Abstract Neonatal thoracoscopic correction of type III esophageal atresia requires the establishment of an artificial carbon dioxide pneumothorax in the affected thoracic cavity. At present, there is no suitable double-lumen endotracheal tube or bronchial occluder to be used in neonatal thoracoscopic surgery. Objectives: To research the influence of sevoflurane pretreatment on neonatal inflammatory response and pulmonary ventilation. Sixty neonates were randomized into 2 groups, group C, group S. Neonates in group S received sevoflurane inhalation at a concentration of 2% after endotracheal intubation until the establishment of pneumothorax, followed by a 10-min washout period, while those in group C only inhaled pure oxygen. Venous blood samples were collected from the subjects in the 2 groups from at 10 min before induction of anesthesia to 24 h after pneumothorax relief to determine the concentrations of serum interleukin (IL)-6, IL-8, and tumor necrosis factor α. Arterial blood gases were drawn from the radial artery at the above time points. The alveolar-arterial oxygen partial pressure difference, and respiratory index were calculated. Concentrations of IL-6, IL-8, and tumor necrosis factor α in serum were all lower in group S. Alveolar-arterial oxygen and respiratory index were also lower in group S. Duration of surgical intensive care unit stay, time of mechanical ventilation, and length of stay were all lower in group S. A concentration of 2% sevoflurane pretreatment may have a protective influence on the neonatal inflammatory response and pulmonary ventilation, which correct type III esophageal atresia by suppressing the inflammatory response under the thoracoscope.

Abstract Chemotherapy is the main treatment option for advanced osteosarcoma, which is the most common type of primary bone malignancy. However, patients develop resistance rapidly and many succumb to the disease. Niclosamide, an anthelmintic drug, has been recently identified to display potent and selective anti-cancer activity. In this work, we show that niclosamide at sub-micromolar concentrations inhibits proliferation and migration, and induces apoptosis in both parental and chemo-resistant osteosarcoma cells, with much less toxicity in normal osteoblastic cells. Interestingly, chemo-resistant osteosarcoma cells are more sensitive to niclosamide compared to parental cells. We further identify that inhibition of β-catenin is the underlying mechanism of niclosamide’s action in osteosarcoma cells. In addition, we reveal that chemo-resistant osteosarcoma cells display increased β-catenin activity compared to parental cells, which might explain the hypersensitivity of chemo-resistant cells to niclosamide. Our work provides pre-clinical evidence that niclosamide can be repurposed for treating osteosarcoma. Our findings also suggest the therapeutic value of β-catenin to overcome osteosarcoma chemo-resistance. malignancy However disease Niclosamide drug anticancer anti cancer submicromolar sub micromolar migration chemoresistant chemo resistant Interestingly βcatenin β catenin niclosamides s addition preclinical pre clinical chemoresistance. chemoresistance resistance. chemo-resistance

ABSTRACT Objective: To have anatomic measurements of carotid artery bifurcation (CAB) with 64-spiral computed tomography angiography (64-SCTA), and provide anatomic basis for related research. Methods: Imaging data of 92 subjects (45 males, 47 females, the age range 20–82 years and mean age 48.4 ± 6.1 years) without pathology of CAB, who underwent 64-SCTA in head and neck from June 1, 2008 to June 30, 2010, were selected from the Picture Archiving and Communication Systems in Zhongshan Hospital of Xiamen University, Fujian, China. On the 3D images, the angle and size of CAB were measured, and the statistical comparisons of measurements were made between the bilateral, sex and age groups. Results: The measurements of CAB were divided into young (≤ 40 years) and older (> 40 years) groups: bifurcation angle is 36.206° ± 10.210° and 49.343° ± 16.489°, respectively; the inner diameter of common carotid artery (CCA) is 6.820 ± 0.635 and 6.845 ± 0.838 mm, respectively; the proximal inner diameter of internal carotid artery (ICA) is 7.143 ± 0.992 and 7.476 ± 1.630 mm, of the enlargement is 7.568 ± 1.069 and 8.554 ± 1.733 mm, of the distal is 4.897 ± 0.508 and 5.123 ± 0.699 mm, respectively; the inner diameter of external carotid artery (ECA) is 4.324 ± 0.580 and 4.104 ± 0.638 mm, respectively. There were statistically significant differences in all the measurements between male and female groups, in the bifurcation angle, inner diameters of ICA and ECA between young and older groups, and in the bifurcation angle between the left and right (p < 0.05). Conclusion: A 64-SCTA with 3D image post-processing technique can clearly observe and show the CAB. All CAB measurements will provide the objective basis for applied anatomy, imaging diagnosis and surgery treatment.

