Søgning på udtrykket 'hiv' giver 149 resultater
Dokumenter [12]
Sider [7]
Kalender [83]
Nyt fra tidsskrifterne [+20]
Aktuelle smitsomme sygdomme [+20]
Dokumenter [12]
Forfattere: Jan Gerstoft, Nina Weis, Terese L. Katzenstein (Dansk Selskab for Infektionsmedicin), Anders Nyboe Andersen og Jens Fedder (Dansk Fertilitetsselskab).
Version: 3. Endelig guideline: 01.09.2020. Guideline skal revideres senest: 01.09.2023
Arbejdsgruppens medlemmer: Peer Brehm Christensen, Christian Erikstrup, Jan Gerstoft, Terese Katzenstein, Alex Laursen, Suzanne Lunding, Birgitte Mørn og Nina Weis.
Arbejdsgruppen bestod af: Jan Gerstoft, Ann-Brit Eg Hansen, Gitte Kronborg, Jens D. Lundgren, Henrik I. Nielsen, Olav Ditlevsen Larsen, Niels Obel og Alex Laursen
Fællesregional retningslinje for udlevering af forebyggende medicin mod HIV (PrEP), udgivet af Danske Regioner.
Anbefaling for profylakse og opfølgning af stikuheld og anden blodeksposition.
Arbejdsgruppe: Suzanne Lunding (formand), Peer Brehm Christensen, Christian Erikstrup, Terese L. Katzenstein, Henrik Krarup, Alex Lund Laursen, Birgitte Mørn og Nina Weis
Senest revideret september 2021 . Arbejdsgruppen bestod af: Jan Gerstoft, Gitte Kronborg , Ann Brit Eg Hansen, Jens D. Lundgren, Henrik I. Nielsen, Olav Ditlevsen Larsen , Niels Obel og Alex Laursen
Arrangeret af Yngre Infektionsmedicinere
Henvendelse til Danske regioner
I forbindelse med Sundhedsstyrelsens udgivelse af "Personer med øget risiko ved COVID-19. Fagligt grundlag", har DSI beskrevet følgende specialespecifikke patienter med øget risiko for et alvorligt COVID-19 sygdomsforløb.
Sider [7]
Formål:
At kursisten skal opnå en forståelse af HIV-infektionen herunder viden om dens epidemiologi, patogenese, patofysiologi, diagnose, forebyggelse, behandlingsmuligheder og prognose samt viden om diagnostik og behandlingen af AIDS-definerende sygdomme og de hyppigste sexuelt overførte sygdomme.
Tid og sted:
Hvidovre Hospital. Lokale 10 i undervisningsbygningen.
Delkursusledere:
Ann-Brit Eg Hansen og Ole Kirk.
Program:
Mandag 3. oktober:
10:00-10:15 Velkomst og introduktion (Ann-…
…me og biologisk terrorisme. Specialet er karakteriseret ved et sygdomspanorama hvor sygdommenes prævalens såvel som incidens ændres hurtigt på lokalt og globalt plan. Over de seneste tyve år har specialet udviklet sig til at håndtere behandlingen af HIV og AIDS. I de seneste år er nye alvorlige infektionssygdomme som SARS, fugleinfluenza, West Nile virus, Hanta virus, Nipah virus, og Hendra virus tilkommet. Alvorlige sygdomme som hæmoragisk viral feber forårsaget af Ebola, Lassa, Dengue, Crimean-Co…
…æsentanter i diverse arbejdsgrupper og udvalg, og publicerede guidelines.
