International Electronic Journal of Medicine最新文献

Predicating Attitude Toward Learning Communication Skills in Medical Students of Shahid Beheshti University 沙希德·贝赫什蒂大学医学生沟通技巧学习态度的预测

International Electronic Journal of Medicine Pub Date : 2020-03-30 DOI: 10.34172/iejm.2020.04

M. Akbarilakeh, Fahimeh Fargah, K. Razjouyan, M. Rahimzadeh

{"title":"Predicating Attitude Toward Learning Communication Skills in Medical Students of Shahid Beheshti University","authors":"M. Akbarilakeh, Fahimeh Fargah, K. Razjouyan, M. Rahimzadeh","doi":"10.34172/iejm.2020.04","DOIUrl":"https://doi.org/10.34172/iejm.2020.04","url":null,"abstract":"\u0000 Background: The ability of communicating with people is of great importance for physicians. Predicting unknown variables like personality traits is one of the important impressive issues in choosing future medical experts in medical training. Regarding this, medical colleges have training programs all around the world. The present study aimed to investigate the attitude toward learning communication skills based on the personality traits of medical students. Materials and Methods: This correlational study was done in 2019 and the participants were medical students who were selected using a convenience sampling method. Zuckerman-Kuhlman personality questionnaire and communication skills attitude scale (CSAS) were used for data collection. CSAS was used to assess positive and negative attitudes. Results: The results showed that only the sociability dimension among the five dimensions of personality had a significant relationship with attitude toward learning communication skills (P=0.018). Moreover, significant relationships of gender (P=0.022), mother’s education level (P=0.049), and residence (P=0.036) with attitude to learning communication skills were found. Conclusion: According to the results, the dimension of demographic characteristics is effective in improving communication skills of medical students. Therefore, it is recommended that it should be considered in medical curriculum development and revision and modifications.","PeriodicalId":367694,"journal":{"name":"International Electronic Journal of Medicine","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132968210","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: 1

Hematological Changes, Serum Interferon Gamma and Interleukin-4 Alterations in Normal Pregnancy and Preeclampsia 正常妊娠和子痫前期的血液学变化、血清干扰素γ和白细胞介素-4的变化

International Electronic Journal of Medicine Pub Date : 2020-03-30 DOI: 10.34172/iejm.2020.08

Shilan Anwar Mawlood, B. Mohamed Mahmoud

{"title":"Hematological Changes, Serum Interferon Gamma and Interleukin-4 Alterations in Normal Pregnancy and Preeclampsia","authors":"Shilan Anwar Mawlood, B. Mohamed Mahmoud","doi":"10.34172/iejm.2020.08","DOIUrl":"https://doi.org/10.34172/iejm.2020.08","url":null,"abstract":"\u0000 Background: Various hematological and immunological changes can occur in pregnancy which could be beneficial for the growth of the fetus and the maintenance of the pregnancy although some of these changes could be hazardous to the fetus and can cause complications during pregnancy. Thus, this study was conducted to investigate the hematological and immunological changes in normal pregnancy and preeclampsia (PE). Materials and Methods: To this end, hematological and immunological changes were evaluated in 62 normal pregnant women and 56 pregnant women with PE. Moreover, 58 healthy non-pregnant women were studied as the control group. The study was done between December 1, 2018 to May 1, 2019 in Chwarbakh Private Clinic and Shorsh Teaching Hospital. The venous peripheral blood from the antecubital vein was used in this study. Results: The results revealed a significant increase in the number of granulocytes, monocytes, and mean platelet (PLT) volume in both normal pregnant women and PE patients in comparison to normal (non-pregnant) controls (P<0.01). In addition, there was a significant correlation between a reduction in their hematocrit (HCT), PLT, and lymphocytes (P<0.01). With regard to immunological changes, a significant increase was also observed in the serum interleukin-4 (IL-4) levels in both normal pregnancy and preeclamptic patients when compared to non-pregnant controls (P<0.01), but gamma interferon was not significantly different. Conversely, there were no significant associations between the serum level of antiphospholipid antibodies and anticardiolipin antibodies in the study groups except for antiphospholipid antibodies which were significantly lower in the third trimester of pregnancy in the preeclamptic patients (P<0.05). Conclusion: In general, significant changes in hematological and immunological parameters were observed in both normal pregnant and PE patients although further studies are required to include more immunological parameters.","PeriodicalId":367694,"journal":{"name":"International Electronic Journal of Medicine","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127795662","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: 1

