Nutrition and Cancer-An International Journal最新文献

{"title":"Early Oral Feeding is Safe and Comfortable in Patients with Gastric Cancer Undergoing Radical Total Gastrectomy.","authors":"Bin Cai, Guangen Xu, Zhenxing Zhang, Kelong Tao, Wei Wang","doi":"10.1080/01635581.2024.2396150","DOIUrl":"10.1080/01635581.2024.2396150","url":null,"abstract":"<p><p>Data supporting the safety and clinical efficacy of early oral feeding (EOF) after total gastrectomy are limited. The aim of this prospective randomized controlled study was to explore the safety and clinical efficacy of two early enteral nutrition approaches for gastric cancer patients after radical total gastrectomy. The EOF group had faster postoperative recovery of intestinal function than the enteral tube feeding (ETF) group. The times to first flatus and first defecation were shorter in the EOF group (<i>p</i> < 0.05). In addition, the EOF protocol effectively avoided abdominal distension (<i>p</i> < 0.05). The hospitalization cost of the EOF group was lower than that of the ETF group (<i>p</i> < 0.05). Moreover, oral nutrition satisfied the physiological need for oral intake. People were more satisfied with EOF (<i>p</i> < 0.01). Furthermore, it is worth noting that compared with ETF, EOF did not increase the risk of anastomotic complications such as leakage and bleeding. Most obviously, EOF not only avoided the risk of complications during tube insertion, but also avoided the discomfort experience of nasal feeding tube. In summary, compared with ETF, EOF promotes early bowel recovery effectively without increasing the risk of postoperative complications. It is safe and comfortable for gastric cancer patients undergoing radical total gastrectomy.</p>","PeriodicalId":54701,"journal":{"name":"Nutrition and Cancer-An International Journal","volume":" ","pages":"79-85"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074600","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}

{"title":"Clinical and Nutritional Aspects and Outcomes of Covid-19 in Cancer and Non-Cancer Pediatric Patients.","authors":"Greice Milena Sant'Ana Reis, Heleni Aires Clemente, José Adailton da Silva, João Araújo Barros Neto, Alane Cabral Menezes de Oliveira, Carolina Santos Mello","doi":"10.1080/01635581.2024.2408765","DOIUrl":"10.1080/01635581.2024.2408765","url":null,"abstract":"<p><p>The SARS-CoV-2 virus has been the subject of study by several researchers worldwide since 2020; however, there are points to be clarified. This study aimed to analyze the clinical and nutritional aspects of hospitalized cancer and non-cancer pediatric patients and the association with COVID-19 outcomes. This is a cohort study of hospitalized children and adolescents with a laboratory diagnosis of COVID-19. Patients were assessed according to the presence or absence of previous oncological diseases. Sociodemographic, clinical and nutritional data were investigated during the course of the infection. Outcomes included Intensive Care Unit (ICU) admission, longer length of stay (14 days), criticality, and death. Oncological disease was found in 16 (19.3%) patients, most of whom had B-type acute lymphoid leukemia. In Poisson regression, adjusted for age and comorbidity, an association was found between oncological disease and length of stay ≥14 days (RR 4.30; 95% CI 1.46 - 15.6; <i>p</i> = 0.013), COVID-19 criticality (RR 3.82; 95% CI 1.66 - 30.9; <i>p</i> = 0.010) and death (RR 3.42; 95% CI 0.94 - 9.96; <i>p</i> = 0.035). The research revealed that cancer patients had longer hospital stays, were more likely to have the severe form of COVID-19, and had a 3.42 times greater risk of dying.</p>","PeriodicalId":54701,"journal":{"name":"Nutrition and Cancer-An International Journal","volume":" ","pages":"179-187"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332564","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}

