Multi-national observational study to assess quality of life and treatment preferences in patients with Crohn’s perianal fistulas

BACKGROUND Patients with Crohn’s disease(CD)are at risk of developing complications such as perianal fistulas.Patients with Crohn’s perianal fistulas(CPF)are affected by fecal incontinence(FI),bleeding,pain,swelling,and purulent perianal discharge,and METHODS This cross-sectional observational study was conducted in patients with CD aged 21-90 years via a web-enabled questionnaire in seven countries(April-August 2021).Patients were recruited into three cohorts:Cohort 1 included patients without perianal fistulas;cohort 2 included patients with perianal fistulas without fistula-related surgery;and cohort 3 included patients with perianal fistulas and fistula-related surgery.Validated patient-reported outcome measures were used to assess quality of life.Drivers of treatment preferences were measured using a discrete choice experiment(DCE).RESULTS In total,929 patients were recruited(cohort 1,n=620;cohort 2,n=174;cohort 3,n=135).Short Inflammatory Bowel Disease Questionnaire scores were worse for patients with CPF(cohorts 2 and 3)than for those with CD without CPF(cohort 1):Mean score 3.8 and 3.7 vs 4.1,respectively,(P<0.001).Similarly,mean Revised FI and FI Quality of Life scores were worse for patients with CPF than for those with CD without CPF.Quality of Life with Anal Fistula scores were similar in patients with CPF with or without CPF-related surgery(cohorts 2 and 3):Mean score 41 and 42,respectively.In the DCE,postoperative discomfort and fistula healing rate were the most important treatment attributes influencing treatment choice:Mean relative importance 35.7 and 24.7,respectively.CONCLUSION The burden of illness in CD is significantly higher for patients with CPF and patients rate lower postoperative discomfort and higher healing rates as the most desirable treatment attributes.

Dynamic programming methodology for multi-criteria group decision-making under ordinal preferences

A method of minimizing rankings inconsistency is proposed for a decision-making problem with rankings of alternatives given by multiple decision makers according to multiple criteria. For each criteria, at first, the total inconsistency between the rankings of all alternatives for the group and the ones for every decision maker is defined after the decision maker weights in respect to the criteria are considered. Similarly, the total inconsistency between their final rankings for the group and the ones under every criteria is determined after the criteria weights are taken into account. Then two nonlinear integer programming models minimizing respectively the two total inconsistencies above are developed and then transformed to two dynamic programming models to obtain separately the rankings of all alternatives for the group with respect to each criteria and their final rankings. A supplier selection case illustrated the proposed method, and some discussions on the results verified its effectiveness. This work develops a new measurement of ordinal preferences’ inconsistency in multi-criteria group decision-making （MCGDM） and extends the cook-seiford social selection function to MCGDM considering weights of criteria and decision makers and can obtain unique ranking result.

Group Decision-Making Method with Incomplete Intuitionistic Fuzzy Preference Relations Based on a Generalized Multiplicative Consistent Concept

Based on the analyses of existing preference group decision-making(PGDM)methods with intuitionistic fuzzy preference relations(IFPRs),we present a new PGDM framework with incomplete IFPRs.A generalized multiplicative consistent for IFPRs is defined,and a mathematical programming model is constructed to supplement the missing values in incomplete IFPRs.Moreover,in this study,another mathematical programming model is constructed to improve the consistency level of unacceptably multiplicative consistent IFPRs.For group decisionmaking(GDM)with incomplete IFPRs,three reliable sources influencing the weights of experts are identified.Subsequently,a method for determining the weights of experts is developed by simultaneously considering three reliable sources.Furthermore,a targeted consensus process(CPR)is developed in this study with reference to the actual situation of the consensus level of each IFPR.Meanwhile,in response to the proposed multiplicative consistency definition,a novel method for determining the optimal priority weights of alternatives is redefined.Lastly,based on the above theory,a novel GDM method with incomplete IFPRs is developed,and the comparative and sensitivity analysis results demonstrate the utility and superiority of this work.

