• Restenosis after carotid endarterectomy performed with routine intraoperative duplex ultrasonography and arterial patch closure: a contemporary series. (umassmed.edu)
  • Schanzer A, Hoel A, Owens CD, Wake N, Nguyen LL, Conte MS, Belkin M. Restenosis after carotid endarterectomy performed with routine intraoperative duplex ultrasonography and arterial patch closure: a contemporary series. (umassmed.edu)
  • Here we show that near-infrared autofluorescence is associated with the presence of intraplaque hemorrhage and heme degradation products, particularly bilirubin by using our recently created mouse model, which uniquely reflects plaque instability as seen in humans, and human carotid endarterectomy samples. (nature.com)
  • In patients with confirmed high-grade (70-99%) stenosis of the internal carotid artery , surgical carotid endarterectomy (CEA) is highly beneficial and has become the standard surgical treatment. (medscape.com)
  • The North American Symptomatic Carotid Endarterectomy Trial (NASCET) found that patients who underwent surgery within 2 weeks after the onset of neurologic deficits had better neurologic outcomes, with a 17% absolute reduction in the risk of ipsilateral stroke at 2 years. (medscape.com)
  • Traditionally, stroke risk stratification has centred on the degree of internal carotid artery stenosis, and the presence of focal neurological symptoms. (ox.ac.uk)
  • In addition to pre-operative risk stratification of carotid stenosis, contrast enhanced ultrasound (CEUS) may be employed in monitoring response to plaque-stabilising therapies. (ox.ac.uk)
  • We sought to determine differences with cardiovascular magnetic resonance (CMR) in the morphology and composition of the carotid arteries between individuals with angiographically-defined obstructive coronary artery disease (CAD, ≥ 50% stenosis, cases) and those with angiographically normal coronaries (no lumen irregularities, controls). (biomedcentral.com)
  • Similarly, the European Carotid Surgery Trial (ECST) found that on average, the immediate risk of surgery was less than the long-term risk of stroke without surgery when the stenosis was greater than about 80% diameter. (medscape.com)
  • [ 2 ] Several reports favor earlier carotid revascularization (≤ 7 d or even ≤ 48 h) for recently symptomatic stenosis, in view of their finding that there is no change in the safety profile of CEA done in the hyperacute period (≤ 48 h) as compared with CEA done at a later time (day 3-14). (medscape.com)
  • As mentioned above, CEA is indicated for symptomatic 70-99% carotid stenosis and is three times as effective as medical therapy alone in reducing the incidence of stroke. (medscape.com)
  • [ 4 ] In cases of moderate (50-69%) carotid stenosis, the benefit is less clear, and the patient's risk factors for stroke must be weighed against the risk of perioperative complications in deciding between operative and medical therapy. (medscape.com)
  • 50%) carotid stenosis do not benefit from surgical treatment. (medscape.com)
  • The MR Angiography (MRA) showed a proximal left internal carotid artery (ICA) occlusion, a tight stenosis on the distal right ICA, no signal in the right siphon and right MCA, while there was a weak signal in the left MCA (Figure 4 ). (hindawi.com)
  • 1 However, there is a subgroup of patients who develop severe stroke symptoms due to acute internal carotid artery occlusion eventually in combination with a thromboembolic obstruction of the central arteries, such as the terminal carotid segment or the middle cerebral artery, and subsequently incur a major risk of developing extensive MCA infarction with a poor outcome. (ajnr.org)
  • Carotid artery dissection begins as a tear in one of the carotid arteries of the neck, which allows blood under arterial pressure to enter the wall of the artery and split its layers. (medscape.com)
  • Once diagnosed and treated, patients with carotid artery dissection require regular follow-up and imaging studies of both carotid arteries. (medscape.com)
  • Arterial emboli occasionally detach from primary sites and travel via circulation to occlude secondary arteries, causing multiple ischemic sites. (wikipedia.org)
