Annals of musculoskeletal medicine最新文献

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Effects of postural control by personal mobility on human joint movements-prototype of a new alert system for personal mobility devices 个人移动设备的姿势控制对人体关节运动的影响--个人移动设备新警报系统的原型
Annals of musculoskeletal medicine Pub Date : 2024-05-11 DOI: 10.17352/amm.000034
Tanaka Toshiaki, Miura Takahiro
{"title":"Effects of postural control by personal mobility on human joint movements-prototype of a new alert system for personal mobility devices","authors":"Tanaka Toshiaki, Miura Takahiro","doi":"10.17352/amm.000034","DOIUrl":"https://doi.org/10.17352/amm.000034","url":null,"abstract":"Purpose: This study aimed to develop a prototype Personal Mobility (PM) system with human-robot synchronous motion measurement and sensory feedback as an attention reminder to ensure the safe performance of sustained, step-by-step rehabilitation tailored to the daily living conditions of elderly individuals. Methods: Five healthy adults were fitted with a simulation tool to experience the elderly, and inertial measurement unit sensors were placed on the subjects and the PM device to measure joint movements during two postural movements (sitting to supine and supine to standing). In addition, vibration stimulation and voice guidance were implemented as alerts at a certain set threshold of the joint motion angle. We analyzed the deviation of each joint motion between the subject and the PM device regarding the angle measurements of the trunk, hip, knee, and ankle joints. Results: Trunk angle misalignment was high in the sitting-to-supine position. Hip angle misalignment was greater in the supine to standing position. As an alert system, vibration and voice guidance could be presented to the subject with a 0.3-second delay after the set threshold was reached. Conclusion: The misalignment between a human and a motorized wheelchair in contact with the human is more than several tens of degrees when expressed as the angle change value of the joint motion. We believe that a system that can constantly sense and alert the user regarding whether the user and the PM device are in sync is necessary for PM devices being used in rehabilitation or as daily life support.","PeriodicalId":91838,"journal":{"name":"Annals of musculoskeletal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140988616","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
The eTRIMP method for bodybuilding training load assessment: A review with a case study 用于健美训练负荷评估的 eTRIMP 方法:案例研究综述
Annals of musculoskeletal medicine Pub Date : 2023-11-23 DOI: 10.17352/amm.000033
Fernandes Haniel
{"title":"The eTRIMP method for bodybuilding training load assessment: A review with a case study","authors":"Fernandes Haniel","doi":"10.17352/amm.000033","DOIUrl":"https://doi.org/10.17352/amm.000033","url":null,"abstract":"Objective: The objective of this study is to know if the method of calculating full training load session eTRIMP using pulse monitors would be able to demonstrate a monotony like the total internal load model through the session-RPE using workload method in a resistance athlete. Methods: This is a one-week observational study that evaluated time, heart rate, and session RPE in a 32-year-old adult during prescribed resistance training to compare Internal Training Load (ITL) using the eTRIMP method with traditional assessment methods that use session RPE multiplied by training session duration, known as session workload calculation. Results: The total load for the week varied between models due to the method of obtaining the result being different, 417 au for the weekly summation based on eTRIMP versus 3321 au using the workload method. However, the monotony of the weekly training prescription was similar, observationally evaluated, between the groups (2.4 for the workload method versus 2.9 for the eTRIMP method). Conclusion: The internal load evaluated by the eTRIMP model seems to show a monotony value like the value calculated by the weekly load using session-RPE and workload. Therefore, evaluating resistance training using the eTRIMP by pulse monitoring model seems to be a useful tool in analyzing training week monotony to maintain high loads favoring the hypertrophy and fat-burning process.","PeriodicalId":91838,"journal":{"name":"Annals of musculoskeletal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139245771","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
Intravenous single dose of tranexamic acid safely reduces blood loss and the need for transfusion in elderly patients with hip fracture. A randomized double-blinded controlled trial at 1-year follow-up 静脉注射单剂量氨甲环酸可安全减少老年髋部骨折患者的失血量和输血需求。为期一年的随机双盲对照试验
Annals of musculoskeletal medicine Pub Date : 2023-11-21 DOI: 10.17352/amm.000032
Miralles-Muñoz Francisco A, Martin-Grandes Rosario, Martinez-Mendez Daniel, Mahiques-Segura Gerard, Lizaur-Utrilla Alejandro, Vizcaya-Moreno María Flores
