Clinical, Cosmetic and Investigational Dermatology最新文献

{"title":"Association Between Non-HDL to HDL Cholesterol Ratio (NHHR) and Psoriasis in Adults: A Cross-Sectional Study Using 2009-2014 Data.","authors":"Yizi Jiang, Min Jia","doi":"10.2147/CCID.S492053","DOIUrl":"10.2147/CCID.S492053","url":null,"abstract":"<p><strong>Background: </strong>Because of its possible significance in metabolic diseases, the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) has garnered attention as a novel and trustworthy lipid biomarker. Psoriasis may be linked to metabolic problems and obesity, according earlier research. Uncertainty surrounds the relationship between NHHR and the onset of psoriasis, though. The primary aim of this investigation was to examine the relationship between NHHR and psoriasis.</p><p><strong>Patients and methods: </strong>This cross-sectional analysis used data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2009 and 2014. The association between psoriasis and NHHR was examined using multivariate logistic regression, and smoothed curve fitting was done to explore the non-linear relationship. Furthermore, Subgroup and sensitivity studies were performed in order to confirm the robustness of the findings.</p><p><strong>Results: </strong>Psoriasis and NHHR were shown to be positively correlated in 15,951 adult individuals who were at least 20 years old. Psoriasis risk rose by 7% for each unit increase in NHHR [1.07 (1.01, 1.14)]. Individuals in the highest NHHR tertile were 39% more likely compared to those in the bottom tertile to have psoriasis [1.39 (1.09, 1.78)]. Across subgroups, this favorable connection remained consistent.</p><p><strong>Conclusion: </strong>Elevated NHHR levels are positively correlated with an upsurge chance of psoriasis in the adult population in the United States. The significance of NHHR as an indication for early psoriasis risk assessment is shown by this study.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"17 ","pages":"2523-2531"},"PeriodicalIF":1.9,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11561548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unexpected Repigmentation of Vitiligo Universalis Following Hemodialysis Initiation: A Rare Case Report and Literature Overview.","authors":"Abdulaziz A Alnoshan, Fahad Hamoud Alrashdi, Rawan Abdulaziz AlDahash, Khalid Nabil Nagshabandi, Salman Alotaibi","doi":"10.2147/CCID.S482396","DOIUrl":"https://doi.org/10.2147/CCID.S482396","url":null,"abstract":"<p><p>Vitiligo is a chronic skin depigmentation disorder affecting 0.2-1.8% of the global population, with a significant prevalence in Saudi Arabia. Although not life-threatening, it severely impacts the quality of life and psychological well-being of patients. We report a rare instance of hemodialysis-induced skin repigmentation involving a 25-year-old woman with vitiligo universalis.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"17 ","pages":"2519-2522"},"PeriodicalIF":1.9,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FOXN3 Regulates Autophagic Activity to Suppress Drug Resistance in Melanoma Cells.","authors":"Yaqi Wang, Hui Su, Xiaopeng Wang, Chen Tu, Tong Xiao, Bincheng Ren, Shuang Wang","doi":"10.2147/CCID.S462854","DOIUrl":"https://doi.org/10.2147/CCID.S462854","url":null,"abstract":"<p><strong>Background: </strong>The forkhead box (FOX) family member FOXN3 has been reported to inhibit transcriptional activity associated with regulating tumor development. However, the role of FOXN3 in the pathogenesis of melanoma is not well understood.</p><p><strong>Objective: </strong>To investigate the biological functions of FOXN3 in drug resistance of melanoma.</p><p><strong>Materials and methods: </strong>The expression of FOXN3 in melanoma was investigated using Gene Expression profiling interactive analysis (GEPIA) and Linkedomics databases. Melanoma cell proliferation, invasion, and migration were assessed using the colony formation assay, the scratch wound healing test, the Transwell invasion assay, and the nude mice xenograft to determine the effects of FOXN3 over-expression and depletion. The functional role of the transcriptional regulator in melanoma cells was tested through chromatin immunoprecipitation, immunofluorescence.</p><p><strong>Results: </strong>FOXN3 was downregulated in melanoma. Over-expression of FOXN3 inhibited the proliferation and motility of melanoma cells, whereas FOXN3 knockdown significantly enhanced the proliferation and motility of melanoma cells. Overexpression of FOXN3 reduced autophagic activity in melanoma cells. Enhanced autophagic activity in drug-resistant melanoma cell lines is related to drug-sensitive cells, and significant differences in FOXN3 localization were observed when comparing melanoma cells that were sensitive and resistant to Vemurafenib. Additionally, FOXN3 has been identified as binding to the promoter region of the cancer antigen Fibrous Sheath Interacting Protein 1 (FSIP1), thereby regulating the expression of this gene.