Based on the evidence from epidemiologic, animal, and in vitro data and human clinical trials, it is evident that lycopene, a non-provitamin A carotenoid, is a promising agent for prostate cancer chemoprevention. It is also clear that the form of lycopene used (purified versus food sources), dose of lycopene and concomitant use with other carotenoids and antioxidants, duration of exposure, specific target populations, and stage of disease appear to play a major role in determining agonistic or antagonistic effects. Based on our review, there is enough evidence to warrant use of lycopene in phase I and II clinical trials to examine its safety and efficacy as a potential chemopreventive agent for prostate cancer. The objective of this article is to review this evidence from epidemiologic, animal, in vitro, and clinical trials and provide the need and rationale to examine further the role of lycopene for prostate cancer prevention.
{"title":"Lycopene in the prevention of prostate cancer.","authors":"Karen Dahan, Mildred Fennal, Nagi B Kumar","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Based on the evidence from epidemiologic, animal, and in vitro data and human clinical trials, it is evident that lycopene, a non-provitamin A carotenoid, is a promising agent for prostate cancer chemoprevention. It is also clear that the form of lycopene used (purified versus food sources), dose of lycopene and concomitant use with other carotenoids and antioxidants, duration of exposure, specific target populations, and stage of disease appear to play a major role in determining agonistic or antagonistic effects. Based on our review, there is enough evidence to warrant use of lycopene in phase I and II clinical trials to examine its safety and efficacy as a potential chemopreventive agent for prostate cancer. The objective of this article is to review this evidence from epidemiologic, animal, in vitro, and clinical trials and provide the need and rationale to examine further the role of lycopene for prostate cancer prevention.</p>","PeriodicalId":87409,"journal":{"name":"Journal of the Society for Integrative Oncology","volume":"6 1","pages":"29-36"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27288719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Suzanne C Danhauer, Janet A Tooze, Paige Holder, Christina Miller, Michelle T Jesse
Background: Goals were to determine the feasibility of conducting a study of Healing Touch (HT) for acute leukemia patients and to obtain preliminary data on its effectiveness.
Methods: Forty hospitalized leukemia patients completed a brief survey of HT knowledge/experience. A prospective cohort (N = 12) was invited to participate in an HT intervention (9 30-minute sessions over 3 weeks); they completed measures of distress, symptoms, and sleep (at weeks 1 and 5), and completed single item ratings of fatigue, nausea, distress, and pain immediately pre-post selected HT sessions. The Wilcoxon signed rank test was used to analyze change in pre-post session ratings and distress, symptom, and sleep measures.
Results: Among survey respondents, 8% had used HT in the past, and 71% were interested in using HT. In the prospective cohort, there were significant pre-post session improvements in fatigue and nausea (but not in distress and pain). There were no significant changes between weeks 1 and 5 in distress, symptoms, or sleep. Ratings and qualitative feedback on HT were positive, focused mainly on feeling relaxed following HT sessions.
Conclusions: It is feasible to recruit patients hospitalized for acute leukemia to a study of HT. Preliminary data on short-term improvements in symptoms indicate these are promising outcomes for future study.
{"title":"Healing touch as a supportive intervention for adult acute leukemia patients: a pilot investigation of effects on distress and symptoms.","authors":"Suzanne C Danhauer, Janet A Tooze, Paige Holder, Christina Miller, Michelle T Jesse","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Goals were to determine the feasibility of conducting a study of Healing Touch (HT) for acute leukemia patients and to obtain preliminary data on its effectiveness.</p><p><strong>Methods: </strong>Forty hospitalized leukemia patients completed a brief survey of HT knowledge/experience. A prospective cohort (N = 12) was invited to participate in an HT intervention (9 30-minute sessions over 3 weeks); they completed measures of distress, symptoms, and sleep (at weeks 1 and 5), and completed single item ratings of fatigue, nausea, distress, and pain immediately pre-post selected HT sessions. The Wilcoxon signed rank test was used to analyze change in pre-post session ratings and distress, symptom, and sleep measures.</p><p><strong>Results: </strong>Among survey respondents, 8% had used HT in the past, and 71% were interested in using HT. In the prospective cohort, there were significant pre-post session improvements in fatigue and nausea (but not in distress and pain). There were no significant changes between weeks 1 and 5 in distress, symptoms, or sleep. Ratings and qualitative feedback on HT were positive, focused mainly on feeling relaxed following HT sessions.</p><p><strong>Conclusions: </strong>It is feasible to recruit patients hospitalized for acute leukemia to a study of HT. Preliminary data on short-term improvements in symptoms indicate these are promising outcomes for future study.</p>","PeriodicalId":87409,"journal":{"name":"Journal of the Society for Integrative Oncology","volume":"6 3","pages":"89-97"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3891375/pdf/nihms529226.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27904840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Integrative medicine is becoming an increasingly popular and visible component in oncology care. Thus, the question arises: How can clinicians facilitate, encourage, and integrate the use of complementary and integrative medicines (CIMs) in patients with cancer? The integrative medicine consultation is not easy and involves much more than simply providing reliable information about the proper use of CIM therapies to alleviate symptoms. Some key factors are necessary to allow for a successful consultation for patients and their families and caregivers: physicians must have extensive knowledge of CIM and of cancer care; they must use a sensitive approach in communication with the patient that relies on effective communication skills and experience in listening; and they must have the ability to convey empathy and compassion.