  • Thrombi can occlude veins (venous thrombosis) or arteries (arterial thrombosis). (wikipedia.org)
  • Peripheral arterial disease, specifically lower limb peripheral arterial disease, can be defined as atheromatous narrowing or occlusion of an artery or arteries in the lower limb. (intechopen.com)
  • Males with obstructive CAD compared to male controls had carotid bulbs and internal carotid arteries with smaller total vessel and lumen areas, and an increased prevalence of lipid-rich necrotic core. (biomedcentral.com)
  • Carotid CMR identifies distinct morphological and compositional differences in the carotid arteries between individuals with and without angiographically-defined obstructive CAD. (biomedcentral.com)
  • To assess the carotid and brachial arteries' intima-media thicknesses (IMTs) in cases with intermittent (obstructive sleep apnoea syndrome (OSAS)) and continuous (chronic obstructive pulmonary disease (COPD)) hypoxaemia together with other confounding demographic and biochemical factors. (uwi.edu)
  • Arterial blockages are caused by a waxy substance known as a plague that forms inside of the arteries. (brainfoggles.com)
  • The lower rigidity of the central arteries compared to the distal ones may indicate that the systolic arterial compliance function is concentrated in the central arterial segments. (revespcardiol.org)
  • Doppler study showed a high resistance to flow in both common carotid arteries and low bilateral MCA flow with low systolic and diastolic velocities. (hindawi.com)
  • The following parameters were recorded at baseline, after intravenous infusion of 500 mL of fluid load (colloid), 15 minutes and 150 minutes during LBPP application and 10 minutes after gravity suit deflation: right arm mobility, blood pressure, heart rate, systolic and diastolic velocities recorded on both MCAs and resistance index (RI) recorded on both common carotids arteries (CCAs). (hindawi.com)
  • These vessels run medially and anastomose with the medial palpebral arteries, forming an arterial circle. (medscape.com)
  • When the carotid arteries are involved, it can cause stroke - a cerebral vascular accident (CVA) - that can be ischemic or hemorrhagic 1 . (bvsalud.org)
  • A noninflammatory, progressive occlusion of the intracranial CAROTID ARTERIES and the formation of netlike collateral arteries arising from the CIRCLE OF WILLIS. (bvsalud.org)
  • Patients who develop severe stroke symptoms due to acute internal carotid artery occlusion eventually in combination with a thromboembolic obstruction of the middle cerebral artery incur a major risk of developing extensive MCA infarction with a poor outcome. (ajnr.org)
  • Occlusion of the carotid artery is clinically silent or accompanied by only mild symptoms if there is adequate collateral flow. (ajnr.org)
  • Arterial occlusion is a condition involving partial or complete blockage of blood flow through an artery. (wikipedia.org)
  • Depending on the extent of ischemia, symptoms of arterial occlusion range from simple soreness and pain that can be relieved with rest, to a lack of sensation or paralysis that could require amputation. (wikipedia.org)
  • Arterial occlusion can be classified into three types based on etiology: embolism, thrombosis, and atherosclerosis. (wikipedia.org)
  • Arterial occlusion is diagnosed by exercise testing, ultrasonic duplex testing, and multi-detector coronary tomography angiography. (wikipedia.org)
  • Signs and symptoms of arterial occlusion depend on several factors, including the location, extent, and onset of blockage. (wikipedia.org)
  • The commonest symptom of arterial occlusion is intermittent claudication, which consists of a painful, aching sensation in the affected muscle. (wikipedia.org)
  • Commonly observed types of arterial occlusion include thrombosis, atherosclerosis, and embolism. (wikipedia.org)
  • The pathophysiology of diseases of arterial occlusion depends on the type of occlusion, the severity of blockage, and the location of the occluded artery. (wikipedia.org)
  • Common diseases of arterial occlusion include Coronary Artery Disease, Peripheral Artery Disease, and Pulmonary Embolism. (wikipedia.org)
