951 resultados para electronic devices infection control


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OBJECTIVE: Incomplete compliance is one of several possible causes of uncontrolled hypertension. Yet, non-compliance remains largely unrecognized and is falsely interpreted as treatment resistance, because it is difficult to confirm or exclude objectively. The goal of this study was to evaluate the potential benefits of electronic monitoring of drug compliance in the management of patients with resistant hypertension. METHODS: Forty-one hypertensive patients resistant to a three-drug regimen (average blood pressure 156/ 106 +/- 23/11 mmHg, mean +/- SD) were studied prospectively. They were informed that for the next 2 months, their presently prescribed drugs would be provided in electronic monitors, without any change in treatment, so as to provide the treating physician with a measure of their compliance. Thereafter, patients were offered the possibility of prolonging the monitoring of compliance for another 2 month period, during which treatment was adapted if necessary. RESULTS: Monitoring of compliance alone was associated with a significant improvement of blood pressure at 2 months (145/97 +/- 20/15 mmHg, P < 0.01). During monitoring, blood pressure was normalized (systolic < 140 mmHg or diastolic < 90 mmHg) in one-third of the patients and insufficient compliance was unmasked in another 20%. When analysed according to tertiles of compliance, patients with the lowest compliance exhibited significantly higher achieved diastolic blood pressures (P = 0.04). In 30 patients, compliance was monitored up to 4 months and drug therapy was adapted whenever necessary. In these patients, a further significant decrease in blood pressure was obtained (from 150/100 +/- 18/15 to 143/94 +/- 22/11 mmHg, P = 0.04/0.02). CONCLUSIONS: These results suggest that objective monitoring of compliance using electronic devices may be a useful step in the management of patients with refractory hypertension, as it enables physicians to take rational decisions based on reliable and objective data of drug compliance and hence to improve blood pressure control.

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The evolution of malaria in Brazil, its morbidity, the malaria control programs, and the new challenges for these programs in the light of the emergence of asymptomatic infection in the Amazon region of Brazil were reviewed. At least six Brazilian research groups have demonstrated that asymptomatic infection by Plasmodium is an important impediment to malaria control, among mineral prospectors in Mato Grosso and riverside communities in Rondônia and, in our group, in the middle and upper reaches of the Negro river, in the state of Amazonas. Likewise, other researchers have studied the problem among indigenous communities in the Colombian, Peruvian, and Venezuelan parts of the Amazon basin, adjacent to Brazil. The frequency of positive results from the polymerase chain reaction (PCR) among asymptomatic individuals has ranged from 20.4 to 49.5%, and the presence of Plasmodium in the thick blood smears, from 4.2 to 38.5%. Infection with Anopheles darlingi has also been demonstrated by xenodiagnosis among asymptomatic patients with positive PCR results. If a mean of 25% is taken for the asymptomatic infection caused by Plasmodium sp. in the Amazon region of Brazil, malaria control will be difficult to achieve in that region with the measures currently utilized for such control.

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BACKGROUND: Chlamydia is the most commonly reported bacterial sexually transmitted infection in Europe. The objective of the Screening for Chlamydia in Europe (SCREen) project was to describe current and planned chlamydia control activities in Europe. METHODS: The authors sent a questionnaire asking about different aspects of chlamydia epidemiology and control to public health and clinical experts in each country in 2007. The principles of sexually transmitted infection control were used to develop a typology comprising five categories of chlamydia control activities. Each country was assigned to a category, based on responses to the questionnaire. RESULTS: Experts in 29 of 33 (88%) invited countries responded. Thirteen of 29 countries (45%) had no current chlamydia control activities. Six countries in this group stated that there were plans to introduce chlamydia screening programmes. There were five countries (17%) with case management guidelines only. Three countries (10%) also recommended case finding amongst partners of diagnosed chlamydia cases or people with another sexually transmitted infection. Six countries (21%) further specified groups of asymptomatic people eligible for opportunistic chlamydia testing. Two countries (7%) reported a chlamydia screening programme. There was no consistent association between the per capita gross domestic product of a country and the intensity of chlamydia control activities (P = 0.816). CONCLUSION: A newly developed classification system allowed the breadth of ongoing national chlamydia control activities to be described and categorized. Chlamydia control strategies should ensure that clinical guidelines to optimize chlamydia diagnosis and case management have been implemented before considering the appropriateness of screening programmes.

