Medicine and Health Sciences Commons^™

The Association Of Comt Genotype With Buproprion Treatment Response In The Treatment Of Major Depressive Disorder., Jay Fawver Md, Mindy Flanagan, Thomas Smith, Michelle Drouin, Michael Mirro Md

Health Services and Informatics Research

BACKGROUND: Pharmacodynamics and pharmacogenetics are being explored in pharmacological treatment response for major depressive disorder (MDD). Interactions between genotype and treatment response may be dose dependent. In this study, we examined whether MDD patients with Met/Met, Met/Val, and Val/Val COMT genotypes differed in their response to bupropion in terms of depression scores.

METHODS: This study utilized a convenience sample of 241 adult outpatients (≥18 years) who met DSM-5 criteria for MDD and had visits at a Midwest psychopharmacology clinic between February 2016 and January 2017. Exclusion criteria included various comorbid medical, neurological, and psychiatric conditions and current use of benzodiazepines …

Effectiveness And Experience Of An Integrated Maternal Mental Healthcare Intervention In Private Clinics And Public Health Facilities In Pakistan, Syeda Somyyah Owais

Theses and Dissertations

Maternal depression is often undetected or undertreated at the primary care level. Despite the growing high prevalence of depression among women of childbearing age, the usual primary care practice in Pakistan does not include depression screening. Two facility-based cluster randomized control trials, including a maternal depression intervention component, were conducted within two healthcare settings, private and public primary care facilities in Rawalpindi and Lahore. This study aimed to estimate the effectiveness of each trial in reducing maternal depression among mothers in the intervention arm compared to the control by analyzing the change in PHQ-9 (Patient Health Questionnaire-9) scores from baseline …

Understanding The Role Of Political Commitment And Coherence Across Sectors And Across National And Sub-National Levels In Enabling Improvements In Nutrition In Rwanda, Elyse Iruhiriye

Theses and Dissertations

Reducing undernutrition is on the political agendas of many low- and middle-income countries. There is general consensus that to improve nutritional outcomes involves actions across the different sectors that influence both the immediate and underlying determinants of optimal nutrition and an enabling environment to support the political and policy processes. Despite renewed attention over the last 15 years, addressing nutrition in a multisectoral way was previously promoted in the 1970’s but failed to have sustained political commitment due to its organizational complexities to plan and implement strategies across sectors.

We conducted an in-depth retrospective case study to understand how Rwanda, …

Peer Intervention With Suicidal Disclosures On Social Media: Does The Bystander Effect Play A Role?, Carissa M. Orlando

Theses and Dissertations

Suicide is an increasing public health concern in adolescents and young adults, and many individuals discuss mental health concerns with friends in lieu of professional avenues. Thus, peers can serve as valuable gatekeepers for friends experiencing suicidality. The prevalence of social networking websites means that individuals are likely to encounter suicidal disclosures on the internet, but little research has investigated if young adults possess the skills and motivation to intervene in these contexts. Additionally, there have been virtually no investigations into how the presence of other online users impacts intervention behavior—in short, if there exists a bystander effect. This study …

Antisaccade Performance As A Measure Of Executive Dysfunction In Women With The Fmr1 Premutation, Lyndsay Schmitt

Theses and Dissertations

Women with the FMR1 premutation appear to be at increased risk for executive dysfunction. Findings in this regard have been mixed, leading to controversy surrounding the executive phenotype. Inhibitory deficits have been a more consistently documented component of this cognitive profile (Klusek et al., 2020; Shelton et al., 2014). This study aimed to clarify the executive phenotype through use of the antisaccade task, a well referenced eye-tracking paradigm that targets oculomotor inhibition and motor control and imposes time constraints that may increase sensitivity to executive deficits in women with the FMR1 premutation. The effects of aging were examined in both …

Burden-Of-Illness Associated With Bleeding-Related Hospitalizations In Atrial Fibrillation Patients: Findings From The Nationwide Readmission Database, Benjamin Miao, Monique Miller, Belinda Lovelace, Anne Beaubrun, Kelly Mcneil-Posey, Mark J Alberts, William Frank Peacock, Olivia S Costa, Charles Michael White, Craig I Coleman

Faculty, Staff and Students Publications

Introduction  A paucity of contemporary data examining bleeding-related hospitalization outcomes in atrial fibrillation (AF) patients exists.

