ライフサイエンスコーパス: obstetric

1 ess a rounder inlet, which is beneficial for obstetrics.

2 de a summary of recent guidance on sepsis in obstetrics.

3 Women with CHD had more obstetric (58.9% versus 32.9%, P<0.0001) and offspring e

4 birth before 34 weeks and 0 days gestation (obstetric), a composite of death, brain injury, or bronc

5 the most significant problem in contemporary obstetrics accounting for 5-18% of worldwide deliveries.

6 tal admissions; although notably many of the obstetric admissions were referred to a nearby Medecins

7 parental postnatal smoking, psychosocial and obstetric adversity, maternal prenatal stress, and lifet

8 ence on its protective effects from maternal obstetric anal sphincter injuries.

9 Higher rates of obstetric anal sphincter injury following vaginal birth

10 to be delivered in a comprehensive emergency obstetric and neonatal care facility.

11 Advancements in obstetric and neonatal care may have attenuated the nega

12 s that provided five or more basic emergency obstetric and neonatal care services did not affect neon

13 s that provided five or more basic emergency obstetric and neonatal care services in the preceding 3

14 ded to provide at least five basic emergency obstetric and neonatal care services.

15 The SDA is a training tool in emergency obstetric and neonatal care that uses visual guidance in

16 Secondary outcomes included obstetric and neonatal health outcomes, assessed with al

17 toring (CGM) on maternal glucose control and obstetric and neonatal health outcomes.

18 y associated with increasing risk of adverse obstetric and neonatal outcome.

19 pregnancy requires close collaboration with obstetric and neonatology colleagues as both the materna

20 in facilities capable of providing emergency obstetric and newborn care and capable of safe-guarding

21 ed by WHO; the Needs Assessment of Emergency Obstetric and Newborn Care developed by the Averting Mat

22 Impaired UDF was associated with adverse obstetric and offspring outcome.

23 he study was conducted in a public system of obstetric and pediatric care in Memphis, Tennessee.

24 A complete maternal/obstetric and periodontal exam was performed, and GCF sa

25 g more than 2 h from comprehensive emergency obstetric and surgical care.

26 Obstetric and, particularly, medical comorbid conditions

27 adult patients and relatives who visited the Obstetrics and Gynaecology and General Surgery Clinics o

28 scrub nurses were randomly selected from the Obstetrics and Gynaecology Department of a teaching hosp

29 management in the perioperative period, and obstetrics and gynaecology.

30 of females, particularly those in outpatient obstetrics and gynecology (OB/GYN) settings.

31 , endocrinology, nephrology, psychiatry, and obstetrics and gynecology, but also from recognized expe

32 control group, born at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw,

33 geons across multiple specialties, including obstetrics and gynecology, otolaryngology, and orthopedi

34 logy, emergency medicine, internal medicine, obstetrics and gynecology, pediatrics, and surgery.

35 y PR peer review databases were searched for obstetrics and gynecology-related keywords.

36 Despite advances in obstetrics and neonatology, the rate of premature delive

37 in secondary analyses of publicly available Obstetrics and Periodontal Therapy (OPT) trial data.

38 lished for development of national surgical, obstetric, and anesthesia plans.

39 re comorbidities and adverse cardiovascular, obstetric, and fetal events during delivery between preg

40 iodemographic data and sexual behavior; STI, obstetric, and gynecologic history; and urine, vaginal,

41 Maternal, obstetric, and neonatal factors were obtained from hospi

42 ase (CHD) are susceptible to cardiovascular, obstetric, and offspring complications.

43 ventions were performed in dedicated trauma, obstetric, and reconstructive centers for 2 years.

44 cine, hematology, oncology, transplantation, obstetrics, and immunology, among other areas, are neede

45 es in the management of sickle cell disease, obstetrics, and neonatal medicine, pregnancies complicat

46 In many labor and delivery units, the obstetric anesthesiologist is often responsible for mana

47 low-molecular weight heparin [LDA+LMWH]) for obstetric antiphospholipid syndrome (APS) does not preve

48 with prior pregnancy loss and either purely obstetric antiphospholipid syndrome (APS) or inherited t

49 of pregnancy complications: a mouse model of obstetrics antiphospholipid syndrome (APS) and a mouse m