{"title":"Intravenous single dose of tranexamic acid safely reduces blood loss and the need for transfusion in elderly patients with hip fracture. A randomized double-blinded controlled trial at 1-year follow-up","authors":"Miralles-Muñoz Francisco A, Martin-Grandes Rosario, Martinez-Mendez Daniel, Mahiques-Segura Gerard, Lizaur-Utrilla Alejandro, Vizcaya-Moreno María Flores","doi":"10.17352/amm.000032","DOIUrl":"https://doi.org/10.17352/amm.000032","url":null,"abstract":"Background: A hip fracture usually presents significant blood loss in the perioperative period, with a transfusion rate of 20-60%. In order to reduce the complications associated with this procedure, the administration of Tranexamic Acid (TXA) has been implemented in the treatment of perioperative anemia. The objectives were to evaluate the effectiveness and safety of a single dose of intravenous Tranexamic Acid (TXA) in reducing perioperative blood loss and the requirement for transfusion in elderly patients undergoing hip fracture surgery within one postoperative year. Methods: A double-blind randomized controlled trial was conducted on 129 patients with hip fractures. After randomization, at the start of the surgery, 65 patients received a single dose of 1 gram of intravenous TXA (TXA group), and 64 received a placebo (placebo group). The primary effectiveness outcomes were the total blood loss and transfusion rate. The primary safety outcome was the rate of thromboembolic events. Data on surgical or medical infection, readmission and death were also collected. Results: The TXA group had a significant decrease in blood loss (p = 0.006) and requirement for transfusion (p < 0.001) compared with the placebo group. Likewise, there were no thromboembolic events in the TXA group and seven in the placebo group (p = 0.006). Mortality within 1-year postoperatively was not significantly different (p = 0.115). Conclusion: Using a single dose of intravenous TXA at the start of the surgery significantly reduces blood loss and the requirement for transfusion without increasing the risk of thromboembolic events or mortality within 1-year postoperatively in patients with hip fracture undergoing surgery. Registration number: NCT03211286. https://clinicaltrials.gov/ct2/show/NCT03211286. Level of evidence: I.","PeriodicalId":91838,"journal":{"name":"Annals of musculoskeletal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139253230","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
A case study of the association between adolescent idiopathic scoliosis, weight training and shoulder dislocation 青少年特发性脊柱侧凸、重量训练和肩关节脱位之间关系的个案研究
Annals of musculoskeletal medicine Pub Date : 2023-09-15 DOI: 10.17352/amm.000031
Constantin Marian
{"title":"A case study of the association between adolescent idiopathic scoliosis, weight training and shoulder dislocation","authors":"Constantin Marian","doi":"10.17352/amm.000031","DOIUrl":"https://doi.org/10.17352/amm.000031","url":null,"abstract":"This study shows a rare association between the anomalous position of the shoulder girdle, due to scoliosis, with altered shoulder kinematics, injury of joint capsule ligaments and rotator cuff tendons, and shoulder dislocation due to a traumatic event. The subject has developed adolescent idiopathic scoliosis, with convex curvatures to the right side in the lower region of the thorax (with the Cobb angle of 13 degrees) and to the left side of the upper region of the thorax (with the Cobb angle of 24-degrees), both of them with the axial rotation of vertebra and with visible gibbosities. The upper axial rotation has a 6.5-degree, which causes an unbalance between the two shoulder girdles. In normal situations, the shoulder joint is turned 30 degrees anterior to the coronal plane, but in his case, the right shoulder girdle is pulled 28 degrees anterior by the groove, and the left one is pushed 34.5 degrees anterior by the gibbosity. The major effect of shoulder girdle unbalance appears to be the maximum extension of the upper limbs when the hands can’t be aligned to the coronal plane and this is an important risk factor for the injuries of the left shoulder joint, while some weight training exercises are performed.","PeriodicalId":91838,"journal":{"name":"Annals of musculoskeletal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135485806","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
Spondyloepipheseal dysplasia tarda
Annals of musculoskeletal medicine Pub Date : 2023-04-18 DOI: 10.17352/amm.000030
Altaf Raisa, Siraj Rabiya, Qureshi Ramsha Fatima, Panhwer Uzma, Naseer Hina, Abro Khansa
{"title":"Spondyloepipheseal dysplasia tarda","authors":"Altaf Raisa, Siraj Rabiya, Qureshi Ramsha Fatima, Panhwer Uzma, Naseer Hina, Abro Khansa","doi":"10.17352/amm.000030","DOIUrl":"https://doi.org/10.17352/amm.000030","url":null,"abstract":"Skeletal disorders are common entities that we encounter in our daily practice. Their early diagnosis is key to proper management and genetic counselling. Spondyloepiphyseal dysplasia is one such disorder. It is a genetic bone deformity that affects the spine, proximal epiphysis and pelvis. The disease is either manifested at birth or during adolescence therefore given the terms SED congenita or SED tarda. Patients with SED present with variable features including short height, short neck, club foot, cleft palate, kyphoscoliosis or lordotic abnormalities. We also present a case of an 11-year-old boy who presented to us with complaints of stunted growth and abnormal posture and underwent radiological imaging.","PeriodicalId":91838,"journal":{"name":"Annals of musculoskeletal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78247537","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
