Golnaz Majdizadeh, Mina Beytollahi, Abolghasem Djazayery, Ariyo Movahedi
{"title":"Role of Branched and Aromatic Amino Acids, Diet Inflammatory Index, and Anthropometric Indices on Mental Health.","authors":"Golnaz Majdizadeh, Mina Beytollahi, Abolghasem Djazayery, Ariyo Movahedi","doi":"10.4103/ijpvm.ijpvm_59_23","DOIUrl":"10.4103/ijpvm.ijpvm_59_23","url":null,"abstract":"<p><strong>Background: </strong>Mental health disorders are one of the most important and increasing health problems in the youth of today's societies. Some dietary intake and body mass status are factors that affect mental health. This study aimed to investigate the relationship between the intake of branched-chain amino acids (BCAAs) and aromatic amino acids (AAAs) and anthropometric and dietary inflammatory indices with mental health, including depression, anxiety, and stress.</p><p><strong>Methods: </strong>In this case-control study, the data of 138 teenage girls aged 13-18 years were collected. Three-day 24-hour food recall and standard anthropometric methods were used to calculate the dietary inflammation intake score of normal and energy-adjusted diets. Mental health disorders were diagnosed by the DASS-21 questionnaire. Statistical analysis used Student's <i>t</i>-test, correlation, and multiple regression were used to analyze the data based on the study's statistical requirements.</p><p><strong>Results: </strong>Based on the findings, 59 (42%) of the girls had mental disorders, and 79 (58%) were healthy. The average weight of stressed people was significantly higher than that of healthy people, and the BMI of anxious people was significantly higher than that of nonanxious people (<i>P</i> < 0.05). A significant positive correlation was found between stress and weight and energy intake. Additionally, there was a significant negative correlation between BCAAs and mental health. The average intake of BCAAs was significantly lower in patients (<i>P</i> = 0.01). The trend analysis showed significantly lower BCAA levels among the 4<sup>th</sup> quartile of mental disorders. No significant relationship was observed between DII, AAA, and anthropometric indices. After adjustment of the results, no relationship was observed between mental health and the studied factors.</p><p><strong>Conclusions: </strong>BCAA might be related to mental health. Further studies in different age and sex groups are highly recommended.</p>","PeriodicalId":14342,"journal":{"name":"International Journal of Preventive Medicine","volume":"15 ","pages":"23"},"PeriodicalIF":1.7,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11338367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Advancing Diabetes Self-Management: A Novel Smartphone Application Featuring a Scoring Algorithm for Tailored User Engagement.","authors":"Mohammad A Tebianian, Soodeh Razeghi Jahromi","doi":"10.4103/ijpvm.ijpvm_268_23","DOIUrl":"10.4103/ijpvm.ijpvm_268_23","url":null,"abstract":"<p><strong>Background: </strong>We developed and evaluated an intelligent diabetes assistant application (Diabetter) for the self-management of diabetes. It suggested that increasing the patient's interest and participation in using smartphone apps is important for the effectiveness of diabetes management apps.</p><p><strong>Methods: </strong>After evaluating all-encompassing features for diabetes management, we divided the selected factors into sub-factors for use in the application. Then, we created the first high-fidelity prototype using related programs and conducted early user testing to validate and improve Diabetter. To handle the user transaction time and keep them motivated, we designed and implemented a scoring system based on the nudge theory rules within the app.</p><p><strong>Results: </strong>To evaluate Diabetter's impact on diabetes self-management, we measured HbA1c levels after a prolonged period. The Diabetter prototype was developed and modified in a revised version for better user interaction with the app. The scoring system increased the input of users' information, which resulted in more analysis and recommendations to users. Clinical studies showed that as a result of continuous input of information from users who had been using the application for a longer period of time, their HbA1c levels were within the healthy range.