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Standardizing Definitions Of Hematopoietic Recovery, Graft Rejection, Graft Failure, Poor Graft Function, And Donor Chimerism In Allogeneic Hematopoietic Cell Transplantation: A Report On Behalf Of The American Society For Transplantation And Cellular Therapy, Mohamed A Kharfan-Dabaja, Iskra Pusic, Shalini Shenoy, Et Al. Aug 2021

Standardizing Definitions Of Hematopoietic Recovery, Graft Rejection, Graft Failure, Poor Graft Function, And Donor Chimerism In Allogeneic Hematopoietic Cell Transplantation: A Report On Behalf Of The American Society For Transplantation And Cellular Therapy, Mohamed A Kharfan-Dabaja, Iskra Pusic, Shalini Shenoy, Et Al.

2020-Current year OA Pubs

Allogeneic hematopoietic cell transplantation (allo-HCT) is potentially curative for certain hematologic malignancies and nonmalignant diseases. The field of allo-HCT has witnessed significant advances, including broadening indications for transplantation, availability of alternative donor sources, less toxic preparative regimens, new cell manipulation techniques, and novel GVHD prevention methods, all of which have expanded the applicability of the procedure. These advances have led to clinical practice conundrums when applying traditional definitions of hematopoietic recovery, graft rejection, graft failure, poor graft function, and donor chimerism, because these may vary based on donor type, cell source, cell dose, primary disease, graft-versus-host disease (GVHD) prophylaxis, and …


Association Of Low Center Performance Evaluations And Pediatric Heart Transplant Center Behavior In The United States, Shahnawaz Amdani, Gerard Boyle, Joseph Rossano, Janet Scheel, Marc Richmond, Susana Arrigain, Jesse D Schold Aug 2021

Association Of Low Center Performance Evaluations And Pediatric Heart Transplant Center Behavior In The United States, Shahnawaz Amdani, Gerard Boyle, Joseph Rossano, Janet Scheel, Marc Richmond, Susana Arrigain, Jesse D Schold

2020-Current year OA Pubs

BACKGROUND: To date, no study has evaluated the effects of low center performance evaluations (CPE) on pediatric heart transplant center behavior. We sought to assess the impact of low CPE flags on pediatric heart transplant center listing and transplant volumes and center recipient and donor characteristics.

METHODS: We included centers performing at least 10 pediatric (age <18 years) transplants during the Scientific Registry of Transplant Recipients reporting period January 2009-June 2011 and evaluated consecutive biannual program specific reports until the last reporting period January 2016-June 2018. We evaluated changes in center behavior at following time points: a year before flagging, a year and two years after the flag; and at last reporting period.

RESULTS: During our study period, 24 pediatric centers were non-flagged and 6 were flagged. Compared to non-flagged centers, there was a decline in candidate listings in flagged centers at the last reporting period (mean increase of 5.5 ± 12.4 listings vs"?> mean decrease of …


Comparative Effectiveness Of Sodium-Glucose Cotransporter 2 Inhibitors Vs Sulfonylureas In Patients With Type 2 Diabetes, Yan Xie, Benjamin Bowe, Andrew K Gibson, Janet B Mcgill, Geetha Maddukuri, Ziyad Al-Aly Aug 2021

Comparative Effectiveness Of Sodium-Glucose Cotransporter 2 Inhibitors Vs Sulfonylureas In Patients With Type 2 Diabetes, Yan Xie, Benjamin Bowe, Andrew K Gibson, Janet B Mcgill, Geetha Maddukuri, Ziyad Al-Aly

2020-Current year OA Pubs

IMPORTANCE: In the treatment of type 2 diabetes, evidence of the comparative effectiveness of sodium-glucose cotransporter 2 (SGLT2) inhibitors vs sulfonylureas-the second most widely used antihyperglycemic class after metformin-is lacking.

OBJECTIVE: To evaluate the comparative effectiveness of SGLT2 inhibitors and sulfonylureas associated with the risk of all-cause mortality among patients with type 2 diabetes using metformin.