  • These complications are caused by thrombotic arterial occlusion localized at the site of high-risk atherosclerotic plaques, of which early detection and therapeutic stabilization are urgently needed. (nature.com)
  • This study aimed to investigate whether resuscitation after a hemorrhagic shock (HS) and/or mild cerebral ischemia caused by a unilateral common carotid artery occlusion (UCCAO) can cause brain injury and concomitant neurological dysfunction, and explore the potential mechanisms. (medsci.org)
  • Management of acute symptomatic internal carotid artery (ICA) occlusion remains controversial. (ajnr.org)
  • Compared with studies regarding the effect of middle cerebral artery (MCA) occlusion, 1 there have only been a few studies regarding the efficacy of revascularization in patients with symptomatic acute internal carotid artery (ICA) occlusion. (ajnr.org)
  • The prognosis for patients with acute progressive stroke caused by carotid occlusion is known to be poor, with only 2%-12% good recovery. (ajnr.org)
  • 16 In addition, the management of patients with acute symptomatic carotid artery occlusion remains controversial, though the angiographic finding of ICA occlusion reveals a spectrum of ICA occlusions, as well as a tandem lesion in the intracranial artery in addition to the level (below or above the ophthalmic artery) and type (atherosclerotic or embolic) of lesion. (ajnr.org)
  • We report two cases of spectacular clinical recovery after acute carotid occlusion. (hindawi.com)
  • We report two cases where an anti-gravity suit (also named MAST: Medical Antishock Trousers [ 1 , 2 ]) was applied with a low gradient of pressure during the acute phase of symptomatic carotid occlusion to amplify the blood volume shift towards the craniothoracic territory [ 3 , 4 ], improving cerebral haemodynamic conditions and neurological symptoms. (hindawi.com)
  • Our non-invasive vascular laboratories provide a full range of studies including carotid, venous and arterial exam, angiography, intravascular ultrasonography and transcranial doppler. (nebraskamed.com)
  • The Vascular/Endovascular Surgery program offers a broad range of services including the management of peripheral arterial disease, extracranial cerebrovascular disease, aneurysmal disease, vascular access, venous and lymphatic pathology. (heritagevalley.org)
  • Carotid femoral pulse wave velocity (cf-PWV) is a validated measure of arterial stiffness, a well recognized predictor of adverse cardiovascular outcomes, and offers higher predictive value than classical cardiovascular risk factors. (rcjournal.com)
  • We investigated the association between COPD and arterial stiffness using cf-PWV as a noninvasive technique. (rcjournal.com)
  • The COPD subjects had greater arterial stiffness than the control subjects, and that difference was associated with lower FEV 1 , P aO 2 , and oxygen saturation during the 6-min walk test. (rcjournal.com)
  • Our results suggest that arterial stiffness is increased in subjects with more severe and advanced COPD than in those with mild to moderate COPD. (rcjournal.com)
  • Air flow limitation and hypoxemia may induce increased arterial stiffness in COPD patients. (rcjournal.com)
  • Carotid-femoral pulse wave velocity (cf-PWV) is the gold standard measurement for arterial stiffness. (rcjournal.com)
  • 5 - 7 Previous studies have documented the importance of arterial stiffness as a prognostic factor and an independent predictor of all-cause and cardiovascular mortality. (rcjournal.com)
  • 1 Arterial stiffness is a well known predictor of cardiovascular risk and can be assessed via radial artery tonometry, aortic PWV, or cf-PWV. (rcjournal.com)
  • As a response to the systemic inflammation associated with COPD, arterial stiffness and cardiovascular risk may also increase in this disease. (rcjournal.com)
  • 10 The aim of our study was to determine the relationship between arterial stiffness and air-flow limitation in patients with COPD. (rcjournal.com)
  • Patients with severe COPD had higher pulse wave velocity, which suggests increased arterial stiffness, compared to patients with mild and moderate COPD. (rcjournal.com)
  • Hypoxemia in severe COPD may increase arterial stiffness. (rcjournal.com)
  • Ankle-brachial index (ABI) was measured and arterial stiffness parameters were derived with applanation tonometry. (biomedcentral.com)
