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Assessing Knowledge And Preventive Practices Regarding Infectious Diseases Among Healthcare Workers In Hail City, Saudi Arabia, Sandro Costanilla Villareal

Jurnal Keperawatan Indonesia

Studies suggest that there may be gaps in knowledge and compliance with infection control measures among healthcare workers in Saudi Arabia. This study aimed to determine the knowledge of, and preventive measures employed by the healthcare workers in Hail City, Saudi Arabia, regarding infectious diseases. A cross-sectional design was employed, and the study participants were 265 healthcare workers aged 18 or older who were currently employed at government hospitals, involved in patient care or essential healthcare services, and fluent in English. Healthcare workers on leave, with cognitive impairments, with language barriers, or who refused to participate in the study were …

The Relationship Of Online Learning And Information Technology With Cognitive, Affective, And Psychomotor Abilities, Sidik Awaludin, Usman Chatib Warsa, Soetrisno Soemardjo, Elly Nurachmah, Arum Atmawikarta, Dwi Novitasari

Jurnal Keperawatan Indonesia

The COVID-19 pandemic had a significant impact on education in nursing programs. Changes in the learning system were followed by changes in learning methods and information technology as a means of support. In fact, mastery of learning methods and information technology support is still not optimal. To improve students’ cognitive, affective, and psychomotor capacities, lecturers must grasp numerous learning approaches and information technology. This study aimed to examine the relationship of mastery of online learning methods and information technology assistance with nursing students’ cognitive, emotional, and psychomotor capacities in Indonesia. The design of this study was a cross- sectional internet-based …

Relational Egalitarianism And The Covid-19 Pandemic, Jacqueline Marie J. Tolentino

Budhi: A Journal of Ideas and Culture

The current COVID-19 pandemic has called for unprecedented measures to contain it and, as such, has reinforced and produced complex and intertwining health and non-health inequalities. I take the perspective of relational egalitarianism and argue that these inequalities are not only issues of public health and economics but also of social justice. I thus aim to construct a relational egalitarian framework to examine how and why the inequalities of COVID-19 are unjust and to work out what structural changes and processes might be required to justly respond to these inequalities.

Normalizing The Population: The Biopolitics Of The "New Normal", Federico José T. Lagdameo

Budhi: A Journal of Ideas and Culture

While the whole world is trying to get its bearings in the face of the radical changes brought about by the COVID-19 pandemic, two prevailing attitudes or approaches have emerged: (1) a yearning for a return to pre-COVID-19 normalcy typified by what I call the “typhoon-shelter approach” and (2) recognizing the irreversibility of the current condition and seeking to establish a “new normal.” The biopolitical analysis employed in this paper reveals unintended consequences that slip through the mesh of traditional forms of critique centered on capital, ideology, or class conflict. Specifically, the “new normal” project prevents the free movement of …

Disease And Disparities: The Structural Violence In The Time Of Our Covidized Lives, Aurelio S. Agcaoili

Budhi: A Journal of Ideas and Culture

The paper argues that when a country’s social structures— political, economic, and cultural—are arranged such that the arrangement results in a dichotomy between the class of the privileged and the class of the less privileged, any act of addressing a pandemic such as the COVID-19 will always end up in another pandemic: the pandemic of government neglect and ineptitude. There is only one way out in ensuring that this double pandemic can be addressed: a return to the foundations of a good life for all—a democracy that secures that the good of collective life is for all.

Covid-19: Social Disease And Public Prudence, Peter Murphy

Budhi: A Journal of Ideas and Culture

The article profiles the social aspects of the COVID-19 pandemic including the social component of virus transmission, the parallels between national and regional social distancing habits, and the impact of COVID-19 on populations. The interaction of low-contact and high-contact cultures with the COVID-19 virus is analyzed. The public policy response is examined with particular reference to proportionality in decision-making. The article explores the role of mid-range, balanced policies and temperate, moderate actions in dealing with a serious public health issue.

