ABSTRACT Introduction: Postoperative urinary retention may predispose to permanent bladder damage. Risk factors include type of anesthesia, type of surgery, and use of anticholinergics, analgesics, and opioids. Once the lesion is established, complementary urodynamic tests are essential for etiological diagnosis and treatment. The objective of this study is to report a case of a patient with urinary retention in the postoperative period of lipoabdominoplasty. Case Report: 27-year-old female patient, without comorbidities or use of continuous medication. She underwent lipoabdominoplasty and evolved postoperatively with urinary retention and bladder distention, diagnosed as detrusor contractility and sensitivity deficit in the urodynamic study. She was maintained in outpatient follow-up with the surgical team and Urology, with a progressive reduction in urinary catheter use and complete removal in eight months of follow-up. Discussion: The objective of aesthetic plastic surgery is to improve the physical appearance of the body. It is subject to complications like other surgical procedures, and pain seems to be the most frequent. Urinary retention may be secondary to the use of opioids, and its diagnosis in the postoperative period of lipoabdominoplasty still has some obstacles. Plication of the rectus muscle diastasis, liposuction, and the use of a compressive abdominal belt make it difficult to identify a possible bladder distention. An episode of bladder overdistention can result in significant morbidity. Conclusion: The present report demonstrated the good evolution of a patient who developed urinary retention in the postoperative period of lipoabdominoplasty. The main diagnostic hypothesis was that it was secondary to the use of opioids.

RESUMO Introdução: A retenção urinária pós-operatória pode predispor a danos permanentes à bexiga. Os fatores de risco incluem tipo de anestesia, tipo de cirurgia e uso anticolinérgicos, analgésicos e opioides. Uma vez que a lesão está estabelecida, os exames complementares urodinâmicos são fundamentais para diagnóstico etiológico e tratamento. O objetivo deste trabalho é relatar caso de paciente com quadro de retenção urinária no pós-operatório de lipoabdominoplastia. Relato de Caso: Paciente de 27 anos, sexo feminino, sem comorbidades ou uso de medicamentos contínuos. Foi submetida a lipoabdominoplastia, e evoluiu no pós-operatório com quadro de retenção urinária e bexigoma, diagnosticada como acontratilidade detrusora e déficit de sensibilidade no estudo urodinâmico. Manteve acompanhamento ambulatorial com a equipe cirúrgica e a Urologia, com redução progressiva do uso do cateter vesical e retirada completa em oito meses de seguimento. Discussão: O objetivo da cirurgia plástica estética é melhorar o aspecto físico do corpo. Como os demais procedimentos cirúrgicos, está sujeita a complicações e a dor parece ser a mais frequente. A retenção urinária pode ser secundária ao uso de opioides e seu diagnóstico no pós-operatório da lipoabdominoplastia ainda possui alguns obstáculos. A plicatura da diástase do músculo reto, a lipoaspiração e o uso de cinta abdominal compressiva dificultam a identificação do possível bexigoma. Um episódio de hiperdistensão da bexiga pode resultar em morbidade significativa. Conclusão: O presente relato demonstrou boa evolução de paciente que desenvolveu retenção urinária no pós-operatório de lipoabdominoplastia. A principal hipótese diagnóstica foi de ser secundária ao uso de opioide.

ABSTRACT Salinity stress profoundly affects crop plants’ morphological structures and physiological processes, decreasing plant growth and development. The application of phytohormones has been proved an efficient way to alleviate salinity stress. This study was done to evaluate the effects of exogenous application of gibberellic acid (GA3; 0.288 mM), salicylic acid (SA; 0.362 mM), indole acetic acid (IAA; 0.285 mM) and control (0 mM) on seedling growth and physiological parameters of hargel (Solenostemma argel Hayne) seedlings under different salinity levels (0, 50 and 100 mM NaCl). Significant decreases due to salinity stress were observed in all the seedling growth parameters shoot and root length, shoot fresh weight, shoot dry weight, root fresh weight, root dry weight, chlorophyll a and b content, and antioxidant enzymes activities such as superoxide dismutase (SOD), peroxidase (POD), catalase (CAT), and ascorbate peroxidase (APX). In contrast, soluble protein and carotenoid content increased with increasing salinity. At high salinity level, GA3 increased carotenoid content and APX activity by 56.4% and 53.4%, respectively, while SA increased shoot dry weight, SOD, POD and soluble protein by 1.3-fold, 1.3-fold, 1.95-fold and 93.2%, compared with the control, IAA increased root length and fresh root weight at the same salinity level by 1.58-fold and 2-fold, respectively. In conclusion, seed priming with an appropriate dosage of exogenous hormones successfully mitigates the adverse effects of NaCl by increasing photosynthetic pigment, antioxidant enzyme activity and seedling growth parameters. Furthermore, SA exhibited the best mitigating effects compared to IAA and GA3.