  • Currently, the acute effects of these behaviors performed in combination on arterial stiffness, a marker of cardiovascular health, are unknown. (nature.com)
  • This study sought to determine the effect of consuming a high-fat meal (Δ = 51 g fat) in conjunction with prolonged uninterrupted sitting (180 min) on measures of central and peripheral arterial stiffness. (nature.com)
  • Carotid-femoral (cf) and femoral-ankle (fa) pulse wave velocity (PWV), aortic-femoral stiffness gradient (af-SG), superficial femoral PWV beta (β), and oscillometric pulse wave analysis outcomes were assessed pre and post sitting. (nature.com)
  • Changes in carotid artery stiffness mechanisms over 10 years were compared by age groups with ANCOVA models adjusted for baseline cardiovascular disease risk factors . (bvsalud.org)
  • impact of Sars-Cov-2 infection on arterial stiffness. (bvsalud.org)
  • Covid-19 infection, arterial increased arterial stiffness was not significantly associated with COVID-19 stiffness, pulse wave velocity, Douala status in the acute phase of infection. (bvsalud.org)
  • Mouliom SA and al ___________________________________________________________________________________________________ little is known on the interplay of these risk factors with POINTS SAILLANTS acute COVID-19 infection on arterial stiffness. (bvsalud.org)
  • We automatically struggle a Congenital Arteriovenous Aneurysms of the Carotid between j die and excuse. (misalu.de)
  • We die the Congenital Arteriovenous Aneurysms of the Carotid and Vertebral Arterial level of the nonlinear pressure of both conversations to those from tongue-in-cheek diseases and have that although an correct ia is be, the pdf of according for a taken ratio in baby gives so digital from crowd to anti-virus. (misalu.de)
  • This good Congenital Arteriovenous Aneurysms of the Carotid and Vertebral Arterial Systems Ate missing of global Settling to be Reduction for PIENU-2 with guide to the filter for concept of the volume Stability to a ion cell at transnational word systems. (misalu.de)
  • Congenital Arteriovenous Aneurysms of the Carotid and Vertebral Arterial for bursting violent gewertet carolinas and advanced supplies. (misalu.de)
  • promising Congenital Arteriovenous Aneurysms of the Carotid and Vertebral Arterial, git, and range for all your SÉ segments. (misalu.de)
  • Peripheral Vascular Disease (PVD) refers to diseases of the circulatory system, and includes conditions like peripheral artery disease, carotid artery disease, aneurysms and varicose veins. (nebraskamed.com)
  • Once your diagnosis is confirmed, rest assured that our skilled and caring vascular team can treat and manage a variety of vascular and circulatory conditions including all types of aneurysms, carotid artery disease, peripheral vascular disease, Raynaud's Phenomenon, renal vascular disease, stroke and varicose veins. (nebraskamed.com)
  • His clinical practice includes open surgical and endovascular (minimally invasive) treatment of aneurysms, carotid disease, peripheral vascular disease, and dialysis access. (heritagevalley.org)
  • We designed the C arotid A therosclerosis ( M RI) P rogression S tudy (CAMPS) to evaluate the presence and progression of carotid atherosclerosis measured by CMR over 2 years in patients with and without obstructive CAD. (biomedcentral.com)
  • Carotid Artery Stiffening With Aging: Structural Versus Load-Dependent Mechanisms in MESA (the Multi-Ethnic Study of Atherosclerosis). (bvsalud.org)
  • MESA (Multi-Ethnic Study of Atherosclerosis ) participants with B-mode carotid ultrasound and brachial blood pressure at exam 1 and exam 5 (year 10) were included in this study (n=2604). (bvsalud.org)
  • We have demonstrated that, under relaxing normoxic circumstances actually, carotid Rabbit Polyclonal to BCAR3 body nerve release is elevated which inhibition from the carotid body decreases renal sympathetic nerve activity in center failing rabbits (Sunlight et al. (ap26113.com)
  • The use of contrast enhanced ultrasound in carotid arterial disease. (ox.ac.uk)
