International journal of tropical disease & health最新文献

{"title":"Prevalence of Intestinal Parasitic Infection in Relation to Age in the Urban Population from Chandigarh, India","authors":"M. Mehta, S. Bhardwaj, J. Sharma","doi":"10.9734/ijtdh/2021/v42i1230504","DOIUrl":"https://doi.org/10.9734/ijtdh/2021/v42i1230504","url":null,"abstract":"Background: Intestinal parasitic infection is a global health problem particularly in the developing countries with different prevalence rates in different regions. The aim of this study was to evaluate the prevalence of intestinal parasitic infection in different age groups in the urban population of Chandigarh, India. \u0000Materials and Methods: The retrospective study included stool samples 504 in number from human subjects from Chandigarh. Unstained wet saline mount preparations of stool sample were done to detect eggs or larvae and iodine wet mount to detect ova/ cysts of tapeworm, Enterobius, Ascaris, Giardia, Trichuris and Hookworm. \u0000Results: A high prevalence rate of intestinal parasitosis (73%) was seen. The age group distribution shows a higher prevalence of intestinal parasitic infection in the young population (age group 21-30 years and 31-40 years). Ascariasis was the most common parasitic infection observed. \u0000Conclusion: The present study reveals a high prevalence of intestinal parasitic infection in the study population and calls for long term control measures to improve their sanitary and living conditions.","PeriodicalId":90555,"journal":{"name":"International journal of tropical disease & health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44602366","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}

{"title":"Transitioning Adolescents with Perinatally Acquired HIV from Paediatric to Adult Centered Care: Caregivers’ Perspective","authors":"Chigozirim Ogubuike, E. Asuquo, A. Alabi","doi":"10.9734/ijtdh/2021/v42i1230502","DOIUrl":"https://doi.org/10.9734/ijtdh/2021/v42i1230502","url":null,"abstract":"Aim: To investigate caregivers’ attitude towards transitioning HIV-positive adolescents from paediatric to adult centered care as well as understanding their perspective of transition inhibitors and facilitators. \u0000Study Design: We used a descriptive qualitative design and purposively selected principal caregivers of adolescents aged 15 to 19 years with perinatally acquired HIV who had been attending the paediatric infectious diseases clinic for at least 12 months before the study. \u0000Place and Duration of Study: Rivers State University Teaching Hospital, Port Harcourt, Nigeria. The study was conducted from August 2020 to November 2020. \u0000Methodology: We included principal caregivers whose wards were not cognitively impaired, whose HIV serostatus had    been disclosed to them and who had been attending the Rivers State University Teaching Hospital paediatric infectious diseases clinic for at least 12 months before the onset of the study. Fifteen In-depth interviews were conducted and data was analyzed using the thematic analysis method with Atlas ti data qualitative software version 7.5.21. The sample size was determined when data saturation was reached. \u0000Results: Most principal caregivers did not understand their role and were not involved in preparing their wards for the transition to adult care. Perceived inhibitors to transition were anxiety on severing the long-term relationship with the paediatric health care team and concern that adult physicians may not be as caring as those in the paediatric clinic. Seropositive caregivers suggested that taking their wards along with them to their appointment at the adult clinic would facilitate transition.  \u0000Conclusion: Principal caregivers were unaware of their roles in the transition process, healthcare providers should actively involve and educate them to ensure a smooth transitioning to the adult centered care.","PeriodicalId":90555,"journal":{"name":"International journal of tropical disease & health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46441668","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}

