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Articles 220231 - 220260 of 294581

Full-Text Articles in Medicine and Health Sciences

Effect Of The Infection With Porcine Reproductive And Respiratory Syndrome Virus On The Regulation Of Cytokines - Tumor Necrosis Factor-Alpha And Interleukin-10, Sakthivel Subramaniam Aug 2011

Effect Of The Infection With Porcine Reproductive And Respiratory Syndrome Virus On The Regulation Of Cytokines - Tumor Necrosis Factor-Alpha And Interleukin-10, Sakthivel Subramaniam

School of Veterinary and Biomedical Sciences: Dissertations, Theses, and Student Research

Porcine reproductive and respiratory syndrome virus (PRRSV) causes late-term abortion in sows and pneumonia in growing piglets. PRRSV evades the host immune response by several mechanisms, including the modulation of cytokine secretions in infected pigs, which is the subject of this dissertation. Particularly, PRRSV reduces the secretion of the pro-inflammatory cytokine, tumor necrosis factor-α (TNF-α) but increases the secretion of the anti-inflammatory cytokine interleukin-10 (IL-10). The latter effect, however, is PRRSV strain-specific. In this dissertation, we have examined mechanisms by which PRRSV regulates TNF-α and IL-10 expressions. The pathogenic strain FL12, derived from a PRRSV infectious clone, consistently suppressed TNF-α …


Primary Provider Beliefs And Practice Patterns Contribute To The Lack Of Hiv/Hcv Coinfected Patients Undergoing Liver Transplantation In The United States, Jonathan M. Fenkel, Md, Victor J. Navarro, Md Aug 2011

Primary Provider Beliefs And Practice Patterns Contribute To The Lack Of Hiv/Hcv Coinfected Patients Undergoing Liver Transplantation In The United States, Jonathan M. Fenkel, Md, Victor J. Navarro, Md

Division of Gastroenterology and Hepatology Faculty Papers

Conclusions:

1. The majority of primary providers were ambivalent toward or against LT for HIV/HCV coninfected patients.

2. Half of all respondents were unlikely to refer cirrhotic coinfected patients for LT evaluation.

3. HIV specialists were significantly more likely to believe transplant should be offered, but reported no difference in likelihood of LT referral.

4. These findings suggest that primary provider beliefs and self-reported practice patterns may partially explain the paucity of coinfected US liver transplant recipients.


Latent Growth Modeling Of A Nutrition And Physical Activity Intervention, Alicia Dea Sample Aug 2011

Latent Growth Modeling Of A Nutrition And Physical Activity Intervention, Alicia Dea Sample

Dissertations

The health, economic, and social impacts of physical inactivity and unhealthy dietary patterns are quite significant and evidenced by the fact that only 3-4% of American adults follow all the dietary advice recommended by the Dietary Guidelines for Americans (DGA; Kohatsu, Robinson, & Torner, 2004), and specific subpopulations, including the rural South, are affected even more drastically (McCabe-Sellers et al., 2007). Furthermore, the majority of the people in the United States do not currently meet recommended amounts of physical activity (PA) and have not since the mid 1980s (U.S. Department of Health and Human Services [USDHHS], 2008). To address the …


Positive Emotions And Suicide Intervention Response, Crystal Rodriguez Aug 2011

Positive Emotions And Suicide Intervention Response, Crystal Rodriguez

Theses and Dissertations - UTB/UTPA

This study investigated the role of positive emotions in suicide intervention response, in an effort to inform future directions in suicide intervention strategies. Participants were 381 Hispanic college students who completed a measure of suicide intervention skill and wrote written responses to a vignette of a peer in crisis. Results indicated that communication of positive emotions and suicide intervention response skill were not related. Possible explanations and future directions are discussed.


