to enroll were minimal. Enrolled individuals had a slightly lower blood pressure (129/77 mmHg vs 132/79 mmHg; P=.04 for systolic blood pressure and P=.01 for diastolic blood pressure), were more likely to self-pay for their care (26% vs 10%; P<.001), and had a more recent primary care visit (164 days vs 231 days; P<.001). The enrolled cohort reported a high prevalence of poor health, low socioeconomic status, and high levels of basic material needs.ConclusionsThe Controlling Blood Pressure Trial has successfully enrolled a representative sample of individuals receiving health care at a UIHO. Trial follow-up will conclude in February 2019.Trial RegistrationClinicalTrials.gov NCT03135405; http://clinicaltrials.gov/ct2/show/NCT03135405 (Archived by WebCite http://www.webcitation.org/76H2B4SO6)International Registered Report Identifier (IRRID)DERR1-10.2196/11794

Prohibited Expression in Wedding Advice: Entextualization of Pasang ri Kajang

This research is entitled Prohibited expression in wedding Advice: Entextualization of Pasang ri Kajang.The objectives of this research is: 1). To disclose denotational text uttered in wedding advice of ethnic Kajang. 2).To reveal interactional text in wedding advice of ethnic Kajang.3). In addition to denotational and interactional text, this research used semiotic mediational approach to relate between denotational and interactional text of wedding advice Qualitative method was used in obtaining the data whereas the researcher herself had a role as a key instrument which has the to master the field being researched and the preparation to come to the object of the research. The data of wedding advice were obtained through, observation, interview, and note taking. Whereas the result of the research shows that denotational text is related to the structure of utterances or text sentences. Interactional text on the other hand is a text based upon social relation which emphazises on social aspect of language. Apart from denotational and interactional text, semiotic mediational approach was used to relate the two texts denotational text and interactional text ( text-context) which is shown by indexical cues.

Use of Telehealth to Enhance Care in a Family-Centered Childhood Obesity Intervention.

Family-centered childhood obesity interventions have been found to be effective. We describe the use of telehealth for tailored behavior change support in a family-centered randomized trial. Children of 2 to 12 years with body mass index ≥85th percentile were randomized to Enhanced Primary Care (EPC) or Enhanced Primary Care + Coaching (EPC + C). EPC + C received 6 health coach visits (in-person or by video or phone call) over 1 year. Telehealth modalities included interactive text messaging, video calls, and an online community resource map. There were 360 children randomized to the EPC + C arm; 87% of parents completed ≥1 health coaching contacts. Overall, 93% parents were sent text messages of which 99% responded at least once. About 72% parents were very satisfied with the message content and 97% were satisfied with information provided about community health resources. The high level of participant engagement and satisfaction suggests that telehealth is feasible and acceptable in family-centered childhood obesity programs.

EXPLORING COLLABORATIVE ONLINE LEARNING

An investigation was carried out to determine the extent to which evidence of collaborative learning could be identified in students’ textual interactions in an online learning environment. The literature on collaborative learning has identified a range of behaviors that characterize successful collaborative learning in face-to-face situations. Evidence of these behaviors was sought in the messages that were posted by students as they interacted in online work groups. Analysis of students’ contributions reveals that there is substantial evidence of collaboration, but that there are differences between conventional face-to-face instances of collaborative learning and what occurs in an asynchronous, networked environment.

The latent topic block model for the co-clustering of textual interaction data

Textual interaction data involving two disjoint sets of individuals/objects are considered. An example of such data is given by the reviews on web platforms (e.g. Amazon, TripAdvisor, etc.) where buyers comment on products/services they bought. A new generative model, the latent topic block model (LTBM), is developed along with an inference algorithm to simultaneously partition the elements of each set, accounting for the textual information. The estimation of the model parameters is performed via a variational version of the expectation maximization (EM) algorithm. A model selection criterion is formally obtained to estimate the number of partitions. Numerical experiments on simulated data are carried out to highlight the main features of the estimation procedure. Two real-world datasets are finally employed to show the usefulness of the proposed approach.