{"title":"Clinical consultation, a personal perspective: components of a successful integrative medicine clinical consultation.","authors":"Moshe Frenkel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Integrative medicine is becoming an increasingly popular and visible component in oncology care. Thus, the question arises: How can clinicians facilitate, encourage, and integrate the use of complementary and integrative medicines (CIMs) in patients with cancer? The integrative medicine consultation is not easy and involves much more than simply providing reliable information about the proper use of CIM therapies to alleviate symptoms. Some key factors are necessary to allow for a successful consultation for patients and their families and caregivers: physicians must have extensive knowledge of CIM and of cancer care; they must use a sensitive approach in communication with the patient that relies on effective communication skills and experience in listening; and they must have the ability to convey empathy and compassion.</p>","PeriodicalId":87409,"journal":{"name":"Journal of the Society for Integrative Oncology","volume":"6 3","pages":"129-33"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27904218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Standish, E. Sweet, J. Novack, C. A. Wenner, C. Bridge, A. Nelson, M. Martzen, C. Torkelson
This article reviews the evidence that the functioning of both the innate and the adaptive immune system plays a role in preventing relapse in women with breast cancer. Lymphocytes, including T cells, T regulatory cells, and natural killer cells, and their cytokine release patterns are implicated in both primary prevention and recurrence of breast cancer. Cancer prognosis may be related to immune system functional status. The hypothesis that the immune system has a causal role in breast cancer etiology is supported by epidemiologic, preclinical, and clinical research. Empirical support for the concept that immune status and immunomodulatory therapy have important roles in comprehensive breast cancer treatment is provided.
{"title":"Breast cancer and the immune system.","authors":"L. Standish, E. Sweet, J. Novack, C. A. Wenner, C. Bridge, A. Nelson, M. Martzen, C. Torkelson","doi":"10.2310/7200.2008.0027","DOIUrl":"https://doi.org/10.2310/7200.2008.0027","url":null,"abstract":"This article reviews the evidence that the functioning of both the innate and the adaptive immune system plays a role in preventing relapse in women with breast cancer. Lymphocytes, including T cells, T regulatory cells, and natural killer cells, and their cytokine release patterns are implicated in both primary prevention and recurrence of breast cancer. Cancer prognosis may be related to immune system functional status. The hypothesis that the immune system has a causal role in breast cancer etiology is supported by epidemiologic, preclinical, and clinical research. Empirical support for the concept that immune status and immunomodulatory therapy have important roles in comprehensive breast cancer treatment is provided.","PeriodicalId":87409,"journal":{"name":"Journal of the Society for Integrative Oncology","volume":"6 4 1","pages":"158-68"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2310/7200.2008.0027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68604807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Shiitake Mushroom (Lentinula edodes).","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":87409,"journal":{"name":"Journal of the Society for Integrative Oncology","volume":"6 3","pages":"134-5"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27904219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Janet S. de Moor, L. Moye, M. Low, E. Rivera, S. Singletary, R. Fouladi, L. Cohen
This study evaluated whether expressive writing (EW) was an effective stress management intervention for breast cancer patients. Women were recruited at the end of neoadjuvant chemotherapy and assigned to write about their cancer experience (EW group; n = 24) or neutral topics (neutral writing [NW] group; n = 25). Women were asked to write for 20 minutes a day for a total of four writing sessions that were completed over a 7-day period. Participants were reassessed approximately 3 days before and 2 weeks after surgery. The intervention did not significantly decrease women's distress, perceived stress, sleep disturbance, or pain. There was some evidence that the EW group used more sleep medication at the presurgical assessment than the NW group. Social constraints moderated the effect of the intervention. Among women with high social constraints, the EW group reported lower average daily pain than the NW group. Among women with low social constraints, the EW group reported higher average daily pain than the NW group. EW was not broadly effective as a stress management intervention for women with breast cancer. These data do not support the use of EW as a presurgical mind-body complementary medicine program for this population.
