Research and Reports in Tropical Medicine最新文献

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Delivering insecticide-treated nets for malaria prevention: innovative strategies. 提供驱虫蚊帐预防疟疾:创新战略。
IF 3.1
Research and Reports in Tropical Medicine Pub Date : 2016-09-22 eCollection Date: 2016-01-01 DOI: 10.2147/RRTM.S83173
Paul J Krezanoski
{"title":"Delivering insecticide-treated nets for malaria prevention: innovative strategies.","authors":"Paul J Krezanoski","doi":"10.2147/RRTM.S83173","DOIUrl":"https://doi.org/10.2147/RRTM.S83173","url":null,"abstract":"<p><p>The wide-scale adoption of insecticide-treated nets (ITNs) has led to significant reductions in malaria morbidity and mortality worldwide. Delivery of ITNs to the 3.2 billion people at risk of malaria requires multiple steps in diverse settings. The effectiveness of the delivery of ITNs in order to prevent malaria relies on activities that include ITN manufacturing and design, integration into national and international malaria prevention policies, supplying and distributing ITNs to households and individuals, and, finally, programs focused on spurring demand for and use of ITNs by individuals at risk. This paper reviews some recent innovative strategies for ITN delivery across these four domains, places these innovations within the context of the history of ITN deployment, and identifies opportunities to further improve the effectiveness of this ubiquitous public health tool.</p>","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"7 ","pages":"39-47"},"PeriodicalIF":3.1,"publicationDate":"2016-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/RRTM.S83173","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36348691","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}
引用次数: 8
Evaluation of released malathion and spinosad from chitosan/alginate/gelatin capsules against Culex pipiens larvae. 壳聚糖/海藻酸盐/明胶胶囊对淡库蚊幼虫释放马拉硫磷和棘糖的效果评价。
IF 3.1
Research and Reports in Tropical Medicine Pub Date : 2016-09-19 eCollection Date: 2016-01-01 DOI: 10.2147/RRTM.S108881
Mohamed Ei Badawy, Nehad Em Taktak, Osama M Awad, Souraya A Elfiki, Nadia E Abou El-Ela
{"title":"Evaluation of released malathion and spinosad from chitosan/alginate/gelatin capsules against <i>Culex pipiens</i> larvae.","authors":"Mohamed Ei Badawy,&nbsp;Nehad Em Taktak,&nbsp;Osama M Awad,&nbsp;Souraya A Elfiki,&nbsp;Nadia E Abou El-Ela","doi":"10.2147/RRTM.S108881","DOIUrl":"https://doi.org/10.2147/RRTM.S108881","url":null,"abstract":"<p><p>Efficacy of spinosad and malathion loaded in eco-friendly biodegradable formulations was evaluated for controlling <i>Culex pipiens</i> larvae. Malathion (organophosphorus larvicide) and spinosad (naturally derived insecticide) were loaded on chitosan/alginate/gelatin capsules. Capsules were characterized by size measurement, scanning electron microscopy, Fourier transform infrared spectroscopy, and water uptake. In vitro release kinetics of the larvicides was studied in the running and stagnant water. Biochemical studies on the larvae treated with technical and formulated insecticides were also demonstrated. The results indicated that the released spinosad was active for a long time up to 48 and 211 days in the running and stagnant water, respectively. However, the capsules loaded with malathion showed larvicidal activity for 20 and 27 days in the running and stagnant water, respectively. Technical and formulated malathion and spinosad had an inhibition effect on acetylcholinesterase, carboxylesterase, and glutathione <i>S</i>-transferase. The results proved that the prepared capsules consisting of biodegradable polymers containing larvicides could be effective as controlled-release formulation against <i>C. pipiens</i> larvae for a long period.</p>","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"7 ","pages":"23-38"},"PeriodicalIF":3.1,"publicationDate":"2016-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/RRTM.S108881","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36348690","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}
引用次数: 12
A 5-year trend of Helicobacter pylori seroprevalence among dyspeptic patients at Bahir Dar Felege Hiwot Referral Hospital, Northwest Ethiopia. 埃塞俄比亚西北部Bahir Dar Felege Hiwot转诊医院消化不良患者幽门螺杆菌血清患病率的5年趋势
IF 3.1
Research and Reports in Tropical Medicine Pub Date : 2016-07-08 eCollection Date: 2016-01-01 DOI: 10.2147/RRTM.S105361
Meseret Workineh, Desalegn Andargie