50 R, 1.9 [95% CI, 1.7-2.1]) and, specifically, obstetric (aPR, 1.3 [95% CI, 1.2-1.4]) and cardiac condi

51 nancy complications, are urgently needed for obstetric APS and should be evaluated according to the t

52 ated in monocytes treated with thrombotic or obstetric APS IgG, compared with healthy control (HC) Ig

53 pregnancy outcomes in women with refractory obstetric APS when taken at the onset of PE or IUGR unti

54 ook at five mortality prediction scores (one obstetric-based and four general) in the septic obstetri

55 owth, abortion, preterm delivery, C-section, obstetric bleeding, infection of the amniotic fluid, ven

56 olid or hematologic malignancies, trauma, or obstetric calamities.

57 asked except pain management; this included obstetric care (23.7% vs 7.7%; difference, 16.0% [95% CI

58 facilities offering comprehensive emergency obstetric care (CEmOC), emergency newborn care, or high-

59 eam used TDABC to map clinical processes for obstetric care (vaginal and caesarean deliveries, from t

60 a cohort of pregnant females presenting for obstetric care and secondarily to ensure that there was

61 explain delays in women accessing emergency obstetric care as the result of: 1) decision-making, 2)

62 ers to the receipt of timely and appropriate obstetric care at the facility level were identified and

63 Since improvement of obstetric care at the hospital level needs quantitative

64 For many humans living today, obstetric care begins early in pregnancy, and most babie

65 ) were referred to a comprehensive emergency obstetric care facility, of whom 864 (82%) accepted the

66 as processes of routine and basic emergency obstetric care for all facilities in the country were ob

67 ry continuity of care linked with specialist obstetric care for women at increased risk of PTB in an

68 considerable inequity in access to emergency obstetric care in developing countries.

69 maternal near-miss (MNM), and the quality of obstetric care in referral hospitals in Kenya.

70 s and improved access to essential emergency obstetric care interventions.

71 when an AFE is suspected, initial supportive obstetric care is important, but having an obstetrician

72 pronounced in indicators of basic emergency obstetric care procedures.

73 enign pruritus gravidarum, enabling targeted obstetric care to a high-risk population.

74 ical care, defined as access to trauma care, obstetric care, and care of common abdominal emergencies

75 alnutrition, waterborne illness, and lack of obstetric care.

76 to improving the consistency and quality of obstetric care.

77 rehensive for guiding quality improvement in obstetric care.

78 entions aimed at improving the efficiency of obstetric care.

79 as a tool to monitor and improve quality of obstetric care.

80 ths between 2003 and 2009 were due to direct obstetric causes and deaths due to indirect causes accou

81 Non-obstetric causes such as infectious diseases including t

82 Father's age, low gestational age, obstetric characteristics (eg, caesarean section), and c

83 We collected information on demographic and obstetric characteristics via extraction from case notes

84 continuity of care linked with a specialist obstetric clinic for women considered at increased risk

85 Participants were recruited from obstetric clinics in Salt Lake City, Utah; San Francisco

86 al of 146 septic patients were found for the obstetric cohort and 299 patients for the nonobstetric c

87 s of 0.67, 0.68, 0.72, 0.79, and 0.84 in the obstetric cohort, respectively, and 0.64, 0.72, 0.61, 0.

88 increased over the study period by 111%, and obstetric comorbid conditions increased by 30% to 40%.

89 The obstetric comorbidity index that is most often used may

90 vered during labour and birth, including for obstetric complications (41%), followed by care of small

91 Furthermore, a range of obstetric complications (e.g., lower birth weight) are c

92 characteristics, chronic medical conditions, obstetric complications and family history in both the c

93 raphic characteristics, gestational age, and obstetric complications and stillbirths using logistic r

94 l hypertension and pre-eclampsia, are common obstetric complications associated with adverse health o

95 en with epilepsy, which assessed the risk of obstetric complications in the antenatal, intrapartum, o

96 on between FGM/C and painful gynecologic and obstetric complications in women affected by the practic

97 atients receiving antenatal therapy had more obstetric complications than those without antenatal the

98 aternal deaths (ie, those that resulted from obstetric complications), and 13.8% (9.0-20.7, I(2)=84%)

99 23.0%] vs 124 of 481 [25.8%]; p=0.29), other obstetric complications, and neonatal morbidity were sim

100 se(s) of death (maternal medical conditions, obstetric complications, fetal abnormalities, placental

101 es, including maternal socioeconomic status, obstetric complications, obesity, recent interpersonal v

102 and for all major ICD9-CM categories except obstetric complications, skin and musculoskeletal diseas

103 and unable to cope effectively with serious obstetric complications.