The Effect of Gender on Brain Tissue Changes Induced by Renal Ischemia-Reperfusion Injury in Adult Rats 性别对成年大鼠肾缺血再灌注损伤后脑组织变化的影响

International Electronic Journal of Medicine Pub Date : 2019-12-15 DOI: 10.34172/IEJM.2019.07

Fakhri Armin, Fariba Azarkish, Ali Atash Ab Parvar, A. Dehghani

{"title":"The Effect of Gender on Brain Tissue Changes Induced by Renal Ischemia-Reperfusion Injury in Adult Rats","authors":"Fakhri Armin, Fariba Azarkish, Ali Atash Ab Parvar, A. Dehghani","doi":"10.34172/IEJM.2019.07","DOIUrl":"https://doi.org/10.34172/IEJM.2019.07","url":null,"abstract":"\u0000 Background: Renal ischemia-reperfusion (RIR) is a common clinical injury that affects the function of other remote organs such as the brain by initiating a cascade of complex and wide-ranging inflammatory responses. RIR also follows a different course in men and women. Since there is little information on the effect of RIR on the brain as a sensitive organ in both males and females, the present research was performed to investigate the effect of gender on RIR-induced brain tissue alterations in adult rats. Materials and Methods: In this study, 28 Wistar rats (14 female and 14 male rats) weighing 200 ± 20 g were divided into the following groups: 1- male sham (MS), 2- female sham (FS), 3- male ischemia (MI) with 3-hour reperfusion (ISC3hr), and 4- Female ischemia (FI) with 3-hour reperfusion (ISC3hr). Bilateral renal ischemia was induced for 45 minutes and blood samples were taken after reperfusion for the measurements of serum blood urea nitrogen (BUN), creatinine (Cr), malondialdehyde (MDA), and nitrite levels. The left kidney was removed for evaluation of MDA and tissue nitrite levels. Right kidney and brain tissue underwent histological examination. Results: Serum BUN level increased in both genders. Serum nitrite level was significantly different between both genders, meaning that it was increased in the female rats as compared to male ones. Overall brain tissue damage was significantly increased in males compared to females. Conclusion: RIR has an effect on the function and tissue of kidney and brain in both genders. Female rats are more susceptible to the nitric oxide system than the male ones. This study showed that male brain tissue was more susceptible to RIR. Therefore, gender is one of the important factors that should be considered in clinical treatments.","PeriodicalId":367694,"journal":{"name":"International Electronic Journal of Medicine","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132984138","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: 2

Determining the Factors Affecting the Survival of HIV Patients: Comparison of Cox Model and the Random Survival Forest Method 确定影响HIV患者生存的因素:Cox模型与随机生存森林法的比较

International Electronic Journal of Medicine Pub Date : 2019-12-10 DOI: 10.34172/IEJM.2019.09