</p><p><strong>Conclusion: </strong>FOXN3 functions as an important regulator of the development and progression of Vemurafenib-resistant melanoma cells, partly owing to its binding to the <i>FISP1</i>. As such, FOXN3 may represent a relevant target for therapeutic interventions in patients suffering from drug-resistant melanoma.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"17 ","pages":"2505-2518"},"PeriodicalIF":1.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Overview of Commonly Used Natural Alternatives for the Treatment of Androgenetic Alopecia, with Special Emphasis on Rosemary Oil.","authors":"Nouf F Bin Rubaian, Haya Fahad Abdulaziz Alzamami, Baraa Abdulrazack Amir","doi":"10.2147/CCID.S470989","DOIUrl":"https://doi.org/10.2147/CCID.S470989","url":null,"abstract":"<p><p>Androgenetic alopecia is a chronic dermatological condition in which genetically predisposed individuals undergo progressive hair loss secondary to the effects of circulating androgens. It has been well documented that dihydrotestosterone binds to the androgenic receptors prevalent in the scalp, thus inducing miniaturization of the hair follicle. To date, the only FDA approved medications for the treatment of androgenetic alopecia are finasteride and minoxidil. A plethora of studies have been conducted testing the efficacy of various herbal compounds, but additional research is needed to further establish the concrete efficacy of such natural remedies in treating androgenetic alopecia. Of late, rosemary oil has gained mass popularity as a promising natural alternative. This review article will not only provide a detailed background on this ancient herbal component but will additionally overview all other major herbal alternatives including peppermint oil, tea tree oil, green tea, pumpkin seed oil, saw palmetto, and lavender oil and will summarize the latest clinical studies, which have tested their efficacy for the management of androgenetic alopecia.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"17 ","pages":"2495-2503"},"PeriodicalIF":1.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Chronic Nature of Generalized Pustular Psoriasis [Podcast].","authors":"Boni Elewski, Mark G Lebwohl","doi":"10.2147/CCID.S501061","DOIUrl":"https://doi.org/10.2147/CCID.S501061","url":null,"abstract":"<p><p>Generalized pustular psoriasis (GPP) is a rare, chronic, inflammatory skin disease characterized by persistent symptoms and sudden flares of painful, sterile pustules, and may be accompanied by systemic inflammation. Ongoing symptoms of GPP can have a serious impact on patient quality of life, morbidity, and mortality, and severe flares may be life-threatening if left untreated. Guidelines have been developed for the treatment of GPP flares; however, health care professionals and patients are lacking guidance on the management of long-term, persistent symptoms of GPP. Spesolimab is the only FDA-approved treatment for GPP and is approved for use in adults and pediatric patients aged 12 years or older and weighing at least 40 kg. Spesolimab recently gained FDA approval as a subcutaneous injection to treat GPP when patients are not experiencing a flare. In this podcast episode, we discuss what is known about the chronic disease burden of GPP and how persistent symptoms affect quality of life when patients are not experiencing a flare. We address the need for treatment guidelines for chronic GPP and discuss the results of the EFFISAYIL^® 2 clinical trial, which led to the approval of the subcutaneous formulation of spesolimab to treat GPP when patients are not experiencing a flare. Finally, we discuss what can be done to improve the treatment of patients with chronic GPP, both while experiencing a flare, and while living with persistent symptoms.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"17 ","pages":"2487-2493"},"PeriodicalIF":1.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11551722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Phenotype to Molecules: Unveiling the Genetic and Immunological Bridges Between Autoimmune Diseases and Vitiligo.","authors":"Yuan Hu, Shao-Bo Wang, Kun Wang, Ming-Jie He","doi":"10.2147/CCID.S488746","DOIUrl":"https://doi.org/10.2147/CCID.S488746","url":null,"abstract":"<p><strong>Introduction: </strong>Vitiligo is an autoimmune disease characterized by the loss of skin pigmentation. This study aims to explore genetic associations between vitiligo and 21 autoimmune diseases using Mendelian randomization (MR) analysis, with a focus on identifying potential risk and protective factors.