Abstract Objective: The aim of this study was to evaluate whether sufentanil can reduce emergence delirium in children undergoing transthoracic device closure of ventricular septal defect (VSD) after sevoflurane-based cardiac anesthesia. Methods: From February 2019 to May 2019, 68 children who underwent transthoracic device closure of VSD at our center were retrospectively analyzed. All patients were divided into two groups: 36 patients in group S, who were given sufentanil and sevoflurane-based cardiac anesthesia, and 32 patients in group F, who were given fentanyl and sevoflurane-based cardiac anesthesia. The following clinical data were recorded: age, sex, body weight, operation time, and bispectral index (BIS). After the children were sent to the intensive care unit (ICU), pediatric anesthesia emergence delirium (PAED) and face, legs, activity, cry, consolability (FLACC) scale scores were also assessed. The incidence of adverse reactions, such as nausea, vomiting, drowsiness and dizziness, was recorded. Results: There was no significant difference in age, sex, body weight, operation time or BIS value between the two groups. Extubation time (min), PEAD score and FLACC scale score in group S were significantly better than those in group F (P<0.05). No serious anesthesia or drug-related side effects occurred. Conclusions: Sufentanil can be safely used in sevoflurane-based fast-track cardiac anesthesia for transthoracic device closure of VSD in children. Compared to fentanyl, sufentanil is more effective in reducing postoperative emergence delirium, with lower analgesia scores and greater comfort.

RESUMO: Para resolver o problema que os nós do caule são difíceis de identificar no processo de corte automático de sementes de cana-de-açúcar, é proposto, neste artigo, um método para identificar os nós do colmo da cana-de-açúcar com base nos pontos extremos da função de projeção vertical. Em primeiro lugar, a fim de reduzir a influência da luz no processamento da imagem, a imagem de cor RGB foi convertida em imagem de cor HSI, e a imagem de componente S do espaço de cores HSI é extraída como um objeto de pesquisa. Em seguida, o método Otsu foi usado para binarizar o mapa do componente S, e a operação morfológica fechada foi usada para preencher os espaços da imagem binária, e a projeção horizontal da imagem binária foi usada para separar a cana de açúcar do fundo. Finalmente, a posição do caule de cana-de-açúcar foi preliminarmente determinada através da tomada contínua do derivado da função de projeção vertical da imagem binária, e a soma do valor pixel local da coluna de pixel suspeito foi comparada para determinar ainda mais o nódulo da cana-de-açúcar. Os resultados experimentais mostram que a taxa de reconhecimento do nó de haste única foi de 100%, o desvio padrão foi inferior a 1.1 mm. A precisão da identificação simultânea de nós de haste dupla foi de 98%, o desvio padrão foi menor que 1.7 mm. A precisão da identificação simultânea dos três nós de haste é de 95%, o desvio padrão foi inferior a 2.2 mm. Comparado com os outros métodos introduzidos neste artigo, o método proposto possui maior reconhecimento e precisão.

ABSTRACT: In order to solve the problem that the stem nodes are difficult to identify in the process of sugarcane seed automatic cutting, a method of identifying the stem nodes of sugarcane based on the extreme points of vertical projection function is proposed in this paper. Firstly, in order to reduce the influence of light on image processing, the RGB color image is converted to HSI color image, and the S component image of the HSI color space is extracted as a research object. Then, the S component image is binarized by the Otsu method, the hole of the binary image is filled by morphology closing algorithm, and the sugarcane and the background are initially separated by the horizontal projection map of the binary image. Finally, the position of sugarcane stem is preliminarily determined by continuously taking the derivative of the vertical projection function of the binary image, and the sum of the local pixel value of the suspicious pixel column is compared to further determine the sugarcane stem node. The experimental results showed that the recognition rate of single stem node is 100%, and the standard deviation is less than 1.1 mm. The accuracy of simultaneous identification of double stem nodes is 98%, and the standard deviation is less than 1.7 mm. The accuracy of simultaneous identification of the three stem nodes is 95%, and the standard deviation is less than 2.2 mm. Compared with the other methods introduced in this paper, the proposed method has higher recognition and accuracy.