Role Of Porcine Reproductive And Respiratory Syndrome Virus Non-Structural Protein 1 In Viral Replication And Pathogenesis, Lalit Beura Aug 2011

Role Of Porcine Reproductive And Respiratory Syndrome Virus Non-Structural Protein 1 In Viral Replication And Pathogenesis, Lalit Beura

School of Veterinary and Biomedical Sciences: Dissertations, Theses, and Student Research

Porcine reproductive and respiratory syndrome virus (PRRSV) is an infectious agent of significant concern to the global swine industry. PRRSV infection of pigs is initiated by a long viremia after which the virus enters in an extended persistent phase of 3-4 months that ultimately is resolved by the immune system. The delayed and weak host adaptive response is responsible for the protracted convalescence period. An initial sub-optimal innate immune response is postulated to be the reason behind such meager adaptive immune response. A major focus of the studies undertaken in this dissertation was to identify the viral non-structural proteins (nsps) …


Effects Of Single Nucleotide Polymorphisms In The Human Holocarboxylase Synthetase Gene On Catalytic Activity, Shingo Esaki Aug 2011

Effects Of Single Nucleotide Polymorphisms In The Human Holocarboxylase Synthetase Gene On Catalytic Activity, Shingo Esaki

Department of Nutrition and Health Sciences: Dissertations, Theses, and Student Research

Holocarboxylase synthetase (HCS) catalyzes the covalent binding of biotin to carboxylases and histones in eukaryotic cells. Biotinylated carboxylases play essential roles in the metabolism of fatty acids, amino acids, and glucose; biotinylated histones play essential roles in gene regulation and genome stability. HCS null individuals are not viable whereas HCS deficiency is linked to developmental delays and phenotypes such as short life span and low stress resistance. Greater than 2,500 single nucleotide polymorphisms (SNPs) have been reported for HCS, but the biological importance of these polymorphisms is unknown. We hypothesized that some of these SNPs impair catalytic activity and that …


Ada News - 08/01/2011, American Dental Association, Publishing Division Aug 2011

Ada News - 08/01/2011, American Dental Association, Publishing Division

ADA News

Established in 1970 as the official newspaper of the American Dental Association, the ADA News serves practicing dentists and others allied to the dental profession in the U.S. and internationally. It is the No. 1 source of news and information about the many benefits and services the ADA delivers to members daily as well as timely information on scientific, social, political and economic developments affecting dentistry and health care.


Capacity Building For Participatory Health Services Research In Housing First, Lara Carson Weinstein, Md Aug 2011

Capacity Building For Participatory Health Services Research In Housing First, Lara Carson Weinstein, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Background:

Pathways to Housing ends chronic homelessness for individuals with serious mental illness (SMI) by providing housing first, and then combining that housing with supportive treatment services in the area of mental and physical health, substance abuse, education, and employment. Housing is provided in apartments scattered throughout a community. This "scattered site" model fosters a sense of home and self-determination, and it helps speed client's reintegration into the community. The Pathways model has been remarkable successful in addressing chronic homelessness.

Research Question

What are the chronic physical disease self management support needs of Pathways to Housing clients?


Athletic Training Students' Ability To Identify Scapular Dyskinesis, Priscilla M. Dwelly Aug 2011

Athletic Training Students' Ability To Identify Scapular Dyskinesis, Priscilla M. Dwelly

Graduate Theses and Dissertations

Scapular dyskinesis refers to abnormal movement patterns of the scapula, which have been associated with injury. Previous investigations have validated the scapular dyskinesis test as a visual assessment method using physicians, physical therapists, and certified athletic trainers. Through educational programs, athletic training students should be taught what scapular dyskinesis is and how to identify it. Therefore, the purpose of this investigation was to (a) evaluate entry-level graduate athletic training students' ability to identify scapular dyskinesis, (b) assess their reliability, and (c) determine if they were able to correctly identify the muscles involved in rehabilitating an individual with scapular dyskinesis. Follow-up …


Identification Of Ssr Markers Associated With Height Using Pool-Based Genome-Wide Association Mapping In Sorghum, Paul W. Bible, Yi-Hong Wang, Rasiah Loganantharaj, Hari D. Upadhyaya Aug 2011

Identification Of Ssr Markers Associated With Height Using Pool-Based Genome-Wide Association Mapping In Sorghum, Paul W. Bible, Yi-Hong Wang, Rasiah Loganantharaj, Hari D. Upadhyaya

Computer Science Faculty publications

Sorghum has been proposed as a potential energy crop. However, it has been traditionally bred for grain yield and forage quality, not traits related to bioenergy production. To develop tools for genetic improvement of bioenergy-related traits such as height, genetic markers associated with these traits have first to be identified. Association mapping has been extensively used in humans and in some crop plants for this purpose. However, genome-wide association mapping using the whole association panel is costly and time-consuming. A variation of this method called pool-based genome-wide association mapping has been extensively used in humans. In this variation, pools of …


Ada Code Of Ethics (August 2011), American Dental Association Aug 2011

Ada Code Of Ethics (August 2011), American Dental Association

Code of Ethics

The ADA Code of Ethics has three main components: The Principles of Ethics, the Code of Professional Conduct and the Advisory Opinions. Contents may also include: Amendment to ADA Principles of Ethics and Code of Professional Conduct and Insert for the ADA Principles of Ethics and Code of Professional Conduct. The most current issue is available on the ADA’s website.


