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Need to Take Heart? Talk to Your Psychiatrist for 20 Minutes. 需要振作？与你的心理医生交谈 20 分钟。
IF 1.9 4区 医学
Journal of Nervous and Mental Disease Pub Date : 2024-05-01 Epub Date: 2024-01-10 DOI: 10.1097/NMD.0000000000001758
Eduard B Dinca, Adrian T Balseanu
{"title":"Need to Take Heart? Talk to Your Psychiatrist for 20 Minutes.","authors":"Eduard B Dinca, Adrian T Balseanu","doi":"10.1097/NMD.0000000000001758","DOIUrl":"10.1097/NMD.0000000000001758","url":null,"abstract":"<p><strong>Abstract: </strong>A powerful correlation exists between the equilibrium of the sympathetic and parasympathetic nervous systems and heart rate variability (HRV). Thus, HRV is useful as a physiological index of both physical and emotional health; autonomic nervous system dysregulation, with a sympathetic predominance and a low HRV, has been associated with a variety of physical (cardiovascular, neurological) and psychiatric disorders. We used a validated algorithm of measuring the HRV (noninvasive, 2-minute approach) in new psychiatric outpatients in first author's private practice. The subjects had an initial measurement, followed by a 20-minute consultation with minimal supportive psychotherapy, followed by an exit measurement. The initial study spanned the \"COVID months\"; to control for this variable, an identical study was performed in 2023. There was a highly significant decrease in the sympathetic predominance in the test groups; no such trend was found in the control groups. A short psychiatry consultation may be sufficient to decrease patients' sympathetic hyperactivity and improve their well-being.</p>","PeriodicalId":16480,"journal":{"name":"Journal of Nervous and Mental Disease","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139417355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Narcissistic Trauma: Main Characteristics and Life Impact. 自恋创伤：主要特征和对生活的影响。
IF 1.9 4区 医学
Journal of Nervous and Mental Disease Pub Date : 2024-05-01 Epub Date: 2024-01-24 DOI: 10.1097/NMD.0000000000001760
Liana Spytska
{"title":"Narcissistic Trauma: Main Characteristics and Life Impact.","authors":"Liana Spytska","doi":"10.1097/NMD.0000000000001760","DOIUrl":"10.1097/NMD.0000000000001760","url":null,"abstract":"<p><strong>Abstract: </strong>Narcissistic trauma can lead to disruption of the personality functioning system. Therefore, it is important to study the persons who have it, their traits, the sphere of relationships, and strategies of social adaptation. The research aims to study narcissism indicators among individuals with narcissistic trauma diagnosed during a therapeutic conversation to identify its connection with loneliness, life satisfaction, and communication style. The empirical research involved 32 people who sought psychotherapeutic help. All participants provided written consent to participate in the research. A clinical methodology was used to identify the degree of personal narcissism-the Narcissism Assessment Test. The study of the dominant style of social interaction revealed the dominance of two opposite styles: straightforward-aggressive and responsible-generous. Thus, narcissistic trauma is likely to lead to dysfunction of the self-system, and the ability to enjoy life and communication. The data obtained can be useful for both theoretical psychologists and psychotherapists.</p>","PeriodicalId":16480,"journal":{"name":"Journal of Nervous and Mental Disease","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139983158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Nature of Combat Stress Development During Military Operations and Psychotherapy in Extreme Situations. 军事行动中战斗应激发展的性质和极端情况下的心理疗法》（The Nature of Combat Stress Development during Military Operations and Psychotherapy in Extreme Situations）。
IF 1.9 4区 医学
Journal of Nervous and Mental Disease Pub Date : 2024-05-01 Epub Date: 2024-03-13 DOI: 10.1097/NMD.0000000000001768
Yanina Ovsyannikova, Diana Pokhilko, Mykola Krasnokutskyi, Valentyn Kerdyvar, Kateryna Kreshchuk
{"title":"The Nature of Combat Stress Development During Military Operations and Psychotherapy in Extreme Situations.","authors":"Yanina Ovsyannikova, Diana Pokhilko, Mykola Krasnokutskyi, Valentyn Kerdyvar, Kateryna Kreshchuk","doi":"10.1097/NMD.0000000000001768","DOIUrl":"10.1097/NMD.0000000000001768","url":null,"abstract":"<p><strong>Abstract: </strong>The purpose of the research work is the theoretical and empirical analysis of the study of the nature of combat stress in military personnel and the assessment of psychotherapeutic methods of providing psychological assistance in extreme situations. The authors used the following methods to achieve this goal: method of analysis and synthesis, hermeneutic method, testing method, comparative method, and generalization method. The results of the research work have revealed the meaning of traumatic stress, psychological trauma, and combat mental trauma, and explained the concept of combat stress and the