104 Obstetrics complications and excessive bleeding during d

105 However, the significant role of several obstetric conditions did not influence hospital variatio

106 e elevated prevalence of adverse cardiac and obstetric conditions during pregnancy; 4 in 100 used pot

107 several factors related to the clinical and obstetric conditions of the mothers and the newborn, the

108 o-demographic background; obstetric history; obstetric conditions) were used as independent variables

109 to stillbirth caused by placental abruption, obstetric conditions, or infection.

110 rs, socio-demographic background and present obstetric conditions.

111 Several obstetric conditions/complications were associated with

112 nsiderable number factors, including various obstetric conditions/complications.

113 conjugate was at least 15 mm longer than the obstetric conjugate.

114 garding cesarean delivery should be based on obstetric considerations and not the diagnosis of IBD al

115 Seven hundred twenty-six obstetric critical care patients were included.

116 Physiology Score 3 overestimate mortality in obstetric critical care patients.

117 ctive cohort study including oncological and obstetric data from 134 pregnant patients diagnosed with

118 Access to skilled obstetric delivery and emergency care is deemed crucial

119 moking during pregnancy, labor presentation, obstetric delivery, gestational age (for preterm birth),

120 regnant or post-partum women admitted to the obstetric department.

121 luding infections, stress, inflammation, and obstetric diagnoses.

122 proposed adaptive arguments, particularly an obstetric dilemma placing constraints on neural and cran

123 d three mutually nonexclusive pressures: an "obstetric dilemma," high early postnatal brain growth ra

124 nd obstructed labor, the two extremes of the obstetric dilemma.

125 iance patterns contribute to ameliorate the "obstetric dilemma." Females with a large head, who are l

126 males, resulting in significant reduction of obstetric dimensions.

127 alues may be warranted to help prevent these obstetric diseases.

128 imarily for general surgical, traumatic, and obstetric emergencies and were categorized by mechanism,

129 istula, neurosurgery, burn, general surgery, obstetric emergency procedures, anaesthesia, and unspeci

130 tococcal infection, should be regarded as an obstetric emergency.

131 The only related obstetric event was a cesarean delivery.

132 Serious obstetric events were also examined.

133 Serious obstetric events were less common (1.7%) and were primar

134 in China and to explore sociodemographic and obstetric factors associated with variation in the still

135 International Federation of Gynaecology and Obstetrics (FIGO) 2009 stage I, endometrioid grade 3 can

136 h International Federation of Gynecology and Obstetrics (FIGO) high-risk stage I-IV epithelial ovaria

137 d International Federation of Gynecology and Obstetrics (FIGO) score was 0-4 in 33.3%, 5-6 in 46.7%,

138 International Federation of Gynaecology and Obstetrics (FIGO) stage IA1 with lymphovascular space in

139 n International Federation of Gynecology and Obstetrics (FIGO) stage IB3 squamous cell carcinoma of t

140 d International Federation of Gynecology and Obstetrics (FIGO) stage II endometrial cancer: a 12-cm g

141 d International Federation of Gynecology and Obstetrics (FIGO) stage III to IV epithelial ovarian, pr

142 e International Federation of Gynecology and Obstetrics (FIGO) stage of ECs, respectively.

143 g International Federation of Gynecology and Obstetrics (FIGO) stage.

144 d International Federation of Gynecology and Obstetrics (FIGO; 1988) stage IC-IIA high-grade serous,

145 (International Federation of Gynecology and Obstetrics [FIGO] stage I-IIa, grade 3 or clear cell his

146 (International Federation of Gynecology and Obstetrics [FIGO] stage III), for which the standard of

147 phalus (0.6%), cleft lip or palate (0%), and obstetric fistula (0%).