Nasim Karimi, M. Safari, M. Mirzaei, Amir Kassaeian, G. Roshanaei, T. Omidi

{"title":"Determining the Factors Affecting the Survival of HIV Patients: Comparison of Cox Model and the Random Survival Forest Method","authors":"Nasim Karimi, M. Safari, M. Mirzaei, Amir Kassaeian, G. Roshanaei, T. Omidi","doi":"10.34172/IEJM.2019.09","DOIUrl":"https://doi.org/10.34172/IEJM.2019.09","url":null,"abstract":"\u0000 Background: In recent years, sexually transmitted diseases such as AIDS have become an epidemic and are growing rapidly. Given the importance of controlling the disease in recent years, the awareness of the most important risk factors associated with patient survival is important. Therefore, this study aimed to determine the most important factors affecting the survival of HIV patients using the random survival forest (RSF) method. Materials and Methods: In this retrospective study, medical records of 769 HIV patients in Hamadan Health Center from 1997 to 2017 were used to determine the most important factors in patient survival using Cox proportional hazards model and RSF method. The Brier score and C-index were applied to compare the Cox model and RSF method. Results: Based on the results, 662 (86.1%) patients were male. The mean ± SD diagnosis age was 33.83 ± 9.63 years. Using Cox model, variables such as injection history, co-injection history, tuberculosis (TB) status, the first CD4 cell count, and the time of disease diagnosis until TB were determined to be variables affecting the survival of patients. According to the hazard ratio (HR), the risk of death for those with a history of injections was 12.328 times greater than that of noninjectors, and for those with TB, it was 13.565 times greater than that of non-TB patients. An increase in CD4 cell counts was associated with a decline in the risk of mortality. Based on the log-rank model, the variables such as the time until diagnosis of TB, the first CD4 cell count, ART, and history of co-injection had the highest impact on predicting the survival of HIV+ patients, respectively. Conclusion: In case of the presence of many risk factors and the relationship between risk factors, the use of RSF offers a better performance in determining the influential survival factors as compared to Cox model which has limiting presumptions.","PeriodicalId":367694,"journal":{"name":"International Electronic Journal of Medicine","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114766216","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: 1

Role of Free Radical-induced Oxidative Stress in the Pathogenesis of Coronary Artery Disease 自由基诱导的氧化应激在冠状动脉疾病发病中的作用

International Electronic Journal of Medicine Pub Date : 2019-12-10 DOI: 10.34172/IEJM.2019.11

R. Alipoor, Mahta Moraghebi, Hossein Abbasi, E. Eftekhar

引用次数: 0

Designing an Annual Educational Calendar of Medical Parasitology Based on Training Weeks 基于培训周的医学寄生虫学年历设计

International Electronic Journal of Medicine Pub Date : 2019-12-10 DOI: 10.34172/IEJM.2019.03

M. Salehi, A. Nasirzadeh, H. Niazkar, Kokab Basiri Moghaddam

{"title":"Designing an Annual Educational Calendar of Medical Parasitology Based on Training Weeks","authors":"M. Salehi, A. Nasirzadeh, H. Niazkar, Kokab Basiri Moghaddam","doi":"10.34172/IEJM.2019.03","DOIUrl":"https://doi.org/10.34172/IEJM.2019.03","url":null,"abstract":"\u0000 Background: Parasitology is a course filled with many complicated terminologies. In this study, a guide was designed to facilitate the learning of parasitology. More precisely, an annual educational calendar of medical parasitology was designed based on the weeks of education and its effectiveness was assessed in university students of medical sciences. Materials and Methods: This cross-sectional study included 174 students who were randomly divided into two intervention and control groups. At the baseline, the students were tested with a questionnaire at the beginning of each teaching session and the end of the intervention. In addition, another questionnaire was used to compare the attitude and satisfaction of students in two groups. Finally, the scores of the students were entered in SPSS 16 for analysis. Results: The results of parametric tests showed that the mean scores of laboratory and medical students during several tests in different sessions were significantly different in the two groups. Conclusion: The educational calendar is a new method in medical education, especially in the field of medical parasitology. This calendar as an educational supplement, emphasizes on students’ active learning and contributes to improving the quality of teaching the parasitology course in addition to meeting their educational needs.","PeriodicalId":367694,"journal":{"name":"International Electronic Journal of Medicine","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126008763","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: 0

Investigating the Relationship Between Personality Dimensions and Choice of Type of Delivery in Patients Referred to Hazrat Abolfazl Hospital in Minab County 米纳布县Hazrat Abolfazl医院转诊患者人格维度与分娩方式选择的关系研究

International Electronic Journal of Medicine Pub Date : 2019-12-10 DOI: 10.34172/IEJM.2019.08