dynamics of its growth. The findings identified the factors of posttraumatic stress syndrome and its prevalence, tracked down the dynamics of psychoemotional disorders, and revealed the importance of military psychological selection and determination of combat readiness. The authors established the main tasks of a staff psychologist in working with military personnel, conducted an empirical study of the nature of combat stress in the military, observed main psychotherapeutic tools for the prevention of negative mental states in combat conditions, and investigated self-regulation techniques of emotional, physical, and mental health. The practical significance of the scientific work lies in the modern coverage of the phenomenon of combat stress and the classification of effective psychotherapeutic methods that will ensure the sustainable psychological preparation of the soldiers for extreme situations.</p>","PeriodicalId":16480,"journal":{"name":"Journal of Nervous and Mental Disease","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140293810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Interpersonal Sensitivity as a Mediator of the Effect of Childhood Parenting Quality on Depressive Symptoms. 人际关系敏感性是儿童养育质量对抑郁症状影响的中介。
IF 1.9 4区 医学
Journal of Nervous and Mental Disease Pub Date : 2024-05-01 Epub Date: 2024-01-10 DOI: 10.1097/NMD.0000000000001756
Chihiro Morishita, Jiro Masuya, Yoshitaka Ishii, Tomoteru Seki, Ayaka Deguchi, Motoki Higashiyama, Miki Ono, Mina Honyashiki, Shinji Higashi, Ichiro Kusumi, Takeshi Inoue
{"title":"Interpersonal Sensitivity as a Mediator of the Effect of Childhood Parenting Quality on Depressive Symptoms.","authors":"Chihiro Morishita, Jiro Masuya, Yoshitaka Ishii, Tomoteru Seki, Ayaka Deguchi, Motoki Higashiyama, Miki Ono, Mina Honyashiki, Shinji Higashi, Ichiro Kusumi, Takeshi Inoue","doi":"10.1097/NMD.0000000000001756","DOIUrl":"10.1097/NMD.0000000000001756","url":null,"abstract":"<p><strong>Abstract: </strong>The aim of this study was to analyze whether interpersonal sensitivity mediates the effect of qualitative parenting characteristics experienced during childhood on the appraisal of life experiences and depression severity during adulthood in adult community volunteers. A total of 404 Japanese adult volunteers answered the following four self-report questionnaires: Parental Bonding Instrument, Interpersonal Sensitivity Measure, Life Experiences Survey, and Patient Health Questionnaire-9. Structural equation modeling was performed to analyze whether childhood parenting quality increases depressive symptom severity through interpersonal sensitivity, which then affects the appraisal of recent life events. In the two structural equation models, inadequate care and excessive overprotection received during childhood were associated with the negative evaluation of life experiences and depression severity in adulthood through high interpersonal sensitivity. Our findings indicate interpersonal sensitivity as a mediator of the effect of inadequate care and excessive overprotection experienced in childhood on the negative evaluation of life experiences and depression severity in adulthood.</p>","PeriodicalId":16480,"journal":{"name":"Journal of Nervous and Mental Disease","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139417354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mental Symptoms Among Mental Health Workers During the COVID-19 Pandemic. COVID-19 大流行期间心理健康工作者的精神症状。
IF 1.9 4区 医学
Journal of Nervous and Mental Disease Pub Date : 2024-04-01 Epub Date: 2023-12-17 DOI: 10.1097/NMD.0000000000001751
Mehmet Baltacioglu
{"title":"Mental Symptoms Among Mental Health Workers During the COVID-19 Pandemic.","authors":"Mehmet Baltacioglu","doi":"10.1097/NMD.0000000000001751","DOIUrl":"10.1097/NMD.0000000000001751","url":null,"abstract":"<p><strong>Abstract: </strong>We aimed to examine the psychological reactions of healthcare professionals working in the field of mental health during the pandemic and their relationship with sleep quality, eating attitudes, and burnout. A cross-sectional survey was conducted over online platforms. A total of 128 mental health workers were included. Beck Depression Inventory, Beck Anxiety Inventory, Maslach Burnout Inventory, Pittsburg Sleep Quality Index, and Eating Attitudes Test were administered. Depression was detected in 38.3%, anxiety in 73.4%, decreased sleep quality in 89.1%, emotional burnout in 64.8%, depersonalization in 85.9%, and decreased personal achievement in 75.8% of the participants. Anxiety scores of participants who did not take an active role in COVID-19 (22.23 ± 5.067) were significantly higher ( p < 0.001) than those who took an active role in COVID-19 (16.5 ± 6.273). Special attention must be paid to the mental health professionals, especially during crisis periods.</p>","PeriodicalId":16480,"journal":{"name":"Journal of Nervous and Mental Disease","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
