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Digital journal of ophthalmology : DJO最新文献

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Video-based surgical curriculum for open-globe injury repair, VI: other trauma sequelae. 基于视频的开放性眼球损伤修复外科课程，VI：其他创伤后遗症。
Digital journal of ophthalmology : DJO Pub Date : 2023-06-06 eCollection Date: 2023-01-01 DOI: 10.5693/djo.01.2022.08.004
Sila Bal, Carolina A Chiou, Inês Laíns, Amy Yuan, Roberto Pineda
{"title":"Video-based surgical curriculum for open-globe injury repair, VI: other trauma sequelae.","authors":"Sila Bal, Carolina A Chiou, Inês Laíns, Amy Yuan, Roberto Pineda","doi":"10.5693/djo.01.2022.08.004","DOIUrl":"https://doi.org/10.5693/djo.01.2022.08.004","url":null,"abstract":"As one of the most severe forms of ocular trauma, open-globe injury (OGI) causes significant vision loss. Timely and meticulous repair of these injuries can improve patient outcomes. This video-based educational curriculum is intended to serve as an efficient yet comprehensive reference for OGI repair. We hope that these video-based articles help surgeons and trainees from around the world find answers to specific surgical questions in OGI management. The curriculum has been divided into six separate review articles, each authored by a different set of authors, to facilitate a systematic and practical approach to the subject of wound types and repair techniques. The sixth article highlights special considerations in the management of open-globe injuries and their sequelae, including management of traumatic cataracts and trauma to the iris.","PeriodicalId":38112,"journal":{"name":"Digital journal of ophthalmology : DJO","volume":"29 2","pages":"20-25"},"PeriodicalIF":0.0,"publicationDate":"2023-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10506620/pdf/djo-21-076.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41159369","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: 0
Video-based surgical curriculum for open-globe injury repair, V: scleral wounds. 基于视频的开放性眼球损伤修复外科课程，V：巩膜伤口。
Digital journal of ophthalmology : DJO Pub Date : 2023-06-05 eCollection Date: 2023-01-01 DOI: 10.5693/djo.01.2022.02.001
Enchi K Chang
{"title":"Video-based surgical curriculum for open-globe injury repair, V: scleral wounds.","authors":"Enchi K Chang","doi":"10.5693/djo.01.2022.02.001","DOIUrl":"https://doi.org/10.5693/djo.01.2022.02.001","url":null,"abstract":"As one of the most severe forms of ocular trauma, open-globe injury (OGI) causes significant vision loss. Timely and meticulous repair of these injuries can improve patient outcomes. This video-based educational curriculum is intended to serve as an efficient yet comprehensive reference for OGI repair. We hope that these video-based articles help surgeons and trainees from around the world find answers to specific surgical questions in OGI management. The curriculum has been divided into six separate review articles, each authored by a different set of authors, to facilitate a systematic and practical approach to the subject of wound types and repair techniques. The fifth article highlights special considerations in the management of full-thickness scleral wounds during OGI repair.","PeriodicalId":38112,"journal":{"name":"Digital journal of ophthalmology : DJO","volume":"29 2","pages":"14-19"},"PeriodicalIF":0.0,"publicationDate":"2023-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10506619/pdf/djo-21-075.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41151621","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: 0
A 14-year-old girl with intermittent headache, palpitations, tachycardia, and diaphoresis. 一名14岁女孩，间歇性头痛、心悸、心动过速和发汗。
Digital journal of ophthalmology : DJO Pub Date : 2023-05-22 eCollection Date: 2023-01-01 DOI: 10.5693/djo.03.2023.04.003
Vasileios N Pililis, John Patrick O'Neill, Iason S Mantagos
{"title":"A 14-year-old girl with intermittent headache, palpitations, tachycardia, and diaphoresis.","authors":"Vasileios N Pililis, John Patrick O'Neill, Iason S Mantagos","doi":"10.5693/djo.03.2023.04.003","DOIUrl":"https://doi.org/10.5693/djo.03.2023.04.003","url":null,"abstract":"Pheochromocytomas are neuroendocrine tumors originating from chromaffin cells.  Most arise from the adrenal medulla, while approximately one out of ten cases originate from the extra-adrenal paraganglia. These catecholamine-secreting tumors cause a broad spectrum of symptoms and may resemble various clinical disorders. Their clinical picture varies greatly, from the classic triad of headaches, diaphoresis and palpitations, to asymptomatic tumors discovered incidentally on imaging. We present the case of a 14-year-old girl with pheochromocytoma of adrenal origin and grade IV hypertensive retinopathy and review the clinical picture, follow-up examination, molecular findings and outcome of the 11 reported cases of pheochromocytoma and hypertensive retinopathy in children.","PeriodicalId":38112,"journal":{"name":"Digital journal of ophthalmology : DJO","volume":"29 2","pages":"61-65"},"PeriodicalIF":0.0,"publicationDate":"2023-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10506618/pdf/djo-23-421.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41166422","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: 0