Abstract Introduction Sacrococcygeal pilonidal disease (SPD) is a chronic suppurative condition of the sacrococcygeal region causing chronic sinus tract or cyst. It is an acquired complex disease more common in young adult males, causing considerable morbidity and long periods of interruption in work or education. From simple conservative techniques to complex flap reconstruction, many debatable treatment options are offered; however clear dynamics toward the widespread use of minimally invasive methods and off-midline flap reconstruction are suggested in all guidelines, which recommend the Karydakis and Limberg flap modification. The plethora of literature compares procedures for identification of a single best treatment approach, which has proven to be difficult. The surgical outcome of both techniques is compared in the present study. Objective To compare the surgical outcomes of the modified Karydakis flap (MKF) versus the modified Limberg flap (MLF) in SPD. Materials and Methods The present study was conducted at the general surgery department on SPD patients who were ≥18 years old. A total of 67 participants were included after obtaining the informed consent, with group A comprising 33 patients undergoing the MLF procedure and group B comprising 34 patients undergoing the MKF procedure. Results The mean patient age was 28.85 (range, 18–44) years old. For the MKF and MLF methods, the average operating duration was 32.5 (range, 25–40) and 54.5 (range, 45–65) minutes, respectively. The MKF approach was found to significantly improve pain score, mean sitting painless time, return to normal activity, wound healing time, and patient satisfaction. Conclusion Comparative outcomes were seen between both MKF and MLF; however, our findings show that MKF is a more favourable method than MLF with superior outcomes.

Abstract Introduction The coronavirus disease 2019 (COVID-19) has made otolaryngologists more susceptible than their counterparts to its effect. Objective This study aimed to find if COVID-19 had a different impact on ear, nose, and throat (ENT) physicians’ of various categories (residents, registrars, and consultants ) regarding many aspects of the quality of life (protection, training, financial, and psychological aspects). Methods We included 375 ENT physicians, of different categories (residents, registrars, and consultants), from 33 general hospitals and 26 university hospitals in Egypt. The study was conducted using a 20-item questionnaire with a response scale consisting of three categories: yes, no, and not sure. It covered infection control and personal protective equipment (PPE) usage; medical practice and safety; online consultation and telemedicine,; webinars and online lectures; COVID-19 psychological, financial, and quarantine period effects; and future expectations. Results The results of the questionnaire showed that COVID-19 had a statistically significant impact on the daily life of the responders. There were statistically significant differences among the three involved categories, based on their answers. Conclusion This study showed a statistically significant difference regarding the impact of COVID-19 on many aspects of the quality of life (protection, training, financial, and psychological aspects) of ENT physicians of various categories (residents, registrars, and consultants), and these effects may persist for a long time.

Abstract Colorectal cancer (CRC) is the third most prevalent cancer and the second most common cause of cancer death; however, its early detection can improve the survival. Colonic polyps are considered one of the CRC's major risk factors. Throughout many biological processes and malignancies, the non-coding RNAs have essential functions. Certain long noncoding RNAs (lncRNAs), including H19, were supposed to be CRC possible biomarkers. Also, H19 has been reported to play a role in regulating the activity of β-catenin, a protein that regulates cell-to-cell adhesion, as well as gene transcription. The current work aimed to investigate the potential significance of LncRNA H19 relative serum expression level by quantitative polymerase chain reaction (q-PCR) and β-catenin by enzyme-linked immunosorbent assay (ELISA) as noninvasive biomarkers to discriminate between colorectal cancer and colonic polyps. The statistical analysis of the studied factors revealed that the serum expression of H19 and β-catenin in cancer cases were substantially greater than colonic polyp cases and normal control. Conclusion The relative expressions of H19 and beta-catenin in the serum can significantly discriminate patients with CRC from those with polyp and normal controls, which could help when screening for CRC.

