Use Of Current Technology Research Articles

Patients’ trust in health information sources as an antecedent of novel healthcare technology usage

Abstract Background As professional health information sources, healthcare maintenance organizations (HMOs) need to convince patients of the necessity, efficiency, and reliability of technology-based services to increase and optimize their usage. It raises the question of whether patients’ trust in health information sources shapes the use of technology-based services and, in return, increases their willingness to use novel healthcare services in the future. Methods Data were collected through an online close-ended survey among 668 adult Israeli citizens insured with Israeli health insurance (85% of them Jewish, 52.5% female, and in their early 40s, with half holding an academic degree). The survey explored actual use and willingness to use innovative healthcare technologies and the trust respondents attributed to various sources of health information. Data were analyzed by SPSS 28. Results Participants generally use healthcare technology primarily to schedule appointments, search for medical information, and make health-related requests. To quite an extent, they are willing to be treated with innovative healthcare technologies (e.g., for radiological purposes and personally tailored medication). Preliminary results suggest that trust in the measured formal health information sources (i.e., formal health providers, HMO, HMO online services) was positively associated with technology-based healthcare services usage (r=.14 - .20, p<.001). A positive association also emerged between the current use of healthcare technology and the willingness to use innovative medical technologies in the future (r=.23, p<.001). Conclusions HMOs, as key players, have the power to maximize the usage of advanced health services by establishing trusting relationships with their patients. This will increase the usage of healthcare technology-based services and generate positive patient experiences, which will result in the willingness to experience novel types of health services in the future. Key messages • Encouraging patients to use technology-based health services will maximize the potential inherent in the use of innovative health services and treatments in the future. • Nurturing trusting relationships with patients at any level in the health system will increase their compliance with health providers’ recommendations to use advanced health services.

The use of 7T MRI in multiple sclerosis: review and consensus statement from the North American Imaging in Multiple Sclerosis Cooperative.

The use of ultra-high-field 7-Tesla (7T) MRI in multiple sclerosis (MS) research has grown significantly over the past two decades. With recent regulatory approvals of 7T scanners for clinical use in 2017 and 2020, the use of this technology for routine care is poised to continue to increase in the coming years. In this context, the North American Imaging in MS Cooperative (NAIMS) convened a workshop in February 2023 to review the previous and current use of 7T technology for MS research and potential future research and clinical applications. In this workshop, experts were tasked with reviewing the current literature and proposing a series of consensus statements, which were reviewed and approved by the NAIMS. In this review and consensus paper, we provide background on the use of 7T MRI in MS research, highlighting this technology's promise for identification and quantification of aspects of MS pathology that are more difficult to visualize with lower-field MRI, such as grey matter lesions, paramagnetic rim lesions, leptomeningeal enhancement and the central vein sign. We also review the promise of 7T MRI to study metabolic and functional changes to the brain in MS. The NAIMS provides a series of consensus statements regarding what is currently known about the use of 7T MRI in MS, and additional statements intended to provide guidance as to what work is necessary going forward to accelerate 7T MRI research in MS and translate this technology for use in clinical practice and clinical trials. This includes guidance on technical development, proposals for a universal acquisition protocol and suggestions for research geared towards assessing the utility of 7T MRI to improve MS diagnostics, prognostics and therapeutic efficacy monitoring. The NAIMS expects that this article will provide a roadmap for future use of 7T MRI in MS.

ASSESSING HEALTHCARE PROVIDERS’ ACCEPTANCE OF THE HOSPITAL MANAGEMENT SYSTEM IN A PRIVATE HOSPITAL IN SELANGOR, MALAYSIA

Introduction: In the current technological era, the implementation and use of information and communication technology are crucial for productivity and organizational management in the health sector. This study aimed to investigate factors influencing staff acceptance of the Hospital Management System (HMS) using the Unified Theory of Acceptance and Use of Technology (UTAUT) in a private hospital in Selangor, Malaysia. Methods: Semi-structured interviews were conducted with 25 healthcare professionals, including doctors, nurses, and administrative staff, to explore their experiences and perceptions of the HMS. Data collection was performed through interviews and observations and analyzed using thematic analysis with ATLAS.ti. Results: The study identified five key themes influencing HMS acceptance: performance expectancy, effort expectancy, social influence, facilitating conditions, and behavioral intention. Participants emphasized the importance of system reliability, speed, and user-friendly interfaces for efficient workflow. Peer support and a technology-promoting organizational culture positively influenced system use. Comprehensive training and continuous technical support were crucial for user confidence. Despite recognizing the system's benefits, participants highlighted challenges such as inadequate system integration and the need for simultaneous digital and traditional record-keeping. Conclusion: Addressing these issues and tailoring the HMS to meet specific departmental needs can enhance user satisfaction and system effectiveness. The study underscores the importance of understanding user needs and providing robust support systems to facilitate the successful implementation and adoption of HMS in healthcare settings.

