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49 records – page 1 of 5.

Age, prognostic impact of QRS prolongation and left bundle branch block, and utilization of cardiac resynchronization therapy: findings from 14,713 patients in the Swedish Heart Failure Registry.

https://arctichealth.org/en/permalink/ahliterature264273
Source
Eur J Heart Fail. 2014 Oct;16(10):1073-81
Publication Type
Article
Date
Oct-2014
Author
Lars H Lund
Lina Benson
Marcus Ståhlberg
Frieder Braunschweig
Magnus Edner
Ulf Dahlström
Cecilia Linde
Source
Eur J Heart Fail. 2014 Oct;16(10):1073-81
Date
Oct-2014
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Arrhythmias, Cardiac - diagnosis - epidemiology - etiology
Bundle-Branch Block - diagnosis - epidemiology - etiology
Cardiac Resynchronization Therapy - utilization
Electrocardiography - methods
Female
Heart Conduction System - abnormalities
Heart Failure - complications - diagnosis - mortality
Humans
Male
Middle Aged
Prevalence
Prognosis
Registries
Sweden - epidemiology
Treatment Outcome
Abstract
Age is not a contraindication to cardiac resynchronization therapy (CRT), but the prevalence and prognostic impact of QRS prolongation with intraventricular conduction delay (IVCD) and left bundle branch block (LBBB), as well as CRT utilization, may differ with age. We tested the hypotheses that in the elderly: (i) IVCD and LBBB are more prevalent, (ii) IVCD and LBBB are more harmful, and (iii) CRT is underutilized.
We studied 14?713 patients with ejection fraction =39% in the Swedish Heart Failure Registry and divided into age groups =65?years, 66-80?years and >80?years. Among 13?782 patients without CRT, IVCD was present in the three age groups in 11% vs. 15% vs. 19% and LBBB was present in 20% vs. 27% vs. 28%, respectively, (P?80?year group. For LBBB vs. narrow QRS it was 1.29 (1.07-1.56, P?=?0.009), 1.17 (1.06-1.30, P?=?0.002), and 1.10 (0.99-1.22, P?=?0.091), respectively. The adjusted P for interaction between age and QRS morphology was 0.664. In the three age groups, CRT was present in 6% vs. 8% vs. 4% and absent but with indication in 23% vs. 32% vs. 37%, respectively (P?
PubMed ID
25201219 View in PubMed
Less detail

The association between circulating angiotensin-converting enzyme and cardiovascular risk in the elderly: a cross-sectional study.

https://arctichealth.org/en/permalink/ahliterature137532
Source
J Renin Angiotensin Aldosterone Syst. 2011 Sep;12(3):281-9
Publication Type
Article
Date
Sep-2011
Author
Liza Ljungberg
Urban Alehagen
Toste Länne
Hanna Björck
Rachel De Basso
Ulf Dahlström
Karin Persson
Author Affiliation
Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Sweden. liza.ljungberg@liu.se
Source
J Renin Angiotensin Aldosterone Syst. 2011 Sep;12(3):281-9
Date
Sep-2011
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cardiovascular diseases - blood - epidemiology - genetics
Cross-Sectional Studies
Female
Genetic Predisposition to Disease
Humans
INDEL Mutation - genetics
Male
Peptidyl-Dipeptidase A - blood - genetics
Polymorphism, Genetic
Risk factors
Sweden - epidemiology
Abstract
A polymorphism in the angiotensin-converting enzyme gene (ACE I/D polymorphism) has been associated with increased risk for cardiovascular disease (CVD). This polymorphism affects the level of circulating ACE, but there is great individual variation, even between those with the same genotype. Few previous studies have investigated the link between circulating ACE and cardiovascular risk. The aim of this study was to investigate this association, and to examine the relationship between ACE level, ACE genotype and CVD.
The study population consisted of 322 men and 350 women aged 69-87. Plasma ACE level was determined using enzyme-linked immunosorbent assay (ELISA), and ACE genotype was analysed using PCR followed by gel electrophoresis.
In men, ACE levels increased with increasing number of cardiovascular risk factors (p = 0.003). There was a significant association in men between increased ACE level and both diabetes (p = 0.007) and smoking (p = 0.037).
This study shows that cardiovascular risk factors (such as smoking and diabetes) are associated with higher levels of circulating ACE in men. High ACE levels may represent one of the cellular mechanisms involved in producing the vascular damage associated with cardiovascular risk factors.
PubMed ID
21273224 View in PubMed
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Association between demographic, organizational, clinical, and socio-economic characteristics and underutilization of cardiac resynchronization therapy: results from the Swedish Heart Failure Registry.