</p><p><strong>Conclusions: </strong>The results demonstrate that the Diabetter application has been able to play an effective role in diabetes self-management by increasing users' app usage time. However, future study is needed to provide a better interpretation.</p>","PeriodicalId":14342,"journal":{"name":"International Journal of Preventive Medicine","volume":"15 ","pages":"20"},"PeriodicalIF":1.7,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11338364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Solitary Functioning Kidneys Attenuate Renal Hemodynamics Responses to Angiotensin II in Male But Not in Female Rats.","authors":"Zahra Pezeshki, Mehdi Nematbakhsh","doi":"10.4103/ijpvm.ijpvm_195_23","DOIUrl":"10.4103/ijpvm.ijpvm_195_23","url":null,"abstract":"<p><strong>Backgrounds: </strong>People with solitary functioning kidneys (SFK) are prone to renal failure with time. Accordingly, local renin angiotensin system (RAS) and renal functions in subjects with SFK may act differently compared to normal condition. This study was designed to determine the renal hemodynamics responses to angiotensin II (Ang. II) in SFK male and female rats.</p><p><strong>Methods: </strong>Fifty to sixty-day-old male and female Wistar rats were subjected to unilateral renal artery obstruction, and 28 days later basal renal hemodynamic responses to Ang. II were examined in SFK groups compared to sham groups.</p><p><strong>Results: </strong>The findings indicated lower renal vascular resistance (RVR) and renal blood flow (RBF) responses to Ang. II in male SFK compared to sham group. Such observation was not seen in female animals.</p><p><strong>Conclusions: </strong>An increase in renal metabolism due to hyperfunction, especially in SFK male rats, may cause a decrease in RVR. Moreover, the lower RBF response to Ang. II may be related to alteration to Ang. II receptors in the remnant kidneys in SFK rats.</p>","PeriodicalId":14342,"journal":{"name":"International Journal of Preventive Medicine","volume":"15 ","pages":"19"},"PeriodicalIF":1.7,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11338366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amirreza Manteghinejad, Sina Rasti, Maryam Nasirian, Shaghayegh Haghjooy Javanmard
{"title":"Association of Prior COVID-19 Infection with Risk of Breakthrough Infection Following Vaccination: A Cohort Study in Isfahan, Iran.","authors":"Amirreza Manteghinejad, Sina Rasti, Maryam Nasirian, Shaghayegh Haghjooy Javanmard","doi":"10.4103/ijpvm.ijpvm_173_23","DOIUrl":"10.4103/ijpvm.ijpvm_173_23","url":null,"abstract":"<p><strong>Background: </strong>Many people worldwide have developed a combination of natural and vaccine-induced immunity to COVID-19. This study investigated whether exposure to SARS-CoV-2 before full vaccination promotes protection against a breakthrough infection.</p><p><strong>Methods: </strong>We studied a total of 2,902,545 people in the Isfahan COVID-19 Registry. All the participants had received two doses of either Sinopharm BIBP, ChAdOx1-nCoV-19, Gam-COVID-Vac, or BIV1-CovIran vaccines. A cohort study examined the association between prior COVID-19 infection and the risk of a breakthrough infection for each vaccine. Cohorts in each pair were matched by gender, age group, calendar week of the first dose, the interval between the first and second doses, and the proportion of healthcare workers. The probable virus variant for the previous infections was also considered. Each individual's follow-up started 14 days after their second vaccine dose until either the end of the study censoring date, occurrence of a COVID-19 infection, or death. The breakthrough infection risk was compared between each cohort pair by using the hazard ratio (HR) and incidence rate ratio (IRR).</p><p><strong>Results: </strong>Total breakthrough HRs (95% confidence interval) (previously infected over infection-naïve matched cohort) were 0.36 (0.23-0.55), 0.35 (0.32-0.40), 0.37 (0.30-0.46), and 0.43 (0.32-0.56) for the BIV1-CovIran, Sinopharm BIBP, Gam-COVID-Vac, and ChAdOx1-nCoV-19 vaccine groups, respectively. The breakthrough infection IRRs were approximately similar to the total HRs mentioned above.