Comparative analysis of healthcare systems in the Horn of Africa and the evaluation of Türkiye's diplomatic health studies conducted in Somalia.

This study examines the effectiveness of the countries' health systems in the Horn of Africa region. It also investigates the perspectives of actors who have played an active role in health affairs in Somalia carried out by Türkiye. Using the Data Envelopment Analysis and Malmquist Total Factor Efficiency Analysis, we investigated the effectiveness of the health systems and improvements made throughout the years. In the countries of interest, efficiency levels and average total factor productivity showed positive and/or negative trends between 2000 and 2020. Kenya showed a marked performance in achieving improved average total factor productivity thanks to the effective use of current technology in health, success in integrating new technologies into the health system, and a high potential to produce more output despite insufficient existing inputs. The remaining countries lagged behind in improving their production factors. Since 2014, Türkiye has provided health services in Somalia through health diplomacy and conducted medical examinations for numerous patients in a well-equipped hospital.

Application of health technology assessment: a new need for an ethical neonatology.

New health technologies are constantly developing. However, their impacts on health and implications for health systems are not always clear. Faced with this situation, in the last 45years, Health Technology Assessment (HTA) has taken an important role in the decision-making process related to the implementation of technologies in healthcare systems. According to the Core Model® EUnetHTA, a "full HTA" should cover nine domains: health problems and current use of technology, description and technical characteristics, safety, clinical effectiveness, costs and economic evaluation, ethical analysis, organizational aspects, patients and social aspects, legal aspects. In all domains of a HTA, the approach is evidence-based and uses epidemiological data, systematic reviews to gather the best level of proofs regarding clinical efficacy and safety of interventions and comparators and organizational and economic models. One exception is the ethical analysis, that uses value-based approach. Although in Neonatal Intensive Care Units (NICUs) there are highly advanced technological environments, HTA has not yet been widely used in this field for determining the "value" of the diagnostic and therapeutic procedures. An example of diagnostic tool used in NICUs is the near-infrared spectroscopy (NIRS), a noninvasive device that enables real-time monitoring of the condition of peripheral tissues in critically ill newborns. The availability of this diagnostic tool could improve the choice of the most appropriate treatment to the clinical situation of the newborn. The expected benefit of NIRS motivates the need of a full HTA. Conclusion: HTA is still little used in Neonatal Critical Care, but it may be the appropriate tool to determine the "value" of technologies used in this field. The implementation of clinical trials and HTA may help in an evidence-based evaluation of new technologies for the neonatal critical care. This could facilitate the rapid introduction of the best health technologies into clinical practice. What is Known: • Health Technology Assessment (HTA) has taken an important role in the decision-making process related to the implementation of technologies in healthcare systems • The centrality of ethics in HTA has been known. In fact, ethics is everywhere in HTA, and value judgments permeate all levels of HTA What is New: • HTA is still little used in Neonatal Critical Care, but it may be the appropriate tool to determine the "value" of technologies used in this field • The implementation of clinical trials and HTA may help in an evidence-based evaluation of new technologies for the neonatal critical care and in introduction of the best and ethically acceptable health technologies into clinical practice.

Teacher Barriers in Utilizing Google Meet in Speaking Class

E-learning developments are almost relevant with the use of current famous learning technology like Google Meet which can be recommended to build communication between teachers and students. This research was carried out to find out how the teacher utilizes Google Meet and reveals the teacher’s barriers to practicing Google Meet in speaking class. This research adopted a qualitative case study and with online classroom observation and semi-structured interviews as the instruments of the study. Research participants embraced in this research were an English teacher and fifteen students of class 1B in the first semester of an English education department at a University in Ciamis. In processing the data of online classroom observation, the researcher classified and interpreted the classroom observation data. Then, the interview data were transcribed, translated it into English, analyzed, interpreted, and concluded. The findings showed that there were three key elements of the present research. First, Google Meet is beneficial in online learning. Second, Google Meet provided several advanced features that were simple to use. Third, the teacher had some troubles in using Google Meet including bad internet connection, student’ gadget error, and students’ distracted in learning.