https://arctichealth.org/en/permalink/ahliterature289489
Source
Eur J Heart Fail. 2017 10; 19(10):1270-1279
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
10-2017
Author
Lars H Lund
Frieder Braunschweig
Lina Benson
Marcus Ståhlberg
Ulf Dahlström
Cecilia Linde
Author Affiliation
Karolinska Institutet, Department of Medicine, Stockholm, Sweden.
Source
Eur J Heart Fail. 2017 10; 19(10):1270-1279
Date
10-2017
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Aged
Aged, 80 and over
Cardiac Resynchronization Therapy - utilization
Demography
Female
Heart Failure - epidemiology - therapy
Humans
Male
Middle Aged
Registries
Socioeconomic Factors
Sweden - epidemiology
Treatment Outcome
Abstract
Cardiac resynchronization therapy (CRT) improves outcomes in heart failure (HF) but may be underutilized. The reasons are unknown.
We linked the Swedish Heart Failure Registry to national registries with ICD-10 (International Classification of Diseases-10th Revision) co-morbidity diagnoses and demographic and socio-economic data. In patients with EF =39% and NYHA II-IV, we assessed prevalence of CRT indication and CRT use. In those with CRT indication, we assessed the association between 37 potential baseline covariates and CRT non-use using multivariable generalized estimating equation (GEE) models. Of 12 807 patients (mean age 71?±?12?years, 28% female), 841 (7%) had CRT, 3094 (24%) had an indication for but non-use of CRT, and 8872 (69%) had no indication. Important variables independently associated with CRT non-use were: HF duration 75?years (RR 1.13, 95% CI 1.09-1.18); non-cardiology care at baseline (RR 1.10, 95% CI 1.07-1.14); small-town non-university centre (RR 1.08, 95% CI 1.05-1.12); female sex (RR 1.07 95% CI 1.03-1.10) (all P
Notes
CommentIn: Eur J Heart Fail. 2017 Oct;19(10 ):1280-1283 PMID 28805992
PubMed ID
28176416 View in PubMed
Less detail

Association between demographic, organizational, clinical, and socio-economic characteristics and underutilization of cardiac resynchronization therapy: results from the Swedish Heart Failure Registry.

https://arctichealth.org/en/permalink/ahliterature289647
Source
Eur J Heart Fail. 2017 10; 19(10):1270-1279
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
10-2017
Author
Lars H Lund
Frieder Braunschweig
Lina Benson
Marcus Ståhlberg
Ulf Dahlström
Cecilia Linde
Author Affiliation
Karolinska Institutet, Department of Medicine, Stockholm, Sweden.
Source
Eur J Heart Fail. 2017 10; 19(10):1270-1279
Date
10-2017
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Aged
Aged, 80 and over
Cardiac Resynchronization Therapy - utilization
Demography
Female
Heart Failure - epidemiology - therapy
Humans
Male
Middle Aged
Registries
Socioeconomic Factors
Sweden - epidemiology
Treatment Outcome
Abstract
Cardiac resynchronization therapy (CRT) improves outcomes in heart failure (HF) but may be underutilized. The reasons are unknown.
We linked the Swedish Heart Failure Registry to national registries with ICD-10 (International Classification of Diseases-10th Revision) co-morbidity diagnoses and demographic and socio-economic data. In patients with EF =39% and NYHA II-IV, we assessed prevalence of CRT indication and CRT use. In those with CRT indication, we assessed the association between 37 potential baseline covariates and CRT non-use using multivariable generalized estimating equation (GEE) models. Of 12 807 patients (mean age 71?±?12?years, 28% female), 841 (7%) had CRT, 3094 (24%) had an indication for but non-use of CRT, and 8872 (69%) had no indication. Important variables independently associated with CRT non-use were: HF duration 75?years (RR 1.13, 95% CI 1.09-1.18); non-cardiology care at baseline (RR 1.10, 95% CI 1.07-1.14); small-town non-university centre (RR 1.08, 95% CI 1.05-1.12); female sex (RR 1.07 95% CI 1.03-1.10) (all P
Notes
CommentIn: Eur J Heart Fail. 2017 Oct;19(10 ):1280-1283 PMID 28805992
PubMed ID
28176416 View in PubMed
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Association between enrolment in a heart failure quality registry and subsequent mortality-a nationwide cohort study.