ABSTRACT Photoperiod and nutrition are major factors that affect the reproductive efficiency particularly in female animals. In this study we examined the interaction of photoperiod and food restriction on growth, sexual maturation and receptor mRNA expressions of leptin, melatonin, and estrogen in abdominal fat and the ovary of pullets. There were no interaction effects between photoperiod and feeding level on body weight, abdominal fat weight, ovary weight at both 14 wk and 18 wk. Abdominal fat weight of feed restriction group was significantly lower compared with the control group at the age of 14 wk, 18 wk, and age of the first egg (AFE) (p<0.05). Ovary LEPR (Leptin receptor) gene expression showed an interaction effect of the first egg. Restricted feeding significantly inhibited ovary ER (Estrogen receptor), LEPR and MELR1B (Melatonin 1B receptor) gene expression at 14 wk, 18 wk and the first egg. At 14-week-old, abdominal fat LEPR gene expression was significantly lower in long photoperiod group compared with the short photoperiod group. At the first egg, short photoperiod and feed restriction group reduced abdominal fat LEPR gene expression. The results indicated that the reproductive activity of pullets is sensitive to feed intake and photoperiod. Feed restriction down regulated the ER, LEPR, MELR1A (Melatonin 1A receptor) and MELR1B mRNA expression of the ovary at 14 wk, 18wk and AFE. Long photoperiod enhanced the LEPR, MELR1A and MELR1B mRNA expression of abdominal fat at AFE.

Marasmius androsaceus is a medicinal fungus mainly used to treat various forms of pain in China. This study investigated the analgesic effects of an ethanol extract of M. androsaceus (MAE) and its potential molecular mechanisms. Oral administration of MAE (50, 200, and 1000 mg/kg) had significant analgesic effects in an acid-induced writhing test, a formalin test, and a hot-plate test, with effectiveness similar to tramadol (the positive control drug). The autonomic activity test showed that MAE had no harmful effects on the central nervous system in mice. MAE resulted in significantly enhanced levels of noradrenalin and 5-hydroxytryptamine in serum but suppressed both of these neurotransmitters in the hypothalamus after 30 s of hot-plate stimulation. Co-administration with nimodipine (10 mg/kg; a Ca2+ channel blocker) strongly enhanced the analgesic effect in the hot-plate test compared to MAE alone. Moreover, MAE down-regulated the expression of calmodulin-dependent protein kinase II (CaMKII) in the hypothalamus after a 30-s thermal stimulus. These results suggested that the analgesic ability of MAE is related to the regulation of metabolism by monoamine neurotransmitters and Ca2+/CaMKII-mediated signaling, which can potentially aid the development of peripheral neuropathic pain treatments obtained from M. androsaceus.

Abstract Purpose: To determine whether dexmedetomidine (DEX) could attenuate acute kidney injury (AKI) induced by ischemia/reperfusion (I/R) in streptozotocin (STZ)-induced diabetic rats. Methods: Four groups each containing six rats were created (sham control(S), diabetes-sham (DS), diabetes I/R (DI/R), and diabetes-I/R-dexmedetomidine (DI/R-DEX). In diabetes groups, single-dose (65 mg/kg) STZ was administered intraperitoneally (i.p.). In Group DI/R, ischemia reperfusion was produced via 25 min of bilateral renal pedicle clamping followed by 48 h of reperfusion. In Group DI/R-DEX, 50 μg/kg dexmedetomidine was administered intraperitoneally 30 minutes before ischemia. Renal function, histology, apoptosis, the levels of TNF-α, IL-1β, and oxidative stress in diabetic kidney were determined. Moreover, expression of P38 mitogen-activated protein kinase (P38-MAPK), phosphorylated-P38-MAPK(p-P38-MAPK) and thioredoxin-interacting protein (TXNIP) were assessed. Results: The degree of renal I/R injury was significantly increased in DI/R group compared with S group and DS group. The levels of TNF-α, IL-1β, oxidative stress and apoptosis were found significantly higher in DI/R Group when compared with S Group and DS Group. The protein expression of p-P38-MAPK and TXNIP were significantly increased after I/R. All these changes were reversed by DEX treatment. Conclusion: The renoprotective effects of DEX-pretreatment which attenuates I/R-induced AKI were partly through inhibition of P38-MAPK activation and expression of TXINP in diabetic kidney.