{"title":"Expressive writing as a presurgical stress management intervention for breast cancer patients.","authors":"Janet S. de Moor, L. Moye, M. Low, E. Rivera, S. Singletary, R. Fouladi, L. Cohen","doi":"10.2310/7200.2008.0010","DOIUrl":"https://doi.org/10.2310/7200.2008.0010","url":null,"abstract":"This study evaluated whether expressive writing (EW) was an effective stress management intervention for breast cancer patients. Women were recruited at the end of neoadjuvant chemotherapy and assigned to write about their cancer experience (EW group; n = 24) or neutral topics (neutral writing [NW] group; n = 25). Women were asked to write for 20 minutes a day for a total of four writing sessions that were completed over a 7-day period. Participants were reassessed approximately 3 days before and 2 weeks after surgery. The intervention did not significantly decrease women's distress, perceived stress, sleep disturbance, or pain. There was some evidence that the EW group used more sleep medication at the presurgical assessment than the NW group. Social constraints moderated the effect of the intervention. Among women with high social constraints, the EW group reported lower average daily pain than the NW group. Among women with low social constraints, the EW group reported higher average daily pain than the NW group. EW was not broadly effective as a stress management intervention for women with breast cancer. These data do not support the use of EW as a presurgical mind-body complementary medicine program for this population.","PeriodicalId":87409,"journal":{"name":"Journal of the Society for Integrative Oncology","volume":"6 2 1","pages":"59-66"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2310/7200.2008.0010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68604544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leanna J Standish, Cynthia A Wenner, Erin S Sweet, Carly Bridge, Ana Nelson, Mark Martzen, Jeffrey Novack, Carolyn Torkelson
Data from multiple epidemiologic and clinical studies on immune effects of conventional cancer treatment and the clinical benefits of polysaccharide immune therapy suggest that immune function has a role in breast cancer prevention. Immune therapy utilizing the polysaccharide constituents of Trametes versicolor (Tv) as concurrent adjuvant cancer therapy may be warranted as part of a comprehensive cancer treatment and secondary prevention strategy.
{"title":"Trametes versicolor mushroom immune therapy in breast cancer.","authors":"Leanna J Standish, Cynthia A Wenner, Erin S Sweet, Carly Bridge, Ana Nelson, Mark Martzen, Jeffrey Novack, Carolyn Torkelson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Data from multiple epidemiologic and clinical studies on immune effects of conventional cancer treatment and the clinical benefits of polysaccharide immune therapy suggest that immune function has a role in breast cancer prevention. Immune therapy utilizing the polysaccharide constituents of Trametes versicolor (Tv) as concurrent adjuvant cancer therapy may be warranted as part of a comprehensive cancer treatment and secondary prevention strategy.</p>","PeriodicalId":87409,"journal":{"name":"Journal of the Society for Integrative Oncology","volume":"6 3","pages":"122-8"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2845472/pdf/nihms157798.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27904220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Serenoa repens (Saw Palmetto).","authors":"Angela Donato","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":87409,"journal":{"name":"Journal of the Society for Integrative Oncology","volume":"6 1","pages":"41-2"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27288721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Freeman, L. Cohen, M. Stewart, Rebecca White, Judith Link, J. Palmer, D. Welton
In a phase I National Cancer Institute (NCI)-funded clinical trial, 34 breast cancer survivors, six weeks to one year post-treatment, were recruited to participate in a 6-class, 8-week long imagery stress reduction program entitled "Envision the Rhythms of Life." Patients practiced imagery during and between sessions. Outcomes for quality of life and cortisol rhythm were assessed pre- to post-intervention, in two subsets of survivors (intravenous [IV] chemotherapy, or no IV chemotherapy). Thirty survivors completed the 8-week program. Quality of life outcomes demonstrated statistically and clinically significant outcomes for the functional assessment of cancer therapy-general (FACT-G) global index (p<.001), representing improvements in survivor quality of life related to physical, social/family, emotional, and function well-being. Survivors also improved significantly on the breast cancer (p<.001) and spiritual subscales (p = .008.) Brief symptom inventory (BSI) assessment reported significant improvement for the global index (p<.001) which included the categories of depression, somatization and anxiety. At eight weeks, cortisol rhythm, a biochemical indicator of stress and likelihood of cancer recurrence, produced a trend toward improvement for the fifth time point of the day (p = .18). Likert-based stress scales showed highly significant reductions in stress (p<.0001) with subjects practicing imagery the most producing the best scores. Outcomes suggest the imagery program may significantly improve survivor quality of life and reduce stress.