</p><p><strong>Conclusion: </strong>Prior SARS-CoV-2 infection conferred additive immunity against breakthrough after vaccination, no matter which vaccine brand was injected. Such a result could guide health authorities to codify low-cost high-benefit vaccination protocols and protect the community's well-being.</p>","PeriodicalId":14342,"journal":{"name":"International Journal of Preventive Medicine","volume":"15 ","pages":"18"},"PeriodicalIF":1.7,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11338365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Developing an intelligent prediction system for successful aging based on artificial neural networks.","authors":"Raoof Nopour, Hadi Kazemi-Arpanahi","doi":"10.4103/ijpvm.ijpvm_47_23","DOIUrl":"10.4103/ijpvm.ijpvm_47_23","url":null,"abstract":"<p><strong>Background: </strong>Due to the growing number of disabilities in elderly, Attention to this period of life is essential to be considered. Few studies focused on the physical, mental, disabilities, and disorders affecting the quality of life in elderly people. SA<sup>1</sup> is related to various factors influencing the elderly's life. So, the objective of the current study is to build an intelligent system for SA prediction through ANN<sup>2</sup> algorithms to investigate better all factors affecting the elderly life and promote them.</p><p><strong>Methods: </strong>This study was performed on 1156 SA and non-SA cases. We applied statistical feature reduction method to obtain the best factors predicting the SA. Two models of ANNs with 5, 10, 15, and 20 neurons in hidden layers were used for model construction. Finally, the best ANN configuration was obtained for predicting the SA using sensitivity, specificity, accuracy, and cross-entropy loss function.</p><p><strong>Results: </strong>The study showed that 25 factors correlated with SA at the statistical level of <i>P</i> < 0.05. Assessing all ANN structures resulted in FF-BP<sup>3</sup> algorithm having the configuration of 25-15-1 with accuracy-train of 0.92, accuracy-test of 0.86, and accuracy-validation of 0.87 gaining the best performance over other ANN algorithms.</p><p><strong>Conclusions: </strong>Developing the CDSS for predicting SA has crucial role to effectively inform geriatrics and health care policymakers decision making.</p>","PeriodicalId":14342,"journal":{"name":"International Journal of Preventive Medicine","volume":"15 ","pages":"10"},"PeriodicalIF":2.1,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10982733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140335632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Atefe Torabi, Jalil Reisi, Mehdi Kargarfard, Marjan Mansourian
{"title":"Differences in the Impact of Various Types of Exercise on Irisin Levels: A Systematic Review and Meta-Analysis.","authors":"Atefe Torabi, Jalil Reisi, Mehdi Kargarfard, Marjan Mansourian","doi":"10.4103/ijpvm.ijpvm_76_23","DOIUrl":"10.4103/ijpvm.ijpvm_76_23","url":null,"abstract":"<p><strong>Background: </strong>Irisin, a myokine that is responsive to exercise, induces significant changes in subcutaneous adipose tissue. By promoting the browning of white fat tissue, it enhances energy expenditure, thereby addressing overweight and obesity. This systematic review and meta-analysis aimed to compare the effects of different types of physical exercises on irisin levels in overweight and obese adults.</p><p><strong>Methods: </strong>Specifically, the review focused on studies involving obese or overweight individuals who participated in exercise training for a minimum of 8 weeks, with measured and reported changes in serum irisin levels compared to a control group. Data were collected from four databases (Google Scholar, ISI Web of Science Core Collection, PubMed, and Scopus). The risk of bias was assessed using the Begg and Egger tests, and the results were synthesized.</p><p><strong>Results: </strong>Initial searches identified 560 titles, out of which only seven met the criteria for inclusion in the systematic review. Statistical analysis demonstrated a significant increase in serum irisin concentration (SMD = 0.957, <i>P</i> = 0.005) among obese and overweight individuals who engaged in exercise, compared to the passive control group. High-intensity interval training (HIIT) (SMD = 1.229, <i>P</i> < 0.001) had a more pronounced effect on increasing serum irisin levels than other exercise protocols. Furthermore, the effectiveness of exercise varied based on the participants' weight status (significant changes for overweight individuals; <i>P</i> < 0.001 and insignificant changes for obese individuals; <i>P</i> = 0.1), age (significant changes for those under 40 years old; <i>P</i> < 0.001 and insignificant changes for those over 40 years old; <i>P</i> = 0.322), and gender (significant changes for men; <i>P</i> < 0.001 and insignificant changes for women; <i>P</i> = 0.285).