https://arctichealth.org/en/permalink/ahliterature292019
Source
Eur J Heart Fail. 2017 09; 19(9):1107-1116
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
09-2017
Author
Lars H Lund
Juan-Jesus Carrero
Bahman Farahmand
Karin M Henriksson
Åsa Jonsson
Tomas Jernberg
Ulf Dahlström
Author Affiliation
Department of Medicine, Karolinska Institute, Stockholm, Sweden.
Source
Eur J Heart Fail. 2017 09; 19(9):1107-1116
Date
09-2017
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Age Factors
Aged
Aged, 80 and over
Cardiovascular Agents - therapeutic use
Comorbidity
Demography
Female
Heart Failure - diagnosis - mortality - therapy
Hospitalization - statistics & numerical data
Humans
International Classification of Diseases
Male
Middle Aged
Proportional Hazards Models
Quality of Health Care - statistics & numerical data
Registries - statistics & numerical data
Sweden - epidemiology
Abstract
Heart failure (HF) quality registries report quality of care but it is unknown whether they improve outcomes. The aims were to assess predictors of enrolment in a HF registry, test the hypothesis that enrolment in a HF registry is associated with reduced mortality, and assess potential explanatory factors for this reduction in mortality, if present.
We conducted a nationwide prospective cohort study of patients with new-onset HF registered in the Swedish National Patient Registry (NPR, a mandatory registry of ICD-code diagnoses) with or without concurrent registration in the Swedish Heart Failure Registry (SwedeHF, a voluntary quality reporting registry) 2006-2013. The association between demographics, co-morbidities and medications, and enrolment in the SwedeHF, was assessed using multivariable logistic regression. The association between enrolment in the SwedeHF and all-cause mortality was assessed using multivariable Cox regression, with adjustment for demographics, co-morbidities and medications. A total of 231?437 patients were included, of which 21?888 (9.5%) were in the SwedeHF [age (mean?±?standard deviation) 74?±?13 years; 41% women; 68% inpatients] and 209?549 (90.5%) were not (age 78?±?12 years, 50% women; 79% inpatients). Selected variables independently associated with enrolment in the SwedeHF were male sex, younger age, higher education, absent co-morbidities and co-morbidity-related medications, and use of HF and cardiovascular medications. Over a median (interquartile range) follow-up of 874 (247-1667) days, there were 13.0 vs. 20.8 deaths per 100 patient-years (P?
Notes
CommentIn: Eur J Heart Fail. 2017 Sep;19(9):1117-1118 PMID 28580664
PubMed ID
28229520 View in PubMed
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Association between use of ß-blockers and outcomes in patients with heart failure and preserved ejection fraction.