PREFERENCE AND EVOLUTION IN THE ITERATED PRISONER'S DILEMMA

Game theory is extensively used to study strategy-making and actions of play- ers. The authors proposed an analysis method for study the evolutionary outcome and behaviors of players with preference in iterated prisoner＇s dilemma. In this article, a preference parameter k was introduced in the payoff matrix, wherein the value of k denotes the player＇s degree of egoism and altruism （preference）. Then, a game-theoretic dynamical model was formulated using Birth-and-Death process. The authors studied how preference influences the evolutionary equilibrium and behaviors of players. The authors get the general results： egoism leads to defection, and altruism can make players build trust and maintain cooperation, and so, the hope of the Pareto optimal solution. In the end, the simulation experiments proved the efficiency of the method.

Do inflammatory bowel disease patient preferences from treatment outcomes differ by ethnicity and gender?A cross-sectional observational study

BACKGROUND Inflammatory bowel disease(IBD)patients’expectations of treatment outcomes may differ by ethnicity.AIM To investigate treatment preferences of Jewish and Arabs patients.METHODS This prospective survey ranked outcomes treatment preferences among Arab IBD patients,based on the 10 IBD-disk items compared to historical data of Jews.An anonymous questionnaire in either Arabic or Hebrew was distributed among IBD patients.Patients were required to rank 10 statements describing different aspects of IBD according to their importance to the patients as treatment goals.Answers were compared to the answers of a historical group of Jewish patients.RESULTS IBD-disk items of 121 Arabs were compared to 240 Jewish patients.The Jewish patients included more females,[151(62.9%)vs 52(43.3%);P<0.001],higher education level(P=0.02),more urban residence[188(78.3%)vs 54(45.4%);P<0.001],less unemployment[52(21.7%)vs 41(33.9%);P=0.012],higher income level(P<0.001),and more in a partnership[162(67.8%)vs 55(45.4%);P<0.001].Expectations regarding disease symptoms:abdominal pain,energy,and regular defecation ranked highest for both groups.Arabs gave significantly lower rankings(range 4.29-6.69)than Jewish patients(range 6.25-9.03)regarding all items,except for body image.Compared to Arab women,Jewish women attached higher priority to abdominal pain,energy,education/work,sleep,and joint pain.Multivariable regression analysis revealed that higher patient preferences were associated with Jewish ethnicity(OR 4.77;95%CI 2.36-9.61,P<0.001)and disease activity.The more active the disease,the greater the odds ratio for higher ranking of the questionnaire items(1-2 attacks per year:OR 2.13;95%CI 1.02-4.45,P=0.043;and primarily active disease:OR 5.29;95%CI 2.30-12.18,P<0.001).Factors inversely associated with higher patient preference were male gender(OR 0.5;95%CI 0.271-0.935,P=0.030),UC(OR 0.444;95%CI 0.241-0.819,P=0.009),and above average income level(OR 0.267;95%CI:0.124-0.577,P=0.001).CONCLUSION The highest priority for treatment outcomes was symptom relief.,Patients preferences were impacted by ethnicity,gender,and socio-economic disparity.Understanding patients'priorities may improve communication and enable a personalized approach.

Application Research of Ingroup Preference in Employee Relationship Management

With stepwise development of Chinese enterprise,management problem is increasingly prominent,especially human resource management issues. Facing international environment of entering into World Trade Organization,the country accelerates construction pace of human resource management subject in colleges and universities,which provides professional channel for management efficiency and market competition ability of Chinese enterprise,but it is still far from practice. In this paper,the concept,origin and inhibition factors of ingroup preference are elaborated. Based on the visual angle of ingroup preference,started from four dimensions( enterprise incentive system,talent management idea,psychological contract and employee communication consciousness),main problems existing in employee relationship management of modern enterprise are explored. It is specially emphasized that manager often holds the blame in front of dealing with the crisis after contradiction,which is " fatal point" neglected in employee relationship management of modern enterprise. To improve its core competitive power,enterprise must value harmonious relationship with employees.