The use of technology by seniors with neurocognitive disorders in long-term care: a scoping review

BackgroundTo map the current state of knowledge about the use of technology with seniors with neurocognitive disorders in long-term care to foster interactions, wellness, and stimulation.MethodsCumulative Index to Nursing and Allied Health Literature (CINAHL Plus); MEDLINE; PsycINFO; Embase and Web of Science were searched in eligible literature, with no limit of time, to describe the current use of technology by seniors with neurocognitive disorders in long-term care. All types of literature were considered except for theses, editorial, social media. This scoping review was built around the recommendations of Peters et al. (2020 version). Three researchers collaborated on the selection of articles and independently reviewed the papers, based on the eligibility criteria and review questions.ResultsThe search yielded 3,605 studies, of which 39 were included. Most technology type reported was robotics. Included studies reports different positive effects on the use of such technology such as increase of engagement and positive.ConclusionThe study highlights different types and potential benefits of technology for long-term care residents with neurocognitive disorders, emphasizing the crucial need for additional research to refine interventions and their use.

Single-cell sequencing: Current applications in various tuberculosis specimen types.

Tuberculosis (TB) is a chronic disease caused by Mycobacterium tuberculosis (M.tb) and responsible for millions of deaths worldwide each year. It has a complex pathogenesis that primarily affects the lungs but can also impact systemic organs. In recent years, single-cell sequencing technology has been utilized to characterize the composition and proportion of immune cell subpopulations associated with the pathogenesis of TB disease since it has a high resolution that surpasses conventional techniques. This paper reviews the current use of single-cell sequencing technologies in TB research and their application in analysing specimens from various sources of TB, primarily peripheral blood and lung specimens. The focus is on how these technologies can reveal dynamic changes in immune cell subpopulations, genes and proteins during disease progression after M.tb infection. Based on the current findings, single-cell sequencing has significant potential clinical value in the field of TB research. Next, we will focus on the real-world applications of the potential targets identified through single-cell sequencing for diagnostics, therapeutics and the development of effective vaccines.

DIGITAL TRANSFORMATION TRENDS IN FOREIGN LANGUAGE TRAINING OF STUDENTS OF NON-LINGUISTIC SPECIALTIES

Education refers to the spheres of human activity that are most susceptible to digitalization. Within the framework of this article, the trends of digital transformation of foreign language training of university students of non-linguistic specialties are considered in the context of education 4.0, including digital space, digital technologies, and directions of the organization of educational activities. Longitudinal observations, pedagogical experiments, and analysis of educational data have been used in the research. The results suggest that the use of advanced digital learning technologies contributes to the activation of interaction between professors and students in an electronic educational environment, personalization of the educational process, increased motivation for the independent cognitive activity of students, as well as the formation of a wide range of competencies during foreign language training. Digital technologies in a foreign language(s) training, which are implemented in the educational process of the university and constitute a scientific and methodological foundation in the development and use of all types of digital educational resources, are identified. The expediency of their introduction to foreign language teaching is substantiated. One of the most effective directions of digital transformation is the introduction of virtual reality technologies. The analysis of the current use of VR technologies in the electronic educational environment of the university shows the positive impact of immersive on the cognitive functions of students.

Ethical Aspects of Using Artificial Intelligence in the Educational Process of Secondary Schools

The article investigates the current use of artificial intelligence technologies and services in the educational process of general secondary education institutions by participants in the educational process – teachers and students. An analysis of research and publications that highlight the issues of using artificial intelligence in education has been conducted. The potential and specific features of implementing artificial intelligence at the present stage are outlined. Positive developments in pedagogical practice regarding the use of artificial intelligence in the educational process are identified. Risks and negative trends that need to be considered to ensure fair and safe use of AI in education are highlighted. In particular, important ethical aspects of applying artificial intelligence in the educational process are emphasized, the consideration and implementation of which are urgent needs for the ethical and responsible use of AI-based tools. This will improve teaching practices and the learning experience of students, ensuring they develop future skills within ethical frameworks, and provide teachers with the support needed to enhance the effectiveness of their pedagogical activities and the development of innovative teaching methods.