Methods  Adults in the Nationwide Readmissions Database (January 2016–November 2016) with AF and hospitalized for intracranial hemorrhage (ICH), gastrointestinal, genitourinary, or other bleeding were identified. Association between bleed types and outcomes were assessed using multivariable regression (gastrointestinal defined as referent) and reported as crude incidences and adjusted odds ratios (ORs) or mean differences with 95% confidence intervals (CIs).

Results  In total, 196,878 index bleeding-related hospitalizations were identified in this AF cohort (CHA2DS2VASc score ≥2 in 95.1%), with 70.8% classified as gastrointestinal. The overall incidences …

Combined Lenvatinib And Pembrolizumab As Salvage Therapy In Advanced Adrenal Cortical Carcinoma, Sara Bedrose, Kevin Charles Miller, Lina Altameemi, Mohamed S Ali, Sameh Nassar, Naveen Garg, Marilyne Daher, Keith D Eaton, Jeffrey Thomas Yorio, Davey B Daniel, Matthew Campbell, Keith C Bible, Mabel Ryder, Ashish V Chintakuntlawar, Mouhammed Amir Habra

Faculty, Staff and Students Publications

BACKGROUND: There is no effective systemic therapy for metastatic adrenal cortical carcinoma (ACC) after failure of platinum-based chemotherapy. The efficacies of single-agent oral multikinase inhibitors (MKIs) or salvage immune checkpoint inhibitors (CPIs) have been very limited. It is unknown whether combining CPIs, such as pembrolizumab (PEM), with other therapies, such as MKIs, could yield higher response rates in ACC, yet this combination has shown promise in other cancers. Herein, we describe the first case series using PEM in combination with the MKI lenvatinib (LEN) in patients with progressive, metastatic ACC.

METHODS: A retrospective case series describing the use of LEN/PEM …

Rna-Gps Predicts High-Resolution Rna Subcellular Localization And Highlights The Role Of Splicing, Kevin E Wu, Kevin R Parker, Furqan M Fazal, Howard Y Chang, James Zou

Faculty, Staff and Students Publications

Subcellular localization is essential to RNA biogenesis, processing, and function across the gene expression life cycle. However, the specific nucleotide sequence motifs that direct RNA localization are incompletely understood. Fortunately, new sequencing technologies have provided transcriptome-wide atlases of RNA localization, creating an opportunity to leverage computational modeling. Here we present RNA-GPS, a new machine learning model that uses nucleotide-level features to predict RNA localization across eight different subcellular locations-the first to provide such a wide range of predictions. RNA-GPS's design enables high-throughput sequence ablation and feature importance analyses to probe the sequence motifs that drive localization prediction. We find localization …

Renal Trajectory Patterns Are Associated With Postdischarge Mortality In Patients With Cirrhosis And Acute Kidney Injury, Ayse L Mindikoglu, Ruben Hernaez, Yan Liu, Jennifer R Kramer, Thomas Taylor, Abbas Rana, Fasiha Kanwal

Faculty, Staff and Students Publications

BACKGROUND & AIMS: Little is known about long-term outcomes of acute kidney injury (AKI) in patients with cirrhosis. Outcomes can vary with stage of AKI, chronic kidney disease, and trajectory of renal function.

METHODS: We collected data from the Department of Veterans Affairs and identified 6917 patients with cirrhosis who developed AKI during hospitalization at any of its 127 hospitals, from 2004 through 2014. We used latent class analysis of serial creatinine measurements during the index hospitalization to determine trajectories of renal function.

RESULTS: Overall, 32% of patients died within 90 days of discharge from the hospital and 48% of …

Glycemic Control And Infections Among Us Hemodialysis Patients With Diabetes Mellitus, Jinnie J Rhee, Yuanchao Zheng, Sai Liu, Maria E Montez-Rath, Richard J Hamill, Julie H Ishida, Wolfgang C Winkelmayer

Faculty, Staff and Students Publications

INTRODUCTION: Patients with diabetes mellitus (DM) on hemodialysis (HD) may be particularly vulnerable to infections.