Risk Factors Of Covid-19 Infection Among Health Workers Post-Vaccination In Jakarta, Rahmat Saputra, Nurhayati Adnan Prihartono, Mondastri Korib Sudaryo, Renti Mahkota, Yeni Devita, Ni Wayan Deisy Arisanti

Kesmas

One of the best approaches to stop the COVID-19 pandemic is vaccination. In Indonesia, the first round of vaccinations was prioritized for health workers on January 14, 2021 (first dose) and March 1, 2021 (second dose). However, some health workers who have been vaccinated were found to be reinfected after receiving the second dose. This cross-sectional study examined the risk factors for COVID-19 infection among health workers after vaccination using secondary and primary data. The data analysis was carried out in univariate (examining the frequency distribution and proportion of independent variables), bivariate (Chi-square test to explore the relationship between independent …

Blood Matters: The Hematological Signatures Of Coronavirus Infection, Ayelen Toro, Ana P Arévalo, Marianoel Pereira-Gómez, Agustina Sabater, Eric A Zizzi, Paula Perbolianachis, Gaston Pascual, Sofia Lage-Vickers, Jorge L Pórfido, Ines Achinelli, Rocio Seniuk, Juan Bizzotto, Pablo Sanchis, Alvaro Olivera, Alejandro Leyva, Pilar Moreno, Alicia Costábile, Alvaro Fajardo, Federico Carrión, Martín Fló, Natalia Olivero-Deibe, Fernando Rodriguez, Nicolas Nin, Nicolas Anselmino, Estefania Labanca, Elba Vazquez, Javier Cotignola, Daniel F Alonso, Maria P Valacco, Marcelo Marti, Francesco Gentile, Artem Cherkasov, Martina Crispo, Gonzalo Moratorio, Geraldine Gueron

Faculty, Staff and Student Publications

Recent developments have broadened our perception of SARS-CoV-2, indicating its capability to affect the body systemically beyond its initial recognition as a mere respiratory pathogen. However, the pathways of its widespread are not well understood. Employing a dual-modality approach, we integrated findings from a Murine Hepatitis Virus (MHV) infection model with corroborative clinical data to investigate the pervasive reach of Coronaviruses. The novel presence of viral particles within red blood cells (RBCs) was demonstrated via high-resolution transmission electron microscopy, with computational modeling elucidating a potential heme-mediated viral entry mechanism via Spike protein affinity. Our data affirm viral localization in RBCs, …

Study Abroad Angst: A Literature Review On The Mental Health Of International Students During Covid-19, Daisuke Akiba, Michael Perrone, Caterina Almendral

Publications and Research

Background: The COVID-19 pandemic presented unique and unprecedented challenges for international students, those studying at institutions of higher education outside of their home countries, due to their distinct circumstances and vulnerabilities. This literature review examines the multifaceted mental health burdens they experienced and highlights the need for targeted support and interventions. Methods: A rigorous search across three databases (i.e., PubMed, PsycINFO, and ERIC) yielded 50 empirical studies for inclusion in this literature review. A six-phase thematic analysis framework was employed to identify and synthesize key themes. Results: Seven prominent themes emerged: (1) academic and professional disruptions; (2) challenges navigating international …

Clinical Effects Of Dexamethasone Among Patients With Sickle Cell Disease Hospitalized With Covid-19: Outcomes From A Single Academic Health System, William M. Garneau, Matthew J. Lankiewicz, Catherine R. Lesko, Ashley P. Lauriello, Kelly A. Gebo, Sophie M. Lanzkron

Department of Medicine Faculty Papers

BACKGROUND: Dexamethasone is a steroid used in the treatment of hospitalized patients with severe COVID-19. However, the effect of dexamethasone in patients with SCD remains unclear given that steroids may precipitate vaso-occlusive crisis (VOC) in patients with SCD.

METHODS AND FINDINGS: We performed a retrospective analysis of patients with SCD who were hospitalized at Johns Hopkins Health System between June 1, 2020 and June 26, 2022. We reviewed individual charts to assess severity of illness and eligibility for dexamethasone treatment. The exposure of interest was treatment with dexamethasone. Outcomes of interest included incident VTE, length of hospital stay, ICU admission, …

Covid 19 Is A Hoax, Vidushi Sharma '28

Best First-Year Seminar Writing

When COVID-19 first swept across the globe, it brought more than just a viral contagion—it sparked an epidemic of misinformation. Among the various conspiracy theories, one stands out for its audacity: the claim that COVID-19 does not exist. This theory undermines public health efforts, sows mistrust, and complicates crisis management. But why do people believe it, and what makes such narratives so compelling? More importantly, how can we combat this damaging misinformation? This essay explores the origins of the "COVID-19 doesn't exist" conspiracy, examines its three main iterations—denial of the virus’s existence, claims of government overreach, and accusations of corporate …