ABSTRACT Toll-like receptors (TLRs) are well-characterized in mice and rats, but little is known on their role in broiler chickens during acute heat stress (AHS). The aim of the present study was to estimate the change in TLR4 mRNA expression in the liver, kidney's pleen, heart, and small intestine of broiler chickens under AHS. A total of 240 healthy Arbor Acres (AA) broiler chickens were randomly divided into four groups: control group (22±1°C; 0h), HS2, HS5 and HS10 (38±1°C; 2h, 5h and 10h of heat stress, respectively). As AHS duration increased, TLR4 mRNA expression slightly decreased at HS2 and HS5, but was dramatically elevated in HS10 (p<0.001) compared with the control group in the small intestine, as well as in the spleen at HS2 (p=0.001) and HS10 (p<0.001). The mRNA expression levels of TLR4 significantly increased in the liver, heart, and kidneys (p<0.001) at HS10, and in the kidneys at HS5 (p=0.003). It is found that TLR4 mRNA expression at HS10 in different organs was significantly higher (p<0.001) compared with HS2 and HS5. The results of the present study suggest that AHS may modulate the functional responses of the liver, kidney, spleen, heart, and small intestine of broilers by regulating TLR4 mRNA expression.

ABSTRACT Objective: The objective of the study was to investigate the epidemiology of paediatric hand injuries treated in emergency departments (EDs) in Foshan City, as well as to supply data for the development of preventive strategies in South China and similar developing areas. Methods: From July 2010 to June 2011, a multicentre study was prospectively designed and conducted in five large hospital EDs in Foshan. An anonymous questionnaire was specially designed for data collection. Results: A total of 317 (95.48%) subjects with paediatric hand injuries completed questionnaires within the one-year study period. Most subjects were injured at home or work (40.69% vs 36.60%). The majority of paediatric hand injuries occurred in daily activities (164, 51.74%) or were caused by crushing (144, 45.43%). There were significant statistical differences among age groups and places of occurrence (p < 0.05). Most subjects got their fingers injured (174, 54.89%). About 116 (36.59%) subjects were injured while at work and 106 (91.38%) subjects had medical insurance. About 59 (50.86%) subjects had < 0.5 year of job tenure. However, only less than half of the subjects (46.55%) had the related experience of safety training. Upon the occurrence of hand injuries, the subjects had been working for 4.49 ± 3.05 hours without rest. Among them, 19 (5.99%) subjects were younger than 16 years old and should not be employed, according to the Chinese labour law. Conclusions: Epidemiology data enhance our knowledge of paediatric hand injuries and facilitate prevention and treatment in the future, thus reducing loss of hand function as well as psychological and economic burden.

RESUMEN Objetivo: El objetivo del estudio fue investigar la epidemiología de las lesiones de mano pediátricas tratadas en departamentos de emergencias (DE) en la ciudad de Foshan, así como suministrar datos para el desarrollo de estrategias preventivas en el sur de China y áreas de desarrollo similar. Métodos: De julio de 2010 a junio de 2011 de junio, se diseñó y realizó prospectivamente un estudio multicéntrico en cinco DE hospitalarios mayores de Foshan. Un cuestionario anónimo fue especialmente diseñado para la recolección de datos. Resultados: Un total de 317 (95.48%) sujetos con lesiones de mano pediátricas completaron cuestionarios dentro del período de estudio de un año. La mayoría de los sujetos recibieron lesiones en el hogar o en el trabajo (40.69% vs 36.60%). La mayoría de las lesiones de mano pediátricas ocurrieron en actividades diarias (164, 51.74%) o fueron causadas por aplastamiento (144, 45.43%). Hubo diferencias estadísticas significativas entre los grupos por edad y los lugares de ocurrencia (p < 0.05). La mayoría de los sujetos se lesionaron los dedos (174, 54.89%). Alrededor de 116 (36.59%) sujetos resultaron heridos durante el trabajo y 106 (91.38%) sujetos tenían seguro médico. Alrededor de 59 (50.86%) sujetos tenían < 0.5 año de permanencia en el empleo. Sin embargo, sólo menos de la mitad de los sujetos (46.55%) tenían experiencia en relación con entrenamiento de seguridad. Cuando ocurrieron las lesiones en las manos, los sujetos habían estado trabajando por 4.49 ± 3.05 horas sin descanso. Entre ellos, 19 (5.99%) sujetos tenían menos de 16 años de edad, y no debían estar empleados de acuerdo con las leyes laborales en China. Conclusiones: Los datos epidemiológicos mejoran nuestro conocimiento sobre las lesiones de mano pediátricas, y facilitan la prevención y el tratamiento futuros, reduciendo así la pérdida de la función de la mano y la consiguiente carga psicológica y económica.