</p><p><strong>Methods: </strong>We performed univariable and multivariable Mendelian randomization analyses to assess the causal associations between 21 autoimmune diseases and vitiligo. Confounding factors, including smoking, alcohol consumption, and Body Mass Index (BMI), were integrated into the multivariable analysis. Strongly associated single nucleotide polymorphisms (SNPs) were mapped to genes, followed by Summary-data-based Mendelian Randomization (SMR) analysis with expression Quantitative Trait Loci (eQTL) and methylation Quantitative Trait Loci (mQTL) data. Risk and protective factors were further identified by evaluating inflammatory mediators and immune cell phenotypes.</p><p><strong>Results: </strong>The MR analysis identified seven autoimmune diseases with potential causal associations with vitiligo. However, after accounting for confounding factors, only Hashimoto's thyroiditis and type 1 diabetes maintained genetic associations with vitiligo. Gene mapping revealed 25 intersecting genes between these two diseases and vitiligo. SMR analysis confirmed <i>Sulfite Oxidase (SUOX)</i> as a protective gene across multiple tissues. Furthermore, several inflammatory factors were identified as risk factors, including C-X-C motif chemokine ligand 9 (CXCL9), C-X-C motif chemokine ligand 10 (CXCL10), Tumor Necrosis Factor (TNF), and Signaling Lymphocytic Activation Molecule (SLAM). In contrast, Osteoprotegerin (OPG) was identified as a protective factor.</p><p><strong>Discussion: </strong>This study provides novel insights into the shared molecular mechanisms linking vitiligo with other autoimmune diseases. The identification of SUOX as a common protective gene and the discovery of specific inflammatory and immune-related factors may facilitate future therapeutic strategies.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"17 ","pages":"2475-2486"},"PeriodicalIF":1.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11546147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Prevention of Melasma During Pregnancy: Risk Factors and Photoprotection-Focused Strategies [Corrigendum].","authors":"","doi":"10.2147/CCID.S503955","DOIUrl":"https://doi.org/10.2147/CCID.S503955","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.2147/CCID.S488663.].</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"17 ","pages":"2445-2446"},"PeriodicalIF":1.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11546277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustained Repigmentation in Vitiligo and Leukodermas Using Melanocyte-Keratinocyte Transplantation: 7 Years of Data.","authors":"Nuttaporn Nuntawisuttiwong, Punyanut Yothachai, Teerapat Paringkarn, Chayada Chaiyabutr, Chanisada Wongpraparut, Narumol Silpa-Archa","doi":"10.2147/CCID.S485421","DOIUrl":"10.2147/CCID.S485421","url":null,"abstract":"<p><strong>Background: </strong>The autologous non-cultured melanocyte-keratinocyte transplantation procedure (MKTP) has emerged as an effective treatment for various types of vitiligo and leukodermas. However, there is limited data on the long-term outcomes of the MKTP, especially in Thai patients.</p><p><strong>Objective: </strong>To assess the long-term efficacy and safety of the MKTP in patients with vitiligo and other leukodermas.</p><p><strong>Methods: </strong>This retrospective observational study analyzed data from 23 patients who underwent the MKTP for vitiligo and other leukodermas at the Siriraj MKTP Clinic, Thailand, and had a follow-up period exceeding 12 months. Clinical characteristics and MKTP specifics were evaluated. Repigmentation outcomes were assessed using the Vitiligo Area Scoring Index (VASI).</p><p><strong>Results: </strong>Of the 23 patients (24 treated lesions), 78.3% had segmental vitiligo, while the others had nevus depigmentosus, nonsegmental vitiligo, or piebaldism. Most lesions (70.8%) were located on the face. At the 12-month follow-up, repigmentation showed an 80.8% ± 19.3% VASI improvement, which was sustained over 84 months with an 80%-90% VASI improvement. There was no statistically significant difference in repigmentation outcomes between facial and non-facial lesions.</p><p><strong>Conclusion: </strong>The MKTP demonstrated long-term efficacy and safety in treating vitiligo and other leukodermas, with sustained repigmentation over 84 months. These findings support the use of the MKTP as an effective treatment option for patients with refractory vitiligo and leukodermas, particularly within Thai populations.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"17 ","pages":"2447-2457"},"PeriodicalIF":1.