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BACKGROUND: Exposure to urinary catheters is considered the most important risk factor for healthcare-associated urinary tract infection (UTI) and is associated with significant morbidity and substantial extra-costs. In this study, we assessed the impact of urinary catheterisation (UC) on symptomatic healthcare-associated UTI among hospitalized patients. METHODS: A nationwide period prevalence survey of healthcare-associated infections was conducted during 1 May to 30 June 2004 in 49 Swiss hospitals and included 8169 adult patients (4313 female; 52.8%) hospitalised in medical, surgical, intermediate, and intensive care wards. Additional data were collected on exposure to UC to investigate factors associated with UTI among hospitalised adult patients exposed and non-exposed to UC. RESULTS: 1917 (23.5%) patients were exposed to UC within the week prior to survey day; 126 (126/8169; 1.5%) developed UTI. Exposure to UC preceded UTI only in 73 cases (58%). By multivariate logistic regression analysis, UTI was independently associated with exposure to UC (odds ratio [OR], 3.9 [95% CI, 2.6-5.9]), female gender (OR, 2.1 [95% CI, 1.4-3.1]), an American Society of Anesthesiologists' score > 2 points (OR, 3.2 [95% CI, 1.1-9.4], and prolonged hospital stay >20 days (OR, 1.9 [95% CI, 1.4-3.2]. Further analysis showed that the only significant factor for UTI with exposure to UC use was prolonged hospital stay >40 days (OR, 2.9 [95% CI, 1.3-6.1], while female gender only showed a tendency (OR, 1.6 [95% CI, 1.0-2.7]. In the absence of exposure to UC, the only significant risk factor for UTI was female gender (OR, 3.3 [95% CI, 1.7-6.5]). CONCLUSIONS: Exposure to UC was the most important risk factor for symptomatic healthcare-associated UTI, but only concerned about half of all patients with UTI. Further investigation is warranted to improve overall infection control strategies for UTI.

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Water lines are an important source of potentíal contamination. Every dental unit is equipped with small-bore flexible plastic tubing to bring water to different hand pieces, such as the air/water syringe, the ultrasonic scaler or the high-speed hand piece. Most dental units are connected directly to municipal distribution systems for potable water and chlorinated or not, this water contains diverse...

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The objective of this study is to retrospectively report the results of interventions for controlling a vancomycin-resistant enterococcus (VRE) outbreak in a tertiary-care pediatric intensive care unit (PICU) of a University Hospital. After identification of the outbreak, interventions were made at the following levels: patient care, microbiological surveillance, and medical and nursing staff training. Data were collected from computer-based databases and from the electronic prescription system. Vancomycin use progressively increased after March 2008, peaking in August 2009. Five cases of VRE infection were identified, with 3 deaths. After the interventions, we noted a significant reduction in vancomycin prescription and use (75% reduction), and the last case of VRE infection was identified 4 months later. The survivors remained colonized until hospital discharge. After interventions there was a transient increase in PICU length-of-stay and mortality. Since then, the use of vancomycin has remained relatively constant and strict, no other cases of VRE infection or colonization have been identified and length-of-stay and mortality returned to baseline. In conclusion, we showed that a bundle intervention aiming at a strict control of vancomycin use and full compliance with the Hospital Infection Control Practices Advisory Committee guidelines, along with contact precautions and hand-hygiene promotion, can be effective in reducing vancomycin use and the emergence and spread of vancomycin-resistant bacteria in a tertiary-care PICU.