{"title":"Histopathological Aspects of Cutaneous Leishmaniasis due to Leishmania-Major in Libya","authors":"Safa Sharfuldeen, B. Annajar, Hamida Al-Dwibe, Said El- Zubi, Ahmeda Benjama","doi":"10.9734/ijtdh/2021/v42i1230501","DOIUrl":"https://doi.org/10.9734/ijtdh/2021/v42i1230501","url":null,"abstract":"Aims: To describes the histopathological characteristics of skin lesions from patients with cutaneous leishmaniasis caused by Leishmania major in northwestern Libya and correlate with clinical presentation. \u0000Study Design: case series study. \u0000Place and Duration of Study: This study was carried on patients referred by the region's healthcare institutions and those presented at the Tripoli Central Hospital or the Libyan National Centre for Disease Control between July 2017 to January 2018. \u0000Methodology: The study included 38 patients, aged between 1-73 years, of both sexes, and came from 18 endemic areas in North-Western of Libya. The inclusion criteria were clinical symptoms and microscopic visualization of the parasite on a Giemsa-stained skin smear, in addition, clinical by the slit and smear technique, polymerase chain reaction for L. major. In addition, statistical analysis was conducted for the Histopathological examination. \u0000Results: The study found that 36 (94%) of the cases studied were positive by the slit and smear technique, and 32 (88.9%) were positive by PCR for L. major. Five histopathological patterns were observed: (i) diffuse cellular reaction without necrosis (25%); (ii) diffuse cellular reaction with necrosis (31.3%); (iii) exudative and necrotic granulomatous reaction (25%); (iv) exudative granulomatous reaction without necrosis (9.3%); (v) exudative-tuberculoid reaction with typical tuberculoid granuloma (organized) (9.3%). Inflammatory cellular infiltration ranged from mild to severe. Lymph plasmacytosis and lymph histiocytosis were predominant (34.4% and 21.7%, respectively). Necrosis was diffuse or local. The clinical features were correlated with this histological pattern. Epidermal changes included acanthosis, exocytosis, spongiosis, hyperkeratosis, and atrophy. \u0000Conclusion: The histopathological changes observed in CL caused by L. major in North-Western of Libya are characterized by an intense diffuse inflammatory reaction in the dermis with the predominance of lymphoplasmacytic infiltration. Overall, the granulomatous presentation was the main one. Various clinical forms, including papule, plaque, erythematous nodule with hemorrhagic crust, or violaceous nodule with adherent crust and ulcerated nodule, are significantly correlated with the histopathological stages, whereas disease progression could be related to age. The histopathological diagnosis of CL caused by L. major has a sensitivity of 78% relative to PCR.","PeriodicalId":90555,"journal":{"name":"International journal of tropical disease & health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43387574","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}

{"title":"Parasitic Contamination of Fresh Fruits and Vegetables Sold in Port Harcourt Metropolis Markets, Rivers State, Nigeria","authors":"L. Gboeloh, I. I. Sounyo","doi":"10.9734/ijtdh/2021/v42i1230500","DOIUrl":"https://doi.org/10.9734/ijtdh/2021/v42i1230500","url":null,"abstract":"Parasitic contamination of fresh fruits and vegetables sold in selected markets in Port Harcourt Metropolis, Rivers State, Nigeria. was investigated. Oil mill and Creek Road were the two major markets in Port Harcourt metropolis area selected for this study. A total of 216 samples of different types of fruits and vegetables were randomly sampled for parasitological examination using normal saline and zinc sulphate floatation techniques. The results showed that out of the 216 samples of vegetables and fruits examined, 87 (40.3%) were infected. The results were statistically significant (P< 0.05). The parasites identified included Entamoeba coli; Entamoeba histolytica, Giardia lamblia, Balantidium coli, Ascaris lumbricoides, Ancyclostoma spp and Fasciola spp. Entamoeba coli was the most prevalent parasite (83.15%) while Ascaris lumbricodes (1.12%), Ancyclostoma spp (1.12%) and Fasciola spp (1.12%) had least prevalence. There was statistical no difference (P>0.05) in prevalence of parasites genus in the two markets. Tomatoes had the highest contamination rate of (10.6%) followed by waterleaf, bitter leaf, green leaf, pumpkin leaf, pear, orange, and scent leaf with the prevalence rate of 9.3%, 8.8%, 4.6%, 3.2%, 1.9%, 1.4% and 0.5% respectively. Produce contaminated with intestinal parasites poses a serious health challenge to the consumers if they are not properly washed before consumption. Personal hygiene and proper washing of fresh fruit and vegetable before consumption will reduce the prevalence of food-borne parasitic infections.","PeriodicalId":90555,"journal":{"name":"International journal of tropical disease & health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44684332","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}