Antiretroviral terapi:
Henrik Nielsen, Jan Gerstoft, Jens Lundgren, Alex Laursen, Niels Obel, Olav Larsen, Gitte Kronborg, Ann-Brit Eg Hansen
Antiviral behandling af hiv smittede personer,
Fertilitetsbehandling ved HIV og hepatitis B og C,
HIV behandling af gravide,
HIV post exposure profylakse (PEP),
Pre-exposure profylakse mod HIV (PrEP),
Borrelia:
Anne-Mette Lebech, Sigurdur Skarphedinsson
…
…r 2021
Gastroenterologiske infektioner og kronisk hepatitis:
Dato for næste kursus
Efterår 2023:
Sted
Hvidovre Hospital
Delkursusledelse
Lone Mygind, Micha Jepsen og Belinda Mössner
Tidligere kurser
3. og 4. december 2020
HIV-infektion:
Næste kursus
Efterår 2025 (2 dage):
Sted
Afventer
Delkursusledelse
Ole Schmeltz Søgaard og Lene Ryom Nielsen
Program
Afventer
Tidligere kurser
12. og 13. oktober 2022
7. og 8. oktober 2019
3. og 4. oktober 2016
…
…me og biologisk terrorisme. Specialet er karakteriseret ved et sygdomspanorama hvor sygdommenes prævalens såvel som incidens ændres hurtigt på lokalt og globalt plan. Over de seneste tyve år har specialet udviklet sig til at håndtere behandlingen af HIV og AIDS. I de seneste år er nye alvorlige infektionssygdomme som SARS, fugleinfluenza, West Nile virus, Hanta virus, Nipah virus, og Hendra virus tilkommet. Alvorlige sygdomme som hæmoragisk viral feber forårsaget af Ebola, Lassa, Dengue, Crimean-Co…
…iklen summerer på en rimelig afbalanceret måde den globale kontrovers, som 2013 var præget af, om hvorvidt ART skal benyttes som forebyggende middel, som led i en individuel-baseret eller en folkesundsbaseret strategi for at reducere smittespredning af HIV. De udfordringer som den vestlige verden, trods udbredt og gratis behandlingstilbud, har med at få styr på smittespredning blandt fx mænd-der-har-sex-med-mænd viser, at det - der intuitivt synes ligefor - ikke nødvendigvis virker når det kommer t…
Professor Henrik Nielsen kommenterer: Trods indiskutable fremskridt i den farmakologiske behandling af HIV/AIDS er der fortsat områder med plads til forbedring.
Blandt patienter i kronisk behandling er HAND (HIV-associated neurocognitive disorder) et af disse eksempler. Det har været debatteret om forskelle i antiretrovirale lægemidlers penetrans over blod/hjerne barrieren har betydning for HAND og for AIDS-definerende opportunistisk infektion i hjernen.
Der er ingen tvivl om at koncentr…
Professor Jens Lundgren kommenterer: I 2014 var verden optaget af Ebola udbruddet i Vest Afrika – et udbrud der blev erkendt hurtigt (om end den internationale assistance lod vente på sig).
Vedlagte artikel belyser detaljeret hvorledes HIV pandemien startede i 1920’erne og hvor det jo som bekendt tog over 60 år af finde ud at der overhovedet var et problem.
Synes artiklen er godt skrevet og giver et indblik i Afrika for 90 års siden og de ingredienser der skulle til for at ud…
Professor Lars Østergaard kommenterer: Jeg vil gerne anbefale vedlagte artikel som julemånedslæsning. Grundene er som følger: 1) Det vises for første gang, at et medikament kan reaktivere latent HIV-virus under samtidig HAART-behandling i en grad, så virus kan påvises i perifert blod. 2) Der er (omend videnskaligt svage) indicier på, at HIV-reservoir kan reduceres hos nogle patienter, og at effekten af det innate immunforsvar er af betydning herfor. 3) Det er den første originalartikel trykt i den …
Professor Jens Lundgren kommenterer: I 2015 nåede WHO sit mål om at få 15 million på behandling. START studiet afklarede også at alle HIV+ personer har gavn af at starte på HIV behandling. Der er fortsat mere end 20 millioner der endnu ikke er startet. Hovedparten bor i ressource svage lande hvor adgang til monitorering af HIV mængden er begrænset og behandlingsskift pga behandlingssvigt er derfor primært drevet af klinik og CD4 tals måling. Omkostning ifm nyttevirkning er central i at forbedre be…
… dolutegravir, især når det kombineres med TAF fremfor tenofovir DF, forårsager markant vægtøgning. Især hos kvinder med mørk hudfarve. Artiklen gør indtryk af en række grunde:. Da dolutegravir blev markedsført havde det profilen som det eneste HIV præparat uden bivirkninger. Læring: der er ingen medicinske præparater der ikke har nogle bivirkninger, og typen af bivirkninger kan ikke altid forudsiges udfra markedsføringsstudier (fase I-III). Dette faktum er universelt og set for praktisk tage…
Professor Jens Lundgren kommenterer: Første lægemiddel mod SARS-CoV-2 udviklet fra ”bunden” – bruger et gammel trick fra HIV medicinen (ritonavir) for at holde plasma koncentrationerne oppe. Læringen er, at det tager tid at lave nye lægemidler helt fra bunden, men det er noget nær en verdensrekord så hurtigt som det skete under pandemien – både hvad angår vacciner (hvor det tog < 1 år fra design ex vivo til markedsføring), men altså ca 2 år for lægemidler som dette.