{"title":"A Novel Nutrition-Related Prognostic Biomarker for Predicting Survival in Patients with Colorectal Cancer.","authors":"Hao Cai, Yu Chen, Jian-Cheng Li, Yu-Xin Wang, An-Kang Chen, Hou-Jun Jia","doi":"10.1080/01635581.2024.2412356","DOIUrl":"10.1080/01635581.2024.2412356","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) is a prevalent global malignancy with substantial morbidity and mortality. Accurate prognostic evaluation is essential in CRC patient management. This study investigates the prognostic significance of red blood cell count (RBC) and Onodera's prognostic nutritional index (OPNI) in resectable CRC patients.</p><p><strong>Methods: </strong>A retrospective analysis of 210 CRC patients undergoing radical resection (January 2015-January 2017) assessed clinical and hematological factors, including RBC, albumin, hemoglobin, and OPNI. A novel comprehensive biomarker, R-OPNI, combining preoperative RBC with OPNI, was introduced. Correlations with patient survival were analyzed, and R-OPNI's independent prognostic value was assessed through univariate and multivariate Cox models. Predictive ability was compared to other factors using the receiver operating characteristic (ROC) method.</p><p><strong>Results: </strong>Higher RBC levels (≥ 3.9 × 10¹²/L) and elevated OPNI were associated with significantly improved overall survival. Lower R-OPNI scores (0 or 1) indicated notably poorer survival. Multivariate analysis confirmed R-OPNI's independent prognostic significance (HR: 0.273, 95% CI: 0.098-0.763, <i>p</i> = 0.013). R-OPNI (AUC = 0.732) demonstrated superior predictive value compared to individual prognostic factors.</p><p><strong>Conclusion: </strong>R-OPNI emerges as a robust, independent prognostic predictor for resectable CRC patients, emphasizing the importance of assessing preoperative nutritional status.</p>","PeriodicalId":54701,"journal":{"name":"Nutrition and Cancer-An International Journal","volume":" ","pages":"221-229"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395332","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}

{"title":"Vitamin B12 Intake and Cancer Risk: Findings from a Case-Control Study in Vietnam.","authors":"Ngoan Tran Le, Yen Thi-Hai Pham, Y-Thanh Lu, Linh Thuy Le, Nhi Yen Ngoc Huynh, Hang Viet Dao, Dai Duc Nguyen, Kathryn Demanelis, Toan H Ha, Suresh V Kuchipudi, Hung N Luu","doi":"10.1080/01635581.2024.2415143","DOIUrl":"10.1080/01635581.2024.2415143","url":null,"abstract":"<p><p>There is inconclusive evidence on the role of dietary intake of vitamin B₁₂ in cancer. We evaluated the association between vitamin B₁₂ intake and cancer risk in a hospital-based case-control study, comprising 3,758 cancer cases and 2,995 controls in Vietnam. Vitamin B₁₂ intake was derived from the validated food frequency questionnaire. Unconditional logistic regression model was used to calculate the odds ratios (ORs), and respective 95% confidence intervals (CIs) for the association between vitamin B₁₂ and cancer risk. There was a U-shaped association between vitamin B₁₂ intake and overall risk of cancer. Individuals with intakes lower than the median intake had a 6% (OR = 1.06, 95% CI: 0.86-1.31)-107% (OR = 2.07, 95% CI: 1.58-2.71), increased risk of cancer (<i>P_trend</i><0.001), whereas those with higher intakes than the median intake had a 20% (OR = 1.20, 95% CI: 0.97-1.48)-52% (OR = 1.52, 95% CI: 1.22-1.89) increased risk of cancer (<i>P_trend</i><0.04). The excess risk of cancer associated with low intakes of vitamin B₁₂ was observed among esophageal, lung, and breast cancer patients, whereas with high intakes of vitamin B₁₂ among gastric cancer patients. In summary, a U-shaped association between vitamin B₁₂ intake and increased cancer risk was observed in the Vietnamese population.</p>","PeriodicalId":54701,"journal":{"name":"Nutrition and Cancer-An International Journal","volume":" ","pages":"252-264"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481159","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}