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La Fibrose Kystique (FK) est une maladie dégénérative qui entraine une dégénération des poumons dû au problème de clairance mucociliaire (CMC). Le volume de surface liquide (SL) couvrant les cellules pulmonaires est essentiel à la clairance de mucus et au combat contre les infections. Les nucléotides extracellulaires jouent un rôle important dans la CMC des voies aériennes, en modifiant le volume de la SL pulmonaire. Cependant, les mécanismes du relâchement de l’ATP et de leurs déplacements à travers la SL, restent inconnus. Des études ultérieures démontrent que l’exocytose d’ATP mécano-sensible et Ca2+-dépendant, dans les cellules A549, est amplifié par les actions synergétiques autocrine/paracrine des cellules avoisinantes. Nous avions comme but de confirmer la présence de la boucle purinergique dans plusieurs modèles de cellules épithéliales et de développer un système nous permettant d’observer directement la SL. Nous avons démontrés que la boucle purinergique est fonctionnelle dans les modèles de cellules épithéliales examinés, mis appart les cellules Calu-3. L’utilisation de modulateur de la signalisation purinergique nous a permis d’observer que le relâchement d’ATP ainsi que l’augmentation du [Ca2+]i suivant un stress hypotonique, sont modulés par le biais de cette boucle purinergique et des récepteurs P2Y. De plus, nous avons développé un système de microscopie qui permet d’observer les changements de volume de SL en temps réel. Notre système permet de contrôler la température et l’humidité de l’environnement où se trouvent les cellules, reproduisant l’environnement pulmonaire humain. Nous avons démontré que notre système peut identifier même les petits changements de volume de SL.

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Une préoccupation grandissante face aux risques biologiques reliés aux maladies infectieuses est palpable tant au niveau international que national ou provincial. Des maladies émergentes telles que le SRAS ou la grippe A/H1N1 ont amené une prise en charge des risques pandémiques et à l’élaboration de mesures d’urgence pour maîtriser ces risques : développer une culture de sécurité est devenu une priorité de recherche de l’OMS. Malgré tout, peu d’écrits existent face à cette volonté de sécuriser la santé et le bien-être par toute une série de dispositifs au sein desquels les discours occupent une place importante en matière de culture de sécurité face aux risques biologiques. Une réflexion sociopolitique était nécessaire pour les infirmières qui sont aux premières loges en dispensant des soins à la population dans une perspective de prévention et de contrôle des infections (PCI) dans laquelle elles se spécialisent. Dès lors, ce projet avait pour buts d’explorer la perception du risque et de la sécurité face aux maladies infectieuses auprès des infirmières cliniciennes et gestionnaires québécoises; d’explorer plus spécifiquement l'existence ou l'absence de culture de sécurité dans un centre de santé et de services sociaux québécois (CSSS); et d’explorer les discours en présence dans le CSSS en matière de sécurité et de risques biologiques face aux maladies infectieuses et comment ces discours de sécurité face aux risques biologiques se traduisent dans le quotidien des infirmières. Les risques biologiques sont perçus comme identifiables, mesurables et évitables dans la mesure où les infirmières appliquent les mesures de préventions et contrôle des infections, ce qui s’inscrit dans une perspective positiviste du risque (Lupton, 1999). La gestion de ces risques se décline au travers de rituels de purification et de protection afin de se protéger de toute maladie infectieuse. Face à ces risques, une culture de sécurité unique est en émergence dans le CSSS dans une perspective de prévention de la maladie. Toutefois, cette culture de sécurité désirée est confrontée à une mosaïque de cultures qui couvrent différentes façons d’appliquer ou non les mesures de PCI selon les participants. La contribution de cette recherche est pertinente dans ce nouveau domaine de spécialité que constituent la prévention et le contrôle des infections pour les infirmières québécoises. Une analyse critique des relations de pouvoir tel qu’entendu par Foucault a permis de soulever les questions de surveillance infirmière, de politique de l’aveu valorisée, de punition de tout écart à l’application rigoureuse des normes de PCI, de contrôle de la part des cadres infirmiers et d’assujettissement des corps relevant des mécanismes disciplinaires. Elle a permis également de documenter la présence de dispositifs de sécurité en lien avec la tenue de statistiques sur les patients qui sont répertoriés en tant que cas infectieux, mais également en termes de circulation des personnes au sein de l’établissement. La présence d’un pouvoir pastoral est perceptible dans la traduction du rôle d’infirmière gestionnaire qui doit s’assurer que ses équipes agissent de la bonne façon et appliquent les normes de PCI privilégiées au sein du CSSS afin de réguler les taux d’infections nosocomiales présents dans l’établissement. En cas de non-respect des mesures de PCI touchant à l’hygiène des mains ou à la vaccination, l’infirmière s’expose à des mesures disciplinaires passant de l’avertissement, la relocalisation, l’exclusion ou la suspension de l’emploi. Une culture du blâme a été décrite par la recherche d’un coupable au sein de l’institution, particulièrement en temps de pandémie. Au CSSS, l’Autre est perçu comme étant à l’origine de la contamination, tandis que le Soi est perçu comme à l’abri de tout risque à partir du moment où l’infirmière respecte les normes d’hygiène de vie en termes de saines habitudes alimentaires et d’activité physique. Par ailleurs, les infirmières se doivent de respecter des normes de PCI qu’elles connaissent peu, puisque les participantes à la recherche ont souligné le manque de formation académique et continue quant aux maladies infectieuses, aux risques biologiques et à la culture de sécurité qu’elles considèrent pourtant comme des sujets priorisés par leur établissement de santé. Le pouvoir produit des effets sur les corps en les modifiant. Cette étude ethnographique critique a permis de soulever les enjeux sociopolitiques reliés aux discours en présence et de mettre en lumière ce que Foucault a appelé le gouvernement des corps et ses effets qui se capillarisent dans le quotidien des infirmières. Des recherches ultérieures sont nécessaires afin d’approfondir ce champ de spécialité de notre discipline infirmière et de mieux arrimer la formation académique et continue aux réalités infectieuses cliniques.