Kalender [83]
23. juli, Brisbane, Australien og virtuelt
10. maj, Avignon, Frankrig
27. januar, Karen Brahe auditoriet, Odense Adelige Jomfrukloster (og online)
14. december 2022, Statens Institut for Folkesundhed og online
23. oktober 2022, Glasgow, Skotland
20. oktober 2022, Washington DC, USA
12. oktober 2022, Hvidovre Hospital
28. september 2022, Stockholm, Sverige
22. september 2022, Barcelona, Spanien
10. juni 2022, Panum, København
17. maj 2022, Niels K. Jerne auditoriet, Panum Instituttet, København
10. maj 2022, Avignon, Frankrig
6. december 2021, Rigshospitalet
26. november 2021, Panum, København
30. september 2021, Barcelona, Spanien
18. juli 2021, Berlin, Tyskland
28. oktober 2020, Paris, Frankrig
25. oktober 2020, Glasgow, Skotland
28. august 2020, Online og Henrik Dam auditoriet, Maersk Tårnet
10. marts 2020, KolleKolle, Værløse
7. oktober 2019, København
11. september 2019, DGI-byen, København
21. juli 2019, Mexico City, Mexico
22. maj 2019, Rom, Italien
13. maj 2019, København, Odense, Aarhus
6. marts 2019, KolleKolle, Værløse
2. november 2018, Mærsk Tower, København
28. oktober 2018, Glasgow, Skotland
30. maj 2018, Rom, Italien
16. maj 2018, Marseille, Frankrig
4. maj 2018, Hindsgavl, Middelfart
28. februar 2018, Nielsine Nielsen Auditorium, Mærsk Tårnet, København
23. februar 2018, Syddansk Universitet, Odense
1. februar 2018, Nielsine Nielsen auditoriet, Mærsk Tårnet, København
6. oktober 2017, Holst Auditoriet, Mærsk tårnet, København
8. juni 2017, Hvidovre Hospital
4. maj 2017, Odense Universitetshospital
18. april 2017, Auditorium 93, Rigshospitalet
23. oktober 2016, Glasgow, Skotland
3. oktober 2016, Hvidovre Hospital
18. september 2016, Brisbane, Australien
25. maj 2016, Rom, Italien
29. april 2016, Hindsgavl, Middelfart
7. januar 2016, Medicinsk Museion, København
18. december 2015, Emil Aarestrup auditorium, Odense Universitetshospital
24. november 2015, Hvidovre Universitetshospital
8. september 2015, Panum Instituttet, København
18. juni 2015, Rigshospitalet, Teilum B
12. juni 2015, Medicinsk Museion, København
3. juni 2015, Barcelona, Spanien
24. april 2015, Auditorium 93, Rigshospitalet
17. april 2015, Foredragssalen, Statens Serum Institut
19. marts 2015, Auditorium 1, Rigshospitalet
2. november 2014, Glasgow, Skotland
5. oktober 2014, Barcelona, Spanien
5. juli 2014, Sigtuna, Sverige
18. juni 2014, Store Auditorium, Winsløwparken 15, st., 5000 Odense C
22. april 2014, Auditorium 5, Hvidovre Hospital
26. marts 2014, Barcelona, Spanien
20. februar 2014, Rigshospitalet
25. oktober 2013, Hannover auditoriet, Panum Instituttet, København
30. juni 2013, Kuala Lumpur, Malaysia
10. juni 2013, Centre for Medical Parasitology, København
3. maj 2013, Hindsgavl, Fyn
20. marts 2013, Rom, Italien
3. marts 2013, Atlanta, Georgia, USA
14. januar 2013, Auditorium 2, Rigshospitalet
10. november 2012, Auditorium 2, Rigshospitalet
25. oktober 2012, Danmarks Medie- og Journalisthøjskole
23. oktober 2012, Rigshospitalet
2. oktober 2013, San Francisco, USA
27. september 2012, Auditorium 1, Bartholinbygningen, bygning 1241, lokale 135, Aarhus Universitet
29. februar 2012, SSI, København
9. december 2011, Rigshospitalet, københavn
7. november 2011, Auditorium 93, Rigshospitalet
13. maj 2011, Panum instituttet, København
29. april 2011, Auditorium B, Skejby
12. april 2011, Auditorium 100, Campusvej 55, 5230 Odense M, Syddansk Universitet
30. november 2007, Panum Instituttet, København
Nyt fra tidsskrifterne [+20]
Der er mere end 20 resultater, måske du vil se
flere resultater her?