148 AID projects were identified; all related to obstetric fistula care totalling US$438 million (2006-13

149 aedics, cardiac, paediatric, reconstructive, obstetric fistula, neurosurgery, burn, general surgery,

150 aedics, cardiac, paediatric, reconstructive, obstetric fistula, neurosurgery, urology, ENT, craniofac

151 hernias, hydroceles, breast mass, neck mass, obstetric fistula, undescended testes, hypospadias, hydr

152 nias/hydroceles, breast masses, neck masses, obstetric fistulas, undescended testes, hypospadias, hyd

153 ted patients can be considered, with regular obstetric follow-up to safeguard foetal growth.

154 pregnancy outcomes for women with the purely obstetric form of antiphospholipid syndrome (APS) treate

155 A crucial contrast distinguishes obstetrics from cardiology and nephrology.

156 cemic effects of probiotics in this specific obstetric group require additional investigation.

157 Obstetric-gynecologic findings (OR, 4.4; 95% CI: 2.1, 9.

158 ed from the reproductive tract of women with obstetric/gynecologic health complications.

159 The authors evaluated whether an obstetrics-gynecology clinic-based collaborative depress

160 Collaborative depression care adapted to obstetrics-gynecology settings had a greater impact on d

161 h-year medical students completing an 8-week obstetrics/gynecology clinical rotation, attendance at c

162 urgery, vascular surgery, pediatric surgery, obstetrics/gynecology, ophthalmology, and urology (n = 1

163 roup vs 2% in the intervention group), major obstetric haemorrhage (1% vs 3%), and small-for-gestatio

164 5% CI 1.46-13.65]), and perioperative severe obstetric haemorrhage (5.87 [1.99-17.34]) or anaesthesia

165 uired for 1 woman in every 700 births; major obstetric haemorrhage is experienced by 1 in 172 women;

166 Obstetric haemorrhage, sepsis, and hypertensive disorder

167 idity have decreased during the audit, major obstetric haemorrhage, the most common cause of severe m

168 Cardio-obstetrics has emerged as an important multidisciplinary

169 FRT) is associated with many gynecologic and obstetric health complications.

170 blood and dried blood spots (DBS) samples at obstetric health facilities in Tanzania at birth and at

171 erational feasibility for PoC-EID testing at obstetric health facilities.

172 ver, women with stillbirths, preterm births, obstetric hemorrhage, caesarean section delivery, medica

173 The conditions reported most frequently were obstetric hemorrhages (34.2%) and hypertensive disorders

174 aried substantially in terms of sample size, obstetric histories of subjects, study preterm birth rat

175 nditions of the mothers and the newborn, the obstetric history and socio-demographic background.

176 ith the impact of some socio-demographic and obstetric history factors on LoS, seemingly suggests a p

177 al health factors, newborn clinical factors, obstetric history factors, socio-demographic background

178 ty, race, education, marital status, income, obstetric history, and language.

179 Data were collected on maternal and obstetric history, clinical maternal and neonatal condit

180 d range of predictors that typically exclude obstetric history, lack of validation, and restriction t

181 ten groups on the basis of five parameters: obstetric history, onset of labour, fetal lie, number of

182 nal age, gestation (31 vs 30 weeks), weight, obstetric history, viral load (4.5 log10 copies/mL both

183 ility factors; socio-demographic background; obstetric history; obstetric conditions) were used as in

184 .90]; p=0.021), and reduced incidence of non-obstetric hospital admissions (RR, 0.59 [95% CI 0.37-0.9

185 based test in a cohort of 159 newborns at an obstetric hospital in Cabinda, Angola.

186 nd 31 March 2013 to examine whether rates of obstetric intervention and outcome change "out-of-hours,

187 x, placenta, and amniotic fluid; and guiding obstetric interventional procedures.

188 Use of obstetric interventions (induction, prelabour caesarean

189 dy limitation was lack of data on effects of obstetric interventions and neonatal resuscitation effor

190 The management of severe sepsis in obstetrics is multidisciplinary.

191 A challenge in obstetrics is to distinguish pathological symptoms from

192 during pregnancy and the postpartum period; obstetric, labor, delivery, and pediatric medical record

193 f general surgery procedures, and 43% of non-obstetric laparotomies at three separate hospitals.

194 To exam the biochemical, obstetric management and pregnancy outcome in women with

195 The medical and obstetric management of obese women is focused on identi

196 suspected and confirmed EVD to better inform obstetric management.