What Happens Next? Maintenance of Gains After Discharge From VA Residential PTSD Treatment. 接下来会发生什么？从退伍军人事务部创伤后应激障碍住院治疗出院后收益的维持。
IF 1.9 4区 医学
Journal of Nervous and Mental Disease Pub Date : 2024-04-01 Epub Date: 2024-01-06 DOI: 10.1097/NMD.0000000000001749
Peter P Grau, Ilan Harpaz-Rotem, Mark A Ilgen, Dara Ganoczy, Rebecca K Sripada
{"title":"What Happens Next? Maintenance of Gains After Discharge From VA Residential PTSD Treatment.","authors":"Peter P Grau, Ilan Harpaz-Rotem, Mark A Ilgen, Dara Ganoczy, Rebecca K Sripada","doi":"10.1097/NMD.0000000000001749","DOIUrl":"10.1097/NMD.0000000000001749","url":null,"abstract":"<p><strong>Abstract: </strong>Residential posttraumatic stress disorder (PTSD) treatment in the Department of Veterans Affairs is helpful for many Veterans, yet the majority experience symptom rebound after discharge. This study examined a national cohort of Veterans (n = 1872) who completed VA residential PTSD treatment and identified factors associated with maintenance of gains from discharge to 4-month follow-up. We generated three logistic regression models based on response profiles during residential treatment. In the \"marginal responders\" group, 1-3 \"booster\" sessions of PTSD treatment were associated with decreased odds of maintenance of gains (odds ratio [OR], 0.42), whereas in the \"clinically significant responders\" group, these sessions were associated with increased odds of maintenance of gains (OR, 2.89). Greater pain severity was associated with decreased odds of maintenance of gains in the \"clinically significant responder\" group (OR, 0.90). Results demonstrate several avenues for intervention including targeting pain severity and matching aftercare psychotherapy to Veteran residential treatment response.</p>","PeriodicalId":16480,"journal":{"name":"Journal of Nervous and Mental Disease","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140293813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Transdiagnostic Model for Depression, Anxiety, and Obsessive-Compulsive Disorder. 抑郁症、焦虑症和强迫症的跨诊断模式。
IF 1.9 4区 医学
Journal of Nervous and Mental Disease Pub Date : 2024-04-01 Epub Date: 2024-01-10 DOI: 10.1097/NMD.0000000000001754
Fatma Oktay, İhsan Dağ
{"title":"A Transdiagnostic Model for Depression, Anxiety, and Obsessive-Compulsive Disorder.","authors":"Fatma Oktay, İhsan Dağ","doi":"10.1097/NMD.0000000000001754","DOIUrl":"10.1097/NMD.0000000000001754","url":null,"abstract":"<p><strong>Abstract: </strong>Depression, obsessive-compulsive disorder (OCD), and anxiety disorders (ADs) can seriously impair functionality. Studies have shown that there are common mechanisms in the emergence of these disorders. This study discussed unpredictability beliefs, family unpredictability, locus of control, intolerance of uncertainty, emotional regulation difficulties, and coping styles. In this study, a model created with these transdiagnostic variables that play a role in the emergence of depression, OCD, and ADs was tested. The sample of the study consisted of 795 people. The model explained a significant part of the variance in psychological symptoms. In addition to various limitations, it is thought that this study has important contributions to the field by examining the relationships between unpredictability beliefs and various variables for the first time, and bringing together many transdiagnostic factors related to psychological symptoms. In addition, it provides valuable information for clinicians as it provides a basis for intervention programs targeting many transdiagnostic mechanisms.</p>","PeriodicalId":16480,"journal":{"name":"Journal of Nervous and Mental Disease","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139484738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Psychotic Experiences and Daily Functioning in Borderline Personality Disorder and Schizophrenia. 边缘型人格障碍和精神分裂症患者的精神病体验和日常功能。
IF 1.9 4区 医学
Journal of Nervous and Mental Disease Pub Date : 2024-03-01 DOI: 10.1097/NMD.0000000000001755
Stefan Tschöke, Yvonne Knauer, Erich Flammer, Paula Usemann, Carmen Uhlmann
{"title":"Psychotic Experiences and Daily Functioning in Borderline Personality Disorder and Schizophrenia.","authors":"Stefan Tschöke, Yvonne Knauer, Erich Flammer, Paula Usemann, Carmen Uhlmann","doi":"10.1097/NMD.0000000000001755","DOIUrl":"10.1097/NMD.0000000000001755","url":null,"abstract":"<p><strong>Abstract: </strong>Psychotic experiences have been shown to be comparable in borderline personality disorder (BPD) and schizophrenia. Preliminary evidence suggests differences in the impact of psychotic experiences on daily functioning. Therefore, in this study, we aimed to investigate the role of psychotic experiences in daily functioning in BPD compared with schizophrenia. We performed post hoc analyses on data from 23 inpatients with BPD and 21 inpatients with schizophrenia, for whom results from the Psychotic Symptom Rating Scales were available. No differences were found in frequency, intensity, and disruption of life in relation to auditory verbal hallucinations and the amount of preoccupation and conviction with regard to delusions. Significant differences were found in the disruption of life due to delusions. The results emphasize that the quality of psychotic experiences in BPD and schizophrenia is comparable, but the impact of delusions on daily life is different, which may improve differential diagnosis.