</p><p><strong>Conclusions: </strong>Consequently, exercise can elevate serum irisin levels, leading to alterations in adipose tissue phenotype and thermogenesis, ultimately contributing to weight reduction in obese and overweight individuals.</p>","PeriodicalId":14342,"journal":{"name":"International Journal of Preventive Medicine","volume":"15 ","pages":"11"},"PeriodicalIF":2.1,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10982734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140335633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Screen Time and Child Behavioral Disorders During COVID-19 Pandemic: A Systematic Review.","authors":"Maryam Abdoli, Mohadeseh Khoshgoftar, Hosin Jadidi, Seyede Shahrbanoo Daniali, Roya Kelishadi","doi":"10.4103/ijpvm.ijpvm_78_23","DOIUrl":"10.4103/ijpvm.ijpvm_78_23","url":null,"abstract":"<p><strong>Background: </strong>The extensive use of various electronic games and communication devices, particularly among children and adolescents, has raised concerns, particularly during the COVID-19 pandemic. This study investigated the link between screen time and internalizing disorders, such as anxiety and depression, among individuals aged ≤18 during the global COVID-19 pandemic.</p><p><strong>Methods: </strong>This systematic review aims to summarize scientific publications from 2019 to early 2022 by searching databases, including the Cochrane Library, PubMed, Web of Science, Scopus, and PsycINFO, to identify suitable studies. In each paper, we searched the following keywords and their synonyms: screen, child, high school, middle school, and psychiatric disorders. The quality of the selected papers was evaluated using a checklist recommended by the National Institutes of Health (NIH) for observational cohort studies.</p><p><strong>Results: </strong>Out of 986 reports identified, we included 12 papers with 14,483 participants. The study revealed a negative correlation between screen time (TV, computer, video games, and mobile phones) and behavioral outcomes. Smartphones were the most frequently used devices, with video games being more prevalent among older participants for education, communication, and entertainment purposes. The prevalence of depression ranged between 10% and 25%. Furthermore, anxiety and depression were identified as predictors of increased screen usage. Some results displayed variation based on the type of screen exposure, the questionnaires used, and the age of the participants.</p><p><strong>Conclusions: </strong>The findings imply an indirect association between increased screen time and depression and anxiety. It is crucial to consider limitations on screen time exposure and parental supervision as measures to prevent certain mental disorders.</p>","PeriodicalId":14342,"journal":{"name":"International Journal of Preventive Medicine","volume":"15 ","pages":"9"},"PeriodicalIF":2.1,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10982732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140335634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marziye Hadian, Zahra Khakdel Jelodar, Mohammadreza Jabbari Khanbebin, Pezhman Atafimanesh, Ali Sarabi Asiabar, Seyed Mehdi Hejazi Dehagani
{"title":"Challenges of Implementing Telemedicine Technology: A systematized Review.","authors":"Marziye Hadian, Zahra Khakdel Jelodar, Mohammadreza Jabbari Khanbebin, Pezhman Atafimanesh, Ali Sarabi Asiabar, Seyed Mehdi Hejazi Dehagani","doi":"10.4103/ijpvm.ijpvm_48_23","DOIUrl":"10.4103/ijpvm.ijpvm_48_23","url":null,"abstract":"<p><strong>Background: </strong>Today, the technologies in the world are rapidly evolving, and global infrastructure of information is spreading rapidly. The health system of different countries is facing a variety of challenges in order to apply telemedicine services. The aim of this study was to determine the challenges facing the health system of different countries in the application of telemedicine.