{"title":"Sistematik Bir İnceleme ve Meta-Analiz: Pediatrik ve Ergen Popülasyonlarda Akut Migren Tedavisi","authors":"Emine ÖZDEMİR KAÇER, Can ATEŞ","doi":"10.16899/jcm.1347057","DOIUrl":"https://doi.org/10.16899/jcm.1347057","url":null,"abstract":"Backgrounds: The array of medications used to treat acute migraine in adults is extensive, with several now authorized for use in children and adolescents in outpatient settings. 
 Aims: The aim of this meta-analysis was to evaluate the impact of pharmacological interventions, regardless of the method of delivery, compared to placebo, in treating migraine among individuals aged 18 years or younger. 
 Materials and Methods: We searched PubMed, EMBASE, and Cochrane Library for comparative RCTs published 30 years before May 2023. We included prospective randomized controlled clinical trials of children and adolescents with migraine, comparing acute symptom-relieving migraine medications with a placebo. 
 Results: Twelve clinical trials were included in this meta-analysis. The migraine treatment choice and the proportion of patients with complete pain relief at 2 hours post-treatment were analyzed. Ibuprofen (n=2), sumatriptan (n=3), zolmitriptan (n=3), and rizatriptan (n=4) were used for the analysis. Notably, sumatriptan did not exhibit significant differences compared to placebo, despite mixed individual study outcomes (OR:1.35; 95% CI 0.81, 2.27). Rizatriptan displayed varying efficacies across age groups, showing no significant difference in adolescents aged 12-17 years (p>0.05). Zolmitriptan showed dose-dependent effectiveness, with higher doses yielding better outcomes (OR:2.18; 95% CI 1.45,3.28). Ibuprofen emerged as the sole non-triptan medication to demonstrate efficacy in achieving pain-free status at 2 hours, with a favorable safety profile (OR:2.54; 95% CI 1.20, 5.37).
 Conclusion: These findings suggest that ibuprofen, zolmitriptan, and rizatriptan are potential treatment options for rapidly relieving migraine in children and adolescents. However, ibuprofen may have advantages over triptans, owing to its convenience and cost-effectiveness.","PeriodicalId":15449,"journal":{"name":"Journal of contemporary medicine","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136343291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Merve HAVAN, Ali TUNÇ, Murat ERSOY, Mahmut ASLAN, Arman APİ
{"title":"Çocuk Yoğun Bakım Ünitesinde Trakeostomi Uygulamaları, Tek Merkez Deneyimi","authors":"Merve HAVAN, Ali TUNÇ, Murat ERSOY, Mahmut ASLAN, Arman APİ","doi":"10.16899/jcm.1355300","DOIUrl":"https://doi.org/10.16899/jcm.1355300","url":null,"abstract":"Background/Aims: Tracheostomy is one of the most frequently performed surgical procedures in the pediatric intensive care unit (PICU). While it used to be an emergency treatment method in patients with laryngeal obstruction, it is now mostly used in patients with prolonged mechanical ventilation under elective conditions. In this study, we aimed to evaluate patients who underwent tracheostomy in our PICU, indications, and complications.
 Methods: This retrospective study was conducted from February 2018 through April 2022. Data was collected from the patient’s records and analyzed.
 Results: Forty-three patients were included in the study. The median age of the patients was 5±4.99 (0-17 years) and 30 patients (69.8%) were male. During the four-year study period, the tracheostomy rate was 2.4% and the decannulation rate was 7%. All of the patients were discharged home with the home ventilator. The most common indication for tracheostomy was prolonged mechanical ventilation (88.3%). The median time of mechanical ventilation before tracheostomy was 111.6±57.22 (range 0-240) days. No surgical complications were observed during the PICU follow-up. All patients were discharged from PICU with a home-type mechanical ventilator. The median number of outpatient controls after discharge was 7.28±1.89 (range 3-10), and the median number of annual cannula replacements was 3.62±0.76 (range 1-5). 14 patients died after discharge from the PICU. None of the patients died due to tracheostomy complications. The median time of death was 30±13.97 (range 11-56) days after discharge from the PICU. When the surviving and deceased patients were compared according to age, mechanical ventilation time, and length of stay in the PICU, no significant difference was found (p=0.291, p=0.115, and p=0.291, respectively).
