Current health sciences journal最新文献

{"title":"Burn Debridment - Approach and Review.","authors":"Elena Alexandra Marinescu, Alina Andreea Negrilă, Răzvan Alexandru Marinescu, Oliviu Nica, Alexandru Tălăban, Marius Eugen Ciurea, Ana Maria Ciurea","doi":"10.12865/CHSJ.51.01.01","DOIUrl":"10.12865/CHSJ.51.01.01","url":null,"abstract":"<p><p>Between January 2020 and December 2024, a significant number of burn patients were admitted to the Plastic Surgery Clinic of the Craiova Emergency Clinical Hospital. Due to the high incidence of burns requiring hospitalization and the limited number of beds available for such patients, it became essential to identify optimal treatment methods that could reduce hospital stay while ensuring favorable functional and aesthetic outcomes. Early debridement is considered a vital first step in the treatment of burn patients, ideally performed within the first few days post-injury. Burn treatment involves both surgical and systemic approaches. Surgical management includes debridement, skin grafting, and reconstruction. Tangential surgical debridement remains the gold standard for deep burns, allowing precise removal of necrotic tissue while preserving viable skin. However, it may be associated with disadvantages such as intraoperative blood loss and incomplete excision. Alternative methods have evolved, such as hydrodissection, which uses a high-pressure saline jet for selective debridement, particularly useful in partial thickness burns. Larval therapy (using sterile Lucilia sericata maggots) is another option, especially effective in infected or necrotic wounds, offering antimicrobial benefits as well. Enzymatic debridement, particularly with bromelain-based products, is a modern, selective, and less invasive method that promotes healing with minimal bleeding and often reduces the need for grafting. A clinical case from Craiova highlights the success of enzymatic debridement: a 75-year-old patient with extensive burns showed significant improvement and near-complete epithelialization after 24 days, without requiring grafts. These outcomes support the growing use of enzymatic agents as a valuable tool in modern burn management, offering rapid, effective treatment and better patient recovery.</p>","PeriodicalId":93963,"journal":{"name":"Current health sciences journal","volume":"51 1","pages":"5-13"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661393","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}

{"title":"Complications of Thyroid Surgery-Can We Further Minimize the Risk?","authors":"Ana Laura Manda, Sanda Amelia Dracea, Ana Laura Dima, Dragos Virgil Davitoiu, Danut Vasile, Daniel Iulian Voiculescu","doi":"10.12865/CHSJ.51.01.08","DOIUrl":"10.12865/CHSJ.51.01.08","url":null,"abstract":"<p><p>Thyroid surgery is nowadays a mostly safe and standardized procedure, with low complication and mortality rates. The specific complications of thyroid surgery are lesion of the recurrent laryngeal nerve (RLN), hypoparathyroidism, either transient or permanent, and hemorrhage that can be in some cases life-threatening; even if not, the impact on the quality of life can be negative. The identification of risk factors for complications of thyroid surgery and development of strategies for reducing morbidity are important for the thyroid surgeon. We conducted a retrospective study on a database of 60 patients operated for a thyroid disease in a period of two years in the setting of a non-specialized general emergency hospital in both general surgery department and thoracic surgery department. The main complication was transient hypoparathyroidism (defined by lower than 8mg/dl serum calcium postoperatively)-18.33% of the group, followed by cervical minor hematoma-5.00% of cases and RLN injury in one case-1.67%. Regression analysis showed type of thyroid surgery (p-value 0.0471), histopathology type of disease (p-value 0.0566) and difficulty of surgery defined by operative time (p-value 0.0494) as the risk factors for postoperative complications, of which only the last one can be modifiable by some extent. Identifying and minimizing the risk factors of difficult surgery might improve also complication rates.</p>","PeriodicalId":93963,"journal":{"name":"Current health sciences journal","volume":"51 1","pages":"81-86"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661396","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}