Digital Disparities:How Artificial Intelligence Can Facilitate Anti-Black Racism in the U.S.Healthcare Sector

This paper delves into the intricate interplay between artificial intelligence(AI)systems and the perpetuation of Anti-Black racism within the United States medical industry.Despite the promising potential of AI to enhance healthcare outcomes and reduce disparities,there is a growing concern that these technologies may inadvertently/advertently exacerbate existing racial inequalities.Focusing specifically on the experiences of Black patients,this research investigates how the following AI components:medical algorithms,machine learning,and natural learning processes are contributing to the unequal distribution of medical resources,diagnosis,and health care treatment of those classified as Black.Furthermore,this review employs a multidisciplinary approach,combining insights from computer science,medical ethics,and social justice theory to analyze the mechanisms through which AI systems may encode and reinforce racial biases.By dissecting the three primary components of AI,this paper aims to present a clear understanding of how these technologies work,how they intersect,and how they may inherently perpetuate harmful stereotypes resulting in negligent outcomes for Black patients.Furthermore,this paper explores the ethical implications of deploying AI in healthcare settings and calls for increased transparency,accountability,and diversity in the development and implementation of these technologies.Finally,it is important that I prefer the following paper with a clear and concise definition of what I refer to as Anti-Black racism throughout the text.Therefore,I assert the following:Anti-Black racism refers to prejudice,discrimination,or antagonism directed against individuals or communities of African descent based on their race.It involves the belief in the inherent superiority of one race over another and the systemic and institutional practices that perpetuate inequality and disadvantage for Black people.Furthermore,I proclaim that this form of racism can be manifested in various ways,such as unequal access to opportunities,resources,education,employment,and fair treatment within social,economic,and political systems.It is also pertinent to acknowledge that Anti-Black racism is deeply rooted in historical and societal structures throughout the U.S.borders and beyond,leading to systemic disadvantages and disparities that impact the well-being and life chances of Black individuals and communities.Addressing Anti-Black racism involves recognizing and challenging both individual attitudes and systemic structures that contribute to discrimination and inequality.Efforts to combat Anti-Black racism include promoting awareness,education,advocacy for policy changes,and fostering a culture of inclusivity and equality.

Method for multi-attribute group decision-making based on the compromise weights

Multi-attribute group decision-making problems are considered where information on both attribute weights and value scores of consequences is incomplete.In group decision analysis,if preference information about alternatives is provided by participants,it should be verified whether there exist compromise weights that can support all the preference relations.The different compromise weight vectors may differ for the ranking of the alternatives.In the case that compromise weights exist,the method is proposed to find out all the compromise weight vectors in order to rank the alternatives.Based on the new feasible domain of attribute weights determined by all the compromise weight vectors and the incomplete information on value scores of consequences,dominance relations between alternatives are checked by a nonlinear goal programming model which can be transformed into a linear one by adopting a transformation.The checked dominance relations uniformly hold for all compromise weight vectors and the incomplete information on value scores of consequences.A final ranking of the alternatives can be obtained by aggregating these dominance relations.

Consensus intuitionistic fuzzy group decision-making method for aircraft cockpit display and control system evaluation

A novel group decision-making （GDM） method based on intuitionistic fuzzy sets （IFSs） is developed to evaluate the ergonomics of aircraft cockpit display and control system （ACDCS）. The GDM process with four steps is discussed. Firstly, approaches are proposed to transform four types of common judgement representations into a unified expression by the form of the IFS, and the features of unifications are analyzed. Then, the aggregation operator called the IFSs weighted averaging （IFSWA） operator is taken to synthesize decision-makers’ （DMs’） preferences by the form of the IFS. In this operator, the DM’s reliability weights factors are determined based on the distance measure between their preferences. Finally, an improved score function is used to rank alternatives and to get the best one. An illustrative example proves the proposed method is effective to valuate the ergonomics of the ACDCS.

DNA extraction method selection for agricultural soil using TOPSIS multiple criteria decision-making model

There is an increased interest in the extraction of nucleic acids from various environmental samples since culture-independent molecular techniques contribute to deepen and broaden the understanding of a greater portion of uncultivable microorganisms. Due to difficulties to select the optimum DNA extraction method in view of downstream molecular analyses, this article presents a straightforward mathematical framework for comparing some of the most commonly used methods. Four commercial DNA extraction kits and two physical-chemical methods (bead-beating and freeze-thaw) were compared for the extraction of DNA under several quantitative DNA analysis criteria: yield of extraction, purity of extracted DNA (A260/280 and A260/230 ratios), degradation degree of DNA, easiness of PCR amplification, duration of extraction, and cost per extraction. From a practical point of view, it is unlikely that a single DNA extraction strategy can be optimum for all selected criteria. Hence, a systematic Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) was employed to compare the methods. The PowerSoil? DNA Isolation Kit was systematically defined as the best performing method for extracting DNA from soil samples. More specifically, for soil:manure and soil:manure:biochar mixtures, the PowerSoil?DNA Isolation Kit method performed best, while for neat soil samples its alternative version gained the first rank.