Paracentral acute middle maculopathy immediately following internal carotid endovascular repair. 颈内动脉血管内修复术后立即出现中枢旁急性中间黄斑病变。
Digital journal of ophthalmology : DJO Pub Date : 2023-05-18 eCollection Date: 2023-01-01 DOI: 10.5693/djo.02.2023.04.002
Claire Meyerovitz, Lauren Colwell, Karen Jeng-Miller
{"title":"Paracentral acute middle maculopathy immediately following internal carotid endovascular repair.","authors":"Claire Meyerovitz,&nbsp;Lauren Colwell,&nbsp;Karen Jeng-Miller","doi":"10.5693/djo.02.2023.04.002","DOIUrl":"https://doi.org/10.5693/djo.02.2023.04.002","url":null,"abstract":"<p><p>Paracentral acute middle maculopathy (PAMM) can result from decreased perfusion to retinal and choroidal circulations meeting in the inner nuclear layer (INL) and outer plexiform layer (OPL). Although ischemia in these layers is rare, certain procedures place patients at risk for possible events, such as cardiopulmonary bypass, coronary angiography, and endovascular coil embolization. We report the case of a 70-year-old woman with a sudden-onset left paracentral scotoma following internal carotid endovascular repair. Currently no treatment or preventive technique is available. Additional ischemic events can occur if a preventable cause is not identified.</p>","PeriodicalId":38112,"journal":{"name":"Digital journal of ophthalmology : DJO","volume":"29 2","pages":"58-60"},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10506615/pdf/djo-22-364.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41152748","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: 0
Presumed topiramate-induced retinopathy in a 58-year-old woman. 托吡酯诱发58岁女性视网膜病变。
Digital journal of ophthalmology : DJO Pub Date : 2023-05-07 eCollection Date: 2023-01-01 DOI: 10.5693/djo.02.2023.01.004
Zhihang Cheng, William Purcell, Nima Ghadiri, Shi Zhuan Tan, Savita Madhusudhan
{"title":"Presumed topiramate-induced retinopathy in a 58-year-old woman.","authors":"Zhihang Cheng,&nbsp;William Purcell,&nbsp;Nima Ghadiri,&nbsp;Shi Zhuan Tan,&nbsp;Savita Madhusudhan","doi":"10.5693/djo.02.2023.01.004","DOIUrl":"10.5693/djo.02.2023.01.004","url":null,"abstract":"<p><p>We present a case of presumed topiramate-induced retinopathy in a 58-year-old woman who presented with progressive, bilateral visual loss following a 3- to 4-year history of oral topiramate intake for migraine. She reported difficulty with light adaptation, hemeralopia, and color desaturation. Her best-corrected visual acuity was 1/60 (20/1200) in the right eye and 6/18 (20/60) in the left eye, and she performed poorly on Ishihara color plate testing. Anterior segment examination was normal; dilated funduscopy showed mild macular pigmentary changes. Optical coherence tomography revealed subtle thinning and reduced reflectivity of the subfoveal ellipsoid zone and interdigitation zone bilaterally, associated with increased foveal autofluorescence. Humphrey visual field 24-2 revealed central defects. Electrodiagnostic testing showed a reduced and delayed b-wave and a normal a-wave on photopic full-field electroretinogram (ERG), with normal scotopic responses; multifocal ERG revealed reduced responses in the inner 10° in both eyes. She underwent extensive investigations including whole-body computed tomography and positron emission tomography scan, magnetic resonance imaging of the brain, uveitis screening, retinal autoantibody testing, and genetic testing on the retinal dystrophy panel to rule-out other causes for her presentation, all of which were normal or negative.</p>","PeriodicalId":38112,"journal":{"name":"Digital journal of ophthalmology : DJO","volume":"29 2","pages":"50-57"},"PeriodicalIF":0.0,"publicationDate":"2023-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10506614/pdf/djo-22-185.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41159863","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: 0
Traumatic rupture of the inferior rectus muscle: case report and review of the literature. 外伤性下直肌断裂：病例报告及文献复习。
Digital journal of ophthalmology : DJO Pub Date : 2023-04-26 eCollection Date: 2023-01-01 DOI: 10.5693/djo.02.2022.11.002
Mona M Amer, Dean M Cestari, Michael K Yoon, Grayson W Armstrong