Cost effectiveness of text messages to reduce methamphetamine use and HIV sexual risk behaviors among men who have sex with men

Methamphetamine use is highly prevalent among gay, bisexual, and other men who have sex with men (MSM) in the United States and has been associated with condomless anal intercourse (CAI), a common route of HIV infection. Text messaging is a very low-cost method of delivery for intervention content. This paper presents a cost-effectiveness analysis of a randomized controlled trial testing three nested methods of text message delivery designed to reduce methamphetamine use and HIV sexual risk behaviors among MSM (Project Tech Support2). From March 2014 to January 2016, 286 non-treatment seeking methamphetamine-using MSM were randomized into one of three study arms: 1) Interactive text message conversations with Peer Health Educators, plus five daily automated, unidirectional theory-based messages, plus a weekly self-monitoring text message assessment (TXT-PHE; n = 94); or, 2) Five daily automated, unidirectional theory-based messages plus a weekly self-monitoring text message assessment (TXT-Auto; n = 99); or, 3) The weekly self-monitoring text message assessment only (AO; n = 93). Methamphetamine use at nine months post-enrollment was lower than at baseline in all three arms. The addition of Peer Health Educators and/or theory-based text messages did not produce cost-effective reductions in methamphetamine use over the weekly AO text messages. However, both intervention arms outperformed the AO arm in reducing HIV risk behaviors, but the TXT-Auto arm dominated the TXT-PHE arm in achieving greater reductions in days of methamphetamine use and CAI at lower cost. The TXT-Auto arm achieved greater reductions in CAI than the attentional control at a cost in the base case of ~$37.50 per episode of CAI reduced per month. Sensitivity analyses showed that results were robust to a number of changes in assumptions. Interventions seeking to reduce methamphetamine use among non-treatment-seeking MSM may seek to add minimal attentional control-style text messages to their routines querying about recent methamphetamine use and/or high-risk sex. Interventions seeking to additionally reduce HIV sexual risk behaviors among non-treatment-seeking MSM, specifically engagement in CAI, may seek to additionally apply theory-based text messages.

Sustainable and flexible industrial human machine interfaces to support adaptable applications in the Industry 4.0 paradigm

The Industry 4.0 paradigm introduced several technologies in the industrial manufacturing landscape, highlighting the Cyber Physical Systems, Internet of Things and Visual Computing as some of the key enabling technologies. The fast paced evolution of the technology has to be reflected in the common ground between the machines and the operators. The introduction of advanced, flexible and adaptable Human Machine Interfaces (HMI) will empower the operators with information and custom tools to be more productive in a safer way. This work presents totally functional hardware and a novel software architecture to build flexible advanced HMI interfaces that will provide adaptable and useful information to the operator of the machines. Industrial protocols are used to receive real-time data. A USB camera can be plugged to enable the utilisation of Computer Vision algorithms. A touch display shows adaptable interfaces composed of (a) 3D interactive graphics, (b) texts and 2D images, (c) the camera feed and (d) user interface controls to enable the interaction with the operators. The results present three use cases: (a) an HMI customised for 3D printers, (b) real-time motor control from the HMI and (c) a digital twin of a robotic arm receiving real-time data from the actual robotic arm. This work present data regarding consumption of the hardware for each use case under different work-load.

Abstract WP412: Use of Interactive Cluster Heatmaps and Text Analytics in the Escape-na1 Phase 3 Clinical Trial for Pharmacovigilance of Adverse Events and Site Performance

Introduction: Stroke trial subjects sustain numerous adverse events (AE’s) which may be related to the disease under study or to the therapeutic intervention. In studies involving pharmacovigilance of multiple AE’s, ongoing oversight of AEs by investigators and trial sponsors is critical to ensure the safety and well being of trial subjects. Static cluster heatmaps are used extensively in the field of gene expression studies and text analytics are used widely to monitor text on social media sites such as Twitter. Here we present novel dynamic tools using static cluster heatmaps and text analytics to aid with the visualization of AEs and of clinical site performance in AE reporting in the ESCAPE-NA-1 trial (Clinicaltrials.gov NCT 02930018). Methodology: In an interactive cluster heatmap display, the frequency of AEs is color coded in cells, with the rows corresponding to either sites or patients and columns correspond to unique AEs. Clustering is visualized on a heatmap by addition of row and column dendrograms. Quantification of AEs in the clinical trial is performed through text analytics and the results are visualized using a word cloud. Difference of AE across sites is visualized using a comparison cloud, a cloud that compares frequencies across sites. A cluster heatmap and word cloud are made interactive by formatting into HTML. Results: The main results obtained from interactive AE cluster heatmaps are patient ,site and AE clusters (Figure 1). The results obtained from text analytics are word clouds that convey overall AEs frequency and AEs frequency across sites (Figure 1). Due to active status of the trial, we will share the methodology of constructing interactive AE cluster heatmaps and word clouds and broad visual results without providing specifics of sites or AEs. Conclusion: Interactive cluster heatmaps and word clouds constructed via text analytics are a novel way of visualizing complex multidimensional AE data from clinical trials.