Incongruence between the Preferred Mode of Delivery and Risk of Childbirth Complications among Antepartum Women in Mulago Hospital, Uganda

Objective: Women’s preferences for the mode of delivery provide clues on their knowledge and perceptions of anticipated risk of childbirth complications.?The objective was toinvestigate?incongruence between preferred mode of delivery and risk of adverse pregnancy outcomes. Methods: Through a cross-sectional study, data were?collected from 327?women admitted to Mulago hospital. Data included socio-demographic?characteristics, past medical, gynaecological and obstetric history, pregnancy complications, knowledge of pregnancy complications and preferred mode of delivery. The preferred mode of delivery and knowledge of related risks for adverse pregnancy outcomes were compared. Results: The mean age of participants was 24.7 years (±5.9), ranging?14?-?43 years, of whom 41.4% were nulliparous. The preferred mode of delivery was vaginal (84.1%). Incongruence?(preference for a mode of delivery that did not correspond to expected or anticipated risks) occurred in 88 (26.9%) of the women, and was associated with having secondary school or higher level of education (OR 2.49, CI 1.52?-?4.08) and history of previous vaginal delivery (OR 3.82,?CI 1.94?-?7.49). Conclusion: One in four women had incongruence between preferred mode of delivery and risks of adverse pregnancy outcomes, which called?for urgent interventions to improve decision-making about intrapartum care.

Emancipatory reflection on a nursing practice-based ethical issue about nurses' paternalistic decision-making for patients

Objective: This study aimed to demonstrate and promote the skill of critical emancipatory reflection through reflecting on a nursing practice-based ethical issue about nurses' paternalistic decision-making for patients. Meanwhile, critical awareness will be developed and the underlying issues of paternalism in nursing decision-making will be analyzed. Then, by applying the procedure, improvement in nursing decision-making practice will be expected.Methods: Taylor's model of emancipatory reflection with four steps, including construction, deconstruction, confrontation, and reconstruction, is utilized to guide the author's reflection.Results: Guided by the socialization theory, the author's personal and professional socialization is seen to be associated with the formation of the value of paternalism. The theory of reflexivity is applied to unearth the related issues, including deeper personal value,work environment, as well as historical and cultural contexts. Moreover, the power derived from policy, work relationship, and nursing administration, which could induce paternalism in the author's nursing decision-making practice, was critically debated using the hegemony theory. Finally, new insights into paternalism will be achieved, which enable change in terms of how to facilitate patients' autonomous decision-making.Conclusions: The process of refection makes it clear that respecting patients' right and performing patient-centered caring are the bases to change the paternalism existing in the nursing decision-making practice currently. The reconstruction step assists the author in terms of how to value the patients' autonomy and balance patients' safety and choice, rather than being overprotective; carry out risk assessment, and search for strong evidence to counterbalance the positive and negative aspects of risk-taking; communicate with patients appropriately in a manner that they can comprehend; spend more time to explore patients' preference and choice; make every effort to elevate the patients' decision-making capacity; implement patient-centered care and shared decision-making in nursing practice; consult with other colleagues and obtain the required support when limitations or challenges exist; try to justify and avoid hidden paternalism behind policy or guidelines; deal with the power in hand well and fairly; and also positively face the powers that constrain the author.

Study of Product Quality Information and Construction of Its Decision-Making Support System and Measures to Improve People's Quality Concept