Journal of Medical Virology
27.01.2023
Journal of Medical Virology, Accepted Article.
Journal of Acquired Immune Deficiency Syndromes
27.01.2023
Background: . Early antiretroviral therapy (ART) during infancy reduces cognitive impairment due to HIV, but the extent of benefit is unclear. Setting: . Children were recruited from hospital and health centers providing HIV care and treatment in Nairobi, Kenya. Methods: . Cognitive, behavioral and motor outcomes were assessed in children with HIV (CWHIV) and early-ART (
PLoS One Infectious Diseases
26.01.2023
by The PLOS ONE Staff .
Clinical Infectious Diseases
25.01.2023
An error appeared in the 15 August 2022 issue of the journal (Person et al. “Principles for Ending Human Immunodeficiency Virus as an Epidemic in the United States: A Policy Paper of the Infectious Diseases Society of America and the
HIV Medical Association.” Clin Infect Dis; 76(1): 1-9.
doi.org/10.1093/cid/ciac626). In the title for this IDSA Feature, the “
HIV Medical Association” should be replaced with the “
HIV Medicine Association.”
New England Journal of Medicine
25.01.2023
New England Journal of Medicine, Volume 388, Issue 4, Page 344-356, January 2023.
BMC Infectious Diseases
25.01.2023
. Abstract. . Background and aims. Liver-associated complications still frequently lead to mortality in people with HIV (PWH), even though combined antiretroviral treatment (cART) has significantly improved overall survival. The quantification of circulating collagen fragments released during collagen formation and degradation correlate with the turnover of extracellular matrix (ECM) in liver disease. Here, we analysed the l…
BMC Infectious Diseases
24.01.2023
International Journal of Infectious Diseases
24.01.2023
This study aimed to investigate the factors associated with maintenance of viral suppression after antiretroviral therapy (ART) discontinuation.
Clinical Infectious Diseases
23.01.2023
AbstractBackgroundPeople with HIV (PWH) have increased cardiovascular risk. Higher leukocyte count has been associated with coronary artery disease (CAD) events in the general population. It is unknown whether the leukocyte-CAD association also applies to PWH.MethodsIn a case-control study nested within the Swiss HIV Cohort Study, we obtained uni- and multivariable odds ratios (OR) for CAD events, based on traditional and HIV-related CAD risk factors, leukocyte count, and confounders previously associated w…
PLoS One Infectious Diseases
23.01.2023
… with high rates of adverse birth outcomes, including preterm birth and low birthweight. Studies suggest that progesterone and prolactin may play important intermediary roles. Methods We analyzed data from the Antenatal Component of the PROMISE trial, a multi-center study of pregnant women taking antiretroviral regimens (lopinavir/ritonavir-containing ART or zidovudine alone) to prevent mother-to-child HIV transmission. In a nested case-control study, we compared data from women who gave birth to preterm (
BMC Infectious Diseases
22.01.2023
. Abstract. . Background. Research on the immune response to inactivated COVID-19 vaccination among people living with HIV (PLWH) is limited, especially among those with low CD4+ T lymphocyte (CD4 cell) count. This prospective cohort study aimed to assess the humoral immune response to inactivated COVID-19 vaccination among PLWH compared to HIV negative controls (HNCs) and to determine the impact of CD4 cell count on vacci…
BMC Infectious Diseases
21.01.2023
. Abstract. . Background. Acute and early HIV (AEH) infection is characterized by a high viral load and infectivity. Approximately 50% of cases of HIV-1 transmission occur during AEH. Understanding sexual behaviour trajectories would be useful for predicting changes in the risk of HIV acquisition. However, few studies have investigated sexual behaviour trajectories and their association with AEH acquisition. This study ident…
AIDS
21.01.2023