The Effect Of A Virtual Covid-19 Interprofessional Educational Module On Knowledge, Confidence, Attitude, And Practice Among Health And Allied Health Professions Students, Tsu-Yin Wu, Jenni L. Hoffman, Grigoris Argeros, Sarah Lally, Andrea Gossett Zakrajsek, Jillian Graves, Alice Jo Rainville, Olivia Ford, Angela Lukomski, Renuka Roche, John Sonnega, Joan E. Cowdery Phd

Journal of Interprofessional Practice and Collaboration

Purpose: The purpose of this research study was to examine the effect of an innovative, online COVID-19 interprofessional educational module among health and allied health professions students.

Methods: This study utilized a pre- and posttest design with quantitative and qualitative data collected winter 2023 and spring/summer 2023 semesters, and consisted of health and allied health professions students (N=143) from three Midwestern, urban, public universities. Participants completed a pretest, then an IPE module on COVID-19, and a posttest immediately after the educational intervention, and another (the same) posttest one month later. Quantitative and qualitative data were subject to statistical …

Evidence-Based Pathways For Leveling Digital Access In Higher Education During And Beyond The Covid-19 Pandemic, Christopher Ali, Vikki Katz

Communication Faculty Articles and Research

At the height of the COVID-19 pandemic, policymakers’ attention focused heavily on K–12 student connectivity. By contrast, college students were largely “presumed connected,” even as they lost access to campus Wi-Fi, computer labs, and other digital resources. This study asks what lessons were learned and not learned by university administrators when it came to digital inequality on their campuses during the pandemic. To address this question, the article’s authors relied on a series of student surveys and policy analyses. This article offers evidence-based policy recommendations to university leaders for effectively addressing digital inequality among their student populations as we look …

Teen Dating Violence And The Covid-19 Pandemic: Trends From A Longitudinal Study In Texas, Leila Wood, Elizabeth Baumler, Morgan E Pettyjohn, Jeff R Temple

Faculty, Staff and Student Publications

Purpose: Teen dating violence (TDV) is a global public health and safety issue causing health impacts to youth people. This study aimed to examine: (1) the impact of the pandemic on TDV victimisation rates and (2) socioecological factors associated with sustained risk for TDV victimisation during the first year of COVID-19.

Methods: Data are from an ongoing randomised controlled trial of a TDV prevention programme in Texas (n=2768). We conducted annual assessments in 2019-2021. We used regression modelling to assess demographic, individual, peer and family factors associated with TDV risks.

Results: TDV rates declined from 11.9% in 2019 to 5.2% …

Political Polarization Harms Public Health, Shana Kushner Gadarian, Jay Van Bavel, Kai Ruggeri, Eric Knowles

Population Health Research Brief Series

Political polarization poses considerable risks to well-being. Both ideological polarization (“extremification” of policy positions and ideological orientations) and affective polarization (out-party hate) have increased over the past several decades with detrimental effects on public health. This brief summarizes the impacts of political polarization on public health in the U.S., highlighting the COVID-19 pandemic as a case study on the health risks of polarization. The authors show that, in the United States, one of the strongest predictors of COVID-19 prevention behaviors, such as social distancing and vaccination, was political partisanship. Gaps in these behaviors between Republicans and Democrats increased over the …

Conglomeration, Digital Disruption, And Covid-19: Upheaval-Driven Changes To The Roles Of U.S. Local Television News Directors, Suzanne Lysak, Keren Henderson

Film and Media Arts Faculty Articles and Research

This mixed methods study analyzes how broadcast news directors renegotiate their roles under organizational and cultural times of change. Even before COVID-19, local television news directors, one of the two predominant groups of journalism managers in the United States, were experiencing shifts in roles related to their growing work responsibilities. These changes were the result of long-term workplace upheavals including conglomeration and digital disruption. When the COVID-19 pandemic hit, news directors found themselves managing through this additional, short-term upheaval. The authors of this study sought to discover how industry upheavals impact broadcast newsroom management roles.