{"title":"Imagery intervention for recovering breast cancer patients: clinical trial of safety and efficacy.","authors":"L. Freeman, L. Cohen, M. Stewart, Rebecca White, Judith Link, J. Palmer, D. Welton","doi":"10.2310/7200.2008.0011","DOIUrl":"https://doi.org/10.2310/7200.2008.0011","url":null,"abstract":"In a phase I National Cancer Institute (NCI)-funded clinical trial, 34 breast cancer survivors, six weeks to one year post-treatment, were recruited to participate in a 6-class, 8-week long imagery stress reduction program entitled \"Envision the Rhythms of Life.\" Patients practiced imagery during and between sessions. Outcomes for quality of life and cortisol rhythm were assessed pre- to post-intervention, in two subsets of survivors (intravenous [IV] chemotherapy, or no IV chemotherapy). Thirty survivors completed the 8-week program. Quality of life outcomes demonstrated statistically and clinically significant outcomes for the functional assessment of cancer therapy-general (FACT-G) global index (p<.001), representing improvements in survivor quality of life related to physical, social/family, emotional, and function well-being. Survivors also improved significantly on the breast cancer (p<.001) and spiritual subscales (p = .008.) Brief symptom inventory (BSI) assessment reported significant improvement for the global index (p<.001) which included the categories of depression, somatization and anxiety. At eight weeks, cortisol rhythm, a biochemical indicator of stress and likelihood of cancer recurrence, produced a trend toward improvement for the fifth time point of the day (p = .18). Likert-based stress scales showed highly significant reductions in stress (p<.0001) with subjects practicing imagery the most producing the best scores. Outcomes suggest the imagery program may significantly improve survivor quality of life and reduce stress.","PeriodicalId":87409,"journal":{"name":"Journal of the Society for Integrative Oncology","volume":"6 2 1","pages":"67-75"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2310/7200.2008.0011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68604716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Danhauer, J. Tooze, P. Holder, C. Miller, M. Jesse
BACKGROUND Goals were to determine the feasibility of conducting a study of Healing Touch (HT) for acute leukemia patients and to obtain preliminary data on its effectiveness. METHODS Forty hospitalized leukemia patients completed a brief survey of HT knowledge/experience. A prospective cohort (N = 12) was invited to participate in an HT intervention (9 30-minute sessions over 3 weeks); they completed measures of distress, symptoms, and sleep (at weeks 1 and 5), and completed single item ratings of fatigue, nausea, distress, and pain immediately pre-post selected HT sessions. The Wilcoxon signed rank test was used to analyze change in pre-post session ratings and distress, symptom, and sleep measures. RESULTS Among survey respondents, 8% had used HT in the past, and 71% were interested in using HT. In the prospective cohort, there were significant pre-post session improvements in fatigue and nausea (but not in distress and pain). There were no significant changes between weeks 1 and 5 in distress, symptoms, or sleep. Ratings and qualitative feedback on HT were positive, focused mainly on feeling relaxed following HT sessions. CONCLUSIONS It is feasible to recruit patients hospitalized for acute leukemia to a study of HT. Preliminary data on short-term improvements in symptoms indicate these are promising outcomes for future study.
{"title":"Healing touch as a supportive intervention for adult acute leukemia patients: a pilot investigation of effects on distress and symptoms.","authors":"S. Danhauer, J. Tooze, P. Holder, C. Miller, M. Jesse","doi":"10.2310/7200.2008.0012","DOIUrl":"https://doi.org/10.2310/7200.2008.0012","url":null,"abstract":"BACKGROUND Goals were to determine the feasibility of conducting a study of Healing Touch (HT) for acute leukemia patients and to obtain preliminary data on its effectiveness. METHODS Forty hospitalized leukemia patients completed a brief survey of HT knowledge/experience. A prospective cohort (N = 12) was invited to participate in an HT intervention (9 30-minute sessions over 3 weeks); they completed measures of distress, symptoms, and sleep (at weeks 1 and 5), and completed single item ratings of fatigue, nausea, distress, and pain immediately pre-post selected HT sessions. The Wilcoxon signed rank test was used to analyze change in pre-post session ratings and distress, symptom, and sleep measures. RESULTS Among survey respondents, 8% had used HT in the past, and 71% were interested in using HT. In the prospective cohort, there were significant pre-post session improvements in fatigue and nausea (but not in distress and pain). There were no significant changes between weeks 1 and 5 in distress, symptoms, or sleep. Ratings and qualitative feedback on HT were positive, focused mainly on feeling relaxed following HT sessions. CONCLUSIONS It is feasible to recruit patients hospitalized for acute leukemia to a study of HT. Preliminary data on short-term improvements in symptoms indicate these are promising outcomes for future study.","PeriodicalId":87409,"journal":{"name":"Journal of the Society for Integrative Oncology","volume":"6 3 1","pages":"89-97"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2310/7200.2008.0012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68604777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}