197 = 1.97 x 10-13) was then validated using an obstetric measure of glycosuria measured in the same coh

198 Obstetric mode of delivery defined as unassisted vaginal

199 are needed to evaluate the impact of cardio-obstetric models of care on maternal outcomes.

200 us thromboembolism, arterial thrombosis, and obstetric morbidities in the setting of persistently pos

201 With sepsis remaining a major cause of obstetric mortality, we aimed to look at five mortality

202 hospital contribute to high levels of direct obstetric mortality.

203 icted policy is not associated with improved obstetric, neonatal or two-year outcomes.

204 men or babies were available for analysis of obstetric, neonatal, and childhood outcomes, respectivel

205 factors from all four conceptual categories (obstetric/neonatal risk factors, care environment, and w

206 Obstetric outcomes (birthweight, obstetric or neonatal complications, and admission to a

207 one had no significant effect on the primary obstetric outcome (odds ratio adjusted for multiple comp

208 This poor obstetric outcome is prevented by antibiotic treatment.

209 With low-dose UDCA treatment the obstetric outcome was good.

210 Obstetric outcomes (birthweight, obstetric or neonatal c

211 ume expansion has been implicated in adverse obstetric outcomes such as pre-eclampsia, fetal growth r

212 ariable analysis of risk factors for adverse obstetric outcomes was performed for 19926 women undergo

213 rates, recurrence rates after resection, and obstetric outcomes were analyzed.

214 The aim of this study was to assess obstetric outcomes, antenatal management, and maternal s

215 iron homeostasis and inflammation in adverse obstetric outcomes, especially in obese women.

216 d adult age ranges, and the association with obstetric outcomes.

217 Selected obstetric parameters were collected.

218 re no differences in perinatal, maternal, or obstetric parameters.

219 ecome such a valuable diagnostic tool in the obstetric patient.

220 a significant improvement in pain scores for obstetric patients receiving a transversus abdominis pla

221 Because Medicare DRGs are unsuitable for obstetrics, pediatrics, and neonatology, some payers pre

222 ing accurate diagnosis, pain management, and obstetric planning.

223 In a multicenter obstetric population (n = 797), these included all pregn

224 tetric-based and four general) in the septic obstetric population and compare them to a nonobstetric

225 symptomatic bacterial vaginosis in a general obstetric population but was inconclusive for women with

226 hown that they over-predict mortality in the obstetric population.

227 sed in this and early warning scores for the obstetric population.

228 ver the promise of precision medicine to the obstetric population.

229 Among trials reporting findings from general obstetric populations (n = 7953), no significant associa

230 e used to predict severe maternal outcome in obstetric populations admitted to ICU.

231 imed to analyse the contribution of specific obstetric populations to changes in caesarean section ra

232 c Score, designed specifically for sepsis in obstetric populations, was not better than general sever

233 and do not necessarily reflect contemporary obstetric populations.

234 Risk factors identified are relevant to obstetric practice given their cumulative risk effect an

235 goals of the Surviving Sepsis Campaign into obstetric practice is important to improve outcomes.

236 he clinical utility of full customization in obstetric practice requires further testing.

237 ailability and increase compliance with best obstetric practice.

238 5, and July 14, 2009, recruited women at 137 obstetric practices in Connecticut and Massachusetts bef

239 pregnant women exposed to anaesthesia for an obstetric procedure in countries categorised as low-inco

240 procedures was 1.2 per 1000 women undergoing obstetric procedures (95% CI 0.8-1.7, I(2)=83%).

241 f death from anaesthesia in women undergoing obstetric procedures was 1.2 per 1000 women undergoing o

242 promote VBAC where appropriate, standardized obstetric protocols should be introduced and enforced at

243 The effects of upgrading the obstetric readiness of all facilities, of removing all u

244 ter prelabor fetal heart rates obtained from obstetric records (gestational week 29-41) were lower pe

245 Cardio-obstetrics refers to a team-based approach to maternal c

246 omized controlled trial was conducted at the obstetrics registration centers of 3 tertiary public hos

247 for sociodemographic, maternal medical, and obstetric-related characteristics.

248 The overall frequency of obstetric-related ICU admission and the rates for other

249 vailability remain a key area of interest in obstetric research.

250 banalyses of children born to mothers at low obstetric risk and unchanged in sensitivity analyses.