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Satisfaction Among Recipients of Cosmetic Facial Filling Procedures at Dermatology Clinics in Saudi Arabia: A National Study.","authors":"Hend M Al-Atif, Abdulrhman Mohammed Alqarni, Abdularhman Abdullah Almuntashiri, Ali Saad Almuntashiri, Maram Ahmed Almarhabi","doi":"10.2147/CCID.S470437","DOIUrl":"10.2147/CCID.S470437","url":null,"abstract":"<p><strong>Purpose: </strong>Facial cosmetic procedures, known for their rising popularity, frequently yield high patient satisfaction. However, certain patient characteristics may influence this satisfaction. Additionally, patients' satisfaction can affect their attitudes and preferences toward these procedures and recommendations to others. Our study aimed to assess post-procedure satisfaction among individuals who have undergone cosmetic facial filling procedures at dermatology clinics.</p><p><strong>Patients and methods: </strong>This cross-sectional study targeted the Saudi population who had undergone cosmetic facial filling procedures, excluding individuals under 18, those with a history of mental health disorders, or invasive surgical procedures, as well as those unable or unwilling to provide informed consent. Data were collected using a comprehensive questionnaire covering demographics, procedure details, satisfaction, and future plans. A 5-point Likert scale was used to assess self-perception and satisfaction. The questionnaire was developed after expert consultation and a literature review, with overall satisfaction calculated as the mean of all items.</p><p><strong>Results: </strong>In this study of 408 participants in Saudi Arabia, predominantly young, unmarried females, high satisfaction levels were observed following cosmetic facial filling procedures, with a mean score of 3.9 for procedure results and 3.8 for meeting expectations. Most participants were Saudi nationals (97.8%), aged below 25 (41.7%), and held Bachelor's degrees (80.6%), with a majority being females (87.7%). Notably, factors significantly affecting overall satisfaction included gender (p = 0.001), marital status (p = 0.023), income (p = 0.031), procedure duration (p = 0.003), and procedure type (p = 0.046). These findings offer crucial insights for enhancing patient experiences and outcomes in cosmetic facial filling procedures.</p><p><strong>Conclusion: </strong>This study unveiled substantial self-satisfaction levels, particularly regarding appearance and social well-being, emphasizing the significance of informative pre-procedure guidance, while gender, marital status, income, procedure duration, and type significantly impacted satisfaction. Healthcare providers must heed these factors to enhance patient contentment and overall procedure success.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"17 ","pages":"2465-2474"},"PeriodicalIF":1.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI in Hidradenitis Suppurativa: Expert Evaluation of Patient-Facing Information.","authors":"Anne-Cécile Ezanno, Anne-Claire Fougerousse, Christelle Pruvost-Balland, François Maccari, Charlotte Fite","doi":"10.2147/CCID.S478309","DOIUrl":"10.2147/CCID.S478309","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigates the accuracy of Artificial Intelligence (AI) chatbots, ChatGPT and Bard, in providing information on Hidradenitis Suppurativa (HS), aiming to explore their potential in assisting HS patients by offering insights into symptoms, thus possibly reducing the diagnostic and treatment time gap.</p><p><strong>Patients and methods: </strong>Using questions formulated with the help of HS patient associations, both ChatGPT and Bard were assessed. Responses to these questions were evaluated by 18 hS experts.</p><p><strong>Results: </strong>ChatGPT's responses were considered accurate in 86% of cases, significantly outperforming Bard, which only achieved 14% accuracy. Despite the general efficacy of ChatGPT in providing relevant information across a range of HS-related queries, both AI systems showed limitations in offering adequate advice on treatments. The study identifies a significant difference in the performance of the two AIs, emphasizing the need for improvement in AI-driven medical advice, particularly regarding treatment options.</p><p><strong>Conclusion: </strong>The study highlights the potential of AI chatbots, particularly ChatGPT, in supporting HS patients by improving symptom understanding and potentially reducing the time to diagnosis and treatment. AI chatbots, while promising, cannot yet substitute for professional medical diagnosis and treatment, indicating the importance of enhancing AI capabilities for more accurate and reliable medical information dissemination.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"17 ","pages":"2459-2464"},"PeriodicalIF":1.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}