METHODS: We used merged data from the United States Renal Data System and electronic health records data from a large US dialysis provider to retrospectively examine the association between glycemic control and infections in these patients. Adult patients with DM aged ≥18 years who initiated in-center maintenance HD treatment from 2006 to 2011 and survived >90 days were included. Quarterly mean time-averaged hemoglobin A1c (HbA1c) values were categorized into

RESULTS: In a cohort of 33,753 eligible patients, those with higher HbA1c levels had higher rates …

Differential Vpu-Mediated Cd4 And Tetherin Downregulation Functions Among Major Hiv-1 Group M Subtypes, Gisele Umviligihozo, Kyle D. Cobarrubias, Sandali Chandrarathna, Steven W. Jin, Nicole Reddy, Helen Byakwaga, Conrad Muzoora, Mwebesa B. Bwana, Guinevere Q. Lee, Peter W. Hunt, David Bangsberg, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Downregulation of BST-2/tetherin and CD4 by HIV-1 viral protein U (Vpu) promotes viral egress and allows infected cells to evade host immunity. Little is known however about the natural variability in these Vpu functions among the genetically diverse viral subtypes that contribute to the HIV-1 pandemic. We collected Vpu isolates from 332 treatment-naive individuals living with chronic HIV-1 infection in Uganda, Rwanda, South Africa, and Canada. Together, these Vpu isolates represent four major HIV-1 group M subtypes (A [n = 63], B [n = 84], C [n = 94], and D [n = 59]) plus intersubtype …

Practice Gap In Atrial Fibrillation Oral Anticoagulation Prescribing At Emergency Department Home Discharge, Bory Kea, Bethany T. Waites, Amber Lynn, Merritt H. Raitt, David R. Vinson, Niroj Ari, Luke Welle, Andrew Sill, Dana Button, Benjamin C. Sun

OHSU-PSU School of Public Health Faculty Publications and Presentations

Introduction: Current U.S. cardiology guidelines recommend oral anticoagulation (OAC) to reduce stroke risk in selected patients with atrial fibrillation (AF), but no formal AF OAC recommendations exist to guide emergency medicine clinicians in the acute care setting. We sought to characterize emergency department (ED) OAC prescribing practices after an ED AF diagnosis.

Methods: This retrospective study included index visits for OAC-naive patients ≥18 years old who were discharged home from the ED at an urban, academic, tertiary hospital with a primary diagnosis of AF from 2012-2014. Five hypothesis-blinded, chart reviewers abstracted data from patient problem lists and medical history in …

Clinical Manifestations And Epidemiology Of Adolescent Tuberculosis In Ukraine, Silvia S Chiang, Maria Dolynska, Natasha R Rybak, Andrea T Cruz, Omowunmi Aibana, Yana Sheremeta, Vasyl Petrenko, Andrii Mamotenko, Iana Terleieva, C Robert Horsburgh, Helen E Jenkins

Faculty, Staff and Student Publications

BACKGROUND: During adolescence, childhood and adult forms of tuberculosis (TB) overlap, resulting in diverse disease manifestations. Knowing which patient characteristics are associated with which manifestations may facilitate diagnosis and enhance understanding of TB pathophysiology.

METHODS: In this cross-sectional study, we included 10-19-year-olds in Ukraine's national TB registry who started TB treatment between 2015 and 2018. Using multivariable regression, we estimated associations between patient characteristics and four presentations of TB: pleural, extrathoracic, cavitary and rifampicin-resistant (RR). We also described the epidemiology of adolescent TB in Ukraine.

RESULTS: Among 2491 adolescent TB cases, 88.4% were microbiologically confirmed. RR-TB was confirmed in 16.9% …

Risk Factors For Nonaccidental Burns In Children, Dalya M Ferguson, Tayler D Parker, Vanessa E Marino, Elisa I Garcia, Seyed A Arshad, Pranali S Kamat, Caroline M Anding, Kuojen Tsao, Rebecca G Girardet, Mary T Austin

Faculty, Staff and Student Publications

BACKGROUND: The relative influences of baseline risk factors for pediatric nonaccidental burns have not been well described. We evaluated baseline characteristics of pediatric nonaccidental burn patients and their primary caretakers.

METHODS: A single-center retrospective cohort study was conducted of pediatric (age < 17) burn patients from July 1, 2013, to June 30, 2018. The primary outcome was nonaccidental burn, defined as burn secondary to abuse or neglect as determined by the inpatient child protection team or Child Protective Services. Univariate and multivariate analyses were performed.