 Conclusions: In our study, long mechanical ventilation time was the most common indication for tracheostomy, and our result is consistent with the literature. Although the timing of tracheostomy was long, no significant correlation was observed with mortality.","PeriodicalId":15449,"journal":{"name":"Journal of contemporary medicine","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136343453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Beyza ÖZCAN, Melek BÜYÜKEREN, Aytaç KENAR, Ramazan KEÇECİ
{"title":"Clinical Observation in Premature Babies with Feeding Intolerance","authors":"Beyza ÖZCAN, Melek BÜYÜKEREN, Aytaç KENAR, Ramazan KEÇECİ","doi":"10.16899/jcm.1320497","DOIUrl":"https://doi.org/10.16899/jcm.1320497","url":null,"abstract":"Objective: Feeding intolerance (FI) is a digestive disorder that manifests itself with gastric residue, abdominal distension, and vomiting, especially in preterm infants, and often causes a prolongation of the transition to full enteral feeding. Nutrition strategy is a significant clinical challenge for neonatologists. It is tried to treat feeding intolerance with methods such as minimal enteral nutrition and slow increase in sustenance, probiotic use, prevention/treatment of NEC and sepsis, and use of specially formulated foods, but these methods are only partially effective.
 Methods: Babies under 32 weeks and 1500 g hospitalized in Konya City Hospital between August 2020 and January 2022 were evaluated retrospectively. Babies with and without feeding intolerance were divided into two groups, and their demographic and clinical conditions were examined. The treatment modalities of the group with feeding intolerance were evaluated.
 Results: Of the 86 patients in the study, 36 were included in the FI group, and 50 were in the healthy control group. Late neonatal sepsis and duration of parenteral nutrition were found to be statistically significantly higher in the group with feeding intolerance compared to the control group (p","PeriodicalId":15449,"journal":{"name":"Journal of contemporary medicine","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136343483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mehmet ÇELİK, Ufuk ACAR, Fethiye AKGUL, Yusuf ARSLAN, Mehmet Reşat CEYLAN
{"title":"COVID-19 salgını sonrası mpox (maymun çiçeği) salgını tehdidi: Sağlık çalışanları yeni psikolojik savaşlara hazır mı?","authors":"Mehmet ÇELİK, Ufuk ACAR, Fethiye AKGUL, Yusuf ARSLAN, Mehmet Reşat CEYLAN","doi":"10.16899/jcm.1319280","DOIUrl":"https://doi.org/10.16899/jcm.1319280","url":null,"abstract":"Aims: In this study, it was aimed to evaluate the psychological status of healthcare professionals regarding the COVID-19 pandemic, and to examine their perspectives and knowledge levels regarding the mpox epidemic.
 Methods: Having a cross-sectional design, the present study was carried out by using questions addressing sociodemographic characteristics of healthcare professionals, their experiences with the COVID-19 pandemic, and their knowledge and anxiety levels regarding mpox. 
 Results: 202 healthcare professionals were involved in the present study. Of the participants, 55% were female and the mean age was 35.0±7.7 years. The majority (63.4%) of the participants were midwives/nurses/medical assistants. Of the participants, 68.8% were infected by COVID-19 during the pandemic. Considering the questions addressing their level of knowledge about mpox, 44.1% of participants stated that they had never heard of this disease before. Participants were found to have mainly moderate levels of depression and anxiety and low level of stress, whereas the ratios of very severe depression and anxiety were 5.0% and 7.4%, respectively.
 Conclusion: It was determined that almost half of the participants had no full knowledge of the disease before the increase in mpox cases. It was found that the participants varying levels of depression, anxiety, and stress about a new pandemic. We think that it is important to provide healthcare professionals with psychosocial support, make effort in order to determine and eliminate the sources of psychological negativities.","PeriodicalId":15449,"journal":{"name":"Journal of contemporary medicine","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136343484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluation of Scientific Publications on Osteoblastoma Published between 2000 and 2022","authors":"Selçuk YILMAZ, Mehmet KURT","doi":"10.16899/jcm.1317474","DOIUrl":"https://doi.org/10.16899/jcm.1317474","url":null,"abstract":"Objective: The aim of this bibliometric study was to review the scientific outputs published between 2000 and 2022 on osteoblastoma, a benign aggressive bone tumor.
 Methods: Scientific research articles on osteoblastoma published between 2000 and 2022 were targeted and data were obtained from the Web of Science database. The data obtained were analyzed and visualized using bibliometric programs.
 Results: A total of 679 articles about osteoblastoma published between 2000-2022 met our inclusion criteria. Most of the articles on osteoblastoma (n=48) were published in 2020. There was no noteworthy peak in the trend of the number of publications between 2000 and 2022. These articles cited 10366 times in total and 15.27 times per article. At least 62 various countries and regions took part in osteoblastoma publishing research over the past 22 years. The United States (192) was the largest contributor to osteoblastoma publications followed by China (60), India (51), Italy (50), and Turkey (46). The United States was the country that published the most publications in all years between 2000 and 2022. Especially China's publications increased in 2022. The United States was also the country with the highest level of publication collaboration (such as citation and co-authorship) among countries.