https://arctichealth.org/en/permalink/ahliterature258634
Source
JAMA. 2014 Nov 19;312(19):2008-18
Publication Type
Article
Date
Nov-19-2014
Author
Lars H Lund
Lina Benson
Ulf Dahlström
Magnus Edner
Leif Friberg
Source
JAMA. 2014 Nov 19;312(19):2008-18
Date
Nov-19-2014
Language
English
Publication Type
Article
Keywords
Adrenergic beta-Antagonists - therapeutic use
Aged
Aged, 80 and over
Case-Control Studies
Cohort Studies
Female
Heart Failure - drug therapy - mortality
Hospitalization
Humans
Incidence
Male
Propensity Score
Sweden - epidemiology
Ventricular Function, Left
Abstract
Heart failure with preserved ejection fraction (HFPEF) may be as common and may have similar mortality as heart failure with reduced ejection fraction (HFREF). ß-Blockers reduce mortality in HFREF but are inadequately studied in HFPEF.
To test the hypothesis that ß-blockers are associated with reduced all-cause mortality in HFPEF.
Propensity score-matched cohort study using the Swedish Heart Failure Registry. Propensity scores for ß-blocker use were derived from 52 baseline clinical and socioeconomic variables.
Nationwide registry of 67 hospitals with inpatient and outpatient units and 95 outpatient primary care clinics in Sweden with patients entered into the registry between July 1, 2005, and December 30, 2012, and followed up until December 31, 2012.
From a consecutive sample of 41,976 patients, 19,083 patients with HFPEF (mean [SD] age, 76 [12] years; 46% women). Of these, 8244 were matched 2:1 based on age and propensity score for ß-blocker use, yielding 5496 treated and 2748 untreated patients with HFPEF. Also we conducted a positive-control consistency analysis involving 22,893 patients with HFREF, of whom 6081 were matched yielding 4054 treated and 2027 untreated patients.
ß-Blockers prescribed at discharge from the hospital or during an outpatient visit, analyzed 2 ways: without consideration of crossover and per-protocol analysis with censoring at crossover, if applicable.
The prespecified primary outcome was all-cause mortality and the secondary outcome was combined all-cause mortality or heart failure hospitalization.
Median follow-up in HFPEF was 755 days, overall; 709 days in the matched cohort; no patients were lost to follow-up. In the matched HFPEF cohort, 1-year survival was 80% vs 79% for treated vs untreated patients, and 5-year survival was 45% vs 42%, with 2279 (41%) vs 1244 (45%) total deaths and 177 vs 191 deaths per 1000 patient-years (hazard ratio [HR], 0.93; 95% CI, 0.86-0.996; P?=?.04). ß-Blockers were not associated with reduced combined mortality or heart failure hospitalizations: 3368 (61%) vs 1753 (64%) total for first events, with 371 vs 378 first events per 1000 patient-years (HR, 0.98; 95% CI, 0.92-1.04; P?=?.46). In the matched HFREF cohort, ß-blockers were associated with reduced mortality (HR, 0.89; 95% CI, 0.82-0.97, P=.005) and also with reduced combined mortality or heart failure hospitalization (HR, 0.89; 95% CI, 0.84-0.95; P?=?.001).
In patients with HFPEF, use of ß-blockers was associated with lower all-cause mortality but not with combined all-cause mortality or heart failure hospitalization. ß-Blockers in HFPEF should be examined in a large randomized clinical trial.
Notes
Comment In: JAMA. 2014 Nov 19;312(19):1977-825399271
PubMed ID
25399276 View in PubMed
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Association Between Use of Long-Acting Nitrates and Outcomes in Heart Failure With Preserved Ejection Fraction.