Resumo A glomerulonefrite membranoproliferativa (GNMP) é a glomerulopatia associada ao vírus mais típico da hepatite C (HCV), e os dados disponíveis sobre a utilização de antivirais de ação direta (AAD) na glomerulonefrite associada ao HCV são inadequados. Avaliamos a resposta renal e viral em dois casos de GNMP relacionados ao HCV; o primeiro causado por crioglobulinemia, enquanto o segundo era negativo para crioglobulina. Ambos os pacientes receberam imunossupressão além de AAD em diferentes esquemas terapêuticos. Eles alcançaram remissão parcial, mas permaneceram dependentes da imunossupressão por mais de 6 meses após os AAD, apesar da resposta virológica sustentada, que permitiu a retirada da imunossupressão mais segura, mas incompleta. Ambos os pacientes foram testados para HCV oculto em células mononucleares do sangue periférico e deram resultados negativos. Portanto, o tratamento do GNMP relacionado ao VHC deve ser de acordo com a condição clínica e os efeitos da terapia medicamentosa. É importante considerar que a resposta renal pode ficar aquém da resposta virológica.

Abstract Membranoproliferative glomerulonephritis (MPGN) is the most typical Hepatitis C virus (HCV)-associated glomerulopathy, and the available data about the utilization of direct-acting antivirals (DAA) in HCV-associated glomerulonephritis is inadequate. We evaluated the renal and viral response in two cases of HCV-related MPGN; the first caused by cryoglobulinemia while the second was cryoglobulin-negative. Both patients received immunosuppression besides DAA in different regimens. They achieved partial remission but remained immunosuppression-dependent for more than 6 months after DAA despite sustained virological response, which enabled safer but incomplete immunosuppression withdrawal. Both patients were tested for occult HCV in peripheral blood mononuclear cells and found to be negative. Hence, the treatment of HCV-related MPGN ought to be according to the clinical condition and the effects of drug therapy. It is important to consider that renal response can lag behind the virological response.

SUMMARY: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) represent a unique class of glucose-declining renal-targeted drugs. The SGLT2i Canagliflozin (CANA) is an anti-hyperglycemic drug that reduces various cardiovascular and renal outcomes in patients with type 2 diabetes mellitus. This study aimed to explore the potential effects of CANA on the isolated healthy adult rat hearts to show if CANA has positive inotropic or cardiac depressant effects via analyzing the amplitude and frequency of cardiac contractions. In isolated normal adult rat hearts, the effects of CANA on cardiac contractility were examined. In a dose-response curve, CANA led to a significant cardiac depressant effect in a dose-dependent manner. This cardiac depressant effect of CANA (10-6 M) was not prevented by atropine. However, this cardiac depressant effect was partially antagonized by both Isoproterenol (10-5 M) and Calcium chloride (10-6 M), suggesting beta-adrenoceptor and calcium channel blocking actions. In addition, the cardiac depressant effect of CANA (10-6 M) was mitigated in part by Nitric oxide synthase inhibitor, L-NAME, suggesting that its action probably depends to some extent on the accumulation of nitric oxide, which decreases the rise of intracellular Calcium. Data from this study demonstrate that CANA has a significant cardiac relaxant effect in isolated hearts of healthy adult rats by different possible mechanisms. This inhibitory effect on cardiac contractility may help improve the diastolic ventricular filling providing a therapeutic potential to help the other cardioprotective mechanisms of CANA in the prevention and treatment of heart failure.