{"title":"A 5-year trend of <i>Helicobacter pylori</i> seroprevalence among dyspeptic patients at Bahir Dar Felege Hiwot Referral Hospital, Northwest Ethiopia.","authors":"Meseret Workineh,&nbsp;Desalegn Andargie","doi":"10.2147/RRTM.S105361","DOIUrl":"https://doi.org/10.2147/RRTM.S105361","url":null,"abstract":"<p><strong>Background: </strong><i>Helicobacter pylori</i> infection is a major public health problem affecting half of the world's population. The prevalence of <i>H. pylori</i> varies in different societies and geographical locations. Thus, timely information on <i>H. pylori</i> epidemiology is critical to combat this infection. This study aimed to determine the seroprevalence and trend of <i>H. pylori</i> infection over a period of 5 years among dyspeptic patients at Bahir Dar Felege Hiwot Referral Hospital, Northwest Ethiopia.</p><p><strong>Methods: </strong>A retrospective analysis of consecutive dyspeptic patients' records covering the period between January 2009 and December 2013 was conducted. The hospital laboratory generated the data by a serological method of detecting the antibodies for <i>H. pylori</i> from serum by a one-step rapid test device. Chi-square analysis was used to identify significant predictors. A <i>P</i>-value of <0.05 was considered as statistically significant.</p><p><strong>Results: </strong>Among all the study subjects, 2,733 (41.6%) were found to be seropositive. The seroprevalence was significantly higher in males (43.2%) than in females (39.9%) (<i>χ</i><sup>2</sup>=9; <i>P</i>=0.002). In terms of age groups of the patients, high rates of <i>H. pylori</i> were found among the participants older than 60 years (57%) (<i>χ</i><sup>2</sup>=36.6; <i>P</i>≤0.00001). The trend analysis of <i>H. pylori</i> prevalence revealed a fluctuating prevalence; it was 44.5% in the year 2009 and decreased to 34% and 40% in the years 2010 and 2011, respectively. However, there was an increment to 52.5% in the year 2012, and then it decreased to 30.2% in the year 2013.</p><p><strong>Conclusion: </strong>This study showed high seroprevalence of <i>H. pylori</i> among the dyspeptic patients in Bahir Dar Felege Hiwot Referral Hospital. The trend of the seroprevalence varied from year to year in the 5 consecutive years. Considering this, designing appropriate prevention and control strategies is mandatory.</p>","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"7 ","pages":"17-22"},"PeriodicalIF":3.1,"publicationDate":"2016-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/RRTM.S105361","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36348689","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}
引用次数: 8
A vaccine effective against Zika virus is theoretically possible but may not be delivered anytime soon. 一种有效对抗寨卡病毒的疫苗理论上是可能的,但可能不会很快投入使用。
IF 3.1
Research and Reports in Tropical Medicine Pub Date : 2016-07-05 eCollection Date: 2016-01-01 DOI: 10.2147/RRTM.S108992
Andrew W Taylor-Robinson
{"title":"A vaccine effective against Zika virus is theoretically possible but may not be delivered anytime soon.","authors":"Andrew W Taylor-Robinson","doi":"10.2147/RRTM.S108992","DOIUrl":"https://doi.org/10.2147/RRTM.S108992","url":null,"abstract":"<p><p>Following the first report in May 2015 of the unexpected emergence of Zika in north east Brazil, there has been an explosive epidemic of this infection across Latin America. The outbreak has caused alarm among social and news media as to the virulence and transmission potential of the <i>Aedes</i> mosquito-borne virus. This debate is heightened by the proximity, both in time and distance, to the forthcoming Olympic Games to be held in Rio de Janeiro this August, provoking fears for the safety of athletes and spectators alike. The threat, real or perceived, is exacerbated by the movement between nations in the same or separate continents of persons who act unwittingly as asymptomatic carriers. Pregnant females are considered at greatest risk because microcephaly in newborn infants is linked to, if not yet proven as caused by, Zika infection. In February this year, the World Health Organization declared that further to the then unconfirmed association between the virus and the clinical manifestations of microcephaly and also Guillain-Barré syndrome, the Zika epidemic was a \"public health emergency of international concern\". No anti-Zika therapy, vaccine or drug, is currently available and while the production of the former has now been prioritized by multiple funding agencies, the history of infectious disease vaccine development indicates that this may take several years to reach the market place. The fact that Zika is a close relative of yellow fever and Japanese encephalitis viruses, for both of which there are already effective vaccines, provides a rational basis for the fast-tracked laboratory-based preparation of a candidate vaccine. However, undertaking clinical trials on pregnant females provides ethical and practical hurdles to overcome before licensure is granted for public administration. Meanwhile, public health management strategies, including mosquito control programs to reduce breeding, are needed to limit the global spread of this re-emerging disease.</p>","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"7 ","pages":"11-15"},"PeriodicalIF":3.1,"publicationDate":"2016-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/RRTM.S108992","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36348688","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}