{"title":"Quality of Life of Primary Healthcare Centres Physicians in BURAIDAH City 2020, a Study Using WHOQOL-BREF Questionnaire","authors":"Mohamad Fahad Alreshoudi, C. S. Kalevaru","doi":"10.9734/ijtdh/2021/v42i1230499","DOIUrl":"https://doi.org/10.9734/ijtdh/2021/v42i1230499","url":null,"abstract":"Background: Life of doctors puts them at a high level of challenges and stress which can affect their quality of life. Therefore, the objective of the study was to evaluate the Quality Of Life of Primary health care providers by applying a brief version of the World Health Organization questionnaire for assessing Quality of Life (WHOQOL-BREF). To find the factors which affect the QOL of PHC physicians and know the aspects where it was affecting the health and performance of the Doctors. \u0000Methods: A cross-sectional study was conducted among 186 physicians working in primary health care centers in BURAIDAH city under Ministry Of Health. WHOQOL BREF validated questionnaire was used in both English and Arabic versions. Data was entered and cleaned in SPSS 21.0 version and necessary statistical tests were applied. \u0000Results: In the present study, about 29.6% were females and 70.4% were males. About 66.6% of the study population were in 30-49 years age group and half (48.4%) of them were general practitioners. Mean QOL score in psychological domain (domain 2) was 63.66. In the other three domains of physical health, social relationships and environmental domain (domain 1, 3 & 4) was scoring more than 65. There was a statistically significant association observed between age and physical ,psychological health domains. This association was also seen between marital status and psychological, social domains. \u0000Conclusions: Based on the results, on the whole, the majority of primary health care doctors had a moderate quality of life score to a high quality of life score ranging from 63.66-68.06. Still, there is a scope of improvement in domain 2 (psychological domain). ","PeriodicalId":90555,"journal":{"name":"International journal of tropical disease & health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43028242","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}

{"title":"Assessment of Biomarkers in Patients Co-Infected with HIV/HBV Attending the Antiretroviral Clinic in a Tertiary Institution","authors":"G. B. Baeka, G. A. Isong, B. N. Piakor","doi":"10.9734/ijtdh/2021/v42i1230498","DOIUrl":"https://doi.org/10.9734/ijtdh/2021/v42i1230498","url":null,"abstract":"Aim: The level of some biomarkers such as the Lipid profiles and some liver enzymes were checked for in patients who were found to be co infected with HIV/HBV \u0000Study Design: The study was conducted among patients infected with the Human Immunodeficiency Virus attending the antiretroviral clinic at the Braith Waite memorial hospital, Port Harcourt, Rivers State. The samples and relevant data were gotten between the months of January and March 2019, using a structured questionnaire \u0000Methodology: The Samples were collected from patients infected with HIV attending the Braith Waite memorial hospital on antiretroviral medication. A total number of 98 samples were collected and analyzed for the presence of HBV IgM core antibody using the ELISA method. The statistical analysis was done using a Stata version 16 and the student T-test was used to determine the P value. A total of 98 samples were collected, 66(67.3%) were females and 32(32.6%) of them were males. Of the 98 samples, 5 (5.1%) of them were positive to HIV/HBV co infection of which 3(3.1%) were females and 2(2%) were males. The age range for those co infected was between 29 – 34 years old. The lipid profile and liver enzymes for the positive samples were analyzed. The result showed an increase in the level of LDL, HDL and triglyceride. The analysis for the liver enzymes showed an increase in the level of AST and ALP while the ALT and GGT remained within the healthy range.  The increase in the level of most of the biomarkers, showed that the patients co infected with HIV/HBV were at risk of heart and kidney diseases since they are already immunocompromised. From this result, it shows that patients who are HIV positive should undergo HBV test regularly. Those who are positive should have their biomarkers monitored and put under medication early.","PeriodicalId":90555,"journal":{"name":"International journal of tropical disease & health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48185535","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}