Association Of Binge Alcohol Use With Functional Outcomes Among Individuals With Covid-19 Infection, Sebastian T. Tong, Michael Gottlieb, Imtiaz Ebna Mannan, Zihan Zheng, Manisha Sinha, Michelle Santangelo, Kristyn Gatling, Efrat Kean, Phillip Watts, Ralph Wang, Juan Carlos Montoy, Ahamed Idris, Samuel Macdonald, Ryan Huebinger, Mandy Hill, Kelli N O'Laughlin, Nicole L. Gentile, Jocelyn Dorney, Caitlin Malicki, Joann G. Elmore, Kate Diaz Roldan, Gary Chan, Zhenqiu Lin, Robert A. Weinstein, Kari A. Stephens

Department of Medicine Faculty Papers

AIMS: Alcohol consumption along with negative sequelae from excess alcohol intake increased during the COVID-19 pandemic. We evaluated the association between binge alcohol use and long-term functional outcomes among COVID-19-positive individuals.

METHODS: Using a prospective, longitudinal, multisite cohort study design, we evaluated the association between binge alcohol use and mental and physical functional outcomes using Patient-Reported Outcomes Measurement Information System (PROMIS)-29 scores three and six months postinfection. Eligible patients were those who presented with COVID-19-like symptoms, tested positive for COVID-19, and completed a three-month survey. Binge drinking was identified at the time of infection using the Tobacco, Alcohol, Prescription medication …

Virtual Versus In-Person Ophthalmology Interviews: Perceptions Of U.S. Ophthalmology Fellowship Applicants In 2022–2023, Elliot G. Cherkas, Charlotte N. Shields, Nikhil Mandava, Lily Zhang, Arunan Sivalingam, Richard S. Kaiser, Jonathan S. Myers, Kristin M. Hammersmith, Reza Razeghinejad, Brenton D. Finklea, Carol I. Shields, Jayanth Sridhar, Michael A. Klufas

Journal of Academic Ophthalmology

Purpose

Despite easing restrictions on social distancing and travel since the beginning of coronavirus disease 2019 pandemic, virtual interviews remain a widely used format for ophthalmology fellowship interviews. This study aims to evaluate the relative benefits and drawbacks of in-person versus virtual interviews during a cycle where both formats were prevalent.

Methods

A prospective cross-sectional study surveyed all fellowship applicants (N = 311) who applied to Wills Eye Hospital and Bascom Palmer Eye Institute during the 2022 to 2023 application cycle.

Results

A total of 59 (19%) applicants responded to the survey, with the majority being male (53.0%) and between …

Peran Dukungan Sosial Masyarakat Terhadap Stigma Pada Penyintas Covid-19, Silvi Fatmala Sari, Khoiriyah Isni

Perilaku dan Promosi Kesehatan: Indonesian Journal of Health Promotion and Behavior

Background. COVID-19 continues to kill people in Indonesia. One of the reasons for the rise in COVID-19 cases is the stigma experienced by COVID-19 survivors and their families in Bumi Jawa Village, Batanghari Nuban District, East Lampung Regency, Lampung Province. The kind of stigma received includes rejection of self-isolation, a lack of community empathy, and social support during the isolation phase.

Objective. The purpose of this study is to assess the impact of community social support on community stigma toward COVID-19 survivors in Bumi Jawa Village, Batanghari Nuban District, East Lampung Regency, Lampung Province.

Method. This study is a …

Patients' Perceptions: A Group Differences Study Twelve Months Before And Twelve Months During A Worldwide Pandemic, Nancy B. Valla

Patient Experience Journal

Objective: The COVID-19 pandemic subjected healthcare systems' to decreasing operational margins, enhanced regulatory scrutiny, and challenges related to patients' expectations. Until now, there was a lack of empirical evidence studying patients' perceptions prior to versus deep immersion into the pandemic. Methods: This quantitative non-experimental ex post facto causal-comparative study examined if and to what extent there were significant differences in patients' perceptions of the nurses' communications, doctors' communications, overall hospital rating, and willingness to recommend before versus during the COVID-19 pandemic for HCAHPS participating hospitals in California. The final sample size was 292 facilities grouped by two identically …

State Capacity And Covid-19 Responses: Comparing The Us States, Kiran Auerbach, Joshua Y. Lerner, Hannah M. Ridge