Usability and Acceptability of a Text Message-Based Developmental Screening Tool for Young Children: Pilot Study.

BackgroundOnly 30% of parents of children aged 9-35 months report that their child received a developmental screening in the previous year. Screening rates are even lower in low-income households, where the rates of developmental delays are typically higher than those in high-income households. Seeking to evaluate ways to increase developmental screening, Text4baby, a national perinatal texting program, created an interactive text message-based version of a validated developmental screening tool for parents.ObjectiveThis study aimed to assess whether a text message-based developmental screening tool is usable and acceptable by low-income mothers.MethodsLow-income mothers of infants aged 8-10 months were recruited from the Women, Infants and Children Program clinics in Prince George’s County, MD. Once enrolled, participants used text messages to receive and respond to six developmental screening questions from the Parents’ Evaluation of Developmental Status: Developmental Milestones. After confirming their responses, participants received the results and feedback. Project staff conducted a follow-up phone survey and invited a subset of survey respondents to attend focus groups. A representative of the County’s Infants and Toddlers Program met with or called participants whose results indicated that their infants “may be behind.”ResultsEighty-one low-income mothers enrolled in the study, 93% of whom reported that their infants received Medicaid (75/81). In addition, 49% of the mothers were Hispanic/Latina (40/81) and 42% were African American (34/81). A total of 80% participated in follow-up surveys (65/81), and 14 mothers attended focus groups. All participants initiated the screening and responded to all six screening questions. Of the total, 79% immediately confirmed their responses (64/81), and 21% made one or more changes (17/81). Based on the final responses, 63% of participants received a text that the baby was “doing well” in all six developmental domains (51/81); furthermore, 37% received texts listing domains where their baby was “doing well” and one or more domains where their baby “may be behind” (30/81). All participants received a text with resources for follow-up. In a follow-up survey reaching 65 participants, all respondents said that they would like to answer screening questions again when their baby was older. All but one participant would recommend the tool to a friend and rated the experience of answering questions and receiving feedback by text as “very good” or “good.”ConclusionsA mobile text version of a validated developmental screening tool was both usable and acceptable by low-income mothers, including those whose infants “may be behind.” Our results may inform further research on the use of the tool at older ages and options for a scalable, text-based developmental screening tool such as that in Text4baby.

250. The Development of A Theory-Based, User-Informed, Digital Intervention To Promote Pregnancy Prevention Among Adolescent Female Emergency Department Patients

Over 18 million adolescents use the emergency department (ED) each year. High risk of unintended pregnancy is associated with frequent use of the ED and lack of a primary care provider, making the ED visit an important potential site for intervention. With few adolescent preventive health interventions being implemented and evaluated in the ED setting, the description of the rigorous development of an ED-based pregnancy prevention intervention can guide future adolescent emergency medicine researchers. The objective of this study is to describe a systematic approach, intervention mapping, to develop a theory-based, user-informed, digital intervention aiming to increase contraception use among adolescent female ED patients at high risk of unintended pregnancy. We followed the 6 iterative steps of intervention mapping to create a blueprint for designing, implementing, and evaluating an ED-based, digital, pregnancy prevention intervention: (1) Developed a Logic Model of the Problem—teen pregnancy in the ED setting—based on a needs assessment; (2) Stated the outcomes and objectives of our intervention via a Logic Model of Change, including our theoretical framework; (3) Developed the pregnancy prevention curriculum and plan, including the digital strategy and brand; (4) Produced the intervention, including designing the branched-logic texting algorithms, website, videos, and cartoons; (5) Planned program use, such as implementation strategies in the ED setting; and (6) Developed an evaluation plan. Using the process of intervention mapping, we developed Dr. Erica (Emergency Room Intervention to improve the Care of Adolescents). Dr. Erica is a relatable, empathetic, straightforward and reliable virtual female doctor who sends 10 weeks of personalized and interactive evidence-based text messages that aim to promote healthy sexual behaviors and decrease teen pregnancy risk. Texts are based on key stakeholder input, participatory design, and the Social Cognitive Theory as well as incorporate social media, relatable characters and Motivational Interviewing techniques. Following the outline of intervention mapping led to the development of a theory-based, user-informed, digital pregnancy prevention intervention. Outlining this method may be helpful to future investigators interested in designing and evaluating adolescent preventive health interventions in both the acute and outpatient setting.