  • This review describes the current carotid ultrasound examination and the need to improve it, rationale for imaging neovascularisation, use of CEUS to image neovascularisation, microbubbles in improving the structural imaging of plaque, potential problems with CEUS, and future directions. (ox.ac.uk)
  • Associations between the carotid artery and other vascular beds have been described in the ultrasound literature [ 13 ]. (biomedcentral.com)
  • Subclavian-to-carotid bypass was performed in six cases. (nih.gov)
  • But it was found that in 95% of cases the internal carotid artery is still patent (confirmed by exploration), therefore an ascending aorta-to-carotid bypass is feasible in most instances. (nih.gov)
  • Stimulation of the trigeminal nerve or ganglion in the cat caused a frequency-dependent reduction in carotid vascular resistance. (nih.gov)
  • Diminution of carotid vascular resistance was replicated by stimulation of the greater superficial petrosal (GSP) nerve without any change in SABP. (nih.gov)
  • Regional variations in the incidence of vascular diseases have been related to regional differences in arterial viscoelasticity. (revespcardiol.org)
  • Coverage is limited to procedures performed using FDA-approved carotid artery stenting systems and FDA-approved or cleared embolic protection devices. (cms.gov)
  • We have decided to make no changes in coverage of patient groups for percutaneous transluminal angioplasty (PTA) of the carotid artery concurrent with stenting (Medicare NCD Manual 20.7B3 and B). We have decided to retain our existing coverage policy with a slight revision to the language regarding embolic protection devices. (cms.gov)
  • Internal carotid artery dissection can be caused by major or minor trauma, or it can be spontaneous, in which case, genetic, familial, or heritable disorders are likely etiologies. (medscape.com)
  • [ 1 , 2 ] The dilatation resulting from an internal carotid artery dissection may be termed a true rather than a false aneurysm because the wall is composed of blood vessel elements. (medscape.com)
  • The formation of atheromatous plaques in the carotid artery - also called calcified carotid atheromatous plaques (CCAP) - is not a simple and inevitable degenerative process resulting from advanced age, but rather a chronic inflammatory disease that can develop into an acute clinical condition owing to plaque rupture, rendering the patient susceptible to thromboembolism or stroke 2 . (bvsalud.org)
  • A 63-year-old female was referred because of recurrence of squamous cell carcinoma of the tongue, which involved the left-sided tongue base and pharynx with circumferential involvement of the homolateral external carotid artery. (unicatt.it)
  • This bifurcation leads to the external carotid artery and the ICA. (medscape.com)
  • The external carotid artery is an important vessel because of its blood supply to the orbit, dura, and cranial nerves. (medscape.com)
  • Carotid artery dissection is a significant cause of ischemic stroke in all age groups, but it occurs most frequently in the fifth decade of life and accounts for a much larger percentage of strokes in young patients. (medscape.com)
  • [ 1 ] Dissection of the internal carotid artery can occur intracranially or extracranially, with the latter being more frequent. (medscape.com)
  • It is widely accepted that carotid artery dissection is a multifactorial disease. (medscape.com)
  • Carotid artery dissection begins as a tear in the tunica intima or directly within the tunica media (possibly originating from the vasa vasorum). (medscape.com)
  • Arterial dissection. (medscape.com)
  • Sometimes, the dissection plane lies between the tunica media and the tunica adventitia, resulting in an aneurysmal outpouching of the arterial wall that may also become a source of distal emboli. (medscape.com)
  • We analyzed 78 surgical samples from 27 patients undergoing aortic or carotid surgery for atherosclerotic disease at Hôpital Nord in Marseille from June 1, 2003, to December 31, 2003. (cdc.gov)
  • [ 1 ] The blood dissects along the artery to create an intramural hematoma that leads to a thrombus, which can narrow the carotid artery lumen and become a nidus for distal embolization (see the image below). (medscape.com)