DESIGN, SETTING, AND PARTICIPANTS: A cohort study used data from the US Department of Veterans Affairs compared the use of SGLT2 inhibitors vs sulfonylureas in individuals receiving metformin for treatment of type 2 diabetes. A total of 23 870 individuals with new use of …


Colorectal And Breast Cancer Screening In The U.S. During The Covid-19 Pandemic, Rosheem C. Browne Ms, Jiangong Niu Phd, Daria Zorzi Md, Sharon H. Giordano Md, Mph Jul 2021

Colorectal And Breast Cancer Screening In The U.S. During The Covid-19 Pandemic, Rosheem C. Browne Ms, Jiangong Niu Phd, Daria Zorzi Md, Sharon H. Giordano Md, Mph

Summer Experience 2021

No abstract provided.


Impact Of Amerind Ancestry And Fads Genetic Variation On Omega-3 Deficiency And Cardiometabolic Traits In Hispanic Populations, Chaojie Yang, Brian Hallmark, Jin Choul Chai, Timothy D O'Connor, Lindsay M Reynolds, Alexis C Wood, Michael Seeds, Yii-Der Ida Chen, Lyn M Steffen, Michael Y Tsai, Robert C Kaplan, Martha L Daviglus, Lawrence J Mandarino, Amanda M Fretts, Rozenn N Lemaitre, Dawn K Coletta, Sarah A Blomquist, Laurel M Johnstone, Chandra Tontsch, Qibin Qi, Ingo Ruczinski, Stephen S Rich, Rasika A Mathias, Floyd H Chilton, Ani Manichaikul Jul 2021

Impact Of Amerind Ancestry And Fads Genetic Variation On Omega-3 Deficiency And Cardiometabolic Traits In Hispanic Populations, Chaojie Yang, Brian Hallmark, Jin Choul Chai, Timothy D O'Connor, Lindsay M Reynolds, Alexis C Wood, Michael Seeds, Yii-Der Ida Chen, Lyn M Steffen, Michael Y Tsai, Robert C Kaplan, Martha L Daviglus, Lawrence J Mandarino, Amanda M Fretts, Rozenn N Lemaitre, Dawn K Coletta, Sarah A Blomquist, Laurel M Johnstone, Chandra Tontsch, Qibin Qi, Ingo Ruczinski, Stephen S Rich, Rasika A Mathias, Floyd H Chilton, Ani Manichaikul

Children’s Nutrition Research Center Staff Publications

Long chain polyunsaturated fatty acids (LC-PUFAs) have critical signaling roles that regulate dyslipidemia and inflammation. Genetic variation in the FADS gene cluster accounts for a large portion of interindividual differences in circulating and tissue levels of LC-PUFAs, with the genotypes most strongly predictive of low LC-PUFA levels at strikingly higher frequencies in Amerind ancestry populations. In this study, we examined relationships between genetic ancestry and FADS variation in 1102 Hispanic American participants from the Multi-Ethnic Study of Atherosclerosis. We demonstrate strong negative associations between Amerind genetic ancestry and LC-PUFA levels. The FADS rs174537 single nucleotide polymorphism (SNP) accounted for much …


Hydration, Eating Attitudes And Behaviors In Age And Weight-Restricted Youth American Football Players, Susan W. Yeargin, Toni Torres-Mcgehee, Dawn Emerson, Jessica Koller, John Dickinson Jul 2021

Hydration, Eating Attitudes And Behaviors In Age And Weight-Restricted Youth American Football Players, Susan W. Yeargin, Toni Torres-Mcgehee, Dawn Emerson, Jessica Koller, John Dickinson

Faculty Publications

There is a paucity of research examining hydration and nutrition behaviors in youth American football players. A potentially unique risk factor are league restrictions based on weight (WR) or age (AR). The purpose of this study was to examine hydration status between WR and AR leagues. The secondary purpose was to describe eating patterns in players. An observational cohort design with 63 youth football players (10 ± 1 yrs, 148.2 ± 9.4 cm, 44.9 ± 15.3 kg) was utilized. Independent variables were league (AR ( = 36); WR ( = 27)) and activity type (practice (PX = 8); game (GM …


Exploring How Exposure To Truth And State-Sponsored Anti-Tobacco Media Campaigns Affect Smoking Disparities Among Young Adults Using A National Longitudinal Dataset, 2002-2017, David C. Colston, Yanmei Xie, Jim Thrasher Ph.D.,Ma. Ms, Sherry Emery, Megan E. Patrick, Andrea R. Titus, Micheal R. Elliot, Nancy L. Fleischer Jul 2021