https://arctichealth.org/en/permalink/ahliterature283460
Source
Circ Heart Fail. 2017 Apr;10(4)
Publication Type
Article
Date
Apr-2017
Author
Shir Lynn Lim
Lina Benson
Ulf Dahlström
Carolyn S P Lam
Lars H Lund
Source
Circ Heart Fail. 2017 Apr;10(4)
Date
Apr-2017
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Disease Progression
Drug Therapy, Combination
Female
Heart Failure - diagnosis - drug therapy - mortality - physiopathology
Hospitalization
Humans
Male
Middle Aged
Nitrates - adverse effects - therapeutic use
Propensity Score
Recovery of Function
Registries
Risk assessment
Risk factors
Stroke Volume - drug effects
Sweden
Time Factors
Treatment Outcome
Vasodilator Agents - adverse effects - therapeutic use
Ventricular Function, Left - drug effects
Abstract
Nitrates may be beneficial in heart failure with preserved ejection fraction (HFpEF) by enhancing cGMP signaling and improving hemodynamics, but real-world data on potential efficacy are lacking.
We linked the Swedish Heart Failure Registry to national registries with International Classification of Diseases, Tenth Revision comorbidity diagnoses and demographic and socioeconomic data. In HFpEF, defined as left ventricular ejection fraction =40%, we derived propensity scores for nitrate use using 52 baseline variables. The association between nitrate use and all-cause mortality and the composite of all-cause mortality or first heart failure hospitalization was assessed in a cohort matched 2:1 untreated to treated based on age and propensity score. In the overall HFpEF cohort (n=19?047; mean [SD] age, 76 [12] years; 46% women), nitrates were used in 17%, and the crude 1-year survival for treated versus untreated patients was 79% (95% confidence interval [CI], 78%-80%) versus 84% (95% CI, 83%-84%) respectively; hazard ratio was 1.48 (95% CI, 1.40-1.56; P
PubMed ID
28377439 View in PubMed
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Association between use of renin-angiotensin system antagonists and mortality in patients with heart failure and preserved ejection fraction.

https://arctichealth.org/en/permalink/ahliterature118614
Source
JAMA. 2012 Nov 28;308(20):2108-17
Publication Type
Article
Date
Nov-28-2012
Author
Lars H Lund
Lina Benson
Ulf Dahlström
Magnus Edner
Author Affiliation
Department of Medicine, Unit of Cardiology, Karolinska Institutet, Stockholm, Sweden. lars.lund@alumni.duke.edu
Source
JAMA. 2012 Nov 28;308(20):2108-17
Date
Nov-28-2012
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Angiotensin Receptor Antagonists - therapeutic use
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Female
Heart Failure - drug therapy - mortality
Humans
Male
Propensity Score
Prospective Studies
Registries - statistics & numerical data
Renin-Angiotensin System - drug effects
Stroke Volume
Survival Analysis
Sweden - epidemiology
Abstract
Heart failure with preserved ejection fraction (HFPEF) may be as common and as lethal as heart failure with reduced ejection fraction (HFREF). Three randomized trials of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ie, renin-angiotensin system [RAS] antagonists) did not reach primary end points but may have had selection bias or been underpowered.
To test the hypothesis that use of RAS antagonists is associated with reduced all-cause mortality in an unselected population with HFPEF.
Prospective study using the Swedish Heart Failure Registry of 41,791 unique patients registered from 64 hospitals and 84 outpatient clinics between 2000 and 2011. Of these, 16,216 patients with HFPEF (ejection fraction =40%; mean [SD] age, 75 [11] years; 46% women) were either treated (n = 12,543) or not treated (n = 3673) with RAS antagonists. Propensity scores for RAS antagonist use were derived from 43 variables. The association between use of RAS antagonists and all-cause mortality was assessed in a cohort matched 1:1 based on age and propensity score and in the overall cohort with adjustment for propensity score as a continuous covariate. To assess consistency, separate age and propensity score-matched analyses were performed according to RAS antagonist dose in patients with HFPEF and in 20,111 patients with HFREF (ejection fraction
Notes
Comment In: JAMA. 2013 Mar 20;309(11):1107-823512046
Comment In: JAMA. 2013 Mar 20;309(11):110723512045
Comment In: Evid Based Med. 2013 Dec;18(6):226-723585078
Comment In: JAMA. 2012 Nov 28;308(20):2144-623188032
Comment In: Nat Rev Cardiol. 2013 Feb;10(2):6023247315
Comment In: Dtsch Med Wochenschr. 2013 Feb;138(7):29623520615
PubMed ID
23188027 View in PubMed
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Association Between Use of Statins and Mortality in Patients With Heart Failure and Ejection Fraction of =50.