RESULTS: Of 489 burn patients, 47 (9.6%) suffered nonaccidental burns. Nonaccidental burn patients more frequently had a history of Child Protective Services involvement (48.9% vs 9.7%, P < .001), as did their primary caretakers (59.6% vs 10.9%, P < .001). Non-Hispanic black children had higher rates of Child Protective Services referral (50.7% vs 26.7%, P < .001) and nonaccidental burn diagnosis (18.9% vs 5.6%, P < .001) than children of other races/ethnicities. On multivariate analysis, caretaker involvement with CPS (odds ratio 7.53, 95% confidence interval 3.38-16.77) and non-Hispanic black race/ethnicity (odds ratio 3.28, 95% confidence interval 1.29-8.36) were associated with nonaccidental burn.

CONCLUSION: Caretaker history of Child Protective Services involvement and non-Hispanic black race/ethnicity were associated with increased odds of pediatric nonaccidental burn. Prospective research is necessary to determine whether these represent true risk …

Covid-19 And Management Education: Reflections On Challenges, Opportunities, And Potential Futures, Steve Brammer, Timothy Clark

Research Collection Lee Kong Chian School Of Business

COVID-19 is having profound impacts on tertiary education globally. Border closures, cuts to aviation capacity, mandatory quarantine on entering a country, restrictions on mass gatherings, and social distancing all pose challenges to higher education (HE) institutions. Business Schools (BSs) have larger and more internationally diverse cohorts of students and staff, generating particular challenges, but also often have more mature digital and remote education capabilities that enable responses to COVID-19. Therefore, exploring emergent evidence on how BSs are likely to be affected by COVID-19 over the short, medium, and long term is of significant importance to our community. In this commentary, …

Correlates Of Stigma In People With Epilepsy, Carol Blixen, Daisy Ogede, Farren Briggs, Michelle E. Aebi, Christopher Burant, Betsy Wilson, Javier Ponce Terashima, Martha Sajatovic

Faculty Scholarship

Background and Purpose Epilepsy is often associated with substantial stigma. This study evaluated clinical correlates of stigma in a sample of people living with epilepsy (PLWE) con-sidered high risk due to frequent seizures or other negative health events. Methods Data were derived from an epilepsy self-management clinical trial. Standardized measures assessed socio-demographics, epilepsy stigma, epilepsy severity, self-efficacy, self-management competency, health literacy, depressive symptoms severity, functional status, social support and quality of life. Results There were 120 individuals, mean age of 41.73 (SD=17.08), 81 men (66.9%), and 79 (65.3%) African-American. Individual factors correlated with worse stigma w ere indicative of more …

Abstract Book (Pdf), School Of Medicine

Summer Research Internship Program

Abstract Book for the 2020 Summer Research Internship Program.
Participants are listed alphabetically by last name.

Are Advanced Practice Registered Nurses In Mississippi Participating In Practices That Advocate The Nursing Profession, Sarah Adams, Melanie Bush, Lacy Estes, Lisa King, Paige Long

MSN Research Projects

Previous research studies have focused on patient outcomes related to healthcare interventions, but there is little research available regarding nurses’ involvement in activities that would advance the profession. Advanced Practice Registered Nurses’ (APRN) contributions to the healthcare system lead to direct improvement of patient outcomes through research, mentoring new professionals, and participating in professional organizations. The theoretical motivation behind the study is Ray’s Theory of Bureaucratic Caring that proposed healthcare personnel consider incorporation of the business aspects of healthcare to propel nursing into the future. Ray dared nurses to become leaders in the field, understand the corporate aspects of health …

Assessment Of Prediabetes Testing Practices Among Primary Care Providers In Mississippi, Blake Mccaulley, Marlana Mcfarland, Erica Mosley, Yvette Munn, Lindsay Wynne

MSN Research Projects

Prediabetes is a condition in which a person has impaired glucose metabolism; however, his or her glucose levels do not meet criteria for the diagnosis of diabetes (ADA, 2019). Prediabetes is associated with an increased risk of developing diabetes and cardiovascular disease (ADA, 2019). Early diagnosis and treatment of prediabetes, including lifestyle interventions and medical management, are vital in preventing prediabetes from progressing to diabetes. The review of current literature indicates that prediabetes testing is not being properly utilized in primary care settings. The purpose of this study was to determine if primary care providers (PCPs) were performing prediabetes A1C …