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In this paper, we demonstrate that the intrinsic electric field created by a poly(o-methoxyaniline) (POMA) cushion layer hinders the changes in molecular conformation of poly(p-phenylenevinylene) (PPV) in layer-by-layer with dodecylbenzene sulfonic acid (DBS). This was modeled with density functional theory (DFT) calculations where an energy barrier hampered molecular movements of PPV segments when they were subjected to an electric field comparable to that caused by a charged POMA layer. With restricted changes in molecular conformation, the PPV film exhibited Franck-Condon transitions and the photoexcitation spectra resembled the absorption spectra, in contrast to PPV/DBS films deposited directly on glass, with no POMA cushion. Other effects from the POMA cushion were the reduced number of structural defects, confirmed with Raman spectroscopy, and an enhanced PPV emission at high temperatures (300 K) in comparison with the films on bare glass. The positive effects from the POMA cushion may be exploited for enhanced opto-electronic devices, especially as the intrinsic electric field may assist in separating photoexcited electron-hole pairs in photovoltaic devices. © 2013 American Institute of Physics.

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The number of electronic devices connected to agricultural machinery is increasing to support new agricultural practices tasks related to the Precision Agriculture such as spatial variability mapping and Variable Rate Technology (VRT). The Distributed Control System (DCS) is a suitable solution for decentralization of the data acquisition system and the Controller Area Network (CAN) is the major trend among the embedded communications protocols for agricultural machinery and vehicles. The application of soil correctives is a typical problem in Brazil. The efficiency of this correction process is highly dependent of the inputs way at soil and the occurrence of errors affects directly the agricultural yield. To handle this problem, this paper presents the development of a CAN-based distributed control system for a VRT system of soil corrective in agricultural machinery. The VRT system is composed by a tractor-implement that applies a desired rate of inputs according to the georeferenced prescription map of the farm field to support PA (Precision Agriculture). The performance evaluation of the CAN-based VRT system was done by experimental tests and analyzing the CAN messages transmitted in the operation of the entire system. The results of the control error according to the necessity of agricultural application allow conclude that the developed VRT system is suitable for the agricultural productions reaching an acceptable response time and application error. The CAN-Based DCS solution applied in the VRT system reduced the complexity of the control system, easing the installation and maintenance. The use of VRT system allowed applying only the required inputs, increasing the efficiency operation and minimizing the environmental impact.

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The objective of this study is to retrospectively report the results of interventions for controlling a vancomycin-resistant enterococcus (VRE) outbreak in a tertiary-care pediatric intensive care unit (PICU) of a University Hospital. After identification of the outbreak, interventions were made at the following levels: patient care, microbiological surveillance, and medical and nursing staff training. Data were collected from computer-based databases and from the electronic prescription system. Vancomycin use progressively increased after March 2008, peaking in August 2009. Five cases of VRE infection were identified, with 3 deaths. After the interventions, we noted a significant reduction in vancomycin prescription and use (75% reduction), and the last case of VRE infection was identified 4 months later. The survivors remained colonized until hospital discharge. After interventions there was a transient increase in PICU length-of-stay and mortality. Since then, the use of vancomycin has remained relatively constant and strict, no other cases of VRE infection or colonization have been identified and length-of-stay and mortality returned to baseline. In conclusion, we showed that a bundle intervention aiming at a strict control of vancomycin use and full compliance with the Hospital Infection Control Practices Advisory Committee guidelines, along with contact precautions and hand-hygiene promotion, can be effective in reducing vancomycin use and the emergence and spread of vancomycin-resistant bacteria in a tertiary-care PICU.