Media Framing and Framing by Politicians

There are substantial amount of academic research regarding to how media do the framing on certain issue. However, empirical research on the framing interactions is still difficult to find. This study endeavors to fill the void by questioning the mutual influences between media framing and framing by politicians on a specific issue during the political campaign ahead of 2017 Jakarta Governor Election. Both quantitative and qualitative content analysis methods were employed in this research. First of all, textual data from the media and politicians were coded using Atlas.ti coding software in order to know the usage of five framing types: conflict, morality, economic consequences, responsibility and human interest. After that, the mutual influence was investigated by looking at their most dominant frames, their comparative trends in terms of framing quantity, and their textual interactions. This research then reveals a weak mutual influence between media framing and framing by politicians. It is indicated from their differences in using dominant frames. Conflict consistently dominated media framing, while economic consequences were generally dominant within politician’s framing. Besides, media and politicians produced different quantity of framing and presented different trends. Media and politicians also presented an insignificant textual interactions by sharing small number of similar keywords and mutual quotations.

Analyzing Emergent Users’ Text Messages Data and Exploring Its Benefits

While users in the developed world can choose to adopt the technology that suits their needs, the emergent users cannot afford this luxury, and hence, they adapt themselves to the technology that is readily available. When technology is designed, such as the mobile-phone technology, it is an implicit assumption that it would be adopted by the emergent users in due course. However, such user groups have different needs, and they follow different usage patterns as compared to users from the developed world. In this paper, we target an emergent user base, i.e., users from a university in Pakistan, and analyze their texting behavior on mobile phones. We see interesting results, such as the long-term linguistic adaptation of users in the absence of reasonable Urdu keyboards, the overt preference for communicating in Roman Urdu, and the social forces related to textual interaction. We also present two case studies on how a single dataset can effectively help understand emergent users, improve usability of some tasks, and also help users perform previously difficult tasks with ease.

Techniques of Studying Artistic Text at Literature Lessons in the Modern School of Kazakhstan

The article discusses new opportunities analyzing and interpreting a literary text for students. The object of the study is the poem “Tiger” by English poet William Blake included in the updated literature program. The focus is on the analysis of methodological materials, dedicated to the creativity of the English romantic poet, which are used by teachers of Nazarbayev Intellectual Schools at the lessons. In the article described functions of teaching methods used at the lessons and opportunities of the project method. Executing the project method at the extracurricular time allows the learner to develop creative skills and gain new knowledge. Analysis of the content of the mini-projects performed by the learners gives reason to assume the productivity of this methodical technology, applied by teachers of literature Nazarbayev Intellectual Schools.Key words: updated literature program, interactive text learning techniques, project method.

At the intersection of text and conversation analysis: analysing asynchronous online written interaction

This paper demonstrates how two approaches from discourse studies – digital Conversation Analysis (CA) and Textual Interaction Studies (TIS) – can be used in tandem to analyse asynchronous written conversation. The main motivation for this mixed-methods approach is our observation that interaction in many asynchronous platforms, such as blogs and discussion forums, tends to be located somewhere in between the main focuses of digital CA and TIS. On the one hand, the posts in these platforms are often textually complex, multiparagraph entities. Furthermore, the opening posts usually address an imagined audience similarly to mass media texts. On the other hand, interaction within the conversation threads unfolds through the co-operation of at least two participants, and the meaning of each contribution is jointly negotiated by the participants. Our paper illustrates the benefits of combining digital CA and TIS by presenting a case analysis of one conversation thread from a Finnish book club blog.