Comparison Of The Effects Of Ice And 3.5% Menthol Gel On Blood Flow And Muscle Strength Of The Lower Arm, Robert V. Topp, Lee J. Winchester, Amber M. Mink, Jeremiah S. Kaufmann, Dean E. Jacks Aug 2011

Comparison Of The Effects Of Ice And 3.5% Menthol Gel On Blood Flow And Muscle Strength Of The Lower Arm, Robert V. Topp, Lee J. Winchester, Amber M. Mink, Jeremiah S. Kaufmann, Dean E. Jacks

College of Nursing Faculty Research and Publications

Context: Soft-tissue injuries are commonly treated with ice or menthol gels. Few studies have compared the effects of these treatments on blood flow and muscle strength. Objective: To compare blood flow and muscle strength in the forearm after an application of ice or menthol gel or no treatment. Design: Repeated measures design in which blood-flow and muscle-strength data were collected from subjects under 3 treatment conditions. Setting: Exercise physiology laboratory. Participants: 17 healthy adults with no impediment to the blood flow or strength in their right arm, recruited through word of mouth. Intervention: Three …


“Learning The Hard Way”: An Examination Of Acculturative Support For Latin-American Baseball Players In The South Atlantic League, Lauren Melanie Osmer Aug 2011

“Learning The Hard Way”: An Examination Of Acculturative Support For Latin-American Baseball Players In The South Atlantic League, Lauren Melanie Osmer

Masters Theses

Latin-Americans have become major contributors in Major League Baseball, but face many challenges acculturating to living and playing in the United States. This research examined the acculturative support provided to Latin-American players by teams in the South Atlantic League of Minor League Baseball and whether or not people involved think that support was effective. Semi-structured interviews were conducted with front-office members and Latin-American former players, and transcriptions were analyzed for emerging themes using QDA Miner content analysis software. Three main themes emerged from the interviews: the language barrier, interaction between Latin-American and Anglo-American teammates, and the youth of Latin-American prospects. …


Protein Kinase Cδ And C-Abl Kinase Are Required For Transforming Growth Factor Β Induction Of Endothelial-Mesenchymal Transition In Vitro., Zhaodong Li, Sergio A. Jimenez Aug 2011

Protein Kinase Cδ And C-Abl Kinase Are Required For Transforming Growth Factor Β Induction Of Endothelial-Mesenchymal Transition In Vitro., Zhaodong Li, Sergio A. Jimenez

Department of Medicine Faculty Papers

OBJECTIVE: The origin of the mesenchymal cells responsible for the intimal fibrosis in systemic sclerosis (SSc) has not been fully identified. The present study was undertaken to investigate whether subendothelial mesenchymal cells may emerge through transdifferentiation of endothelial cells (ECs) into myofibroblasts via endothelial-mesenchymal transition (EndoMT) in vitro and to explore the signaling pathways involved in this process.

METHODS: Primary mouse pulmonary ECs isolated by immunomagnetic methods with sequential anti-CD34 and anti-CD102 antibody selection were cultured in monolayers. Cell morphology and diacetylated low-density lipoprotein uptake assays confirmed their EC characteristics. The induction of EndoMT was assessed by determination of α-smooth …


Graduating Bsn Students' Ebp Knowledge, Ebp Readiness And Ebp Implementation, Ludy Sm. Llasus Aug 2011

Graduating Bsn Students' Ebp Knowledge, Ebp Readiness And Ebp Implementation, Ludy Sm. Llasus

UNLV Theses, Dissertations, Professional Papers, and Capstones

Emphasis on evidence-based practice (EBP) in healthcare delivery increased the expectation that nurses utilize research findings to make informed clinical decisions, and guide their nursing actions and interactions with clients in a constantly changing and increasingly complex healthcare environment. Increasing demand for patient safety and quality healthcare requires that translation of best possible evidence into practice is needed to ensure improved patient outcomes. Nursing education is responsible for preparing and providing society with knowledgeable and competent nurses who are ready to engage in EBP for improved patient outcomes.