RESUMEN: Los inhibidores del cotransportador de sodio- glucosa 2 (SGLT2i) representan una clase única de fármacos dirigidos a los riñones que disminuyen la glucosa. El SGLT2i Canagliflozin (CANA) es un fármaco antihiperglucémico que reduce varios resultados cardiovasculares y renales en pacientes con diabetes mellitus tipo 2. Este estudio tuvo como objetivo explorar los efectos potenciales de CANA en corazones aislados de ratas adultas sanas para indicar si CANA tiene efectos inotrópicos o depresores cardíacos positivos mediante el análisis de la amplitud y la frecuencia de las contracciones cardíacas. En corazones aislados de ratas adultas normales, se examinaron los efectos de CANA sobre la contractilidad cardíaca. En una curva de dosis-respuesta, CANA condujo a un efecto depresor cardíaco significativo de manera dependiente de la dosis. Este efecto depresor cardíaco de CANA (10-6 M) no fue impedido por la atropina. Sin embargo, este efecto depresor cardíaco fue parcialmente antagonizado tanto por el isoproterenol (10-5 M) como por el cloruro de calcio (10-6 M), lo que sugiere acciones bloqueadoras de los receptores beta adrenérgicos y de los canales de calcio. Además, el efecto depresor cardíaco de CANA (10-6 M) fue mitigado en parte por el inhibidor de la sintasa de óxido nítrico, L-NAME, lo que sugiere que su acción probablemente depende en cierta medida de la acumulación de óxido nítrico, lo que disminuye el aumento de calcio intracelular. Los datos de este estudio demuestran que CANA tiene un efecto relajante cardíaco significativo en corazones aislados de ratas adultas sanas por diferentes mecanismos posibles. Este efecto inhibitorio sobre la contractilidad cardíaca puede ayudar a mejorar el llenado ventricular diastólico proporcionando un potencial terapéutico para ayudar a los otros mecanismos cardioprotectores de CANA en la prevención y tratamiento de la insuficiencia cardíaca.

Abstract The purpose of this study is to investigate the role of some oxidative stress (OS), ceruloplasmin (Cp), and neopterin (NPT) as diagnostic biomarkers for dromedary camels endometritis as well as to explore the impact of ceftiofur treatment on endometritis. Camels were categorized into two groups; healthy control group (n = 20) and endometritis group (n = 60). She-camels with clinical signs of endometritis (CE) received 6.6 mg/kg BW of ceftiofur (i/m). On days 7, and 14, she-camels were evaluated and clinical cure or failure to cure was determined. The comparison of the groups for OS demonstrated that endometritis caused an increase in serum malondialdehyde (sMDA), Cp, and NPT levels (P<0.05), but decreased serum levels of superoxide dismutase (SOD), catalase (CAT), and glutathione (GSH) (P<0.05). The most prevalent pathogens involved in the etiology of CE are Arcanobacterium pyogenes, Streptococcus pyogenes, and Staphylococcus aureus. All examined biomarkers demonstrated a high degree of recognition between CE camel and healthy controls (the area under the curve (AUC) was 95.9 for NPT). A higher proportion of camels with CE that were treated with ceftiofur (90%, P<0.0001) showed clinical cure by the first dose, while 10% required a second dose. In conclusion, CE causes increased oxidative reactions and decreased antioxidant defense competence. Subsequently, the alteration in that balance that was represented by the biomarkers of OS could be beneficial for clinical practice and basic clinical research. Additionally, all trials demonstrated the efficacy of ceftiofur for the treatment of CE in she-camel.

Abstract Phenylketonuria is a rare disorder that increases the levels of phenylalanine in the blood. As there are scant articles about anesthesia management in phenylketonuria patients, this encouraged us to report a short-time anesthesia management of a child with phenylketonuria for bone fracture. The anesthesia was induced with intravenous ketamine and midazolam. During procedure, he received 100% oxygen via a face mask throughout spontaneous breathing. The operation was uneventful, and he was completely awakened in the recovery room. This report emphasizes that in some situations, the combination of midazolam with ketamine could be used safely for short time anesthesia in phenylketonuria patients.

Abstract: In this research, we used Pistacia atlantica gum during cooling phase of oil-heat treatment of poplar wood (Populus deltoids) to improve its resistance to the white-rot fungus Trametes versicolor and growth of the mold fungus Penicillium expansum. Thermal modification was carried out using rapeseed oil at 180 °C, 200 °C and 220 °C for 2 hours and 4 hours. The modified wood specimens were then directly cooled in the oil containing 0 %, 5 % and 10 % (w/w) of the gum at 25 °C for 30 minutes. The chemical constituents of the essential oil extracted with a Clevenger type apparatus were determined by chromatography-mass spectrometry (GC-MS). The amounts of α-pinene, β-pinene and α-terpinolene of the essential oil were 60,2 %, 8,7 % and 3,9 %, respectively. The mold resistance was greatly improved, while the improvement against the decay fungus was only observed for the specimens modified at 180 °C. Our results confirmed that the enhanced fungal resistance was not only due to the presence of monoterpenes in the essential oil, but also to a further reduction in the hygroscopicity of the treated wood.