{"title":"Histopathological Assessment of Non-Small Cell Lung Carcinomas.","authors":"Daniela Florentina Grecu, Marian Valentin Zorilă, Liliana Stanca, Alexandru Florian Grecu, Oana Iulia Crețu, Marie Badiu, Bianca Cătălina Andreiana, Mirela Marinela Florescu, Alex Emilian Stepan","doi":"10.12865/CHSJ.51.01.11","DOIUrl":"10.12865/CHSJ.51.01.11","url":null,"abstract":"<p><p>Non-small cell lung carcinomas (NSCLC) are common lung tumors with numerous growth patterns associated with lesion types, which are frequently diagnosed late and are associated with a reserved prognosis. In this study, we analyzed histopathologically and statistically 52 cases of NSCLC, for which the growth types/patterns were described and compared with tumor grade, the presence of vessels invasion and stage of tumor. We observed the predominance of adenocarcinomas (ADK) and acinar, cribriform, solid and papillary growth patterns, frequent mixed transitional areas, while for squamous cell carcinomas (SCC) the non-keratinized aspect was dominant. Vascular invasion was identified in 38.5% of cases, most NSCLC being in advanced stages, respectively 57.7%. ADK with cribriform, solid, and micropapillary patterns, as well as nonkeratinized SCC (NKSCC) and large cell carcinoma (LCC) were significantly associated with high grade, vessels invasion, and advanced stage of tumos. Transitional areas of ADK and focal keratinizations in SCC suggest the presence of specific lung tumor histological lesions, which in evolution acquire aggressive patterns.</p>","PeriodicalId":93963,"journal":{"name":"Current health sciences journal","volume":"51 1","pages":"105-111"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661401","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}

{"title":"Tertiary Dentin Barrier Formation: A Comparison Between the Effects of Two Calcium Silicate Based Materials.","authors":"Antoanela Magdalena Covaci, Mihai Andrei, Ioana Dinca, Lucian Toma Ciocan, Madalina Nicoleta Matei, Andreea Cristiana Didilescu","doi":"10.12865/CHSJ.51.01.10","DOIUrl":"10.12865/CHSJ.51.01.10","url":null,"abstract":"<p><p>Pulp capping is a vital pulp therapy that aims to prolong the life of a tooth by protecting it after pulp exposure occurred. Pulp capping biomaterials are intended to induce odontoblasts to deposit a natural tertiary dentin barrier to protect the pulp-dentin complex. Two pulp capping agents with calcium silicates in their composition, but with different mechanisms of the setting reaction were tested in vivo with the main objective of comparing their effect on the pulp-dentin complex. The specific aim was to evaluate the preservation of pulp vitality following in vivo direct and indirect pulp capping on eight human third molars. TheraCal LC, a light-cured calcium silicate-based material, was tested both by direct and indirect pulp capping, while the mineral trioxide aggregate (MTA) cement was tested by direct pulp capping. The molars were assessed by micro-computed tomography (micro-CT) and by light microscopy and stereo-microscopy following histological processing of the teeth. Dental pulp vitality testing was performed before tooth extraction. Inflammatory pulp status was performed on light microscopy images and it was investigated the presence of inflammatory infiltrate, edema, vascular congestion and pulp necrosis. Following pulp capping, the MTA cement showed more favorable results, generating the formation of complete or incomplete dentin bridges in all treated teeth, while TheraCal LC induced the formation of dentin bridges in only two teeth. Tooth vitality was preserved in all tested teeth. In conclusion, both materials stimulated neodentinogenesis, with the MTA cement being more effective and presenting a much more favorable biological pulpal response.</p>","PeriodicalId":93963,"journal":{"name":"Current health sciences journal","volume":"51 1","pages":"96-104"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661305","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}

{"title":"Using Convoluted Neural Networks in Diagnosing Lung Cancer on Computed Tomography Scans.","authors":"Ovidiu Cîmpeanu, Ilona Mihaela Liliac, Mădălin Mămuleanu, Ștefan-Vlad Voinea, Mihai Olteanu, Costin-Teodor Streba","doi":"10.12865/CHSJ.51.01.09","DOIUrl":"10.12865/CHSJ.51.01.09","url":null,"abstract":"<p><strong>Introduction: </strong>Lung cancer represents a major health issue of the modern world, accounting for both most new cases and highest mortality rates worldwide. Early diagnosis and treatment remain essential in managing the disease; therefore, developing novel computer-assisted tools for processing large quantities of imaging data can prove indispensable. Our aim was to develop a novel convoluted neural network (CNN) to classify lung computed tomography (CT) images of suspect nodules.</p><p><strong>Materials and methods: </strong>After obtaining ethical clearance, we included consenting patients with a lung mass found on a chest radiography, visible lung tumor on computer tomography and positive pathology or follow-up. After data augmentation, we trained a deep learning model to classify input images into two classes, malignant or benign. We evaluated the model by calculating accuracy, recall and precision.</p><p><strong>Results: </strong>We successfully enrolled 176 patients from a total of 192 cases. Most were male (135 cases, accounting for 76.7%) and came from urban areas (111 cases, 63%). Most tumors were found on the right lung (103 cases). The model performed well on an imbalanced dataset, with recall values at 79.31%, while precision reached 62.16%, a training accuracy of 76.34% and a validation accuracy of 77.01%.</p><p><strong>Conclusions: </strong>We proved that a CNN model can easily be implemented on regular hardware to successfully classify malignant and benign lung lesions on CT images. Future CNN implementations can greatly improve the imaging diagnosis of lung lesions; however, the physicians should always decide the medical management.</p>","PeriodicalId":93963,"journal":{"name":"Current health sciences journal","volume":"51 1","pages":"87-95"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661308","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}