Zahra Mohammad Alipour, Misa Naghdipour Mirsadeghi, Hadi Marzban, Seyed Hamzeh Seddigh, A. Massoudifar

{"title":"Investigating the Relationship Between Personality Dimensions and Choice of Type of Delivery in Patients Referred to Hazrat Abolfazl Hospital in Minab County","authors":"Zahra Mohammad Alipour, Misa Naghdipour Mirsadeghi, Hadi Marzban, Seyed Hamzeh Seddigh, A. Massoudifar","doi":"10.34172/IEJM.2019.08","DOIUrl":"https://doi.org/10.34172/IEJM.2019.08","url":null,"abstract":"\u0000 Background: Human choices and decisions are highly affected by some psychological and personality traits. These psychological characteristics may also be related to the choice of delivery type. Therefore, the present study aimed to investigate the relationship between personality dimensions and choice of delivery type (cesarean section or normal) in pregnant women referred to Abolfazl hospital in Minab county, Iran, in 2018. Materials and Methods: This is a cross-sectional descriptive study. The statistical population consisted of all pregnant women referred to Abolfazl medical center in 2008 in Minab, 118 of whom were selected by convenience sampling. The NEO Five-Factor Inventory (NEO-FFI) was used to collect the data. Results: There was a significant difference in the choice of delivery type (normal and cesarean section) in pregnant women with extraversion and conscientiousness personality traits (P value <0.05). The mean extraversion and conscientiousness scores were higher in patients who tended to have a vaginal delivery than in those who had chosen cesarean section. Conclusion: The results of the present study show that personality traits can determine the type of delivery by creating specific moods; therefore, considering the high level of complications of cesarean section (CS) and high CS rate in Iran, we can change people’s attitudes and play a role in reducing the number of CSs through long-term training.","PeriodicalId":367694,"journal":{"name":"International Electronic Journal of Medicine","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123487793","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: 1

Sleep Quality of Students during Final Exams in Ardabil and Khalkhal University of Medical Sciences 阿达比尔和哈尔哈尔医科大学学生期末考试睡眠质量调查

International Electronic Journal of Medicine Pub Date : 2019-06-10 DOI: 10.31661/iejm893

K. Nasiri, A. Shekarchi, Amirreza Roshangar, Abbas Nasiri, Milad Jafari

{"title":"Sleep Quality of Students during Final Exams in Ardabil and Khalkhal University of Medical Sciences","authors":"K. Nasiri, A. Shekarchi, Amirreza Roshangar, Abbas Nasiri, Milad Jafari","doi":"10.31661/iejm893","DOIUrl":"https://doi.org/10.31661/iejm893","url":null,"abstract":"Introduction: Sleep is one of the most important circadian cyclic processes that play a significant role in the health of individuals. Students are a community of people who are particularly affected by sleep disorders. The aim of this study was to Sleep quality of students during final exams in Ardabil and Khalkhal Universities of Medical Sciences in 2017. Material and Methods: The present study is a cross-sectional study performed on 340 dormitory and non-dormitory students in Ardabil and Khalkhal University of Medical Sciences. The instrument used in this study was Pittsburgh standard sleep quality questionnaire. Sampling was done randomly. Data were analyzed by SPSS version 16 software. Results: The mean and standard deviation of total sleep quality score in the students participating in the study was 7.63±2.53. According to the findings, 10.58% of the participants (36) had no sleep disorders and 89.41% (304) had sleep disorders. Useful sleep with mean and standard deviation of 2.94±0.36 has the highest score among the components of the questionnaire and the lowest score is related to the use of sleep medications (126.2±0.47). Conclusion: The results of this study show that the sleep quality of students in medical sciences is undesirable and can be an indicator of the job and academic performance of this stratum. Therefore, it is suggested that education and advertising in this field can be effective.","PeriodicalId":367694,"journal":{"name":"International Electronic Journal of Medicine","volume":"108 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127971395","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: 1