Abstract Background In most cases of envenoming by the green habu Viridovipera stejnegeri in Taiwan coagulopathy is not observed. Case presentation Herein, we describe the case of a patient with liver cirrhosis who developed venom-induced consumptive coagulopathy after V. stejnegeri bite. Laboratory investigation revealed the following: prothrombin time > 100 s (international normalized ratio > 10), activated partial thromboplastin time > 100 s, fibrinogen < 50 mg/dL, and fibrin degradation product > 80 μg/mL. The patient recovered after administration of bivalent hemorrhagic antivenom, vitamin K, fresh frozen plasma and cryoprecipitate. Conclusion The liver, directly involved in the acute phase reaction, is the main responsible for neutralization of animal toxins. Any patient with history of liver cirrhosis bitten by a venomous snake, even those whose venoms present low risk of coagulopathy, should be very carefully monitored for venom-induced consumptive coagulopathy (VICC), since the hemostatic balance may be disrupted.

Fluoride, which is often added to toothpaste or mouthwash in order to protect teeth from decay, may be a novel therapeutic approach for acceleration of periodontal regeneration. Therefore, we investigated the effects of fluoride on proliferation and mineralization in human periodontal ligament cells in vitro. The periodontal ligament cells were stimulated with various concentrations of NaF added into osteogenic inductive medium. Immunohistochemistry of cell identification, cell proliferation, alkaline phosphatase (ALP) activity assay, Alizarin red S staining and quantitative real-time-polymerase chain reaction (RT-PCR) were performed. Moderate concentrations of NaF (50-500 μmol/L) had pro-proliferation effects, while 500 μmol/L had the best effects. ALP activity and calcium content were significantly enhanced by 10 μmol/L NaF with osteogenic inductive medium. Quantitative RT-PCR data varied in genes as a result of different NaF concentrations and treatment periods. We conclude that moderate concentrations of NaF can stimulate proliferation and mineralization in periodontal ligament cells. These in vitro findings may provide a novel therapeutic approach for acceleration of periodontal regeneration by addition of suitable concentrations of NaF into the medication for periodontitis treatment, i.e., into periodontal packs and tissue patches.

ABSTRACT Background: The aim of parapelvic cyst treatment is to have complete drainage of cyst fluid and prevent its further compression of the kidney and collective system. This study explores the efficacy and safety of surgical approaches with holmium laser ureteroscopic internal drainage in the treatment of parapelvic cyst. Methods: The compression effect of parapelvic cyst on the renal collective system was observed by rigid ureteroscope using retrograde ureteroscopic technology. With direct vision, the cyst wall on the obvious parapelvic compression site was cut. The diameter of the cyst wall cut was about 1 cm. The internal drainage was obtained by double-J tubes. When the cyst was in the inferior pole of kidney or where the rigid ureteroscope could not reach, a flexible ureteroscope was used. Results: In 28 cases of operation, 27 cases were successful. The cyst treatment time was eight to 40 minutes (average 26 minutes). During the operation, no massive haemorrhage, damage of nearby organ and ureter, or other complications happened. Time of follow-up was 10–72 months (average 39 months). The results of follow-up showed that in 22 cases, the cyst disappeared; the diameter of the cyst in four cases was reduced by more than half, and one case recurred. Conclusion: The treatment of parapelvic cyst by internal drainage operation using holmium laser and ureteroscopy was effective. The operation was safe with few complications.