Нагласи на студентите към смарт технологиите в образованието

The article analyzes students' attitudes towards smart technologies in education. Results of a survey, held in the period September - October 2023 with 64 students, conducted on the current use of smart technologies in the educational process and attitudes towards future use are presented. The survey shows that the respondents know and use more than 10 smart technologies in their everyday life and in their education; use smart technologies in their daily life (86.08) and for entertainment, sports and in their free time (75.04), have positive attitudes towards using smart technologies for learning (very often 35.64 and often 51.56) and attitudes with a reflected positive tendency for social university life (from current use 0 to attitudes to use 41.16). The results engage the digital transformation of education with the implementation of more and different smart-technologies in the educational process. The application of smart technologies in education allows education to be digitally inclusive, personalized and much more attractive and effective for student learners. The established attitudes of the students manifest the tracing of the path of smart education and digital inclusive education.

Community-Dwelling Older Adults' Readiness for Adopting Digital Health Technologies: Cross-Sectional Survey Study.

Digital health technologies offer the potential to improve the daily lives of older adults, maintain their health efficiently, and allow aging in place. Despite increasing evidence of benefits and advantages, readiness for adopting digital interventions among older people remains underexplored. This study aims to explore the relationships between sociodemographic-, health-, and lifestyle-related factors and technology use in everyday life and community-dwelling older adults' readiness to adopt telemedicine, smartphones with texting apps, wearables, and robotics. This was a cross-sectional, population-based survey study with a stratified probabilistic sample of adults aged 75 years or older living in South Tyrol (autonomous province of Bolzano/Bozen, Italy). A random sample of 3600 community-dwelling older adults living at home was invited to complete a questionnaire including single items (older adults' readiness to use health technology) and scales (PRISMA-7; Program of Research on Integration of Services for the Maintenance of Autonomy). Descriptive and logistic regression analyses were performed to analyze the data. In total, 1695 community-dwelling older adults completed the survey (for a response rate of 47%). In terms of potential digital health technology adoption, wearable devices were favored by 33.7% (n=571), telemedicine by 30.1% (n=510), smartphones and texting apps by 24.5% (n=416), and assistant robots by 13.7% (n=232). Sociodemographic-, health- and lifestyle-related factors, as well as the use of technology in everyday life, played a significant role in explaining readiness to adopt digital health technologies. For telemedicine, age ≥85 years (odds ratio [OR] 0.74, 95% CI 0.56-0.96), financial constraints (OR 0.68, 95% CI 0.49-0.95), and less than 2 hours of physical activity per week (OR 0.75, 95% CI 0.58-0.98) were associated with nonreadiness, while Italian-speaking participants (OR 1.54, 95% CI 1.16-2.05) and those regularly using computers (OR 1.74, 95% CI 1.16-2.60), smartphones (OR 1.69, 95% CI 1.22-2.35), and the internet (OR 2.26, 95% CI 1.47-3.49) reported readiness for adoption. Community-dwelling older adults display varied readiness toward the adoption of digital health technologies, influenced by age, mother tongue, living situation, financial resources, physical activity, and current use of technology. The findings underscore the need for tailored interventions and educational programs to boost digital health technology adoption among community-dwelling older adults.

ТЕНДЕНЦИИ РАЗВИТИЯ СИСТЕМ ПЕРЕДАЧИ ЭЛЕКТРИЧЕСКОЙ ЭНЕРГИИ

Based on a comparison of technical, economic, technological and environmental advantages, the prospects for technologies in the transmission of electrical energy are considered. It has been estab-lished that for the transmission of electricity over long distances, a promising trend is the use of di-rect current technology

Drone‐based imaging sensors, techniques, and applications in plant phenotyping for crop breeding: A comprehensive review