The 21th century is a "quality century". Facing the s evere challenge about quality, all the developed industry countries attach impor tance to the research and education about quality project. With the deepening of the reform of China and it’s joining to WTO, many industries and enterprises wi ll be confronted with severe challenge while being offered the opportunity to wa lk up to the world. The arrival of knowledge economy and web time has provided t he space for the innovation on enterprise management. It has also provided new m ethod and model for enterprise management, that is online management based on th e internet. The online management use an enterprise model including the goal of the enterprise and the scheme to carry out it to represent the whole operational of all the work. The online management is constructed on the integration of exp ert system, database, software and other technical models. How to scientifically manage the entire system of product, precisely master the condition of quantity and quality and analyze the rules of the change of produc t quality in order to carry out the overall control of quality, guarantee the go od condition of product as well as improve product quality and prolong it’s se rvice life was discussed in this thesis. Based on the above research the thesis also discussed how to develop the study on product quality information and const ruct it’s decision making support system. The concrete measures to improve peopl e’s concept of quality are also raised. Based on the type analysis, scientific management of product quality information should start from dynamic information of quality, instruction information as we ll as the information about the use, maintain, management and conservation of pr oduct, and induce them and further propose a design scheme of feedback system on product quality information, and then set up the blueprint of the information s ystem of product quality. This thesis included 7 chapters:1.the type of quality information;2.the content of quality information;3.the construction of the se nsitive web for transfering information, and collecting and transfering quality information rapidly and effectively;4.the way and procedure to transfer informa tion;5.the construction of quality information library for all phases; 6.the d isposal of quality information;7.the decision making support system of the mana gement of quality information;8.attach importance to three key factors on impro ving quality concept.

基于改进D-S证据和融合权集的安全风险评估

针对信息化系统安全风险评估过程中安全风险因素指标的重要性难以赋权的问题,本文以建筑工地施工现场为应用场景,提出一种基于改进的D-S证据理论与融合权集结合的安全风险评估模型.首先,在充分研究建筑工地安全风险评估流程和要素的基础上,建立建筑工地安全评价体系;其次,采用基于权值分配和矩阵分析的D-S合成算法改进AHP法和基于数据的熵权法计算评价体系中指标层中各指标的主、客观权重;然后,运用改进的D-S证据融合算法进行多源证据的合成,获取指标权重,避免单一赋权的片面性,得到最优综合权重;最后,根据TOPSIS评价算法计算建筑工地综合评价指数.分析表明,基于改进D-S证据理论-融合权集的安全风险评估模型,能有效评估建筑工地施工现场的安全性,降低评估结果的不确定性,提高风险评估结果可信度.

Two-Sided Matching Decision Making with Multi-Attribute Probabilistic Hesitant Fuzzy Sets

In previous research on two-sided matching(TSM)decision,agents’preferences were often given in the form of exact values of ordinal numbers and linguistic phrase term sets.Nowdays,the matching agent cannot perform the exact evaluation in the TSM situations due to the great fuzziness of human thought and the complexity of reality.Probability hesitant fuzzy sets,however,have grown in popularity due to their advantages in communicating complex information.Therefore,this paper develops a TSM decision-making approach with multi-attribute probability hesitant fuzzy sets and unknown attribute weight information.The agent attribute weight vector should be obtained by using the maximum deviation method and Hamming distance.The probabilistic hesitancy fuzzy information matrix of each agent is then arranged to determine the comprehensive evaluation of two matching agent sets.The agent satisfaction degree is calculated using the technique for order preference by similarity to ideal solution(TOPSIS).Additionally,the multi-object programming technique is used to establish a TSM method with the objective of maximizing the agent satisfaction of two-sided agents,and the matching schemes are then established by solving the built model.The study concludes by providing a real-world supply-demand scenario to illustrate the effectiveness of the proposed method.The proposed method is more flexible than prior research since it expresses evaluation information using probability hesitating fuzzy sets and can be used in scenarios when attribute weight information is unclear.

Selecting suitable key supplier for core components during smart complex equipment central-private enterprises collaborative development process:from two different forms of evaluation information and matching perspective

With the development of central-private enterprises integration,selecting suitable key suppliers are able to provide core components for smart complex equipment.We consider selecting suitable key suppliers from matching perspective,for it not only satisfies natural development of smart complex equipment,it is also a good implementation of equipment project in central-private enterprises integration context.In in this paper,we carry out two parts of research,one is evaluation attributes based on comprehensive analysis,and the other is matching process between key suppliers and core components based on the matching attribute.In practical analysis process,we employ comprehensive evaluated analysis methods to acquire relevant attributes for the matching process that follows.In the analysis process,we adopt entropy-maximum deviation method(MDM)-decision-making trial and evaluation laboratory(DEMATEL)-technique for order preference by similarity to an ideal solution(TOPSIS)to obtain a comprehensive analysis.The entropy-MDM is applied to get weight value,DEMATEL is utilized to obtain internal relations,and TOPSIS is adopted to get ideal evaluated solution.We consider aggregating two types of evaluation information according to similarities of smart complex equipment based on the combination between geometric mean and arithmetic mean.Moreover,based on the aforementioned attributes and generalized power Heronian mean operator,we aggregate preference information to acquire relevant satisfaction degree,then combine the constructed matching model to get suitable key supplier.Through comprehensive analysis of selecting suitable suppliers,we know that two-sided matching and information aggregation can provide more research perspectives for smart complex equipment.Through analysis for relevant factors,we find that leading role and service level are also significant for the smart complex equipment development process.