</p><p><strong>Method: </strong>The present research was conducted in 2022 as a systematized review of studies related to challenges of telemedicine. In this study, Preferred Reporting Items for Systematic Reviews (PRISMA) and Critical Appraisal Skills Program (CASP) guidelines were used to assess the articles. The keywords \"telemedicine,\" \"telehealth,\" \"E-health,\" and \"tele care\" were used in combination with the Boolean operators OR and AND. The ISI Web of Science, PubMed, Scopus, Science Direct, Ovid, Pro Quest, Wiley, and Google Scholar were searched.</p><p><strong>Results: </strong>In this study, based on the search strategy, databases were searched from January 2012 to January 2022, and in the final stage, analysis was performed on 27 selected identified articles. The use of telemedicine technology faced major formality and legality, required bandwidth, development of multilingual systems, economic efficiency, available patterns, payment for services, moral barriers, social status, differences and national and legal contradictions in the world, lack of insurance coverage challenges, and so on. Recognizing gaps and challenges can provide a way to fill these gaps and create opportunities for improvement.</p><p><strong>Conclusions: </strong>Utilizing telemedicine technology can be considered as an effective step in the health system. This technology has weaknesses that may challenge it. Successful application of telemedicine technology cannot be very effective without removing these barriers.</p>","PeriodicalId":14342,"journal":{"name":"International Journal of Preventive Medicine","volume":"15 ","pages":"8"},"PeriodicalIF":2.1,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10982727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140335631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Relationship between Healthy Eating Index and Lipid Profile in Healthy Individuals: A Systematic Review.","authors":"Hossein Faraji, Sanaz Jamshidi, Suzie Ferrie, Pouria Sefidmooye Azar","doi":"10.4103/ijpvm.ijpvm_404_22","DOIUrl":"10.4103/ijpvm.ijpvm_404_22","url":null,"abstract":"<p><strong>Background: </strong>The Healthy Eating Index (HEI) and Alternate Healthy Eating Index (AHEI) are instruments developed by competing American research teams, aiming to assess the level of adherence to a dietary pattern, claimed to prevent chronic illness conditions such as dyslipidemia. This systematic review evaluated cross-sectional studies examining the association between HEI/AHEI score and the lipid profile in healthy participants.</p><p><strong>Methods: </strong>The systematic review was Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) compliant, and a search process was conducted through Scopus, Web of Knowledge, Google Scholar, Cochrane, PubMed, and ScienceDirect up to November 2022. Studies assessing the relationship between HEI/AHEI and lipid profile (low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG)) were eligible for inclusion. The statistical differences in outcomes, anthropometric indices, and demographic data were extracted from the selected studies. Also, the quality assessment of studies was performed using the Newcastle-Ottawa scale.</p><p><strong>Results: </strong>The systematic search presented 17 cross-sectional studies. Most of the studies revealed a significant correlation between HEI score and lipid profile (LDL-C, HDL-C, TG, and TC) (<i>P</i> < 0.05), while a few of them indicated a significant relationship between AHEI score and these factors. Overall, the elevation of HEI/AHEI score was associated with the improvement in lipid profile (<i>P</i> < 0.05), though this association was more obvious for HEI compared with AHEI.</p><p><strong>Conclusions: </strong>Overall, the results of the study indicated that an improved lipid profile in healthy individuals is associated with a higher score in either HEI or AHEI. Further research in the future is required to confirm the claim.</p>","PeriodicalId":14342,"journal":{"name":"International Journal of Preventive Medicine","volume":"15 ","pages":"6"},"PeriodicalIF":2.1,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10935573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140131431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}