Exploring How Exposure To Truth And State-Sponsored Anti-Tobacco Media Campaigns Affect Smoking Disparities Among Young Adults Using A National Longitudinal Dataset, 2002-2017, David C. Colston, Yanmei Xie, Jim Thrasher Ph.D.,Ma. Ms, Sherry Emery, Megan E. Patrick, Andrea R. Titus, Micheal R. Elliot, Nancy L. Fleischer

Faculty Publications

Background. Little is known regarding long-term impacts of anti-tobacco media campaigns on youth smoking and related disparities in the United States. Methods. We examined longitudinal cohort data from Monitoring the Future (MTF) between 2000 and 2017 in modified Poisson regression models to understand the long-term impacts of televised Truth and state-sponsored ad campaign exposure at baseline (age 18) on first cigarette and daily smoking initiation 1 to 2 years later (at modal ages 19/20). We also used additive interactions to test for potential effect modification between campaign exposure and smoking outcomes by sex, race/ethnicity, and parental educational attainment. Results. We …


Standardizing Definitions Of Hematopoietic Recovery, Graft Rejection, Graft Failure, Poor Graft Function, And Donor Chimerism In Allogeneic Hematopoietic Cell Transplantation: A Report On Behalf Of The American Society For Transplantation And Cellular Therapy., Mohamed A. Kharfan-Dabaja, Ambuj Kumar, Ernesto Ayala, Mahmoud Aljurf, Taiga Nishihori, Rebecca Marsh, Lauri M. Burroughs, Navneet Majhail, A. Samer Al-Homsi, Zaid S. Al-Kadhimi, Merav Bar, Alice Bertaina, Jaap J. Boelens, Richard Champlin, Sonali Chaudhury, Zachariah Defilipp, Bhagirathbhai Dholaria, Areej El-Jawahri, Suzanne Fanning, Ellen Fraint, Usama Gergis, Sergio Giralt, Betty K. Hamilton, Shahrukh K. Hashmi, Biljana Horn, Yoshihiro Inamoto, David A. Jacobsohn, Tania Jain, Laura Johnston, Abraham S. Kanate, Ankit Kansagra, Adetola Kassim, Leslie S. Kean, Carrie L. Kitko, Jessica Knight-Perry, Joanne Kurtzberg, Hien Liu, Margaret L. Macmillan, Zahra Mahmoudjafari, Marco Mielcarek, Mohamad Mohty, Arnon Nagler, Eneida Nemecek, Timothy S. Olson, Betul Oran, Miguel-Angel Perales, Susan E. Prockop, Michael A. Pulsipher, Iskra Pusic, Marcie L. Riches, Cesar Rodriguez, Rizwan Romee, Gabriela Rondon, Ayman Saad, Nina Shah, Peter J. Shaw, Shalini Shenoy, Jorge Sierra, Julie Talano, Michael R. Verneris, Paul Veys, John E. Wagner, Bipin N. Savani, Mehdi Hamadani, Paul A. Carpenter Jul 2021

Standardizing Definitions Of Hematopoietic Recovery, Graft Rejection, Graft Failure, Poor Graft Function, And Donor Chimerism In Allogeneic Hematopoietic Cell Transplantation: A Report On Behalf Of The American Society For Transplantation And Cellular Therapy., Mohamed A. Kharfan-Dabaja, Ambuj Kumar, Ernesto Ayala, Mahmoud Aljurf, Taiga Nishihori, Rebecca Marsh, Lauri M. Burroughs, Navneet Majhail, A. Samer Al-Homsi, Zaid S. Al-Kadhimi, Merav Bar, Alice Bertaina, Jaap J. Boelens, Richard Champlin, Sonali Chaudhury, Zachariah Defilipp, Bhagirathbhai Dholaria, Areej El-Jawahri, Suzanne Fanning, Ellen Fraint, Usama Gergis, Sergio Giralt, Betty K. Hamilton, Shahrukh K. Hashmi, Biljana Horn, Yoshihiro Inamoto, David A. Jacobsohn, Tania Jain, Laura Johnston, Abraham S. Kanate, Ankit Kansagra, Adetola Kassim, Leslie S. Kean, Carrie L. Kitko, Jessica Knight-Perry, Joanne Kurtzberg, Hien Liu, Margaret L. Macmillan, Zahra Mahmoudjafari, Marco Mielcarek, Mohamad Mohty, Arnon Nagler, Eneida Nemecek, Timothy S. Olson, Betul Oran, Miguel-Angel Perales, Susan E. Prockop, Michael A. Pulsipher, Iskra Pusic, Marcie L. Riches, Cesar Rodriguez, Rizwan Romee, Gabriela Rondon, Ayman Saad, Nina Shah, Peter J. Shaw, Shalini Shenoy, Jorge Sierra, Julie Talano, Michael R. Verneris, Paul Veys, John E. Wagner, Bipin N. Savani, Mehdi Hamadani, Paul A. Carpenter