{"title":"Prevalence of Helminthiasis and Worm Load among Pre-school Children in Rural Areas of Enugu State","authors":"N. Ugwunna, N. Ude, O. C. Ugwunna, C. Onwasigwe, E. Aguwa, E. Aniwada, F. Aneke","doi":"10.9734/ijtdh/2021/v42i1030488","DOIUrl":"https://doi.org/10.9734/ijtdh/2021/v42i1030488","url":null,"abstract":"Background: Globally, many people suffer from parasitic infections of the intestines with up to 24% of the world population are affected. These infections are particularly prevalent in low-and middle-income countries and exist mainly among economically and socially disadvantaged populations. This study sought to establish the current prevalence of STHs among preschool children in rural areas of Enugu State. \u0000Materials and Methods: This was a cross-sectional descriptive study carried out at Obinofia Ndi-Uno and Obe, rural communities of Enugu State, Nigeria. A pre-tested semi-structured interviewer-administered questionnaire and Laboratory kits for stool analysis were used. Data were analyzed using the IBM SPSS statistics version 22. \u0000Results: A total of 589 preschool children (294 from Obinofia Ndi-Uno and 295 from Obe) were studied. Ova of helminths were seen in the stool of 47 preschool children giving a prevalence of 8% with ascariasis being the predominant infection. \u0000Discussion: The prevalence of worm infection in this study was low compared to some studies in Nigeria, Africa, and other parts of the world.","PeriodicalId":90555,"journal":{"name":"International journal of tropical disease & health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46513245","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}

{"title":"Prevalence, Pattern and Risk Factors of Dating Violence among Undergraduate Students of a Tertiary Institution within Sokoto Metropolis of Sokoto State, Nigeria","authors":"H. Adamu, O. Oche, Muhammad Aisha Isah, Sahabi Abubakar Muhammad, A. Abdullahi","doi":"10.9734/IJTDH/2021/V42I1030487","DOIUrl":"https://doi.org/10.9734/IJTDH/2021/V42I1030487","url":null,"abstract":"Aim: To determine the prevalence, pattern and risk factors of dating violence among undergraduate students of Usmanu Danfodiyo University Sokoto (UDUS). \u0000Methodology: It was a descriptive cross-sectional study involving 340 undergraduate students, selected via multistage sampling technique. A structured self-administered questionnaire was used to collect data from the respondents, and data were analyzed using IBM SPSS version 26.0 and Microsoft Excel 2016. \u0000Results: The ages of the respondents ranged from 18 to 29 years, with mean of 22.4±2 years; 218(66.9%) were males, 214(65.6%) were Hausa/Fulani and 266(81.9%) were Muslims. Majority of the respondents have been in a dating relationship for more than one academic year; 106(37.3%) of the dating partners were students of the university, of which 26(24.8%) were class mates. Current and lifetime prevalence of dating violence were 56% and 59.5% respectively. Form of dating violence experienced mostly by respondents was emotional/psychological violence [44(22.4%)], physical violence was the least experienced [27(14.04%)]. Up to 93(48%) of the dating violence took place on campus and 68(35%) of the perpetrators were current partners. Factors associated with dating violence included feeling overburdened by partners’ demands, and spending too much on partner. \u0000Conclusion: Current and lifetime prevalence of dating violence were high and emotional violence was the commonest form of dating violence experienced by respondents. There is need for school authorities to put in place mechanisms to identify victims of dating violence and come up with measures aimed at stemming the tide of dating violence in university campuses.","PeriodicalId":90555,"journal":{"name":"International journal of tropical disease & health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42059005","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}