{"title":"Nutrient Intakes in Prostate Cancer Survivors in the United States: A Nationally Representative Study.","authors":"Maximilian Andreas Storz, Carla Schmidt, Alvaro Luis Ronco","doi":"10.1080/01635581.2024.2408766","DOIUrl":"10.1080/01635581.2024.2408766","url":null,"abstract":"<p><p>There are currently more than 3.3 million prostate cancer (PC) survivors in the United States. Conformance with national dietary guidelines and a good diet quality may lower the risk for Gleason grade progression in PC patients. Assessing the nutritional status of PC survivors is thus of paramount importance from a public health nutrition perspective. We used 24-h dietary recall data from the National Health and Nutrition Examination Surveys (NHANES) to systematically estimate nutrient intakes in <i>n</i> = 360 PC survivors (which may be extrapolated to represent <i>n</i> = 1,841,030 PC survivors) aged 70.69 years on average, and contrasted the results to the daily nutritional goals (DNG) in the 2020-2025 Dietary Guidelines for Americans (DGA). Diet quality in PC survivors was found to be generally poor, and the DNG as specified in the DGA were not met for many micronutrients, including calcium, magnesium and potassium. PC survivors had an insufficient intake of many vitamins (including vitamins A, C, D and E), and did not meet the intake recommendations for dietary fiber. Racial disparities in PC were reflected in the lower overall DQ in Non-Hispanic Black participants. Our results reiterate the need for nutritional assessment and counseling to improve DQ in PC patients.</p>","PeriodicalId":54701,"journal":{"name":"Nutrition and Cancer-An International Journal","volume":" ","pages":"188-199"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382446","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}

{"title":"Association Between Sarcopenia, Clinical Outcomes, and Survival in Patients with Extensive-Stage Small Cell Lung Cancer Treated with First-Line Immunochemotherapy: A Prospective Cohort Study.","authors":"Le Tian, Jia-Xin Huang, Rui Wan, Jie Zhang, Xi Zhang, Ning Li, Na Li, Xin-Qi Liu, Chen-Xin Song, Xin-Yi Wang, Lei Yu, Shao-Ming Wang, Zhi-Jie Wang, Ming-Hua Cong","doi":"10.1080/01635581.2024.2392297","DOIUrl":"10.1080/01635581.2024.2392297","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between sarcopenia, short-term efficacy, and long-term survival in patients with extensive small-cell lung cancer (SCLC) treated with standard first-line immunochemotherapy.</p><p><strong>Methods: </strong>A total of 63 patients initially diagnosed with extensive-stage small cell lung cancer were enrolled in the prospective study from December 1, 2020 to December 31, 2022. The clinical characteristics, body composition, blood test results, and image data were obtained before treatment. Patients were divided into sarcopenia and non-sarcopenia groups according to the diagnostic criteria of the Asian Sarcopenia Working Group 2019. The primary outcome was overall survival (OS) and comprehensive survival analyses were performed. Secondary outcomes included short-term efficacy and adverse events associated with first-line immunochemotherapy.</p><p><strong>Results: </strong>The median age of the 63 patients enrolled in our study was 63.0 years (40-80 years). The incidence of sarcopenia was 19.0% (12/63) in patients with extensive SCLC. Compared with non-sarcopenia patients, extensive-stage SCLC patients with sarcopenia were significantly older (69.0 vs. 62.0, <i>P</i> = 0.017), and had lower body mass index (BMI) (20.29 vs. 24.27, <i>P</i> < 0.001), hand grip strength (HGS) (20.42 vs. 30.75, <i>P</i> < 0.001), and albumin (35.9 vs. 41.40, <i>P</i> < 0.001). The objective response rate after two cycles of standard first-line immunochemotherapy in the sarcopenia group was lower than in the non-sarcopenia group (30.0 vs. 78.9%, <i>P</i> = 0.012). There was no significant difference in chemotherapy-related hematological toxicity between the two groups. During a median follow-up of 15 months (3-33 months), patients with extensive SCLC had a median OS of 24 months, with 1-year survival of 75% and 2-year survival of 52%, respectively. Compared to non-sarcopenia patients, the median OS in the sarcopenia group was significantly shorter (9 vs. 24 months, <i>P</i> = 0.0014). Multivariate Cox analysis showed that sarcopenia was an independent risk factor for OS in patients with extensive SCLC (HR = 4.993, 95%CI = 1.106-22.538, <i>P</i> = 0.037).</p><p><strong>Conclusions: </strong>Patients with Extensive SCLC and sarcopenia had worse clinical outcomes and shorter OS. Sarcopenia is a prognostic factor affecting first-line treatment efficacy and long-term survival of patients with SCLC in the era of immunotherapy.</p>","PeriodicalId":54701,"journal":{"name":"Nutrition and Cancer-An International Journal","volume":" ","pages":"62-69"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005956","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}