引用次数: 3
Rift Valley fever: current challenges and future prospects. 裂谷热:当前的挑战和未来的前景。
IF 3.1
Research and Reports in Tropical Medicine Pub Date : 2016-03-11 eCollection Date: 2016-01-01 DOI: 10.2147/RRTM.S63520
Yousif E Himeidan
{"title":"Rift Valley fever: current challenges and future prospects.","authors":"Yousif E Himeidan","doi":"10.2147/RRTM.S63520","DOIUrl":"https://doi.org/10.2147/RRTM.S63520","url":null,"abstract":"<p><p>Rift Valley fever (RVF) is a zoonotic, mosquito-borne viral disease that affects human health and causes significant losses in the livestock industry. Recent outbreaks have led to severe human infections with high mortality rates. There are many challenges to applying effective preventive and control measures, including weak infrastructure of health facilities, lack of capacity and support systems for field logistics and communication, access to global expert organizations, and insufficient information on the epidemiological and reservoir status of the RVF virus. The health systems in East African countries are underdeveloped, with gaps in adaptability to new, more accurate and rapid techniques, and well-trained staff that affect their capacity to monitor and evaluate the disease. Surveillance and response systems are inadequate in providing accurate information in a timely manner for decision making to deal with the scope of interrupting the disease transmission by applying mass animal vaccination, and other preventive measures at the early stage of an outbreak. The historical vaccines are unsuitable for use in newborn and gestating livestock, and the recent ones require a booster and annual revaccination. Future live-attenuated RVF vaccines should possess lower safety concerns regardless of the physiologic state of the animal, and provide rapid and long-term immunity after a single dose of vaccination. In the absence of an effective vaccination program, prevention and control measures must be immediately undertaken after an alert is generated. These measures include enforcing and adapting standard protocols for animal trade and movement, extensive vector control, safe disposal of infected animals, and modification of human-animal contact behavior. Directing control efforts on farmers and workers who deal with, handle, or live close to livestock, and focusing on areas with populations at high risk of an epidemic are desirable. Consideration of prevention methods as a first-line strategy against RVF is practical owing to the absence of a human vaccine, particularly under the current high environmental risks and expanding global travel and animal trade. Universal platforms are needed to support coordinated efforts; alert and response operations; exchange of expertise; and disease detection, diagnosis, control, and prevention.</p>","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"7 ","pages":"1-9"},"PeriodicalIF":3.1,"publicationDate":"2016-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/RRTM.S63520","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36348687","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}
引用次数: 6
Global surveillance system to monitor the development of drug resistance in Mycobacterium leprae 监测麻风分枝杆菌耐药性发展的全球监测系统
IF 3.1
Research and Reports in Tropical Medicine Pub Date : 2015-11-30 DOI: 10.2147/RRTM.S54757
M. Matsuoka
{"title":"Global surveillance system to monitor the development of drug resistance in Mycobacterium leprae","authors":"M. Matsuoka","doi":"10.2147/RRTM.S54757","DOIUrl":"https://doi.org/10.2147/RRTM.S54757","url":null,"abstract":"License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php Research and Reports in Tropical Medicine 2015:6 75–83 Research and Reports in Tropical Medicine Dovepress","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"6 1","pages":"75-83"},"PeriodicalIF":3.1,"publicationDate":"2015-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/RRTM.S54757","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68480234","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}
引用次数: 6
Epidemiology and disease burden of Buruli ulcer: a review 布鲁里溃疡流行病学与疾病负担研究进展
IF 3.1
Research and Reports in Tropical Medicine Pub Date : 2015-11-16 DOI: 10.2147/RRTM.S62026
K. Röltgen, G. Pluschke
{"title":"Epidemiology and disease burden of Buruli ulcer: a review","authors":"K. Röltgen, G. Pluschke","doi":"10.2147/RRTM.S62026","DOIUrl":"https://doi.org/10.2147/RRTM.S62026","url":null,"abstract":"License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php Research and Reports in Tropical Medicine 2015:6 59–73 Research and Reports in Tropical Medicine Dovepress","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"6 1","pages":"59-73"},"PeriodicalIF":3.1,"publicationDate":"2015-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/RRTM.S62026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68480154","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}