The effects of carisoprodol on endochondral ossification: A review of the literature and implications for bone health 卡异泊醇对软骨内成骨的影响:文献综述及其对骨骼健康的影响
Annals of musculoskeletal medicine Pub Date : 2022-12-28 DOI: 10.17352/amm.000029
Sai Yrkm
{"title":"The effects of carisoprodol on endochondral ossification: A review of the literature and implications for bone health","authors":"Sai Yrkm","doi":"10.17352/amm.000029","DOIUrl":"https://doi.org/10.17352/amm.000029","url":null,"abstract":"Carisoprodol is a medication commonly prescribed for musculoskeletal pain, but recent studies have raised concerns about its potential negative effects on bone development and health, particularly in relation to endochondral ossification. Endochondral ossification is a critical process that involves the transformation of cartilage into bone, which is essential for the formation of long bones in the body. Carisoprodol has been shown to reduce the activity of osteoblasts while increasing the activity of osteoclasts, leading to an imbalance in bone formation and resorption. Studies also suggest that carisoprodol may inhibit osteoblast differentiation, decrease bone density, strength, and microarchitecture, and affect the expression of genes involved in endochondral ossification. These negative effects may be due, in part, to its inhibition of the Wnt signaling pathway. Healthcare providers should carefully consider the potential risks of carisoprodol on bone development and health when prescribing this medication. Alternative treatments may be considered for patients at high risk of bone-related complications.","PeriodicalId":91838,"journal":{"name":"Annals of musculoskeletal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79433754","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
Prevalence and patient characterization of Work Related Musculoskeletal Disorders in patients visiting the physical therapy department in Karachi, Pakistan 在巴基斯坦卡拉奇的物理治疗部门访问的患者中与工作相关的肌肉骨骼疾病的患病率和患者特征
Annals of musculoskeletal medicine Pub Date : 2021-10-27 DOI: 10.17352/amm.000028
Ali Aadil Ameer, Chandio Fayaz, Naqi Sana, Shaikh Naseebullah, Chandio Shahmeer, Kumail Muhammad, Chandio Shahzeen, Iqbal Shanza
{"title":"Prevalence and patient characterization of Work Related Musculoskeletal Disorders in patients visiting the physical therapy department in Karachi, Pakistan","authors":"Ali Aadil Ameer, Chandio Fayaz, Naqi Sana, Shaikh Naseebullah, Chandio Shahmeer, Kumail Muhammad, Chandio Shahzeen, Iqbal Shanza","doi":"10.17352/amm.000028","DOIUrl":"https://doi.org/10.17352/amm.000028","url":null,"abstract":"Work Related Musculoskeletal Disorders (WRMSD) are the sort of disorders which involves soft tissues. The involvement of soft tissues can be due to the over use, restlessness and improper use. The main target of WRMSD are working indicuduals.it may cause muscle strain, ligament strain, tendon strain, tendinitis and bursitis. The cross section survey was conducted and data was collected from July to October 2018 from Jinnah Post graduate medical Centre Karachi, Pakistan. A self-constructed proforma was used among the 194 patients who meet the inclusion and exclusion criteria and Spss version 23 was used. The majority (n=98, 50.5%) were belongs to age group of 21 to 35 and were (n=102, 52.6%) were male. In marital status majority (n=128, 66%) were married. In involvement of part majority (n=56, 28.9%) were suffering from lower back problem. After checking the type of injury (n=56, 49.5%) were suffering from muscular strain. In the context of onset of injury majority (n=82, 42.3%) were experienced their problem suddenly. The study finalized that WRMSD is most common in working individuals especially in older and females. The WRMDS puts heavy burden on the society, annually. As the participants who belongs to low socio economic status are more vulnerable for WRMDS.","PeriodicalId":91838,"journal":{"name":"Annals of musculoskeletal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81161154","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
Prevalence of Upper Cross Syndrome among Students of University of Balochistan, Quetta Pakistan 巴基斯坦奎达俾路支省大学学生上交叉综合征的流行情况
Annals of musculoskeletal medicine Pub Date : 2021-10-22 DOI: 10.17352/amm.000027
Khokhar Hafsa Imtiaz, K. Amanullah, Zia Amber, Muhamad Deen, Hamid Fatima, S. Ghulam, Qamar Maqbool, Hussain Maryam Sabir, Salah Muhammad, Nawaz Shah, Sharif Shehzad