{"title":"The Chemopreventive Impact of Diet-Derived Phytochemicals on the Adipose Tissue and Breast Tumor Microenvironment Secretome.","authors":"Naoufal Akla, Carolane Veilleux, Borhane Annabi","doi":"10.1080/01635581.2024.2401647","DOIUrl":"10.1080/01635581.2024.2401647","url":null,"abstract":"<p><p>Cancer cells-derived extracellular vesicles can trigger the transformation of adipose-derived mesenchymal stem cells (ADMSC) into a pro-inflammatory, cancer-associated adipocyte (CAA) phenotype. Such secretome-mediated crosstalk between the adipose tissue and the tumor microenvironment (TME) therefore impacts tumor progression and metastatic processes. In addition, emerging roles of diet-derived phytochemicals, especially epigallocatechin-3-gallate (EGCG) among other polyphenols, in modulating exosome-mediated metabolic and inflammatory signaling pathways have been highlighted. Here, we discuss how selected diet-derived phytochemicals could alter the secretome signature as well as the crosstalk dynamics between the adipose tissue and the TME, with a focus on breast cancer. Their broader implication in the chemoprevention of obesity-related cancers is also discussed.</p>","PeriodicalId":54701,"journal":{"name":"Nutrition and Cancer-An International Journal","volume":" ","pages":"9-25"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301173","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}

{"title":"Diet Quality in Patients with Breast Cancer: Results of a Single Cohort Study in a Midwestern US Population.","authors":"Birgit Khandalavala, Sarah Carlson, Lina Elsayed, Jenenne Geske, Jairam Krishnamurthy","doi":"10.1080/01635581.2024.2433812","DOIUrl":"10.1080/01635581.2024.2433812","url":null,"abstract":"<p><p>Emerging research underscores the relationship between diet quality in patients with breast cancer and their cardiovascular health. This study examines the role of diet quality in patients post-breast cancer diagnosis in a single cohort in the midwestern United States (US), along with barriers to the adoption of a healthy diet and willingness to change diet. This cross-sectional study surveyed 108 patients with breast cancer. Diet quality was assessed using the Rapid Assessment of Eating in Participants - Shortened version (REAP-S). Participants had an average total REAP-S Score of 28.44 on a scale of 13-39. This score is lower than that of the average omnivorous population of the US and remained so as time since diagnosis progressed despite participants' overwhelming willingness to make changes toward a better quality diet. Several key barriers to healthier eating were identified, including unpredictable schedules and time constraints. Subaverage diet quality scores suggest that breast cancer patients elevate their future risk of adverse cardiovascular health and underscores the necessity for targeting interventions and reducing barriers to enhance diet quality.</p>","PeriodicalId":54701,"journal":{"name":"Nutrition and Cancer-An International Journal","volume":" ","pages":"380-388"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787807","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}