引用次数: 36
First-line health care provider performance in the management of common skin diseases using an algorithmic approach as a diagnostic tool in Kano State, Nigeria. 尼日利亚卡诺州一线卫生保健提供者在使用算法方法作为诊断工具管理常见皮肤病方面的表现。
IF 3.1
Research and Reports in Tropical Medicine Pub Date : 2015-10-02 eCollection Date: 2015-01-01 DOI: 10.2147/RRTM.S87600
Anna Theodora Taal, Erik B Post, Tijjani Hussaini, Augustin Gayus Barminus, Tahir Dahiru
{"title":"First-line health care provider performance in the management of common skin diseases using an algorithmic approach as a diagnostic tool in Kano State, Nigeria.","authors":"Anna Theodora Taal,&nbsp;Erik B Post,&nbsp;Tijjani Hussaini,&nbsp;Augustin Gayus Barminus,&nbsp;Tahir Dahiru","doi":"10.2147/RRTM.S87600","DOIUrl":"https://doi.org/10.2147/RRTM.S87600","url":null,"abstract":"<p><p>Skin diseases are common worldwide, though prevalence rates in rural areas are difficult to estimate, and are primarily based on hospital studies rather than community-based studies. Primary health care providers in rural areas often lack sufficient knowledge about skin diseases, which contributes to poor skin management and subsequently causes considerable morbidity. This study looked at the performance of first-line health care providers in the management of common skin disease, using an algorithmic approach with a flowchart with diagnostic steps. As a reference standard, two dermatologists independently validated the diagnoses and treatment choices made by the providers. The performance of the algorithm was calculated in terms of the sensitivity, specificity, positive predictive value (PPV), and negative predictive value for each skin disease of the algorithm. A total of 19 patent medicine vendors and 12 traditional healers from Kano State in Nigeria diagnosed 4,147 patients with suspected skin symptoms. The most common skin disease was tinea capitis (59.2%), and it was found predominantly among boys below 15 years of age. Together, patent medicine vendors and traditional healers had 82% of the cases correctly diagnosed, and in 82% they prescribed the correct treatment. The sensitivities varied for each skin disease from 94.8% for tinea capitis to 7.1% for contact dermatitis. The specificities varied between 87.0% and 98.6%. Except for tinea capitis, lower PPVs were found for the various skin diseases when compared to earlier studies. In spite of the observed low sensitivities and low PPVs for several diseases, the algorithm seems to offer an improvement in management of common skin diseases at the peripheral level. With adaptations in training, further refinement of the algorithm and refresher training, predictive values and sensitivities can be increased.</p>","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"6 ","pages":"85-94"},"PeriodicalIF":3.1,"publicationDate":"2015-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/RRTM.S87600","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38155864","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}
引用次数: 2
Perspectives on the impact of stigma in leprosy: strategies to improve access to health care 对麻风病污名化影响的看法:改善获得卫生保健的战略
IF 3.1
Research and Reports in Tropical Medicine Pub Date : 2015-09-18 DOI: 10.2147/RRTM.S55903
P. Rao
{"title":"Perspectives on the impact of stigma in leprosy: strategies to improve access to health care","authors":"P. Rao","doi":"10.2147/RRTM.S55903","DOIUrl":"https://doi.org/10.2147/RRTM.S55903","url":null,"abstract":": Throughout its history, leprosy has been much feared and misunderstood. Today, we have the best knowledge, expertise, therapies","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"29 1","pages":"49-57"},"PeriodicalIF":3.1,"publicationDate":"2015-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/RRTM.S55903","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68480136","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}
引用次数: 10
Current perspectives on leprosy as a public health challenge in India 目前对麻风病作为印度公共卫生挑战的看法
IF 3.1
Research and Reports in Tropical Medicine Pub Date : 2015-07-24 DOI: 10.2147/RRTM.S54783
A. Pandey
{"title":"Current perspectives on leprosy as a public health challenge in India","authors":"A. Pandey","doi":"10.2147/RRTM.S54783","DOIUrl":"https://doi.org/10.2147/RRTM.S54783","url":null,"abstract":"License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php Research and Reports in Tropical Medicine 2015:6 43–48 Research and Reports in Tropical Medicine Dovepress","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"6 1","pages":"43-48"},"PeriodicalIF":3.1,"publicationDate":"2015-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/RRTM.S54783","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68480078","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}
引用次数: 6
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