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[ES] Este software pretende dar soporte a la monitorización y control de señales provenientes de distintos dispositivos electrónicos a través de un sistema empotrado con un sistema operativo en tiempo real que proporcione las herramientas necesarias para cumplir con los requisitos de tiempo que se plantean. Para ello la aplicación se divide en varios procesos encargados de la lectura y configuración de las distintas señales, control de eventos anómalos (interrupciones, fallos del sistema, etc),  almacenamiento en una base de datos de la información generada y una interfaz de usuario vía web que permita la monitorización del sistema en su conjunto.

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Recently in most of the industrial automation process an ever increasing degree of automation has been observed. This increasing is motivated by the higher requirement of systems with great performance in terms of quality of products/services generated, productivity, efficiency and low costs in the design, realization and maintenance. This trend in the growth of complex automation systems is rapidly spreading over automated manufacturing systems (AMS), where the integration of the mechanical and electronic technology, typical of the Mechatronics, is merging with other technologies such as Informatics and the communication networks. An AMS is a very complex system that can be thought constituted by a set of flexible working stations, one or more transportation systems. To understand how this machine are important in our society let considerate that every day most of us use bottles of water or soda, buy product in box like food or cigarets and so on. Another important consideration from its complexity derive from the fact that the the consortium of machine producers has estimated around 350 types of manufacturing machine. A large number of manufacturing machine industry are presented in Italy and notably packaging machine industry,in particular a great concentration of this kind of industry is located in Bologna area; for this reason the Bologna area is called “packaging valley”. Usually, the various parts of the AMS interact among them in a concurrent and asynchronous way, and coordinate the parts of the machine to obtain a desiderated overall behaviour is an hard task. Often, this is the case in large scale systems, organized in a modular and distributed manner. Even if the success of a modern AMS from a functional and behavioural point of view is still to attribute to the design choices operated in the definition of the mechanical structure and electrical electronic architecture, the system that governs the control of the plant is becoming crucial, because of the large number of duties associated to it. Apart from the activity inherent to the automation of themachine cycles, the supervisory system is called to perform other main functions such as: emulating the behaviour of traditional mechanical members thus allowing a drastic constructive simplification of the machine and a crucial functional flexibility; dynamically adapting the control strategies according to the different productive needs and to the different operational scenarios; obtaining a high quality of the final product through the verification of the correctness of the processing; addressing the operator devoted to themachine to promptly and carefully take the actions devoted to establish or restore the optimal operating conditions; managing in real time information on diagnostics, as a support of the maintenance operations of the machine. The kind of facilities that designers can directly find on themarket, in terms of software component libraries provides in fact an adequate support as regard the implementation of either top-level or bottom-level functionalities, typically pertaining to the domains of user-friendly HMIs, closed-loop regulation and motion control, fieldbus-based interconnection of remote smart devices. What is still lacking is a reference framework comprising a comprehensive set of highly reusable logic control components that, focussing on the cross-cutting functionalities characterizing the automation domain, may help the designers in the process of modelling and structuring their applications according to the specific needs. Historically, the design and verification process for complex automated industrial systems is performed in empirical way, without a clear distinction between functional and technological-implementation concepts and without a systematic method to organically deal with the complete system. Traditionally, in the field of analog and digital control design and verification through formal and simulation tools have been adopted since a long time ago, at least for multivariable and/or nonlinear controllers for complex time-driven dynamics as in the fields of vehicles, aircrafts, robots, electric drives and complex power electronics equipments. Moving to the field of logic control, typical for industrial manufacturing automation, the design and verification process is approached in a completely different way, usually very “unstructured”. No clear distinction between functions and implementations, between functional architectures and technological architectures and platforms is considered. Probably this difference is due to the different “dynamical framework”of logic control with respect to analog/digital control. As a matter of facts, in logic control discrete-events dynamics replace time-driven dynamics; hence most of the formal and mathematical tools of analog/digital control cannot be directly migrated to logic control to enlighten the distinction between functions and implementations. In addition, in the common view of application technicians, logic control design is strictly connected to the adopted implementation technology (relays in the past, software nowadays), leading again to a deep confusion among functional view and technological view. In Industrial automation software engineering, concepts as modularity, encapsulation, composability and reusability are strongly emphasized and profitably realized in the so-calledobject-oriented methodologies. Industrial automation is receiving lately this approach, as testified by some IEC standards IEC 611313, IEC 61499 which have been considered in commercial products only recently. On the other hand, in the scientific and technical literature many contributions have been already proposed to establish a suitable modelling framework for industrial automation. During last years it was possible to note a considerable growth in the exploitation of innovative concepts and technologies from ICT world in industrial automation systems. For what concerns the logic control design, Model Based Design (MBD) is being imported in industrial automation from software engineering field. Another key-point in industrial automated systems is the growth of requirements in terms of availability, reliability and safety for technological systems. In other words, the control system should not only deal with the nominal behaviour, but should also deal with other important duties, such as diagnosis and faults isolations, recovery and safety management. Indeed, together with high performance, in complex systems fault occurrences increase. This is a consequence of the fact that, as it typically occurs in reliable mechatronic systems, in complex systems such as AMS, together with reliable mechanical elements, an increasing number of electronic devices are also present, that are more vulnerable by their own nature. The diagnosis problem and the faults isolation in a generic dynamical system consists in the design of an elaboration unit that, appropriately processing the inputs and outputs of the dynamical system, is also capable of detecting incipient faults on the plant devices, reconfiguring the control system so as to guarantee satisfactory performance. The designer should be able to formally verify the product, certifying that, in its final implementation, it will perform itsrequired function guarantying the desired level of reliability and safety; the next step is that of preventing faults and eventually reconfiguring the control system so that faults are tolerated. On this topic an important improvement to formal verification of logic control, fault diagnosis and fault tolerant control results derive from Discrete Event Systems theory. The aimof this work is to define a design pattern and a control architecture to help the designer of control logic in industrial automated systems. The work starts with a brief discussion on main characteristics and description of industrial automated systems on Chapter 1. In Chapter 2 a survey on the state of the software engineering paradigm applied to industrial automation is discussed. Chapter 3 presentes a architecture for industrial automated systems based on the new concept of Generalized Actuator showing its benefits, while in Chapter 4 this architecture is refined using a novel entity, the Generalized Device in order to have a better reusability and modularity of the control logic. In Chapter 5 a new approach will be present based on Discrete Event Systems for the problemof software formal verification and an active fault tolerant control architecture using online diagnostic. Finally conclusive remarks and some ideas on new directions to explore are given. In Appendix A are briefly reported some concepts and results about Discrete Event Systems which should help the reader in understanding some crucial points in chapter 5; while in Appendix B an overview on the experimental testbed of the Laboratory of Automation of University of Bologna, is reported to validated the approach presented in chapter 3, chapter 4 and chapter 5. In Appendix C some components model used in chapter 5 for formal verification are reported.