Political Science Faculty Articles and Research

This article addresses the interstate differences in outcomes from the coronavirus disease COVID-19 pandemic by focusing on state capacity. State capacity refers to states’ ability to create and implement policy. We posit that states want to limit death and destruction within their borders. COVID-19 created an instance in which states had a shared, preferred outcome but had very different levels of success. Using a novel measure of state capacity that allows for subnational comparisons – and is independent of ideological political will – we show that states with greater capacity experienced fewer excess deaths during 2020 and more successfully distributed …

Estimating The Number Of Polygenic Diseases Among Six Mutually Exclusive Entities Of Non-Tumors And Cancer, C I Edvard Smith, Jan A Burger, Rula Zain

Faculty, Staff and Student Publications

In the era of precision medicine with increasing amounts of sequenced cancer and non-cancer genomes of different ancestries, we here enumerate the resulting polygenic disease entities. Based on the cell number status, we first identified six fundamental types of polygenic illnesses, five of which are non-cancerous. Like complex, non-tumor disorders, neoplasms normally carry alterations in multiple genes, including in 'Drivers' and 'Passengers'. However, tumors also lack certain genetic alterations/epigenetic changes, recently named 'Goners', which are toxic for the neoplasm and potentially constitute therapeutic targets. Drivers are considered essential for malignant transformation, whereas environmental influences vary considerably among both types of …

Evaluating The Cavitary Lung Lesions On Ct Scan Of Covid-19 Patients: A Retrospective Study, Golnaz Moradi, Safa Samadzadeh Etehadi, Seyed Hamid Mousavi, Rayeheh Mohammadi

Journal of Community Hospital Internal Medicine Perspectives

Background: It has been shown that cavitary lesions on CT scans of patients with COVID-19 may be related to their clinical symptoms and mortality rate.

Materials and methods: The study population included patients diagnosed with COVID-19 based on RT-PCR results from throat samples or typical clinical and chest CT scan findings who were hospitalized at Sina Hospital in Tehran in 2020 and underwent chest CT scans. Chest CT scans were examined for the severity of pulmonary opacities and the presence, number, size, wall thickness, and distribution of cavitary lung lesions.

Results: Oxygen saturation was lower in patients …

Disability, Urban Influence, And Covid-19 Financial Hardships: Findings From A Predominantly Rural Sample, Mackenzie Brewer, Jodien Johnson, Kyra Davidson, Carson Mencken

Journal of Rural Social Sciences

This study examined the financial impacts of the early COVID-19 pandemic among households with children and compared outcomes based on disability status and urban influence. Survey data were collected in fall 2020 by the Urban Institute from mostly rural households participating in the Meals-to-You program, which delivered food to eligible households with children in the U.S. due to school closures. Relative risk contingency analysis and multivariate logistic regression were used to assess financial hardship from the pandemic. Sampled households reporting at least one member with a disability had greater odds of food insecurity, delaying purchases, depleting savings, and difficulty paying …

Act With Cf: A Randomized Trial Of Acceptance And Commitment Therapy Vs Supportive Psychotherapy For Adults With Cystic Fibrosis, C. Virginia O'Hayer, Patrick J. Smith, Christopher F. Drescher, Heather Bruschwein, Chelsi N. Nurse, Hallie M. Kushner, Krista Ingle, Michael J. Stephen, Jeffrey B. Hoag

Department of Psychiatry and Human Behavior Faculty Papers

PURPOSE: Psychological distress, including anxiety and depression, is common among adults with CF, associating with poor quality of life, lung function, and healthcare utilization. This 3-year, multi-site, telehealth-delivered randomized trial sought to determine whether Acceptance and Commitment Therapy (ACT with CF) is superior to supportive psychotherapy (SP), in improving psychological functioning for adults with CF.

METHODS: One hundred twenty-four adults with CF and elevated anxiety and/or depressive symptoms were recruited coincident with the first COVID lockdown, from Thomas Jefferson University Hospitals, University of Virginia, Augusta University, Duke University Medical Center, and social media. Participants were randomized to 6 weeks of …

Knowledge “Hiding And Seeking” During The Pandemic: Who Really Wins In The New Normal?, Kim-Lim Tan, Ivy S. H. Hii, Chuen Kong Kevin Cheong