{"title":"Dietary Flavonoids and Lung Cancer: A GRADE-Assessed Systematic Review and Meta-Analysis of Observational Studies.","authors":"Kimia Rostampour, Kimia Alipour, Fatemeh Mirjalili, Bita Forootani, Hooman Yekrang Safakar, Sara Beigrezaei, Scott C Forbes, Amin Salehi-Abargouei","doi":"10.1080/01635581.2024.2417457","DOIUrl":"10.1080/01635581.2024.2417457","url":null,"abstract":"<p><p>Individual observational studies examining the association between polyphenols and the risk of lung cancer have reported mixed findings. Therefore, we performed a systematic review and meta-analysis to determine the pooled effects between polyphenol intake and lung cancer risk. A systematic search was performed on PubMed, Scopus, and Web of Science databases in April 2023. Random-effect models were used to estimate odd ratios (OR) and 95% confidence intervals (95% CI). In total, 20 studies were included in the systematic review. The pooled analyses indicated that a higher intake of flavonoids (OR = 0.81; 95% CI: 0.67,0.98; <i>p</i> = 0.03) and isoflavone (OR = 0.82; 95% CI: 0.74,0.92; <i>p</i> < 0.001) were associated with lower odds of lung cancer. In addition, the ingestion of anthocyanidin (OR = 0.80; 95% CI: 0.65,0.98; <i>p</i> = 0.04), kaempferol (OR = 0.78; 95% CI: 0.64,0.96; <i>p</i> = 0.02), quercetin (OR = 0.66; 95% CI: 0.48,0.91; <i>p</i> = 0.01) and flavanones (OR = 0.71; 95% CI: 0.59,0.85; <i>p</i> < 0.001) reduced the likelihood of developing lung cancer. Overall, our findings suggest that flavonoids, isoflavones, anthocyanidin, kaempferol, quercetin, and flavanones may protect against lung cancer.</p>","PeriodicalId":54701,"journal":{"name":"Nutrition and Cancer-An International Journal","volume":" ","pages":"164-178"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513130","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}

{"title":"The Prognostic Utility of the Triceps Skinfold Thickness Albumin Index in Colorectal Cancer Patients with Cachexia.","authors":"Xiao-Yue Liu, Shi-Qi Lin, Guo-Tian Ruan, Xin Zheng, Yue Chen, He-Yang Zhang, Tong Liu, Hai-Lun Xie, Han-Ping Shi","doi":"10.1080/01635581.2024.2416250","DOIUrl":"10.1080/01635581.2024.2416250","url":null,"abstract":"<p><strong>Purpose: </strong>To develop a simple and convenient inflammation-nutrition-adiposity biomarker to complement the TNM staging system, further assess the prognosis of patients with colorectal cancer cachexia.</p><p><strong>Methods: </strong>This study was a multi-centre cohort study. The triceps skinfold thickness-albumin index (TA) was calculated by combining the triceps skinfold thickness (TSF) and serum albumin levels. Kaplan-Meier analysis and Cox proportional risk regression models were used to assess the relationship between the TA and all-cause mortality. Internal validation was carried out.</p><p><strong>Results: </strong>We included 1025 patients with colorectal cancer cachexia, 61.2% of whom were male, with a mean age of 58.91 (12.45) years. As the TA increased, overall mortality decreased in female patients (hazard ratio [HR], 0.95) but not in male patients (HR, 0.99). Multivariate Cox analysis showed that patients in the normal TA group had a significantly lower risk of death than those in the low TA group (HR, 0.53, 95% CI, 0.40-0.72). Patients with a normal TA had a lower risk of malnutrition, poor quality of life, and poor short-term prognosis than those with a low TA.</p><p><strong>Conclusions: </strong>TA index enables clinicians to assess the prognosis of patients as early as possible to improve the survival of patients with colorectal cancer cachexia.</p>","PeriodicalId":54701,"journal":{"name":"Nutrition and Cancer-An International Journal","volume":" ","pages":"265-275"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481158","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}