Department of Medical Oncology Faculty Papers

Allogeneic hematopoietic cell transplantation (allo-HCT) is potentially curative for certain hematologic malignancies and nonmalignant diseases. The field of allo-HCT has witnessed significant advances, including broadening indications for transplantation, availability of alternative donor sources, less toxic preparative regimens, new cell manipulation techniques, and novel GVHD prevention methods, all of which have expanded the applicability of the procedure. These advances have led to clinical practice conundrums when applying traditional definitions of hematopoietic recovery, graft rejection, graft failure, poor graft function, and donor chimerism, because these may vary based on donor type, cell source, cell dose, primary disease, graft-versus-host disease (GVHD) prophylaxis, and …


Virchow At 200 And Lown At 100 - Physicians As Activists., Salvatore Mangione, Mark L. Tykocinski Jul 2021

Virchow At 200 And Lown At 100 - Physicians As Activists., Salvatore Mangione, Mark L. Tykocinski

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

No abstract provided.


Longitudinal Pre-Exposure Prophylaxis (Prep) Acceptability, Initiation And Adherence Among Criminal Justice-Involved Adults In The Usa: The Southern Prep Cohort Study (Specs) Protocol, Katherine Lemasters, Carrie B. Oser, Mariah Cowell, Katie Mollan, Kathryn Nowotny, Lauren Brinkley-Rubinstein Jul 2021

Longitudinal Pre-Exposure Prophylaxis (Prep) Acceptability, Initiation And Adherence Among Criminal Justice-Involved Adults In The Usa: The Southern Prep Cohort Study (Specs) Protocol, Katherine Lemasters, Carrie B. Oser, Mariah Cowell, Katie Mollan, Kathryn Nowotny, Lauren Brinkley-Rubinstein

Sociology Faculty Publications

INTRODUCTION: HIV prevalence among criminal justice (CJ)-involved adults is five times higher than the general population. Following incarceration, CJ-involved individuals experience multilevel barriers to HIV prevention. Pre-exposure prophylaxis (PrEP) is a widely available, daily medication efficacious in preventing HIV. Little is known about PrEP knowledge, acceptability, initiation and sustained use among CJ-involved persons or about how these outcomes vary by multilevel factors. The Southern Pre-Exposure Prophylaxis Study (SPECS) will investigate barriers and facilitators for PrEP initiation and sustained use among CJ-involved adults, building a foundation for PrEP interventions for this underserved population.

METHODS AND ANALYSIS: SPECS uses a mixed-methods sequential …


Rabies Postexposure Prophylaxis In The United States: Opportunities To Improve Access, Coordination, And Delivery, Gavin T. Howington, Huy-Binh Nguyen, P. Brandon Bookstaver, Peter Akpunonu, Joshua T. Swan Jul 2021

Rabies Postexposure Prophylaxis In The United States: Opportunities To Improve Access, Coordination, And Delivery, Gavin T. Howington, Huy-Binh Nguyen, P. Brandon Bookstaver, Peter Akpunonu, Joshua T. Swan

Pharmacy Practice and Science Faculty Publications

No abstract provided.