Major Septal Defects: Comparative Study Of Down Syndrome And Non-Down Syndrome Infants, Before And After Surgery, Saleha Aziz, Maaha Ayub, Laiba Masood, Muneer Amanullah, Rukhsana Hameed, Shiraz Hashmi, Waris Ahmad

Medical College Documents

Objective: To compare pre-operative, intra-operative, and post-operative parameters in Down syndrome (DS) and non-DS patients with atrioventricular septal defects (AVSD) and inlet ventricular septal defects (VSD) in a tertiary care hospital in Pakistan.
Methods: We conducted a retrospective study at Aga Khan University, Pakistan. All complete atrioventricular septal defect (CAVSD), partial atrioventricular septal defect (PAVSD), and VSD with inlet extension surgical cases from January 2007 to January 2019 were included. Patients with congenital heart diseases other than those listed above were excluded.
Results: In 61 cases, 18 had DS. Median age, mean body surface area (BSA), and height were lower …

Investigation Of The Role Of Heparin-Binding Pocket In Amyloid Fibrils Formation Of Fgf-1, I Gusti Ayu Agung Septiari

Graduate Theses and Dissertations

Human acidic fibroblast growth factor (aFGF/hFGF-1) is one of the promising molecules to be investigated to generate an in-depth understanding of the pathological mechanism of Alzheimer's disease (AD) neurodegenerative disorder characterized by the presence of amyloid fibrils. Some in vivo and human brain tissue studies proved the correlation of high-level expression of FGF-1-induced neuroinflammation and the occurrence of AD. The presence of amyloid fibrils as a hallmark of AD can be related to the generic property of the proteins to form amyloid fibrils; High level of FGF-1, in this case, may contribute to the formation of amyloid fibrils. As a …

A School-Based Sexual Health Education Program, Tracy L. Kendall

Electronic Theses and Dissertations

A small rural community has high incidence rates of chlamydia (4,751 per 100,000) and gonorrhea (970 per 100,000) in females 15–24 years old. Data obtained from Texas Health and Human Services showed that incidence rates of chlamydia and gonorrhea in females 15–24 years old were higher in Navarro County, Texas, than the state of Texas. Texas schools do not mandate sex health education. There is a gap in school-based sexual health education available to 18- and 19-year-old females residing in this rural community in Texas. The purpose of this research study was to evaluate the impact of school-based sexual health …

Medical Noncompliance In A Pediatric Patient Living In A Single-Parent Household, Lucy Obianuju Norrell

Electronic Theses and Dissertations

Abstract Noncompliance is a patient’s inability to comply with the recommended treatment for their complete recovery from an ailment, while compliance is the extent to which a patient adheres to the provider’s directive, such as medication and orders given. The purpose of this study was to determine if motivational interviewing when applied to noncompliant pediatric patients from single-parent households, would improve global medical compliance in this population as compared to the standard of care at the end of three months. Thirty-two participants were recruited using the homogeneous purposeful sampling. The project employed a mixed-method approach. Fred Kleinsinger’s noncompliant behavior tool …

Resolving Tensions Between Disability Rights Law And Covid-19 Mask Policies, Elizabeth Pendo, Robert Gatter, Seema Mohapatra

All Faculty Scholarship

As states reopen, an increasing number of state and local officials are requiring people to wear face masks while out of the home. Grocery stores, retail outlets, restaurants and other businesses are also announcing their own mask policies, which may differ from public policies. Public health measures to stop the spread of the coronavirus such as wearing masks have the potential to greatly benefit millions of Americans with disabilities, who are particularly vulnerable to the impact of COVID-19. But certain disabilities may make it difficult or inadvisable to wear a mask.
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Hpv Vaccination In Females: The Role Of Primary Health Care And Primary Health Care Providers, Brooke Bouza

Graduate Theses and Dissertations

Two reasons for subpar coverage of the Human papillomavirus (HPV) vaccine are missed clinical opportunities and nonacceptance of the vaccine upon recommendation from a medical provider. The purpose of study one was to examine factors associated with access and adherence to physician’s recommendations in association with HPV vaccine uptake. Data were obtained from National Health Interview Survey (2017). Variables theoretically related to clinical opportunities and adherence to physician’s recommendations were examined in association with HPV vaccine uptake. Univariate logistic regressions were run to determine the associations between the aforementioned variables and uptake of the HPV vaccine. Multinomial logistic regressions were …