{"title":"The Case of the \"Double Pylorus\".","authors":"Ayush Sutaria, Shamim Ejaz, Irina M Cazacu, Adrian Saftoiu, Manoop S Bhutani","doi":"10.12865/CHSJ.51.01.16","DOIUrl":"10.12865/CHSJ.51.01.16","url":null,"abstract":"<p><p>A 68-year-old female with a history of small cell carcinoma of the lung and peptic ulcer disease presented for evaluation of dysphagia after undergoing radiation and chemotherapy. Esophagogastroduodenoscopy (EGD) revealed a radiation-induced esophageal stricture and incidentally a \"double pylorus (DP)\" with an adjacent similar opening cephalad to the pylorus. There was no evidence of perforation or traumatic injury leading to this finding and upon intubation, both openings led to the duodenal bulb that appeared to be normal. No endoscopic and surgical intervention was offered as patient was asymptomatic.</p>","PeriodicalId":93963,"journal":{"name":"Current health sciences journal","volume":"51 1","pages":"151-154"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661306","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}

{"title":"Analysis of Imaging, Pathology and Demographic Data of Lung Cancer Patients Diagnosed in a Tertiary Medical Center in the South-West Region of Romania.","authors":"Ovidiu Cîmpeanu, Ilona Mihaela Liliac, Daniel-Nicolae Pirici, Mihai Olteanu, Costin-Teodor Streba","doi":"10.12865/CHSJ.51.01.14","DOIUrl":"10.12865/CHSJ.51.01.14","url":null,"abstract":"<p><strong>Introduction: </strong>Lung cancer is the most common type of primary tumor in both males and females, accounting for significant mortality worldwide. Clear evidence regarding comorbidities and aggravating factors exist, with multiple pathways being cited in recent literature.</p><p><strong>Patients and methods: </strong>Our aim was to review relevant sources and demonstrate through an original statistical study that tumor type, location, comorbidities, as well as demographic factors, may play a limited role in the evolution of lung adenocarcinoma. After obtaining ethical clearance, we enrolled consenting lung cancer patients in an observational cross-sectional study, collecting relevant demographic and medical information. Patients were recruited from a single tertiary medical center in Craiova, Romania, between January 2021 and January 2025. We used the Anova and the chi-square tests, considering p values below 0.05 as statistically significant.</p><p><strong>Results: </strong>We enrolled 189 patients (143 males, 75.6% of the entire lot), from urban and rural settings (49.7% from urban areas). The mean age was 64.94±10.47 years, with minimal variance when accounting for gender or provenance (Anova test, p>0.05). Most tumors were located in the upper portions of the lungs, with 111 cases, 53.44%. We found that 55.24% of males had tumors of the right lung, while only 39.13% of females had this location. Men had higher COPD rates (79 cases, 55.24%) and only two females (4.34%), p<0.05. However, we found statistically significant more women smokers than men (82.6% women vs. 41.25% of men).</p><p><strong>Conclusion: </strong>We hereby demonstrated that lung cancer remains a significant medical burden for the medical system, with prevalence in both sexes, irrespective of provenance. Most cases were diagnosed between 40 and 65 years, smoking and toxic exposure being predominant.</p>","PeriodicalId":93963,"journal":{"name":"Current health sciences journal","volume":"51 1","pages":"130-140"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661383","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}