{"title":"Traumatic rupture of the inferior rectus muscle: case report and review of the literature.","authors":"Mona M Amer,&nbsp;Dean M Cestari,&nbsp;Michael K Yoon,&nbsp;Grayson W Armstrong","doi":"10.5693/djo.02.2022.11.002","DOIUrl":"https://doi.org/10.5693/djo.02.2022.11.002","url":null,"abstract":"<p><p>Traumatic inferior rectus muscle rupture secondary to blunt injury in the absence of associated orbital or ocular fractures or injury is rarely encountered, and there are limited published reports on subsequent surgical repair. We present the case of a 74-year-old man with complete inferior rectus transection following a fall with facial strike. A computed tomography scan of the face was unremarkable. Surgical exploration and repair of the muscle was performed by hooking the inferior oblique muscle to identify the inferior rectus muscle. Subsequent strabismus surgery was performed for residual binocular diplopia, resulting in excellent anatomic and visual outcomes and postoperative ocular alignment.</p>","PeriodicalId":38112,"journal":{"name":"Digital journal of ophthalmology : DJO","volume":"29 2","pages":"45-49"},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10506612/pdf/djo-22-188.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41173431","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: 0
Challenges in the diagnosis and management of simultaneous, bilateral, toxic anterior segment syndrome after phacorefractive surgery. 白内障手术后并发双侧毒性眼前节综合征的诊断和治疗面临挑战。
Digital journal of ophthalmology : DJO Pub Date : 2023-04-24 eCollection Date: 2023-01-01 DOI: 10.5693/djo.02.2023.01.003
Raul E Ruiz-Lozano, Eugenia M Ramos-Davila, Lucas A Garza-Garza, Sara Gonzalez-Godinez, Alejandro Rodriguez-Garcia
{"title":"Challenges in the diagnosis and management of simultaneous, bilateral, toxic anterior segment syndrome after phacorefractive surgery.","authors":"Raul E Ruiz-Lozano,&nbsp;Eugenia M Ramos-Davila,&nbsp;Lucas A Garza-Garza,&nbsp;Sara Gonzalez-Godinez,&nbsp;Alejandro Rodriguez-Garcia","doi":"10.5693/djo.02.2023.01.003","DOIUrl":"https://doi.org/10.5693/djo.02.2023.01.003","url":null,"abstract":"<p><p>A 59-year-old woman presented with a 24-hour history of severe, bilateral, painless vision loss starting 1 day after immediately sequential, bilateral, phacorefractive surgery with multifocal intraocular lens (IOL) implantation at another institution. Best-corrected visual acuity was counting fingers at 1 foot in the right eye and 20/100 in the left eye. Slit-lamp evaluation showed a dense fibrin membrane on the anterior surface of the IOL and significant anterior chamber inflammation in both eyes. B-scan ultrasound revealed bilateral vitreous haze, without membrane formation. The rapid onset, absence of sharp pain, ciliary injection, conjunctival chemosis, eyelid edema, and erythema raised suspicion for bilateral toxic anterior segment syndrome. Significant clinical improvement after high-dose prednisone and hourly prednisolone acetate eye drops supported the diagnosis. After 6 months of tapering anti-inflammatory therapy, optical coherence tomography of the macula showed no pathologic changes, and the patient's best-corrected visual acuity improved to 20/25 in both eyes.</p>","PeriodicalId":38112,"journal":{"name":"Digital journal of ophthalmology : DJO","volume":"29 2","pages":"40-44"},"PeriodicalIF":0.0,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10506611/pdf/djo-22-378.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41151607","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: 0
Nd:YAG laser posterior capsulotomy performed under general anesthesia in the sitting position: a novel approach. Nd:YAG激光后囊膜切开术：一种新的方法，在全麻下坐姿进行。
Digital journal of ophthalmology : DJO Pub Date : 2023-04-20 eCollection Date: 2023-01-01 DOI: 10.5693/djo.02.2023.01.001
Amanda L Ely, Seth M Pantanelli, Rucha K Borkhetaria, Carolyn A Barbieri, Patrick M McQuillan
{"title":"Nd:YAG laser posterior capsulotomy performed under general anesthesia in the sitting position: a novel approach.","authors":"Amanda L Ely,&nbsp;Seth M Pantanelli,&nbsp;Rucha K Borkhetaria,&nbsp;Carolyn A Barbieri,&nbsp;Patrick M McQuillan","doi":"10.5693/djo.02.2023.01.001","DOIUrl":"https://doi.org/10.5693/djo.02.2023.01.001","url":null,"abstract":"<p><p>We present a novel approach for performing an Nd:YAG laser posterior capsulotomy under general anesthesia with the patent in a seated position. We illustrate this approach in 2 cases, a young child and an adult patient with developmental delay. This technique may facilitate YAG capsulotomy in patients who cannot sit for the procedure.</p>","PeriodicalId":38112,"journal":{"name":"Digital journal of ophthalmology : DJO","volume":"29 2","pages":"36-39"},"PeriodicalIF":0.0,"publicationDate":"2023-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10506613/pdf/djo-22-207.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41151528","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: 0