The Effect of Health Reform Plan on Job Satisfaction among Nurses in Governmental Hospitals at Ardebil and Khalkhal Cities 医疗改革计划对阿德比尔市和哈尔克哈尔市公立医院护士工作满意度的影响

International Electronic Journal of Medicine Pub Date : 2019-06-10 DOI: 10.31661/iejm892

M. Azad, Milad Jafari, A. Kamran, M. Savadpoor, K. Nasiri

{"title":"The Effect of Health Reform Plan on Job Satisfaction among Nurses in Governmental Hospitals at Ardebil and Khalkhal Cities","authors":"M. Azad, Milad Jafari, A. Kamran, M. Savadpoor, K. Nasiri","doi":"10.31661/iejm892","DOIUrl":"https://doi.org/10.31661/iejm892","url":null,"abstract":"Background: Nurses are one of the main members of the health and treatment team; therefore, attention to job satisfaction is an important factor affecting the quality of health services provided by them. In recent years, improving healthcare has been one of the main concerns of staff in this area. This study aimed to investigate the effect of the health reform plan (HRP) on job satisfaction of nurses working in public hospitals at Ardebil and Khalkhal cities. Materials and Methods: This descriptive-analytic study was conducted on the 380 nurses who worked in public hospitals of Ardebil and Khalkhal cities, in 2017. Job satisfaction was assessed via Whiskey and Chrome occupational satisfaction, and researcher-made questionnaires on the effect of change design on nurses' satisfaction. Data were analyzed using SPSS software. Results: The findings of this study showed that the mean total score of nurses' satisfaction was 22.14±6.75. Also, the mean total score of satisfaction of the HRP was 22.14±6.75. The moderate satisfaction of the HRP among nurses was 35.62%. Also, HRP could not change job satisfaction in 51.84% of nurses. Conclusion: The findings of this study indicate that nurses' job satisfaction was moderate and that the implementation of HRP has not been able to improve their satisfaction.","PeriodicalId":367694,"journal":{"name":"International Electronic Journal of Medicine","volume":"207 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131475568","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: 1

Information Quality of the Emergency Medical Services 115 Report Form Among Traffic Injured in Mashhad Social Welfare Hospitals 马什哈德社会福利医院交通伤者急诊医疗服务115报告表信息质量分析

International Electronic Journal of Medicine Pub Date : 2019-06-10 DOI: 10.31661/iejm108.1

M. Dehnavi, Amir Amirian, M. S. Baghini

{"title":"Information Quality of the Emergency Medical Services 115 Report Form Among Traffic Injured in Mashhad Social Welfare Hospitals","authors":"M. Dehnavi, Amir Amirian, M. S. Baghini","doi":"10.31661/iejm108.1","DOIUrl":"https://doi.org/10.31661/iejm108.1","url":null,"abstract":"BackgroundIncorrect and inadequate information is one of the most important obstacles in providing appropriate health care services to injured traffic accidents. The aim of this study was to measure the quality of patient information about the Emergency Medical Services (EMS) 115 Report Form among traffic injured in Mashhad Social Welfare Hospitals.Materials and MethodsThis descriptive cross-sectional study was comprised of Mashhad social welfare incident cases. The data collection tool was a checklist tailored to the data elements of the EMS 115 care report form. Data collection was carried out in two steps to verify the amount of information documentation and verify the accuracy of the information. To evaluate the findings, the score was less than 50%, 50-90%, and more than 90% was considered as weak, relatively favorable, and desirable, respectively. Data analysis was done using descriptive statistics.ResultsThe findings showed that the amount of information elements in the EMS 115 form was 83.15%, and the accuracy of the completed information was 99.27%.ConclusionAlthough the degree of completion of the study was in a relatively favorable condition and the accuracy of information was in a favorable situation, but due to the importance of information in timely decision-making and the providing the appropriate treatment plan for patients, measures should be taken to optimize the information.","PeriodicalId":367694,"journal":{"name":"International Electronic Journal of Medicine","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117112983","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: 0