RESUMEN Antecedentes: El objetivo del tratamiento de quiste parapélvico es lograr el drenaje completo del líquido del quiste y prevenir su compresión ulterior del riñón y el sistema colectivo. Este estudio explora la eficacia y seguridad de los abordajes quirúrgicos cn drenaje interno mediante ureteroscopia con láser de holmio en el tratamiento de quiste parapélvico. Métodos: El efecto de la compresión del quiste parapélvico del sistema colectivo renal fue observado mediante ureteroscopio rígido utilizando la tecnología ureteroscópica retrógrada. Con visión directa, la pared del quiste fue cortada en el sitio obvio de la compresión parapélvica. El diámetro de la pared del quiste cortada era alrededor de 1 cm. El drenaje interno se obtuvo con catéteres doble J. Cuando el quiste estaba en el polo inferior del riñón o donde no podía llegar el ureteroscopio rígido, se utilizaba un ureteroscopio flexible. Resultados: De 28 casos de operación, 27 casos tuvieron éxito. El tiempo de tratamiento del quiste fue de ocho a 40 minutos (un promedio de 26 minutos). Durante las operaciones, no hubo hemorragias masivas, daños de órganos y uréteres, u otras complicaciones. El tiempo de seguimiento fue de 10 a 72 meses (un promedio de 39 meses). Los resultados del seguimiento mostraron que en 22 casos, el quiste desapareció. En cuatro casos, el diámetro del quiste se redujo en más de la mitad, y reapareció en uno de los casos. Conclusión: El tratamiento de quiste parapélvico por operación de drenaje interno con láser de holmio y ureteroscopia fue eficaz. La operación fue segura con pocas complicaciones.

BACKGROUND: Treatment-resistant depression (TRD) is a therapeutic challenge for clinicians. Augmentation pharmacotherapy is effective for TRD, but it is still unclear which augmentation agent is most efficacious. OBJECTIVE: To assess the effects of seven augmentation agents on TRD. METHODS:We did a multiple-treatments meta-analysis, accounting for both direct and indirect comparisons. PubMed, the Center for Clinical and Translational Research, Web of Science, Embase, CBM-disc, the Chinese National Knowledge Infrastructure and relevant websites (up to August 2013) were searched for randomised controlled trials (RCTs) about augmentation agents. The following terms were used: 'potentiation, 'augmentation', and 'adjunct' paired with 'depression' and 'resistant depression'. No language limitation was imposed. RESULTS: We systematically reviewed 12 RCTs (1 936 participants), which included seven augmentation agents: lithium, tricyclic antidepressants (TCAs), atypical antipsychotics (AAPs), antiepileptic drugs (AEDs), buspirone, cognitive behaviour therapy (CBT) and tri-iodothyronine (T3). The results revealed that T3 was more efficacious than lithium, TCAs, AAPs, AEDs, buspirone and CBT with odds ratios (ORs) of 1.58, 1.56, 1.51, 1.47, 1.77 and 1.25, respectively. ORs favoured CBT compared with lithium, TCAs, AAPs, AEDs and buspirone. Buspirone was the least efficacious of all the other augmentation agents tested. AAPs were significantly more acceptable than lithium, and CBT more than buspirone. T3 was slightly more acceptable than lithium, and CBT more than AAPs. CONCLUSION: T3 as an augmentation agent should be a clinician's first consideration instead of lithium in acute treatment for TRD. CBT might be a good augmentation agent in some communities. Buspirone should be a final option as an augmentation agent. Further research is needed, such as a well-designed, large-scale controlled trial, to support and draw definite conclusions.

Vegetable fields in China are characterized with intensive fertilization and cultivation, and their net effect on the global warming deserves attention. Greenhouse gas fluxes were thus measured, using a static closed chamber method, over approximately 18 months in two typical subtropical vegetable fields with different soil types and contrasting soil properties. Five consecutive crops were planted in one field and four in the other. Intensive fertilization consistently stimulated soil N2O emission, while imposed complicated impact on soil respiration with CO2 emission enhanced in one field and suppressed in the other field. The fertilizer-induced N2O emission factors (EFs) varied with individual crop phases and averaged 1.4 to 3.1% across the whole sampling period for different fields. The interaction of soil temperature and moisture could explain about 58% of the seasonal variation in the EFs. All the soils under different vegetable cropping systems were net sources of atmospheric radiative forcing and the net global warming potential over the entire study period ranged from 1,786 to 3,569 g CO2 equivalence m-2 for fertilized soils with net CO2 emission contributing 53 to 67% and N2O emission occupying the remaining 33 to 47%.