Rejection Sensitivity And Social Support As Predictors Of Peer Victimization Among Youth With Psychiatric Illness, Katherine C. Hyde

Graduate Theses and Dissertations

In this study, I examined whether rejection sensitivity and perceptions of social support predicted concurrent peer victimization in a sample of adolescents with psychiatric illness. Participants included 43 adolescents, aged 12-18 with diverse psychiatric diagnoses, who were recruited from a summer residential treatment program. Participants completed measures of peer victimization, perceptions of social support, and rejection sensitivity. Participants also completed the global victimization item in the Revised Olweus Bully/Victim Questionnaire, which allowed for comparison of rates of peer victimization across studies (Solberg & Olweus, 2003). Results replicate and extend previous research that indicates adolescents with psychiatric illness experience high rates …

Long-Term Impact Of Child-Centered Play Therapy On Academic Achievement: A Longitudinal Examination Of Academic Success In At-Risk Elementary School Students, Brittany D. Massengale

Graduate Theses and Dissertations

This study examined the long-term impact of child-centered play therapy (CCPT) implemented through Primary Project on at-risk second-grade elementary school students. The qualifying group received ten 30-minute play therapy sessions during one academic semester during their second-grade year. In a longitudinal analysis for academic growth, MAP testing was used to determine if there was a long-term impact on both the third grade and fourth-grade years for the original qualifying students. The findings reveal implications for identification of and interventions for at-risk elementary students and CCPT as an intervention for academic achievement; specifically, reading and mathematics scores. Recommendations for future research …

Effect Of The Prospect Of Transport On Captive Tiger Behavior And Fecal Cortisol In Naïve And Experienced Tigers, Callan Lichtenwalter

Graduate Theses and Dissertations

With close to 5,000 captive tigers in the United States, it is vital to ensure that these tigers are receiving adequate welfare whether they are in an accredited facility, or privately owned. The goal of this study was to assess whether captive tigers at a rescue facility with experience being transported outside of the facility would respond differently to the presentation of their transport vehicle than their naïve counterparts who had only been transported within the facility. The behavior of 5 naïve and 7 experienced tigers (n = 12) located at Turpentine Creek Wildlife Refuge in Eureka Springs, Arkansas was …

Respiratory Viral Panels And Pediatric Airway Evaluation: The Role Of Testing For Upper Respiratory Infections To Stratify Perioperative Risk., Weston L Niermeyer, Jessica Ball, Noah Worobetz, Tran Bourgeois, Amanda Onwuka, Candice Burrier, Tendy Chiang

Ambulatory and Primary Care Articles

OBJECTIVES: Children admitted with stridor and respiratory distress comprise a complex patient group that requires the otolaryngologist to decide when to assess and intervene with direct laryngoscopy and bronchoscopy (DLB). Historically, the diagnosis of viral upper respiratory tract infection (URTI) can lead to postponement of surgery due to concerns of perioperative complications related to acute illness. Respiratory viral panels (RVP) are often used to confirm the presence of recent or active viral infection and can affect the differential diagnosis of upper airway obstruction. This study examined whether positive RVP testing is associated with perioperative complications and operative findings in pediatric …

Camps: Efficient And Privacy-Preserving Medical Primary Diagnosis Over Outsourced Cloud, Jianfeng Hua, Guozhen Shi, Hui Zhu, Fengwei Wang, Ximeng Liu, Hao Li

Research Collection School Of Computing and Information Systems

With the flourishing of ubiquitous healthcare and cloud computing technologies, medical primary diagnosis system, which forms a critical capability to link big data analysis technologies with medical knowledge, has shown great potential in improving the quality of healthcare services. However, it still faces many severe challenges on both users' medical privacy and intellectual property of healthcare service providers, which deters the wide adoption of medical primary diagnosis system. In this paper, we propose an efficient and privacy-preserving medical primary diagnosis framework (CAMPS). Within CAMPS framework, the precise diagnosis models are outsourced to the cloud server in an encrypted manner, and …