Objectives: . HIV affects 36 million people globally with prevalence decreasing due to antiretroviral therapy (ART) and social awareness; transmission occurs during substance use. Cocaine usage independently affects brain activity and may result in reduced ART adherence. This study evaluates brain glucose metabolism measured by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in cocaine users with HIV infection. Design: . Sixty-three subjects were categorized into gro…
AIDS
21.01.2023
Objective: . People living with HIV (PLWH) have a higher risk of type 2 diabetes (T2D) than HIV negative individuals. In the general population, diabetes risk scores are used to identify persons at risk of developing T2D, but little is known regarding their performance in PLWH. Design: . Assessment of the capacity of five diabetes risk scores to predict T2D in PLWH. Methods: . Prospective study including all Swiss HIV cohort study (SHCS) participants followed between 2009 and 2019. Five diabetes risk scores…
AIDS
21.01.2023
Objective: . To infer the timing of HIV acquisition in relation to self-reported events in the sexual life course of adolescent girls and young women (AGYW) who self-identify as female sex workers (FSW) in Mombasa, Kenya. Design: . Next-generation viral sequencing of samples of AGYW living with HIV in the Transitions study, a cross-sectional bio-behavioural survey of AGYW aged 14–24 years in Mombasa, Kenya. Method: . Dried blood spot (DBS) specimens were collected from study participants (n = 37, al…
AIDS
21.01.2023
Objectives: . We sought to better understand factors associated with ovarian aging in women living with HIV (WLWH). Design: . HIV has been associated with diminished fertility, younger age at menopause, and shorter leukocyte telomere length (LTL), a marker of cellular aging. We herein examine cross-sectional and longitudinal associations between LTL, Anti-Mullerian hormone (AMH), and HIV. Methods: . We included WLWH and HIV-negative women 12–50 years of age in the CARMA cohort with ≥1 study visit(s). …
AIDS
21.01.2023
Objective: . This study describes adverse events following immunization (AEFIs) and the development of SARS-COV-2 antibodies after Sputnik V, AstraZeneca, and Sinopharm COVID-19 vaccination in PWH. Methods: . N = 595 adult PWH at an HIV center in Argentina from March-December 2021 were enrolled. Analysis included participants who received COVID-19 vaccination with Sputnik V, AstraZeneca, and Sinopharm, and did not receive mRNA COVID-19 vaccines. Clinical data, and local or systemic AEFI variables were c…
AIDS
21.01.2023
Objective: . People living with HIV (PLWHIV) are increasingly experiencing non-communicable complications, including renal impairment, which are associated with worse clinical outcomes. Limited information exists surrounding renal impairment in paediatric PLWHIV, of which the majority live in sub-Saharan Africa, and further information is required to guide clinical practice. This study describes the prevalence of new or worsening renal impairment in adolescents commencing antiretroviral therapy (ART) in Zim…
Tropical Medicine & International Health
20.01.2023
Tropical Medicine &International Health, Accepted Article.
Clinical Infectious Diseases
20.01.2023
AbstractBackgroundCabotegravir (CAB) + rilpivirine (RPV) dosed intramuscularly monthly or every 2 months is a complete long-acting (LA) regimen for the maintenance of HIV-1 virologic suppression. Here, we report the ATLAS-2M study Week 152 results.MethodsATLAS-2M is a Phase 3b, randomized, multicenter study assessing the efficacy and safety of CAB+RPV LA every 8 weeks (Q8W) vs. every 4 weeks (Q4W). Virologically suppressed (HIV-1 RNA <50 copies/mL) individuals were randomized to receive CAB+RPV LA Q8W or…
Aktuelle smitsomme sygdomme [+20]
Der er mere end 20 resultater, måske du vil se
flere resultater her?
Morbidity and Mortality Weekly Report (MMWR)
27.01.2023
This report describes an increase in people with HIV infection receiving PEPFAR-supported antiretroviral therapy in Uganda.