{"title":"Comparison of Running Versus Interrupted Sutures for Fascial Closure in Ileostomy Takedown.","authors":"Tamás Talpai, Bogdan Mărunțelu, Valeriu Șurlin, Silviu-Daniel Preda, Cătălin-Alexandru Pîrvu, Ștelian Pantea, Adrian Dobrinescu","doi":"10.12865/CHSJ.51.01.07","DOIUrl":"10.12865/CHSJ.51.01.07","url":null,"abstract":"<p><p>Temporary loop ileostomies are common after colorectal cancer surgery to reduce anastomotic leak severity. However, ileostomy takedown carries risks like surgical site infections (SSIs) and incisional hernias. The optimal fascial closure technique during takedown remains debated. This study compared these techniques regarding postoperative complications. This retrospective study analyzed data from 69 patients undergoing scheduled loop ileostomy closure between 2016-2020 at two Romanian surgical departments. Data collected included demographics, clinical variables (ASA score, comorbidities), surgical details (suture type, closure time, skin closure type), and follow-up data including CT assessments for hernia detection. The cohort included 69 patients (mean age 63, 64% male). Fascial closure was used in 17 (24.7%) and interrupted in 52 (75.4%) patients. Running sutures were significantly faster (mean 19 vs. 22 min, p=0.028). Overall SSI rate was 21.7%. Ileostomy site incisional hernias occurred in 13 patients (18.6%) after a mean follow-up of 30.7 months. No statistically significant difference in hernia rates was found between running (3/17) and interrupted (10/52) suture groups (p=1). Significant risk factors for hernia development included longer follow-up (OR=0.87, p=.025), BMI≥30 (OR=176, p=.009), and Clavien-Dindo grade 3 postoperative complications (OR=112, p=.033). While running sutures offer faster fascial closure, this study found no significant difference in ileostomy site incisional hernia rates between running and interrupted techniques. Patient factors like BMI ≥30 and severe postoperative complications are significant predictors of hernia formation. Careful technique is crucial, but primary closure without mesh remains standard.</p>","PeriodicalId":93963,"journal":{"name":"Current health sciences journal","volume":"51 1","pages":"72-80"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661395","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}

{"title":"Deep Learning and The Retina: A New Frontier in Multiple Sclerosis Diagnosis.","authors":"Sorina-Elena Abdul-Salam, Ruxandra-Madalina Florescu, Veronica Sfredel, Dragos-Ovidiu Alexandru, Mircea-Sebastian Șerbănescu, Alexandra-Daniela Rotaru-Zăvăleanu","doi":"10.12865/CHSJ.51.01.03","DOIUrl":"10.12865/CHSJ.51.01.03","url":null,"abstract":"<p><p>Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system that leads to neurodegeneration and functional disability. Because recent advances in retinal imaging have revealed that the retina is a non-invasive window into the brain, offering valuable biomarkers for MS diagnosis and progression tracking, we explored the integration of artificial intelligence (AI), particularly deep learning (DL), in the analysis of fundus-based imaging techniques such as Optical Coherence Tomography (OCT), fundus photography, and Scanning Laser Ophthalmoscopy (SLO). These investigations allow for the detection of subtle retinal changes, such as thinning of the retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL), which are closely associated with MS pathology with the help of AI-driven models, including convolutional neural networks (CNNs), generative adversarial networks (GANs), and explainable AI approaches and they have demonstrated high accuracy in classifying MS patients, even at early stages, and predicting disease severity. The review also discusses the challenges and future directions of applying AI in ophthalmic diagnostics, including data standardization, model interpretability, and clinical integration. Overall, AI-enhanced retinal imaging is emerging as a powerful, non-invasive tool that can complement traditional neurological assessments and support earlier, more personalized MS care.</p>","PeriodicalId":93963,"journal":{"name":"Current health sciences journal","volume":"51 1","pages":"26-36"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661398","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}

{"title":"Depressive-Like Behavior and Liver Damage Generate Behavioral and Cortical Microglial Morphological Differences in Mice.","authors":"Gabriel Nedelea, Mădălina Iuliana Mușat, Alina Cătălina Buican-Chirea, Mihai Călin Ciorbagiu, Bogdan Cătălin","doi":"10.12865/CHSJ.50.04.08","DOIUrl":"10.12865/CHSJ.50.04.08","url":null,"abstract":"<p><strong>Introduction: </strong>The correlation between nonalcoholic fatty liver disease (NAFLD) and depression has already been established, but the relation between the two is insufficiently studied. Various murine models have proven effective in evaluating the mechanisms involved in these pathologies.</p><p><strong>Material and methods: </strong>In this study we aimed to assess how the chronic unpredictable mild stress (CUMS) protocol impacts the behavior of mice with liver damage induced by a methionine choline deficient (MCD) diet, and also to evaluate the changes in microglial morphology in the cortex of animals with depressive-like behavior and liver injury. Thus, the cortical region was analyzed using confocal microscopy.</p><p><strong>Results: </strong>Sucrose preference test and open field test revealed induced anhedonia and anxiety-like behavior, but short-term memory was not impaired, as assessed by novel object recognition test. Administration of the MCD diet led to an increase in total branch length and the number of terminal branches, revealing a hyperactivated microglia. The CUMS protocol in combination with MCD diet induced a reduced branching complexity, with fewer tertiary and terminal branches.</p><p><strong>Conclusion: </strong>Our study highlights the importance of microglial morphology at the cortical level in coexisting depression and liver injury.</p>","PeriodicalId":93963,"journal":{"name":"Current health sciences journal","volume":"50 5","pages":"546-555"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722859","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}