</p>","PeriodicalId":16480,"journal":{"name":"Journal of Nervous and Mental Disease","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139983162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparable Efficacy of Repeated Transcranial Direct Current Stimulation, Cognitive Behavioral Therapy, and Their Combination in Improvement of Cold and Hot Cognitive Functions and Amelioration of Depressive Symptoms. 重复经颅直流电刺激疗法、认知行为疗法及其组合疗法在改善冷热认知功能和抑郁症状方面的疗效相当。
IF 1.9 4区 医学
Journal of Nervous and Mental Disease Pub Date : 2024-03-01 Epub Date: 2024-01-31 DOI: 10.1097/NMD.0000000000001745
Vahid Nejati, Masoumeh Nozari, Bahram Mirzaian, Hosein Pourshahriar, Mohammad Ali Salehinejad
{"title":"Comparable Efficacy of Repeated Transcranial Direct Current Stimulation, Cognitive Behavioral Therapy, and Their Combination in Improvement of Cold and Hot Cognitive Functions and Amelioration of Depressive Symptoms.","authors":"Vahid Nejati, Masoumeh Nozari, Bahram Mirzaian, Hosein Pourshahriar, Mohammad Ali Salehinejad","doi":"10.1097/NMD.0000000000001745","DOIUrl":"10.1097/NMD.0000000000001745","url":null,"abstract":"<p><strong>Abstract: </strong>This study aimed to evaluate the effectiveness of repeated transcranial direct current stimulation (rtDCS), cognitive behavioral therapy (CBT), and their combination (rtDCS-CBT) in the treatment of cognitive dysfunction, social cognition, and depressive symptoms in women diagnosed with major depressive disorder (MDD). A total of 40 female participants with MDD were randomly assigned to one of four groups: rtDCS, CBT, rtDCS-CBT, and a control group. The participants' depressive symptoms, executive functions, and social cognition were assessed at baseline, preintervention, postintervention, and during a 1-month follow-up. The rtDCS group received 10 sessions of anodal dorsolateral and cathodal ventromedial prefrontal cortex (2 mA for 20 minutes). The CBT group received 10 sessions of traditional CBT, whereas the combined group received CBT after the tDCS sessions. The results of the analysis of variance indicated that all intervention groups demonstrated significant improvements in depressive symptoms, cognitive dysfunction, and social cognition compared with the control group (all p < 0.001). Furthermore, the rtDCS-CBT group exhibited significantly greater reductions in depressive symptoms when compared with each intervention alone (all p < 0.001). Notably, working memory improvements were observed only in the rtDCS group ( p < 0.001). In conclusion, this study suggests that both CBT and tDCS, either individually or in combination, have a positive therapeutic impact on enhancing executive functions, theory of mind, and depressive symptoms in women with MDD.</p>","PeriodicalId":16480,"journal":{"name":"Journal of Nervous and Mental Disease","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139417353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dissociative Identity Disorder: A Review of Research From 2011 to 2021. 分离性身份识别障碍：2011 年至 2021 年研究综述》。
IF 1.9 4区 医学
Journal of Nervous and Mental Disease Pub Date : 2024-03-01 DOI: 10.1097/NMD.0000000000001764
Guy A Boysen
{"title":"Dissociative Identity Disorder: A Review of Research From 2011 to 2021.","authors":"Guy A Boysen","doi":"10.1097/NMD.0000000000001764","DOIUrl":"10.1097/NMD.0000000000001764","url":null,"abstract":"<p><strong>Abstract: </strong>Dissociative identity disorder (DID) has historically been one of the most controversial topics in the study of psychopathology. Building on a previous review of empirical research on DID from 2000 to 2010, the present review examined DID research from 2011 to 2021. The research output included 56 case studies and 104 empirical studies. Within the empirical studies, approximately 1354 new cases of DID emerged, which resulted in an average samples of approximately 20. Reanalysis of previous samples was standard in the literature with only 40% of reported cases being new. Studies emerged from dozens of countries across the world, but the majority of cases were from Western counties, especially the United States. Diagnosis primarily relied upon validated measures, but 74% of all new cases came from six research groups. Overall, research on DID is steady but methodologically limited in ways that make generalization, especially about etiology, difficult.</p>","PeriodicalId":16480,"journal":{"name":"Journal of Nervous and Mental Disease","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139983160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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