AbstractOver the last decade, the use of unmanned aerial vehicles (UAVs) for plant phenotyping and field crop monitoring has significantly evolved and expanded. These technologies have been particularly valuable for monitoring crop growth and health and for managing abiotic and biotic stresses such as drought, fertilization deficiencies, disease, and bioaggressors. This paper provides a comprehensive review of the progress in UAV‐based plant phenotyping, with a focus on the current use and application of drone technology to gain information on plant growth, development, adaptation, and yield. We reviewed over 200 research articles and discuss the best tools and methodologies for different research purposes, the challenges that need to be overcome, and the major research gaps that remain. First, the review offers a critical focus on elucidating the distinct characteristics of UAV platforms, highlighting the diverse sensor technologies employed and shedding light on the nuances of UAV data acquisition and processing methodologies. Second, it presents a comprehensive analysis of the multiple applications of UAVs in field phenotyping, underscoring the transformative potential of integrating machine learning techniques for plant analysis. Third, it delves into the realm of machine learning applications for plant phenotyping, emphasizing its role in enhancing data analysis and interpretation. Furthermore, the paper extensively examines the open issues and research challenges within the domain, addressing the complexities and limitations faced during data acquisition, processing, and interpretation. Finally, it outlines the future trends and emerging technologies in the field of UAV‐based plant phenotyping, paving the way for innovative advancements and methodologies.

Containerization in Edge Intelligence: A Review

The onset of cloud computing brought with it an adoption of containerization—a lightweight form of virtualization, which provides an easy way of developing and deploying solutions across multiple environments and platforms. This paper describes the current use of containers and complementary technologies in software development and the benefits it brings. Certain applications run into obstacles when deployed on the cloud due to the latency it introduces or the amount of data that needs to be processed. These issues are addressed by edge intelligence. This paper describes edge intelligence, the deployment of artificial intelligence close to the data source, the opportunities it brings, along with some examples of practical applications. We also discuss some of the challenges in the development and deployment of edge intelligence solutions and the possible benefits of applying containerization in edge intelligence.

Geospatial Technology for Sustainable Agricultural Water Management in India—A Systematic Review

Effective management of water resources is crucial for sustainable development in any region. When considering computer-aided analysis for resource management, geospatial technology, i.e., the use of remote sensing (RS) combined with Geographic Information Systems (GIS) proves to be highly valuable. Geospatial technology is more cost-effective and requires less labor compared to ground-based surveys, making it highly suitable for a wide range of agricultural applications. Effectively utilizing the timely, accurate, and objective data provided by RS technologies presents a crucial challenge in the field of water resource management. Satellite-based RS measurements offer consistent information on agricultural and hydrological conditions across extensive land areas. In this study, we carried out a detailed analysis focused on addressing agricultural water management issues in India through the application of RS and GIS technologies. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, we systematically reviewed published research articles, providing a comprehensive and detailed analysis. This study aims to explore the use of RS and GIS technologies in crucial agricultural water management practices with the goal of enhancing their effectiveness and efficiency. This study primarily examines the current use of geospatial technology in Indian agricultural water management and sustainability. We revealed that considerable research has primarily used multispectral Landsat series data. Cutting-edge technologies like Sentinel, Unmanned Aerial Vehicles (UAVs), and hyperspectral technology have not been fully investigated for the assessment and monitoring of water resources. Integrating RS and GIS allows for consistent agricultural monitoring, offering valuable recommendations for effective management.

Overview: mineral elements and their role in animal nutrition

The intensification of livestock farming is aimed at a comprehensive increase in the production of milk, meat, wool, and other products by increasing the productivity of livestock and poultry and obtaining the maximum amount of product per unit of feed consumed with the lowest possible labor and cost. One of the main ways to increase animal productivity is through proper feeding. An imbalance in the rations in terms of essential and biologically active substances leads to metabolic disorders, a decrease in natural immunity, and diseases of the reproductive system, negatively affecting economic efficiency. The current use of industrial technologies for harvesting roughage and juicy feed is often violated, which leads to a decrease in its quality and high demand for protein, vitamins, and trace elements; in this regard, it is necessary to improve existing and look for new methods of production, evaluation, and use of feed and feed additives. Minerals ingested with water and feed play an essential role in animal nutrition. Quite often, both an excess of some and a lack of other trace elements are detected, which leads to a decrease in animal productivity and a deterioration in the quality of the products obtained from them. The lack of mineral elements can cause significant economic losses to livestock enterprises due to the massive occurrence of animal diseases and metabolic disorders, especially in the winter and spring. Trace elements play an essential role in animal nutrition, as they considerably impact the body's defenses, hematopoiesis, endocrine glands, and digestive tract microflora, participate in protein biosynthesis, and regulate metabolism. The extent to which minerals are used in the diet depends not only on their quantity and appropriate ratio but also, to a large extent, on the level of the organic part of the diet (proteins, fats, carbohydrates) and vitamins. It has been proven that the additional introduction of deficient trace elements into the diet of animals increases their levels in the body, primarily in the liver. Thus, when determining the need for mineral elements in animals, their ratio to other biologically active substances should be considered based on balanced feeding. However, it should be noted that the level of absorption of trace elements by animals largely depends on the form of their compounds.