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Electronic devices based on organic semiconductors have gained increased attention in nanotechnology, especially applicable to the field of field-effect transistors and photovoltaic. A promising class of materials in this reseach field are polycyclic aromatic hydrocarbons (PAHs). Alkyl substitution of these graphenes results in the selforganization into one-dimensional columnar superstructures and provides solubility and processibility. The nano-phase separation between the π-stacking aromatic cores and the disordered peripheral alkyl chains leads to the formation of thermotropic mesophases. Hexa-peri-hexabenzocoronenes (HBC), as an example for a PAH, exhibits some of the highest values for the charge carrier mobility for mesogens, which makes them promising candidates for electronic devices. Prerequisites for efficient charge carrier transport between electrodes are a high purity of the material to reduce possible trapping sites for charge carriers and a pronounced and defect-free, long-range order. Appropriate processing techniques are required to induce a high degree of aligned structures in the discotic material over macroscopic dimensions. Highly-ordered supramolecular structures of different discotics, in particular, of HBC derivatives have been obtained by solution processing using the zone-casting technique, zone-melting or simple extrusion. Simplicity and fabrication of highly oriented columnar structures over long-range are the most essential advantages of these zone-processing methods. A close relation between the molecular design, self-aggregation and the processing conditions has been revealed. The long-range order achieved by the zone-casting proved to be suitable for field effect transistors (FET).