Significant Regional Differences In Antibiotic Use Across 576 Us Hospitals And 11 701 326 Adult Admissions, 2016-2017, Katherine E Goodman, Sara E Cosgrove, Lisa Pineles, Laurence S Magder, Deverick J Anderson, Elizabeth Dodds Ashley, Ronald E Polk, Hude Quan, William E Trick, Keith F Woeltje, Surbhi Leekha, Anthony D Harris Jul 2021

Significant Regional Differences In Antibiotic Use Across 576 Us Hospitals And 11 701 326 Adult Admissions, 2016-2017, Katherine E Goodman, Sara E Cosgrove, Lisa Pineles, Laurence S Magder, Deverick J Anderson, Elizabeth Dodds Ashley, Ronald E Polk, Hude Quan, William E Trick, Keith F Woeltje, Surbhi Leekha, Anthony D Harris

2020-Current year OA Pubs

BACKGROUND: Quantifying the amount and diversity of antibiotic use in United States hospitals assists antibiotic stewardship efforts but is hampered by limited national surveillance. Our study aimed to address this knowledge gap by examining adult antibiotic use across 576 hospitals and nearly 12 million encounters in 2016-2017.

METHODS: We conducted a retrospective study of patients aged ≥ 18 years discharged from hospitals in the Premier Healthcare Database between 1 January 2016 and 31 December 2017. Using daily antibiotic charge data, we mapped antibiotics to mutually exclusive classes and to spectrum of activity categories. We evaluated relationships between facility and case-mix …


Ypfs Lessons Learned Oral History Project: An Interview With Matthew Rutherford, Matthew Rutherford, Mercedes Cardona Jul 2021

Ypfs Lessons Learned Oral History Project: An Interview With Matthew Rutherford, Matthew Rutherford, Mercedes Cardona

Documents

No abstract provided.


Capturing Quarantine: Student Pandemic Experience Journal, Casey Groulx Jul 2021

Capturing Quarantine: Student Pandemic Experience Journal, Casey Groulx

Public History Journals

Journal entries submitted by the Public History 2021 summer session class at Columbia College Chicago reflecting on aspects of the global pandemic from the student perspective commenting on their personal pandemic timeline and the other is an essay about what each student learned so far from the pandemic.


Capturing Quarantine: Student Pandemic Experience Journal, Angela Sheridon Jul 2021

Capturing Quarantine: Student Pandemic Experience Journal, Angela Sheridon

Public History Journals

Journal entries submitted by the Public History 2021 summer session class at Columbia College Chicago reflecting on aspects of the global pandemic from the student perspective.


Capturing Quarantine: Student Pandemic Experience Journal, Brianna Montesano Jul 2021

Capturing Quarantine: Student Pandemic Experience Journal, Brianna Montesano

Public History Journals

Journal entries submitted by the Public History 2021 summer session class at Columbia College Chicago reflecting on aspects of the global pandemic from the student perspective commenting on their personal pandemic timeline and the other is an essay about what each student learned so far from the pandemic.


Capturing Quarantine:Student Pandemic Experience Journal, Ann Fernandez Jul 2021

Capturing Quarantine:Student Pandemic Experience Journal, Ann Fernandez

Public History Journals

Journal entries submitted by the Public History 2021 summer session class at Columbia College Chicago reflecting on aspects of the global pandemic from the student perspective.


Capturing Quarantine: Student Pandemic Experience Journal, Bri Johnson Jul 2021

Capturing Quarantine: Student Pandemic Experience Journal, Bri Johnson

Public History Journals

Journal entries submitted by the Public History 2021 summer session class at Columbia College Chicago reflecting on aspects of the global pandemic from the student perspective commenting on their personal pandemic timeline and the other is an essay about what each student learned so far from the pandemic.


Capturing Quarantine: Student Pandemic Experience Journal, Leshana Jackson Jul 2021

Capturing Quarantine: Student Pandemic Experience Journal, Leshana Jackson

Public History Journals

Journal entries submitted by the Public History 2021 summer session class at Columbia College Chicago reflecting on aspects of the global pandemic from the student perspective commenting on their personal pandemic timeline and the other is an essay about what each student learned so far from the pandemic.


Capturing Quarantine: Student Pandemic Experience Journal, Nicole Leung Jul 2021

Capturing Quarantine: Student Pandemic Experience Journal, Nicole Leung

Public History Journals

Journal entries submitted by the Public History 2021 summer session class at Columbia College Chicago reflecting on aspects of the global pandemic from the student perspective commenting on their personal pandemic timeline and the other is an essay about what each student learned so far from the pandemic.


Capturing Quarantine: Student Pandemic Experience Journal, David Olvera Jul 2021

Capturing Quarantine: Student Pandemic Experience Journal, David Olvera

Public History Journals

Journal entries submitted by the Public History 2021 summer session class at Columbia College Chicago reflecting on aspects of the global pandemic from the student perspective commenting on their personal pandemic timeline and the other is an essay about what each student learned so far from the pandemic.