RESUMEN A pesar de que el concepto de marketing con causa (Cause-Related Marketing) lleva cuatro décadas cursando en la literatura académica de los negocios y del marketing, aún no hay un acuerdo general respecto a la definición, el contenido y el alcance del marketing, particularmente en países como Irán. A este respecto, aunque este artículo examinará y presentará el marco conceptual de esta temática durante su periodo de desarroll inicial, lo que pretende es obtener un modelo conceptual para el marketing con causa en el sistema bancario de Irán. De esta manera, el concepto de marketing con causa será analizado respecto a su origen, evolución, contenido y alcance, así como respecto a varias definiciones bien conocidas. En la primera parte se hace una reseña de la literatura pertinente sobre el tema y se integran los hallazgos de los investigadores precedentes. La segunda sección se elaboró mediante el método fenomenológico y entrevistas detalladas con varios expertos en el sistema bancario. La población de este estudio la constituyen gerentes senior del Banco Keshavarzi y la estrategia de muestro fue no aleatoria, por conveniencia, en la que se utilizaron métodos de muestreo teóricos. A este respecto fueron seleccionados 16 gerentes senior del Banco Agrícola de Irán como muestra estadística para la recolección de datos. Los datos cualitativos se analizaron mediante el software MaxQDA12pro usando codificación abierta y axial. En los resultados se hace una separación del concepto de marketing con causa de otros términos similares o relacionados, y se hace una descripción de varios tipos de campañas de marketing con causa. Finalmente, se usó el método fenomenológico para proveer y asignar las dimensiones y componentes del marketing con causa en el sistema bancario de Irán. El análisis de los resultados de las entrevistas muestra que el marketing con causa en el sistema bancario tiene dimensiones directas (en la dirección, en la economía y en las características de las actividades causales) e indirectas (componentes sociales, científicos, culturales, religiosos y geográficos).

ABSTRACT Despite almost four decades of introducing the Cause-Related Marketing (CRM) concept into business and marketing literature, there is still no general agreement as to the definition, content, and scope of marketing, in particular, in countries such as Iran. In this regard, while this article will examine and present the conceptual framework of this issue during the period of creation, it aims to achieve a conceptual model for Cause-Related Marketing in the banking system of Iran. For this reason, the concept of Cause- Related Marketing is analyzed in terms of its origin and evolution, content and scope, and various well- known definitions. The first part reviews the subject literature and integrates the findings of previous researchers. The second section was done by the phenomenological method and through a detailed interview with banking system experts. The study population was senior managers of Keshavarzi Bank, and the strategy of sampling was non-random, available, and utilized theoretical sampling methods. In this regard, 16 senior managers of the Agricultural Bank of Iran were selected as the statistical sample for data collection. Qualitative data were analyzed using open and axial coding using the MaxQDA12pro

Abstract Objective: To investigate the prevalence of maxillary canine impaction and whether the impacted canine cases have had a potentially good or poor prognosis if interceptive treatment was practiced at earlier ages. Material and Methods: 1755 panoramic radiographs of patients, aged 13 to 60 years, attending the University of Babylon, College of Dentistry for the period from November 2016 to July 2018 were collected and assessed for the presence of impacted maxillary canines. Subsequently, four suggested prognostic factors for each impacted canine were analyzed and recorded. Results: The prevalence of maxillary canine impaction was 119 (6.78%) with 89 unilateral impaction and 30 bilateral impaction resulting in a total of 149 impacted canines. Regarding the gender, impaction was more evident in females 70 than in males 49 with no statistical significant difference. For the side, impaction was more prevalent on the left (77) than on the right (72), also with no statistical difference (p>0.05). Following the analysis of the four prognostic factors, most of the cases, 117 (78.5%) had at least one prognostic factor to be poor. Although 82 (55%) of the cases had at least one prognostic factor to be good, only 4 had all the prognostic factors to be good. Conclusion: Although the cases that had a potentially good prognosis were little (4 cases), interceptive extraction of primary canines would mostly be beneficial for these patients as it will minimize the treatment time, cost and complications.