Medscape Infectious Diseases
20.01.2023
"It's obviously disappointing," Anthony Fauci, MD, told MSNBC, noting that other areas of HIV treatment research are promising. "I don't think that people should give up on the field of the HIV vaccine." . WebMD Health News
Statens Serum Institut
13.01.2023
De nyeste tal fra Statens Serum Institut viser, at der ikke blev fundet nogen hiv-positive bloddonorer i bloddonorscreeningen i 2019 og kun ganske få tilfælde af hepatitis B og C.
Medscape Infectious Diseases
22.12.2022
Cases of late HIV might be averted if multi-prong strategies are implemented, including redefining the category for better monitoring. . Medscape Medical News
Medscape Infectious Diseases
20.12.2022
An epidemiologist and advocates say state and local officials in West Virginia, home to one of the worst HIV outbreaks in recent years, have taken measures that render syringe exchange less accessible. . Kaiser Health News
Medscape Infectious Diseases
15.12.2022
Revised draft preexposure prophylaxis recommendations highlight the need for HIV prevention in all at-risk persons while insurers consider pricing tiers. . Medscape Medical News
Medscape Infectious Diseases
6.12.2022
'At the most general level, the trial results show that one can design vaccines that induce antibodies with pre-specified genetic features, and this may herald a new era of precision vaccines.' . WebMD Health News
Statens Serum Institut
2.12.2022
I Danmark fortsætter den positive udvikling med færre nye hiv-diagnoser. Det gælder især blandt mænd der har sex med mænd (MSM), som er den gruppe, der er mest ramt af hiv. Det viser årsopgørelsen for HIV i 2021 fra Statens Serum Institut.
Morbidity and Mortality Weekly Report (MMWR)
2.12.2022
This report describes HIV services and outcomes during the COVID-19 pandemic in the United States.
Eurosurveillance latest updates
1.12.2022
. Background. Adequate identification and testing of people at risk for HIV is fundamental for the HIV care continuum. A key strategy to improve timely testing is HIV indicator condition (IC) guided testing. Aim. To evaluate the uptake of HIV testing recommendations in HIV IC-specific guidelines in European countries. Methods. Between 2019 and 2021, European HIV experts reviewed guideline databases to identify all national guidelines of 62 HIV ICs. The proportion of HIV IC guidelines recommending HIV testin…
Eurosurveillance latest updates
1.12.2022
HIV testing was offered to 2,185 people receiving mpox (formerly monkeypox) vaccination, who reported not being HIV positive. Among them 390 were current PrEP users, and 131 had taken PrEP in the past. Of 958 individuals consenting testing, six were newly diagnosed with HIV. Two patients had symptomatic primary HIV infection. None of the six patients had ever taken PrEP. Mpox vaccination represents an important opportunity for HIV testing and counselling about risk reduction and PrEP.
Medscape Infectious Diseases
24.11.2022
People living with HIV were more likely to seek vaccine information from reputable sources and be compliant with recommendations, a new survey reveals. . Medscape Medical News
Morbidity and Mortality Weekly Report (MMWR)
13.10.2022
This report describes HIV stigma and health care discrimination of Hispanic or Latino people with HIV in the United States.
Medscape Infectious Diseases
7.10.2022
"When novel public health emergencies arise, extant ones cannot go by the wayside." .
Medscape Infectious Diseases
6.10.2022
Pregnant women living with HIV have a higher prevalence of HPV infection than do pregnant women without HIV, researchers in Canada and Denmark report in an analysis with public health implications. .
Medscape Infectious Diseases
6.10.2022
Fueled by significant advances in treatment and prevention as well as an exciting pipeline, the global treatment and prevention HIV drugs market is expected to quickly reverse pandemic-related supply chain challenges. .
Medscape Infectious Diseases
3.10.2022
Italian researchers say the HPV vaccine is needed in young MSM with gonorrhea exposure. The WHO says only 30% of the target population worldwide has received the HPV vaccine. .
Morbidity and Mortality Weekly Report (MMWR)
22.09.2022
This report describes HIV molecular clusters of rapid transmission among gay, bisexual, and other men you have sex with men.
Medscape Infectious Diseases
21.09.2022
In people with HIV, coinfection with hepatitis C is linked to an 85% greater risk of myocardial infarction with every decade, in a new analysis. .
Medscape Infectious Diseases
13.09.2022
A new review of studies of cardiovascular imaging in individuals with HIV shows a large variation in findings, making conclusions difficult, but there are suggestions that myocardial fibrosis may play a role. .