{"title":"Prevalence of Upper Cross Syndrome among Students of University of Balochistan, Quetta Pakistan","authors":"Khokhar Hafsa Imtiaz, K. Amanullah, Zia Amber, Muhamad Deen, Hamid Fatima, S. Ghulam, Qamar Maqbool, Hussain Maryam Sabir, Salah Muhammad, Nawaz Shah, Sharif Shehzad","doi":"10.17352/amm.000027","DOIUrl":"https://doi.org/10.17352/amm.000027","url":null,"abstract":"Objective: To assess the prevalence of upper crossed syndrome among students of Doctor of Physical Therapy (DPT) and Bachelors of Eastern Medicine and Surgery (BEMS) at university of Balochistan Quetta, Pakistan. Background: Upper cross syndrome is characterized as a pattern of tightness or over facilitation of chronically contracted and shortened muscles on one side and weakness or inhibition of chronically lengthened muscles on other side due to the muscle imbalance leading to postural abnormalities including, forward head posture, shoulder protraction, winging of scapula. These changes, in turn, lead to overstress of the cervical cranio-cervical junction, cervical and thoracic spine and shoulders, which can cause neck and/or jaw pain, headaches, and shoulder problems. The purpose of this study was to figure out the number of students of DPT and BEMS suffering from upper crossed syndrome at university of Balochistan Quetta, Pakistan. Methodology: A descriptive cross-sectional study was conducted. A self-constructed questionnaire having two parts, the first part comprised of demographics data while second part comprised of 18 questions and consent form was filled by 340 students both males and females from DPT and BEMS department. The Data was analyzed by Statistical Package for Social Sciences (SPSS) version 16. Results: The study participants had a mean age of ±21.85, most of them were, from 22-25 years n=182 (53.5%) age group, males n=178 (52.4%) and from 3rd semester n=107 (31.5%). The prevalence of upper cross syndrome in the current study was 45.0%. Conclusion: The study concludes that upper cross syndrome has high prevalence in the students of DPT and BEMS in faculty of pharmacy and health sciences, at university of Balochistan Quetta, Pakistan.","PeriodicalId":91838,"journal":{"name":"Annals of musculoskeletal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84844636","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
Prevalence of musculoskeletal disorder in electricity lineman in city Faisalabad, Pakistan 巴基斯坦费萨拉巴德市电线工人肌肉骨骼疾病的患病率
Annals of musculoskeletal medicine Pub Date : 2021-09-14 DOI: 10.17352/amm.000026
Noor Amna, A. Umair, Aslam Sulman, Sabir Raees, S. A. Ahmad, Aslam Hareem, Ch Mahnoor, Ali Muhammad
{"title":"Prevalence of musculoskeletal disorder in electricity lineman in city Faisalabad, Pakistan","authors":"Noor Amna, A. Umair, Aslam Sulman, Sabir Raees, S. A. Ahmad, Aslam Hareem, Ch Mahnoor, Ali Muhammad","doi":"10.17352/amm.000026","DOIUrl":"https://doi.org/10.17352/amm.000026","url":null,"abstract":"Most patients with advanced cancer develop skeletal muscle atrophy called sarcopenia, which reduces treatment tolerance and social activity and worsens the prognosis.","PeriodicalId":91838,"journal":{"name":"Annals of musculoskeletal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75164295","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
Takayasu arteritis miss-diagnosed as thoracic outlet syndrome: A case report 高须动脉炎误诊为胸廓出口综合征1例
Annals of musculoskeletal medicine Pub Date : 2020-09-09 DOI: 10.17352/amm.000023
Naseh Yousefi, P. Roomizadeh, G. Raissi, S. Sadeghi, Katayoun Moradi, Shahram Rahimi-Dehgolan
{"title":"Takayasu arteritis miss-diagnosed as thoracic outlet syndrome: A case report","authors":"Naseh Yousefi, P. Roomizadeh, G. Raissi, S. Sadeghi, Katayoun Moradi, Shahram Rahimi-Dehgolan","doi":"10.17352/amm.000023","DOIUrl":"https://doi.org/10.17352/amm.000023","url":null,"abstract":"Background: Takayasu Arteritis (TA) is an idiopathic inflammatory vasculitis of unknown etiology that mainly \u0000 involves the aorta and its major branches. In this study, we reported the case of a female patient with unilateral \u0000 hand weakness that was initially misdiagnosed as TOS. However, at her most recent admission, the absence of \u0000 radial pulse was noted which eventually led to the diagnosis of TA. Rarity of the disease, non-specific presentation \u0000 and the absence of specific biochemical marker for TA made its early diagnosis difficult. We have tried to highlight \u0000 the importance of conducting a thorough the physical examination when visiting patients with weakness, as well \u0000 as the importance of considering rare differential diagnoses including TA in patients with unilateral limb paresis. \u0000 TA might not manifest its typical constitutional symptoms preceding vessel involvement. Therefore, a thorough \u0000 clinical examination is pivotal in differentiating TA and TOS.","PeriodicalId":91838,"journal":{"name":"Annals of musculoskeletal medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81556069","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
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