Carotid cavernous fistula masquerading as orbital inflammation on noninvasive imaging in a peripartum patient. 一位围产期患者的无创成像显示颈动脉海绵窦瘘伪装成眼眶炎症。
Digital journal of ophthalmology : DJO Pub Date : 2023-04-19 eCollection Date: 2023-01-01 DOI: 10.5693/djo.02.2022.11.001
Lucy Cobbs, Young Sheng, Sarah Amanullah, Cathy Zhang, Charles Brodowski, Sathyadeepak Ramesh
{"title":"Carotid cavernous fistula masquerading as orbital inflammation on noninvasive imaging in a peripartum patient.","authors":"Lucy Cobbs,&nbsp;Young Sheng,&nbsp;Sarah Amanullah,&nbsp;Cathy Zhang,&nbsp;Charles Brodowski,&nbsp;Sathyadeepak Ramesh","doi":"10.5693/djo.02.2022.11.001","DOIUrl":"https://doi.org/10.5693/djo.02.2022.11.001","url":null,"abstract":"<p><p>A carotid cavernous fistula (CCF) is a pathological connection between the internal or external carotid artery and the cavernous sinus venous system. Pregnancy has been proposed as a risk factor for spontaneous CCF, but the exact mechanism of risk is unknown. Overall, there are few published reports describing CCF in pregnancy. Study of this risk factor relationship is further complicated by potential ambiguity in diagnosing CCF, which may present as subtle, nonspecific findings on initial workup. We report a case of CCF during pregnancy in which the diagnostic process was notable for misleading, noninvasive, imaging studies.</p>","PeriodicalId":38112,"journal":{"name":"Digital journal of ophthalmology : DJO","volume":"29 2","pages":"31-35"},"PeriodicalIF":0.0,"publicationDate":"2023-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10506617/pdf/djo-22-175.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41168983","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: 0
Private equity in ophthalmology and optometry: a time series analysis from 2012 to 2021. 眼科和验光配镜领域的私募股权：2012 年至 2021 年的时间序列分析。
Digital journal of ophthalmology : DJO Pub Date : 2023-03-31 eCollection Date: 2023-01-01 DOI: 10.5693/djo.01.2022.10.004
Sachi A Patil, Daniel G Vail, Jacob T Cox, Evan Chen, Prithvi Mruthyunjaya, James C Tsai, Ravi Parikh
{"title":"Private equity in ophthalmology and optometry: a time series analysis from 2012 to 2021.","authors":"Sachi A Patil, Daniel G Vail, Jacob T Cox, Evan Chen, Prithvi Mruthyunjaya, James C Tsai, Ravi Parikh","doi":"10.5693/djo.01.2022.10.004","DOIUrl":"10.5693/djo.01.2022.10.004","url":null,"abstract":"<p><strong>Purpose: </strong>To identify temporal and geographic trends in private equity (PE)-backed acquisitions of ophthalmology and optometry practices in the United States from 2012 to 2021.</p><p><strong>Methods: </strong>In this cross-sectional time series, acquisition data from 10/21/2019 to 9/1/2021 and previously published data from 1/1/2012 to 10/20/2019 were analyzed. Acquisition data were compiled from 6 financial databases, 5 industry news outlets, and publicly available press releases. Linear regression models were used to compare rates of acquisition. Outcomes included number of total acquisitions, practice type, locations, provider details, and geographic footprint.</p><p><strong>Results: </strong>A total of 245 practices associated with 614 clinical locations and 948 ophthalmologists or optometrists were acquired by 30 PE-backed platform companies between 10/21/2019 and 9/1/2021. Of 30 platform companies, 18 were new vis-à-vis our prior study. Of these acquisitions, 127 were comprehensive practices, 29 were retina practices, and 89 were optometry practices. From 2012 to 2021, monthly acquisitions increased by 0.947 acquisitions per year (<i>P</i> < 0.001*). Texas, Florida, Michigan, and New Jersey were the states with the greatest number of PE acquisitions, with 55, 48, 29, and 28 clinic acquisitions, respectively. Average monthly PE acquisitions were 5.71 per month from 1/1/2019 to 2/29/2020 (pre-COVID), 5.30 per month from 3/1/2020 to 12/31/2020 (COVID pre-vaccine [<i>P</i> = 0.81]), and 8.78 per month from 1/1/2021 to 9/1/2021 (COVID post-vaccine [<i>P</i> = 0.20]).</p><p><strong>Conclusions: </strong>PE acquisitions increased during the period 2012-2021 as companies continue to utilize regionally focused strategies for acquisitions.</p>","PeriodicalId":38112,"journal":{"name":"Digital journal of ophthalmology : DJO","volume":"29 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10125728/pdf/djo-22-169.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9404717","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: 0
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