基于TOPSIS的出行方案评价指标权重的确定方法

旅客出行偏好选择问题是旅客出行行为分析理论的一个重要部分,而旅客对出行方案的选择是基于对各种方案的评价指标的综合分析.但旅客对各评价指标的侧重程度,即属性权重的计算,目前常用方法都有一定的局限性.本文以旅客出行偏好选择为背景,借助多指标评价方法TOPSIS的评价准则,以实际的大规模旅客调查数据为基础,分析、确定旅客对出行方案各属性指标的权重,为旅客出行行为分析提供重要、客观、可靠的依据.经过实例验证,证明了该方法的有效性,并将计算结果代入多项Logit模型,进一步验证了计算结果的合理性.此外,该方法计算简便、易于实现,对于各种交通方式下的旅客出行偏好选择问题具有普遍适用性.

基于D-S证据理论的地震应急救援群决策

为解决地震应急救援群决策中专家偏好冲突问题,提出一种基于登普斯特-沙弗尔(DS)证据理论的专家偏好型应急救援群决策方法。首先,考虑方案执行时间和方案资源的客观属性以及专家的主观偏好,在传统地震救援群决策过程基础上,设计改进的专家偏好型群决策过程;然后,借鉴应急协商模型,设计考虑方案执行时间和资源的偏好函数,基于三角模糊数定义专家主观偏好程度,并运用D-S证据理论综合专家偏好度作方案选择;最后,以2017年九寨沟地震为试验算例,开展方法对比性试验和偏好敏感性试验。结果表明:与仅考虑方案执行时间和资源或基于三角模糊偏好相比,考虑方案执行时间和资源偏好的决策方案更能满足实际地震应急救援需求,且专家的平衡性偏好更有利于地震应急救援方案的正确选择。

模糊全区间序导出的T-S弱序及严格T-S弱序

以可加的φ-模糊偏好结构为基础,研究由模糊全区间序结构导出的T-S弱序及严格T-S弱序。首先,我们证明了在一个模糊全区间序结构中,大偏好及严格偏好的右迹均为T-S弱序。其次,通过严格偏好关系P及大偏好关系R给出普通偏好结构下两个严格弱序Q_1及Q_2的等价形式,并据此进行模糊化,在(T,S,N_φ)是一个De Morgan三元组及T是旋转不变t-模的情况下,通过对模糊全区间序结构进行详细讨论,从而得出Q_1及Q_2均为严格T-S弱序。

Assessment of the Impacts of Livestock Grazing on Endangered Red Panda (<i>Ailurus fulgens</i>) Habitat in Eastern Nepal

Disturbances caused by livestock grazing are considered as a key attributable factor for the habitat loss of red panda. The present study was carried out in Eastern Nepal mainly focusing on the habitat preferences of red panda and impacts of livestock grazing on it. In total, 15 linear transects were delineated at an elevation interval of 100 m assessing indirect signs of red panda and livestock. Habitat preferences of red panda, vegetation abundance, coverage percentage of vegetation layers (canopy and shrub layer) and distance to water source were recorded using randomly plotted 58 quadrats of 10 m × 10 m. Questionnaire survey and Key Informant Interviews were carried out to evaluate the perception of local community on conservation threats and importance of red panda conservation. Jaccard’s similarity index was used to determine the spatial habitat overlap of livestock and red panda. Litsea elongata, Lithocarpus pachyphylla and Rhododendron falconeri were the most common species in the study area. Grazing signs were observed from 51% of red panda habitats in the study area. Livestock herding has induced negative impacts on the habitat of red panda inside the community forests. The study findings will extend the existing body of knowledge regarding the status of red panda in Eastern Himalayas. In addition, this research will help in the formulation of effective legal and strategic framework of sustainable grazing management.