Capturing Quarantine: Student Pandemic Experience Journal, Sanaa Raj Jul 2021

Capturing Quarantine: Student Pandemic Experience Journal, Sanaa Raj

Public History Journals

Journal entries submitted by the Public History 2021 summer session class at Columbia College Chicago reflecting on aspects of the global pandemic from the student perspective commenting on their personal pandemic timeline and the other is an essay about what each student learned so far from the pandemic.


Capturing Quarantine: Student Pandemic Experience Journal, Yulin Chen Jul 2021

Capturing Quarantine: Student Pandemic Experience Journal, Yulin Chen

Public History Journals

Journal entries submitted by the Public History 2021 summer session class at Columbia College Chicago reflecting on aspects of the global pandemic from the student perspective commenting on their personal pandemic timeline and the other is an essay about what each student learned so far from the pandemic.


Capturing Quarantine: Student Pandemic Experience Journal, Mackenzie Maples Jul 2021

Capturing Quarantine: Student Pandemic Experience Journal, Mackenzie Maples

Public History Journals

Journal entries submitted by the Public History 2021 summer session class at Columbia College Chicago reflecting on aspects of the global pandemic from the student perspective commenting on their personal pandemic timeline and the other is an essay about what each student learned so far from the pandemic.


Capturing Quarantine: Student Pandemic Experience Journal, Sofiya Vozyakova Jul 2021

Capturing Quarantine: Student Pandemic Experience Journal, Sofiya Vozyakova

Public History Journals

Journal entries submitted by the Public History 2021 summer session class at Columbia College Chicago reflecting on aspects of the global pandemic from the student perspective commenting on their personal pandemic timeline and the other is an essay about what each student learned so far from the pandemic.


Capturing Quarantine: Student Pandemic Experience Journal, Maddie Young Jul 2021

Capturing Quarantine: Student Pandemic Experience Journal, Maddie Young

Public History Journals

Journal entries submitted by the Public History 2021 summer session class at Columbia College Chicago reflecting on aspects of the global pandemic from the student perspective commenting on their personal pandemic timeline and the other is an essay about what each student learned so far from the pandemic.


An Analysis Of 7th Grade Us History Students And The Desire To Participate In Academic Dishonesty In A Forced Hybrid Learning Model, Alexander Jelacic Jul 2021

An Analysis Of 7th Grade Us History Students And The Desire To Participate In Academic Dishonesty In A Forced Hybrid Learning Model, Alexander Jelacic

Education Masters Papers

The purpose of this action research was to analyze ninety students in a 7th grade US History students and the desire to participate in Academic Dishonesty in a forced hybrid learning model. Data was collected over a period of five weeks using pre and post intervention surveys, an exit slip for self-assessment, and unit assessment scores. Then seeing how reading a script with positive words created by students and adding a proctor can affect the results. Results show a positive correlation between reading a script and proctoring with student self-reporting, morality, and efficacy, however, it did not have correlation …


Squawking About Persistently Higher Inflation?, Thomas Lam Jul 2021

Squawking About Persistently Higher Inflation?, Thomas Lam

Sim Kee Boon Institute for Financial Economics

All signs point to an uncertain path for inflation in the future. While inflation is set to stay prospectively higher in the US in the near-term, it's unlikely to remain so.


Droughtscape, Summer 2021, National Drought Mitigation Center Jul 2021

Droughtscape, Summer 2021, National Drought Mitigation Center

DroughtScape: Quarterly Newsletter of the National Drought Mitigation Center (2007–2023)

DroughtScape, Summer 2021


Rabies Postexposure Prophylaxis In The United States: Opportunities To Improve Access, Coordination, And Delivery, Gavin T. Howington, Huy-Binh Nguyen, P Brandon Bookstaver, Peter Akpunonu, Joshua T. Swan Jul 2021

Rabies Postexposure Prophylaxis In The United States: Opportunities To Improve Access, Coordination, And Delivery, Gavin T. Howington, Huy-Binh Nguyen, P Brandon Bookstaver, Peter Akpunonu, Joshua T. Swan

Faculty Publications

No abstract provided.