The purpose of this non-experimental, descriptive, correlational, cross-sectional study was to describe …


A Comparison Of Spatio-Temporal Prediction Methods Of Cancer Incidence In The U.S, Michelle Hamlyn Aug 2011

A Comparison Of Spatio-Temporal Prediction Methods Of Cancer Incidence In The U.S, Michelle Hamlyn

UNLV Theses, Dissertations, Professional Papers, and Capstones

Cancer is the cause of one out of four deaths in the United States, and in 2009, researchers expected over 1.5 million new patients to be diagnosed with some form of cancer. People diagnosed with cancer, whether a common or rare type, need to undergo treatments, the amount and kind of which will depend on the severity of the cancer. So how do healthcare providers know how much funding is needed for treatment? What would better enable a pharmaceutical company to determine how much to allocate for research and development of drugs, the amount of each drug to manufacture, or …


Polycyclic Aromatic Hydrocarbons In Maternal And Umbilical Cord Blood From Pregnant Hispanic Women Living In Brownsville, Texas, Ken Sexton, Jennifer J Salinas, Thomas J Mcdonald, Rose M Z Gowen, Rebecca P Miller, Joseph B Mccormick, Susan P Fisher-Hoch Aug 2011

Polycyclic Aromatic Hydrocarbons In Maternal And Umbilical Cord Blood From Pregnant Hispanic Women Living In Brownsville, Texas, Ken Sexton, Jennifer J Salinas, Thomas J Mcdonald, Rose M Z Gowen, Rebecca P Miller, Joseph B Mccormick, Susan P Fisher-Hoch

Journal Articles

Venous blood was drawn from 35 pregnant Hispanic women living in Brownsville, Texas, and matched cord blood was collected at birth. Gas chromatography/mass spectrometry was used to measure concentrations of 55 individual PAHs or groups of PAHs. Results indicate that these women and their fetuses were regularly exposed to multiple PAHs at comparatively low concentrations, with levels in cord blood generally exceeding levels in paired maternal blood. While the possibility of related adverse effects on the fetus is uncertain, these exposures in combination with socioeconomically-disadvantaged and environmentally-challenging living conditions raise legitimate public health concerns.


Faculty’S Perceptions Of Students’ Abilities To Utilize Self-Regulated Learning Strategies To Improve Critical And Reflective Thinking In Making Clinical Decisions: A Methodological Study, Amber Lynn Donnelli Aug 2011

Faculty’S Perceptions Of Students’ Abilities To Utilize Self-Regulated Learning Strategies To Improve Critical And Reflective Thinking In Making Clinical Decisions: A Methodological Study, Amber Lynn Donnelli

UNLV Theses, Dissertations, Professional Papers, and Capstones

With the rapidly changing health care system, new nurses are expected to be able to collect pertinent data, access resources, prioritize information, solve problems, and ultimately make sound clinical decisions (Kuiper, 2005). Supporting evidence has shown that using self-regulated learning strategies (SRLS) increases the development of critical and reflective thinking within the clinical reasoning context (Kuiper & Pesut, 2004). Despite the fact that instruments have been developed to examine students’ perception of the use of SRLS, there is no existing instrument to measure nursing faculty’s perceptions of a student’s ability to utilize self-regulated learning strategies in the clinical setting. This …


Stewardship In Health Policy And Its Relevance To Pakistan, Asaad Ahmed Nafees, Parvez Nayani Aug 2011

Stewardship In Health Policy And Its Relevance To Pakistan, Asaad Ahmed Nafees, Parvez Nayani

Community Health Sciences

Since the concept of stewardship in health care first appeared in World Health Report 2000 there has been very limited discussion in the academia about its implications. In the present paper we revisit this concept and review the literature that has been written about it. We have particularly focused on the role of stewardship in health policy of Pakistan. We also highlight the improvement that stewardship can bring about in the health policy of Pakistan and the possible constraints that might be faced during its implementation phase. The literature available is on the concept of stewardship in health policy. The …


Impact Of Interdisciplinary Patient Safety Education For Nursing Students And Medical Students On Collaboration And Teamwork, Carol Crosby Jul 2011

Impact Of Interdisciplinary Patient Safety Education For Nursing Students And Medical Students On Collaboration And Teamwork, Carol Crosby

Carol Crosby

No abstract provided.