 Conclusion: The number of published articles is well below the expected level. Although the number of scientific publications from China has increased in recent years, the United States still ranks first.","PeriodicalId":15449,"journal":{"name":"Journal of contemporary medicine","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136343486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"İmmunsupresif Tedavi Alan Hastalarda HBV Reaktivasyonu ve Antiviral Profilaksinin Değerlendirilmesi","authors":"Ahmet ŞAHİN, Selda ASLAN","doi":"10.16899/jcm.1343166","DOIUrl":"https://doi.org/10.16899/jcm.1343166","url":null,"abstract":"Aim: Patients with chronic hepatitis B and people with a history of hepatitis B (HBV) infection are at risk of HBV reactivation (HBVr) when they receive immunosuppressive therapy. In this study, we aimed to evaluate the hepatitis B serology, risk groups and antiviral prophylaxis of patients receiving various immunosuppressive therapies due to rheumatological diseases.
 Material and Method: The study included 375 patients over 18 years of age who received tumor necrosis factor-α (TNF-α) inhibitor, tyrosine kinase inhibitor, steroids, methotrexate or anti-CD20 antibodies due to rheumatic diseases in a training and research hospital between May 2022 and May 2023. Hepatitis B surface antigen (HbsAg), hepatitis B surface antibody (anti-Hbs), hepatitis B core protein antibody (anti-Hbc IgG) serologies, immunosuppressive therapies and oral antivirals were retrospectively analyzed.
 Results: The average age of the 375 patients included in the study was 43.77±13.07 years. 193 (51.5%) of the patients were male. 11 patients were HbsAg positive, 150 patients were anti-Hbs positive, 19 patients were isolated anti-Hbc IgG positive, and 79 patients were both anti-Hbs and anti-Hbc IgG positive. According to serological findings, 109 (29%) patients had HBV exposure. All three test results of 194 (51.7%) patients were negative. A total of 85 (22.7%) patients received oral antiviral prophylaxis due to the use of immunosuppressive agents. In terms of HBVr, 16.5% were evaluated as high risk, 75.3% as moderate risk, and 8.2% as low risk. Out of 85 patients 79 received entecavir, 5 reveived tenofovir disoproxil fumarate (TDF) and 1 received tenofovir alafenamide fumarate (TAF). The mean duration for the immunosuppressive therapy was 6.41±4.20 years. The mean duration of oral antiviral prophylaxis among patients was 1.02±1.72 years. HBVr was not observed in any of our patients.
 Conclusion: Before patients receive immunosuppressive therapy, hepatitis B serologies and prophylaxis indication should be evaluated firstly. In addition, as a preventive medicine activity, hepatitis B vaccinations of unvaccinated patients should be completed as quickly as possible.","PeriodicalId":15449,"journal":{"name":"Journal of contemporary medicine","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136343593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Esma KEPENEK KURT, Mehmet ÖZDEMİR, Fatma ESENKAYA TAŞBENT, İbrahim ERAYMAN
{"title":"Üçüncü Basamak Üniversite Hastanesinde Takip Edilen Altı SARS-CoV-2 Pozitif Hastanın Tüm Genom Dizi Analizi","authors":"Esma KEPENEK KURT, Mehmet ÖZDEMİR, Fatma ESENKAYA TAŞBENT, İbrahim ERAYMAN","doi":"10.16899/jcm.1312540","DOIUrl":"https://doi.org/10.16899/jcm.1312540","url":null,"abstract":"Aims: In this study, we aimed to determine mutations in the gene sequence of this virus, by performing whole genome sequence analysis from patient samples found positive by actual RT-PCR (PCR) for SARS-CoV-2.
 Methods: The study included six adult patient samples with different clinical manifestations with positive PCR tests for SARS-CoV-2, between June 01, 2020, and March 12, 2021. Sequence knowledge of all samples/testers has been loaded into the GISEAD (Global Initiative on Sharing All Influenza Data) data system. Clade Analysis, Genome Analysis, Variant Analysis, and Phylogenetic Tree Analysis were conducted.
 Results: 3 of the patients were women (female), and three were men(male), with the mean age of 42.5 years old (between 20 - 61). Totally 71 mutations were specified in 6 adult patients. By the Pangolin lineage, three of the patients were B.1.177, two were B.1, one was of B1.36 lineage. By the Pango lineage, two of the patients were B.1.609, one was B.177, one was B.1.36. By the Nexstrain Clade, four of the patients were 20A and two were of 19A lineage. No D614G mutation was detected in any of the patients. While five patients recovered, one patient with metastatic lung adenocarcinoma died.
 Conclusion; The patients were detected in the commonly found 'Non-VOC' group. Therefore, variants could not be associated with the clinical status and prognosis of the patients. However, it is thought that the data obtained contribute to both global and national SARS-CoV-2 data.","PeriodicalId":15449,"journal":{"name":"Journal of contemporary medicine","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136343597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparison of Abdominal Initial Entry Techniques in Gynecological Laparoscopy","authors":"Elif GUNDOGDU, Taner USTA","doi":"10.16899/jcm.1338911","DOIUrl":"https://doi.org/10.16899/jcm.1338911","url":null,"abstract":"Objective: The aim of this study is to assess the safety of laparoscopic entry techniques.