{"title":"Easy Protocol Assessment in Children Emergency Room, Irrua Specialist Teaching Hospital Nigeria","authors":"Owobu Adaugo, Kesieme Chinenye, I. Juliet, Owobu Clifford, Ike Chiedozie, Okogbenin Sylvanus","doi":"10.9734/IJTDH/2021/V42I1030486","DOIUrl":"https://doi.org/10.9734/IJTDH/2021/V42I1030486","url":null,"abstract":"Aim:  To determine the effect of the EASY (Early Attention to Sepsis in the Young) protocol on sepsis outcomes in children admitted into the children's emergency unit. \u0000Methodology: Sixty participants (24 males and 36 females) aged 1 month - 16 years were recruited into two arms- The EASY protocol and the non-EASY protocol (control) arm. The researchers obtained relevant treatment history and clinical and laboratory data, which were analyzed statistically using SPSS version 25. \u0000Results: Twenty-five (80%) patients on EASY protocol received saline boluses compared to 5 (16.7%) in the control group. The difference was significant: χ2 = 24.09, p ˂ .001. Similarly, more patients on EASY (10; 33.3%) than the control (3; 10.0%) received continuous positive airway pressure: χ2 = 4.81, p = .03. \u0000Where the symptoms were predominantly restricted to one organ system, those on EASY protocol spent less time in the emergency unit (0.98 ± 0.43 days) than the control (1.87 ± 0.97 days): F = 13.02, p = .001. However, there was no statistically significant difference in the overall duration of hospital admission in both groups: t = 1.33, p = 0.20. \u0000In the EASY arm, the particular EASY treatment used correlated with the presence of underlying chronic disease and the approximate duration of current illness; p= 0.001, R2= 0.37 - 0.59; as well as the presence of abnormal blood cell counts; p= 0.022, R2= 0.39 - 0.64. \u0000Conclusion: The EASY protocol increased the intensity of treating children with sepsis in the emergency unit and reduced the critical phase.","PeriodicalId":90555,"journal":{"name":"International journal of tropical disease & health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47586187","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}

{"title":"Health, Nutrition and Treatment Compliance of People Living with HIV/AIDS (PLWHA) at the Liberian Government Hospital in Buchanan, Grand Bassa County, Liberia","authors":"Arthureen Tina Nessian, Leila S. Africa, Jaidee P. Agne, Kristine V. Montecillo","doi":"10.9734/IJTDH/2021/V42I930485","DOIUrl":"https://doi.org/10.9734/IJTDH/2021/V42I930485","url":null,"abstract":"Aims: To assess the nutritional and health status, and compliance with treatment and health services of adult people living with HIV/AIDS (PLWHA) attending Liberian Government Hospital (LGH). Study Design:  Cross-sectional study Place and Duration of Study: LGH, Buchanan, Grand Bassa County, 2018 Methodology: The survey was conducted among 90 adults PLWHA. Results: The majority had acute HIV infection, and tuberculosis and herpes zoster were the most contracted opportunistic infections. Although the majority had normal nutritional status, malnutrition was still observed especially among the women. Most had poor diet diversity and claimed to have faced challenges, mainly monetary concerns, while some experienced other traumatic events. A few also showed indications of self-harm. Moreover, they generally have a good health condition and medication adherence and demonstrated substantial knowledge about the disease and its treatment. Compliance was found to be associated with the health status of the participants, but not with their nutrition status, socio-economic and other characteristics. Conclusion: The results provide an insight into the nutritional status and compliance of the adult PLWHA in Liberia. It is hoped that this study would be useful in crafting and enhancing existing intervention programs and policies promoting the better quality of life of adult PLWHA in the country.","PeriodicalId":90555,"journal":{"name":"International journal of tropical disease & health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49516633","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}