251 the important influence of preconception and obstetric risk factors on lung health, development, and

252 DF does not increase obstetric risk, and it should not be a contraindication

253 At the 19 hospitals, obstetric rotas ranged from 51 to 106 h of on-site labou

254 Surgical, anaesthetic, and obstetric (SAO) health-care system strengthening is need

255 Furthermore, the Sepsis in Obstetric Score performance was no different in an obste

256 The Sepsis in Obstetric Score performed similarly to all the other sco

257 Sepsis in Obstetric Score, Acute Physiology and Chronic Health Eva

258 The Sepsis in Obstetric Score, Acute Physiology and Chronic Health Eva

259 The Sepsis in Obstetric Score, designed specifically for sepsis in obs

260 ion lends support to the cliff-edge model of obstetric selection and its underlying assumptions, desp

261 Although males are not subject to obstetric selection, they also show part of these associ

262 nce of the distinct characteristics of human obstetric selection.

263 Increased awareness of obstetric sepsis is required.

264 ric Score performance was no different in an obstetric sepsis population compared to a nonobstetric s

265 n-based outcome predictors in ICU even in an obstetric sepsis population.

266 rting prevalences of painful gynecologic and obstetric sequelae resulting from FGM/C.

267 This study describes hospital-based obstetric service losses in rural US counties between 20

268 this study, we aimed to assess the effect of obstetric service regionalisation in pregnant women and

269 rienced hematologist/oncologist, a high-risk obstetrics specialist, a neonatologist, and experienced

270 fort to improve the quality of care, several obstetric-specific quality measures are now monitored an

271 k International Federation of Gynecology and Obstetrics stage I or stage II to IV epithelial ovarian,

272 d International Federation of Gynecology and Obstetrics stage IC-IV epithelial ovarian cancer were ra

273 d International Federation of Gynecology and Obstetrics stage IC-IV ovarian cancer and an Eastern Coo

274 h International Federation of Gynecology and Obstetrics stage IIB to IV ovarian, fallopian tube, or p

275 (International Federation of Gynecology and Obstetrics stage IIB to IVA or with positive lymph nodes

276 y International Federation of Gynecology and Obstetrics stage) 9 or fewer months previously.

277 , International Federation of Gynecology and Obstetrics stage, tumor grade, pelvic node status, and t

278 r International Federation of Gynecology and Obstetrics stage.

279 l International Federation of Gynecology and Obstetrics stages IB2 (n = 79), IIA (n = 10), IIB (n = 1

280 8 International Federation of Gynecology and Obstetrics staging system for uterine cervical cancer.

281 WHO, such as male circumcision and emergency obstetric surgery.

282 f death from anaesthesia in women who had an obstetric surgical procedure; 95 (32,149,636 pregnancies

283 Data were collected by means of the UK Obstetric Surveillance System (UKOSS) on all pregnancies

284 ational coverage was undertaken using the UK Obstetric Surveillance System (UKOSS).

285 conducted using the International Network of Obstetric Survey Systems (INOSS).

286 identified patients evaluated by our cardio-obstetrics team from January 1, 2010, through December 3

287 Early involvement of the cardio-obstetrics team is critical to prevent maternal morbidit

288 n counseling by the multidisciplinary cardio-obstetrics team is essential for women with preexistent

289 d-insured pregnant women managed by a cardio-obstetrics team, maternal outcomes were encouraging and

290 ovascular disease (CVD) followed by a cardio-obstetrics team.

291 h opens new horizons for drug development in obstetrics that could greatly impact preterm birth, whic

292 Here we show for the first time in obstetrics the use of a targeted nanoparticle directed t

293 various disciplines (hematology, nephrology, obstetrics, transplantation, rheumatology, and neurology

294 insulin; they were not at increased risk for obstetric trauma (RR = 0.92; 95% CI, 0.71-1.20), preterm

295 iation of glyburide with diagnosis codes for obstetric trauma, cesarean delivery, birth injury, prete

296 also of clinical relevance in the context of obstetric trials in which allopurinol is being administe

297 multicentre cohort study using data from 19 obstetric units in the United Kingdom between 1 April 20

298 d, randomised controlled trial done at 27 UK obstetric units, women (aged >=16 years) were allocated

299 pragmatic randomised controlled trial (at 26 obstetric units; participants recruited from 4 June 2013

300 used for large numbers of patients attending obstetrics units.