Research Collection Lee Kong Chian School Of Business

PurposeThe recent COVID-19 pandemic caused a severe economic downturn. Employees working in these organisations face employment uncertainty. The pandemic disrupted their daily routines, and it added a layer of complexity to the already resource-constrained environment. During these times, employees would conserve their resources to maintain competitiveness, one of which is knowledge hiding. While economic activities are resuming, the appearance of new variants could mean the transition towards endemicity could be put on hold. Hence, there is a need to rethink the behaviour of employees as they would have elevated levels of anxiety towards resuming daily work activities. Therefore, this study …

A Community-Engaged Interprofessional Project Led By Medical Students, School Of Social Work Students, And Resident Physicians: Lessons Learned And Recommendations For Success, Sabrina Orta, Daniela Santos Cantu, Giuiseppe Allan Fonseca, Luis R. Torres-Hostos, Chelsea Chang

School of Medicine Publications

Addressing health disparities through community engagement and interprofessional partnerships is increasingly critical. However, learner-led approaches that integrate medical students, resident physicians, and social work students are not well-studied. We designed a learner-led, interprofessional, public health campaign for a majority Hispanic community, with the goals of building interprofessional leadership skills, engaging learners to address COVID-19 inequities, and disseminating lessons learned. Faculty and students from the University of Texas Rio Grande Valley Schools of Medicine and Social Work partnered with community leaders to pilot an interprofessional project supported by the American Association of Medical Colleges’ Nurturing Experiences for Tomorrow’s Community Leaders (AAMC …

Seasons Of Kawasaki Disease During The Covid-19 Pandemic., Todd T. Nowlen, Ashraf S. Harahsheh, Geetha Raghuveer, Simon Lee, Anji T. Yetman, Nagib Dahdah, Michael A. Portman, Supriya S. Jain, Michael Khoury, Selemet Tierney, Cedric Manlhiot, Pedrom Farid, Brian W. Mccrindle

Manuscripts, Articles, Book Chapters and Other Papers

The incidence of Kawasaki Disease has a peak in the winter months with a trough in late summer/early fall. Environmental/exposure factors have been associated with a time-varying incidence. These factors were altered during the COVID-19 pandemic. The study was performed through the International Kawasaki Disease Registry. Data from patients diagnosed with acute Kawasaki Disease and Multiple Inflammatory Syndrome-Children were obtained. Guideline case definitions were used to confirm site diagnosis. Enrollment was from 1/2020 to 7/2023. The number of patients was plotted over time. The patients/month were tabulated for the anticipated peak Kawasaki Disease season (December-April) and non-peak season (May-November). Data …

Revealing Patterns Of Sars-Cov-2 Variant Emergence And Evolution Using Rbd Amplicon Sequencing Of Wastewater, Xingwen Chen, John Balliew, Cici X Bauer, Jennifer Deegan, Anna Gitter, Blake M Hanson, Anthony W Maresso, Michael J Tisza, Catherine L Troisi, Janelle Rios, Kristina D Mena, Eric Boerwinkle, Fuqing Wu

Faculty, Staff and Student Publications

Objectives: Rapid evolution of SARS-CoV-2 has resulted in the emergence of numerous variants, posing significant challenges to public health surveillance. Clinical genome sequencing, while valuable, has limitations in capturing the full epidemiological dynamics of circulating variants in the general population. This study aimed to monitor the SARS-CoV-2 variant community dynamics and evolution using receptor-binding domain (RBD) amplicon sequencing of wastewater samples.

Methods: We sequenced wastewater from El Paso, Texas, over 17 months, compared the sequencing data with clinical genome data, and performed biodiversity analysis to reveal SARS-CoV-2 variant dynamics and evolution.

Results: We identified 91 variants and observed waves of …

Meeting Farmer-Member Challenges During The Covid-19 Pandemic Through Direct-Resourcing And Agroecological Work Brigades, Noah R. Mcdonald

Professional Agricultural Workers Journal

The Southeastern African American Farmers Organic Network (SAAFON) is a nonprofit organization dedicated to preserving Black farming and rural lifeways in the Southeast and U.S. Virgin Islands. The COVID-19 pandemic created unique challenges for SAAFON’s members, exacerbating the existing structural conditions that make farming challenging for Black farmers. These conditions include climate-related disasters, economic disparities, lack of political investment, racism, and related discrimination. In this paper, the author presents the activities that SAAFON has undertaken to address the impact of the pandemic on its members. It provided funding for its members and launched a series of farmer brigades to build …