From Nightingale To Naughty, Virgin To Handmaiden: Images Of The Nurse In American Culture And Why They Matter, Erika Metzler Sawin Jul 2011

From Nightingale To Naughty, Virgin To Handmaiden: Images Of The Nurse In American Culture And Why They Matter, Erika Metzler Sawin

Erika Metzler Sawin

No abstract provided.


The Effects Of Spinal Posture And Pelvic Fixation On Trunk Rotation Range Of Motion, Trevor Montgomery, Mark Boocock, Wayne Hing Jul 2011

The Effects Of Spinal Posture And Pelvic Fixation On Trunk Rotation Range Of Motion, Trevor Montgomery, Mark Boocock, Wayne Hing

Wayne Hing

Background: Axial rotation of the trunk is important to many vocational tasks and activities of daily living, and may be associated with back injuries. The influence of spinal postures on trunk rotation appears conflicting. This study investigated the influence of forward trunk inclination, spinal posture and pelvic fixation on maximum trunk rotation.

Methods: Twenty male participants were assessed using an optoelectronic motion-analysis system to track trunk movement during maximal trunk rotations in different spinal positions within the sagittal plane. A repeated-measures multivariate analysis of variance investigated the effects of forward trunk inclination, spinal posture and pelvic fixation on trunk and …


Symptom Persistence In Seriously Emotionally Disordered Children: Findings Of A Two-Year Follow-Up After Residential Treatment, Rebecca Cuthbert, Jeff St. Pierre, Shannon Stewart, Steven Cook, Andrew Johnson, Alan Leschied Jul 2011

Symptom Persistence In Seriously Emotionally Disordered Children: Findings Of A Two-Year Follow-Up After Residential Treatment, Rebecca Cuthbert, Jeff St. Pierre, Shannon Stewart, Steven Cook, Andrew Johnson, Alan Leschied

Andrew M. Johnson

Residential treatment is arguably the most costly and intensive part of the children’s mental health system. Yet, research suggests that a subset of the emotionally disordered children and youth admitted to intensive tertiary care treatment facilities fail to demonstrate symptom reductions upon discharge, with many continuing to deteriorate in their adjustment during the follow-up period. This study reports on the factors that characterize the children and youth that, while showing marginal benefit from residential treatment, continue to show community conduct problems at a two-year follow-up period. The results are discussed in the context of how knowledge of these factors can …


Literature Review: Using Pictographs In Discharge Instructions For Older Adults With Low-Literacy Skills, Jeungok Choi Jul 2011

Literature Review: Using Pictographs In Discharge Instructions For Older Adults With Low-Literacy Skills, Jeungok Choi

Jeungok Choi

No abstract provided.


A Phase Ii Trial Of Arc-Based Hypofractionated Intensity-Modulated Radiotherapy In Localized Prostate Cancer., Michael Lock Jul 2011

A Phase Ii Trial Of Arc-Based Hypofractionated Intensity-Modulated Radiotherapy In Localized Prostate Cancer., Michael Lock

Michael Lock

Lock M, Best L, Wong E, Bauman G, D'Souza D, Venkatesan V, Sexton T, Ahmad B, Izawa J, Rodrigues G. Source Department of Oncology, University of Western Ontario and London Regional Cancer Program, London Health Sciences Centre, London, ON, Canada. Abstract PURPOSE: To evaluate acute and late genitourinary (GU) and gastrointestinal (GI) toxicity and biochemical control of hypofractionated, image-guided (fiducial markers or ultrasound guidance), simplified intensity-modulated arc therapy for localized prostate cancer. METHODS AND MATERIALS: This Phase II prospective clinical trial for T1a-2cNXM0 prostate cancer enrolled 66 patients who received 63.2 Gy in 20 fractions over 4 weeks. Fiducial markers …