https://arctichealth.org/en/permalink/ahliterature268202
Source
Circ Heart Fail. 2015 Sep;8(5):862-70
Publication Type
Article
Date
Sep-2015
Author
Urban Alehagen
Lina Benson
Magnus Edner
Ulf Dahlström
Lars H Lund
Source
Circ Heart Fail. 2015 Sep;8(5):862-70
Date
Sep-2015
Language
English
Publication Type
Article
Keywords
Aged
Cause of Death - trends
Female
Follow-Up Studies
Heart Failure - drug therapy - mortality - physiopathology
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Male
Propensity Score
Retrospective Studies
Risk Assessment - methods
Stroke Volume - physiology
Survival Rate - trends
Sweden - epidemiology
Abstract
The pathophysiology of heart failure with preserved ejection fraction is poorly understood, but may involve a systemic proinflammatory state. Therefore, statins might improve outcomes in patients with heart failure with preserved ejection fraction defined as =50%.
Of 46 959 unique patients in the prospective Swedish Heart Failure Registry, 9140 patients had heart failure and ejection fraction =50% (age 77±11 years, 54.0% women), and of these, 3427 (37.5%) were treated with statins. Propensity scores for statin treatment were derived from 40 baseline variables. The association between statin use and primary (all-cause mortality) and secondary (separately, cardiovascular mortality, and combined all-cause mortality or cardiovascular hospitalization) end points was assessed with Cox regressions in a population matched 1:1 based on age and propensity score. In the matched population, 1-year survival was 85.1% for statin-treated versus 80.9% for untreated patients (hazard ratio, 0.80; 95% confidence interval, 0.72-0.89; P
PubMed ID
26243795 View in PubMed
Less detail

Association between use of statins and outcomes in heart failure with reduced ejection fraction: prospective propensity score matched cohort study of 21 864 patients in the Swedish Heart Failure Registry.

https://arctichealth.org/en/permalink/ahliterature264802
Source
Circ Heart Fail. 2015 Mar;8(2):252-60
Publication Type
Article
Date
Mar-2015
Author
Urban Alehagen
Lina Benson
Magnus Edner
Ulf Dahlström
Lars H Lund
Source
Circ Heart Fail. 2015 Mar;8(2):252-60
Date
Mar-2015
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Female
Heart Failure - drug therapy - mortality - physiopathology
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Kaplan-Meier Estimate
Male
Matched-Pair Analysis
Middle Aged
Outcome Assessment (Health Care)
Propensity Score
Registries
Stroke Volume
Sweden - epidemiology
Abstract
In heart failure (HF) with reduced ejection fraction, randomized trials of statins did not demonstrate improved outcomes. However, randomized trials may not always be generalizable. The aim was to determine whether statins are associated with improved outcomes in an unselected nationwide population of patients with HF with reduced ejection fraction overall and in relation to ischemic heart disease (IHD).
In the Swedish Heart Failure Registry, 21?864 patients with HF with reduced ejection fraction (age ± SD, 72±12 years; 29% women), of whom 10?345 (47%) were treated with statins, were studied. Propensity scores for statin use were derived from 42 baseline variables. The associations between statin use and outcomes were assessed with Cox regressions in a population matched 1:1 based on propensity score and age and in the overall population with adjustment for propensity score and age. The primary outcome was all-cause mortality; secondary outcomes were cardiovascular mortality; HF hospitalization; and combined all-cause mortality or cardiovascular hospitalization. Survival at 1 year in the matched population was 83% for statin-treated versus 79% for untreated patients (hazard ratio, 0.81; 95% confidence interval, 0.76-0.86; P
PubMed ID
25575580 View in PubMed
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49 records – page 1 of 5.