 Materials and Methods: Within the scope of the study, medical records of patients who underwent laparoscopy due to various gynecological indications at our clinic between January 1, 2011, and July 1, 2015, were examined. Evaluation was conducted using our hospital’s electronic database.
 Results: In the patient cohort, direct trocar placement was preferred in 91.8% (1025 patients), Veress needle placement was used in 7.4% (82 patients), and an open technique was used in 0.8% (9 patients). In terms of entry sites, umbilicus was the most commonly chosen option, being preferred in 97.2% (1085 patients) of cases. In 2.4% of patients (27 patients), the midline abdominal trocar was preferred as the initial trocar insertion site. Among these patients, suprapubic incision was preferred in 62% (17 patients), while Lee-Huang point was chosen as the entry site in 38% (10 patients).Looking at the history of previous surgeries, 18.5% (206 patients) had a history of prior abdominal surgery, and 3.5% (39 patients) had undergone two previous surgical procedures. Only 0.1% (1 patient) had undergone three or more abdominal surgeries.
 Discussion: In conclusion, no clear superiority of one initial entry technique over another has been proven. Despite the extensive literature on laparoscopic entry, debates regarding the most effective method to prevent significant complications continue.","PeriodicalId":15449,"journal":{"name":"Journal of contemporary medicine","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136343657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mülteci çocukların renal sağlığı: süregelen bir zorluk","authors":"Sevgin TANER, Gunay EKBERLİ","doi":"10.16899/jcm.1341018","DOIUrl":"https://doi.org/10.16899/jcm.1341018","url":null,"abstract":"Aim: Its geographical proximity to Syria makes Turkey an important destination and transit country for refugees from various countries. The aim of this study is to determine the kidney and urological disease profile and to reveal the ongoing problems of refugee children who applied to a single center in Adana, home to a dense refugee population. To the best of our knowledge, this study is the largest single center experience with the refugee pediatric patient population in this field.
 Methods: Medical records of 614 refugee children admitted to the pediatric nephrology and urology departments between February 2020 and May 2022 evaluated retrospectively. A total of 530 patients were included in the study.
 Results: Median age of the 530 patients (301 male/229 female) was 72 months. The median follow-up time was 7 months (IQR 14 months). Congenital anomalies of the kidney and urinary tract with 181 patients (34.2%) is the most common diagnosis. The frequency of chronic kidney disease (CKD) of the patients was determined as 25% with 132 patients. 64 (12%) of the patients required surgical intervention. It was observed that 322 (61%) of the patients did not come to their regular follow-ups and delayed their follow-up.
 Conclusion: Irregular follow-up and delaying the treatment can lead to sad consequences in patients with CKD in the long term. We believe that regular patient follow-up will have a positive impact on the long-term follow-up results of the patients and on the health costs of the country hosting the refugee patient profile.","PeriodicalId":15449,"journal":{"name":"Journal of contemporary medicine","volume":"75 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136343795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Küçük ve Orta Büyüklükteki Primer Ortahat Karın Duvarı FıtIklarında sIPOM ve IPOM-Plus Tekniklerinin Sonuçlarının Karşılaştırılması","authors":"Halil Afşin TAŞDELEN","doi":"10.16899/jcm.1348372","DOIUrl":"https://doi.org/10.16899/jcm.1348372","url":null,"abstract":"Abstract
 
 Aims: To compare the results of the standard intraperitoneal onlay mesh (sIPOM) and intraperitoneal onlay mesh-plus (IPOM-Plus) techniques for the repair of small and medium-sized primary midline abdominal wall hernias (PMAWHs).
 Material and Method: A prospectively documented data of 82 patients who underwent the sIPOM and IPOM-Plus approach between January 2016 and December 2021 was retrospectively evaluated. Forty-one patients with PMAWH repaired with sIPOM (18) and IPOM-Plus (23) were included in the study. Median follow-up for the sIPOM and IPOM-Plus was 73 and 51 months (mean 73.83±7.81vs. 47.43±19.22), respectively.
 Results: Both groups had no difference in demographics, comorbidities, and smoking habits. The mesh area (MA) and the mesh-to-defect ratio (MDR) were not significant (p=0.083 and p= 0.30, respectively); however, the defect area (DA) was higher in the sIPOM group (p= 0.005). The IPOM-Plus group had a longer operative time and length of hospital stay (LOHS) and higher early postoperative pain than the IPOM group (p = 0.002, p = 0.049 and p","PeriodicalId":15449,"journal":{"name":"Journal of contemporary medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136342732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}