Abstract Background/aims: Hereditary nonpolyposis colorectal cancer (HNPCC) is the most common form of colorectal cancer (CRC) syndrome, in which the mutations in mismatch repair genes have been implicated in the disease etiopathogenesis. The aim of this study was to investigate the prevalence of human mutL homolog 1 (hMLH1) gene point mutations in patients with HNPCC in Northwest of Iran Methodology: In this study, 30 patients with HNPCC were selected who fulfilled the Amsterdam II criteria. Moreover, 30 subjects were selected as the control group. Total RNA was extracted from peripheral blood sample, and complementary DNA (cDNA) was synthesized using specific primers. Screening of germline mutations within the hMLH1 gene was performed by direct cDNA sequencing. Functional evaluation was conducted through real-time polymerase chain reaction mRNA expression using the TaqMan Gene Expression Assay. Results: In this study, c.655A >G polymorphism was found in 13.3% of patients and 10% of the control group, while c.1959G > T polymorphism was found in only one of the patients. Two novel variants, including c.973C > A and c.1086C > A, were found in 13.3% and 20% of patients, respectively, that were identified for the 1st time in this study. Moreover, the mRNA expression of hMLH1 gene in patients carrying the c.973C > A and c.1086C > A mutations showed no statistically significant difference in comparison to patients with no mutation and healthy controls. Conclusions: This study establishes that the frequency and type of mutations do not follow a similar pattern in other populations due to genetic and geographical differences.

Resumen Antecedentes/objetivos: El cáncer colorrectal hereditario sin poliposis (HNPCC) es la forma más común del síndrome de cáncer colorrectal (CCR) en el que las mutaciones en los genes reparadores de desajustes (MMR) se han implicado en la etiopatogenia de la enfermedad. El objetivo de este estudio fue investigar la prevalencia de mutaciones puntuales del gen homólogo humano MUTL1 (hMLH1) en pacientes con HNPCC en el noroeste de Irán. Metodología: En este estudio, se seleccionaron 30 pacientes con HNPCC que cumplían los criterios de Amsterdam II. Además, se seleccionaron 30 sujetos como grupo control. Se extrajo el RNA total de la muestra de sangre periférica y se sintetizó el cDNA usando iniciadores específicos. La detección de mutaciones en la línea germinal dentro del gen hMLH1 se realizó mediante secuenciación directa del cDNA. La evaluación funcional se realizó mediante expresión de mRNA de PCR en tiempo real utilizando el ensayo de expresión génica TaqMan. Resultados: En este estudio, se encontró polimorfismo c.655A > G en el 13.3% de los pacientes y el 10% del grupo control, mientras que se encontró polimorfismo c.1959 G > T en solo uno de los pacientes. Dos nuevas variantes, incluidas c.9730 > A y c. 1086C > A, se encontraron en el 13.3 y el 20% de pacientes, respectivamente, que fueron identificados por primera vez en este estudio. Además, la expresión de mRNA del gen hMLH1 en pacientes portadores de las mutaciones C.973C > A y c.1086C > A no mostró diferencias estadísticamente significativas en comparación con pacientes sin mutación y controles sanos. Conclusiones: Este estudio establece que la frecuencia y el tipo de mutaciones no siguen un patrón similar en otras poblaciones debido a diferencias genéticas y geográficas.

Abstract Objective: To compare the effect of three different fiber reinforcement strategies on the fracture strength of composite resin restored endodontically treated premolars. Material and Methods: Seventy-two sound human premolars extracted for orthodontic reasons were divided into 6 groups (n=12) after endodontic treatment. Group 1: intact teeth (positive control); Group 2: endodontically treated teeth without restoration (negative control); Group 3: composite resin restoration; Group 4: placement of fibers at occlusal position; Group 5: splinting the buccal and palatal walls with horizontal fiber posts; Group 6: placement of fibers at the occlusal position after splinting the buccal and palatal walls with horizontal fiber posts. Then fracture strength was measured at a crosshead speed of 0.5 mm/min in a universal testing machine. Data were analyzed using one-way ANOVA and post hoc Tukey tests at α=0.05. Results: There were significant differences between the negative and positive control groups (p<0.001) and between the negative control group and all the other study groups (p<0.001). However, there were no statistically significant differences between the positive control group and all the experimental groups and between the experimental groups (p>0.05). Conclusion: Fiber insertion had no additional reinforcing effect on the fracture strength following composite resin restoration.