Digital technologies in bronchiectasis physiotherapy services: a survey of patients and physiotherapists in a UK centre.

We aimed to explore how digital technology is currently used, could be used and how services could be improved in order to optimise bronchiectasis physiotherapy care. Online surveys were designed and distributed amongst people with bronchiectasis and physiotherapists in Northern Ireland. Responses to closed and open question formats were collected and analysed. The survey was completed by 48 out of 100 physiotherapists (48%) between January 2020 and January 2021 and by 205 out of 398 people with bronchiectasis (52%) between October 2020 and October 2021. 56% of physiotherapists (27 out of 48) reporting using some type of digital technology to facilitate services, whereas 44% (21 out of 48) reported that they had never used a digital technology in this patient group. When physiotherapists were asked whether they would be likely to use certain remote and/or digital options to deliver follow-up care for airway clearance techniques, most (31-38 out of 48; 65-79%) indicated that they would. Regarding patient responses, most reported that they would use telephone consultation (145 out of 199, 73%) and a smaller proportion were likely to use video consultation (64 out of 199, 32%). The most commonly mentioned theme for improvement amongst patients was follow-ups, while improved access, quality of services and treatments were the most commonly mentioned amongst physiotherapists. Despite a large proportion of physiotherapists in this survey reporting no current use of digital technology in bronchiectasis physiotherapy care, there was significant interest and willingness to do so, amongst both physiotherapists and patients. This survey highlighted a range of care areas, specifically follow-up visits, where digital methods could be further explored.

Enhancing IoT Data Security: Using the Blockchain to Boost Data Integrity and Privacy

The Internet of Things (IoT) is a technology that can connect billions of devices or “things” to other devices (machine to machine) or even to people via an existing infrastructure. IoT applications in real-world scenarios include smart cities, smart houses, connected appliances, shipping, monitoring, smart supply chain management, and smart grids. As the number of devices all over the world is increasing (in all aspects of daily life), huge amounts of data are being produced as a result. New issues are therefore arising from the use and development of current technologies, regarding new applications, regulation, cloud computing, security, and privacy. The blockchain has shown promise in terms of securing and preserving the privacy of users and data, in a decentralized manner. In particular, Hyperledger Fabric v2.x is a new generation of blockchain that is open source and offers versatility, modularity, and performance. In this paper, a blockchain as a service (BaaS) application based on Hyperledger Fabric is presented to address the security and privacy challenges associated with the IoT. A new architecture is introduced to enable this integration, and is developed and deployed, and its performance is analyzed in real-world scenarios. We also propose a new data structure with encryption based on public and private keys for enhanced security and privacy.

Assessing the Value of Information Technology for the Decarbonization of Freight Transport

In its first part, the paper gives a summary of the levels of emissions resulting from each mode of transport by use of statistics at the European and global levels. It also summarizes the main measures and policies that have been put forward for the reduction of freight transport greenhouse gas (GHG) emissions. To facilitate the subsequent analyses, these measures and policies are classified into four categories, i.e., affecting the “demand” for freight transport services, shifting freight to less or no carbon-intensive modes, improving the energy efficiency of existing freight vehicles, and transitioning to “clean” fuels including electricity and hydrogen. For each of these categories, their current or potential use of information technology (IT) applications is presented, and key examples of such applications are mentioned. In the final part, a multicriteria analysis is performed with the help of two expert panels which are asked to assess, on a 5-level Likert-type scale, the extent of IT use in each of the four categories. The results show an important or very important contribution of IT in all categories except “improving the energy efficiency of current vehicles”. The highest contribution (with scores higher than 4) appears to be in the category “shifting freight to less carbon-intensive modes”.