Radiolabeled Oligonucleotides For Antisense Imaging., Arun Iyer Jul 2011

Radiolabeled Oligonucleotides For Antisense Imaging., Arun Iyer

Arun Iyer

Oligonucleotides radiolabeled with isotopes emitting γ-rays (for SPECT imaging) or positrons (for PET imaging) can be useful for targeting messenger RNA (mRNA) thereby serving as non-invasive imaging tools for detection of gene expression in vivo (antisense imaging). Radiolabeled oligonucleotides may also be used for monitoring their in vivo fate, thereby helping us better understand the barriers to its delivery for antisense targeting. These developments have led to a new area of molecular imaging and targeting, utilizing radiolabeled antisense oligonucleotides. However, the success of antisense imaging relies heavily on overcoming the barriers for its targeted delivery in vivo. Furthermore, the low …


Racial And Sexual Identity-Related Maltreatment Among Minority Ymsm: Prevalence, Perceptions, And The Association With Emotional Distress, Sheldon Fields Jul 2011

Racial And Sexual Identity-Related Maltreatment Among Minority Ymsm: Prevalence, Perceptions, And The Association With Emotional Distress, Sheldon Fields

Sheldon D. Fields

Bullying is a form of violence characterized as an aggressive behavior that is unprovoked and intended to cause harm. Prior studies have found that lesbian, gay, bisexual, and transgender (LGBT) youth experience high levels of bullying related to their sexuality and this harassment can lead to engagement in risk behaviors, depression, and suicide. Ethnic/racial minority young men who have sex with men (YMSM) may experience dual levels of stigma and maltreatment due to both their sexuality and their race. The aim of the current study was to assess the prevalence and perceptions of racial and sexual identity-based abuse among a …


Age Of Msm Sexual Debut And Risk Factors: Results From A Multisite Study Of Racial/Ethnic Minority Ymsm Living With Hiv, Sheldon Fields Jul 2011

Age Of Msm Sexual Debut And Risk Factors: Results From A Multisite Study Of Racial/Ethnic Minority Ymsm Living With Hiv, Sheldon Fields

Sheldon D. Fields

The average reported age of sexual debut for youth in the United States is 14.4 years, with approximately 7% reporting their sexual debut prior to age 13. While the research literature on sexual debut for youth addresses gender and ethnic differences (with males and African-American youth experiencing earlier sexual debut), there is limited data regarding factors associated with sexual debut for young men who have sex with men (YMSM). Early sexual debut poses potential health risks, such as contracting HIV with an increased risk of unprotected intercourse. Given current high HIV infection rates for racial/ethnic minority YMSM, learning more about …


Sexual Behaviors Of Racial/Ethnic Minority Young Men Who Have Sex With Men., Sheldon Fields Jul 2011

Sexual Behaviors Of Racial/Ethnic Minority Young Men Who Have Sex With Men., Sheldon Fields

Sheldon D. Fields

We assessed changes in sexual behaviors from baseline to 12-month follow-up among a multisite cohort of HIV-positive racial/ethnic minority young men who have sex with men enrolled in an outreach, linkage, and retention study. In the 3 months prior to their baseline interview, more than three-quarters of participants (78.5%) reported sex with at least one man (mean: 2.3 partners). Among sexually active participants, 44.2% had one partner; 50.5% had 2-9 partners; and 5.3% had 10 or more partners. Over three-quarters (77.5%) reported engaging in sex with at least one steady partner, 43.5% with at least one casual partner, and 29.5% …


Contractile And Non-Contractile Tissue Volume And Distribution In Ankle Muscles Of Young And Older Adults, Christopher J. Hasson, Jane A. Kent-Braun, Graham E. Caldwell Jul 2011

Contractile And Non-Contractile Tissue Volume And Distribution In Ankle Muscles Of Young And Older Adults, Christopher J. Hasson, Jane A. Kent-Braun, Graham E. Caldwell

Graham E. Caldwell

Magnetic resonance imaging (MRI) enables accurate in vivo quantification of human muscle volumes, which can be used to estimate subject-specific muscle force capabilities. An important consideration is the amount of contractile and non-contractile tissue in the muscle compartment, which will influence force capability. We quantified age-related differences in the proportion and distribution of contractile and non-contractile tissue in the dorsiflexor and plantar flexor (soleus, and medial and lateral heads of gastrocnemius) muscles, and examined how well these volumes can be estimated from single MRI cross-sections. Axial MRIs of the left leg for 12 young (mean age 27 years) and 12 …