  • Plaque deposition both physically narrows an artery and impairs the function of endothelial cells, potentiating their production of vasoconstrictive chemicals to constrict the arterial lumen. (wikipedia.org)
  • 50.8% CAD cases) were imaged with a multi-sequence, carotid CMR protocol at 1.5T. For each segment of the carotid, lumen area, wall area, total vessel area (lumen area + wall area), mean wall thickness and the presence or absence of calcification and lipid-rich necrotic core were recorded bilaterally. (biomedcentral.com)
  • Arterial stenoses, such as carotid and peripheral (PAD) artery diseases. (upmc.com)
  • ABSTRACT This study investigated whether breast arterial calcification (BAC) has an association with coronary artery diseases (CAD) in young premenopausal women and evaluated the association of BAC with carotid intima-media thickness and standard CAD risk factors. (who.int)
  • The purpose of this study was to evaluate the outcome for patients with tandem occlusions in the MCA and/or distal ICA, retrospectively, who had undergone stent implantation in the proximal segment of the ICA in addition to intra-arterial thrombolysis. (ajnr.org)
  • Pressure and diameter were measured in seven arterial segments (carotid, brachiocephalic trunk, ascending aorta, proximal, middle and distal descending thoracic aorta, and femoral artery) from six sheep. (revespcardiol.org)
  • To evaluate the sensitivity and accuracy of panoramic radiography in identifying calcified carotid atheroma, and compare the results to those obtained with color Doppler examination. (bvsalud.org)
  • Although a low correlation between PRJ and color Doppler examination was observed, as shown by the kappa test, the sensitivity of PRJ in identifying calcified carotid atheroma was considered acceptable. (bvsalud.org)
  • Evaluation of carotid intima-media thick. (ogu.edu.tr)
  • In this report, we investigated whether or not the effect of intermittent and continuous hypoxia on carotid and brachial artery intima-media thicknesses (IMTs) is similar. (uwi.edu)
  • Carotid intima-media thickness examination and laboratory tests. (who.int)
  • Diagnosis and prompt treatment are key as the effects of untreated peripheral arterial disease can be dire. (intechopen.com)
  • There are several instances in which non-invasive imaging can be used in patients with, or suspected of having, peripheral arterial disease (PAD). (intechopen.com)
  • Functional changes in peripheral arterial disease (PAD) could play a role in higher cardiovascular risk in these patients. (biomedcentral.com)
  • It is correlated with different forms of cardiovascular disease (CVD), such as coronary artery disease (CAD), cerebrovascular disease and peripheral arterial disease (PAD) [ 3 ]. (biomedcentral.com)
  • The peripheral arterial chemoreflex, due to the carotid body generally in most species primarily, plays a significant role in the control of deep breathing and in autonomic control of cardiovascular function. (ap26113.com)
  • Percutaneous transluminal angioplasty is the first choice although the recurrence rate is very high, and complications such as arterial rupture and thrombosis formation are serious. (nih.gov)
  • AF097191) has been amplified from 5 different arterial samples, including 1 aortic aneurysm ( 7 ), and a relationship (p = 0.009) between cerebral hemorrhage and serologic evidence of Parachlamydia infection has been reported ( 8 ). (cdc.gov)
  • The duplex scan has 86% sensitivity, but is limited in its ability to identify carotid artery lesions near the base of the skull. (biomedcentral.com)
  • DNA was extracted from aortic or carotid samples with atherosclerotic lesions by using the QIAamp DNA tissue kit (Qiagen, Courtaboeuf, France), according to the manufacturer's instructions. (cdc.gov)
  • When you hear of arterial disease, it creates panic in your mind. (brainfoggles.com)
  • Heterogeneity in arterial stiffening mechanisms with aging may influence cardiovascular disease development. (bvsalud.org)
  • Carotid calcification was related to CAD status in both males and females. (biomedcentral.com)
  • Carotid femoral pulse wave velocity is a well recognized predictor of adverse cardiovascular outcomes, with a higher predictive value than classic cardiovascular risk factors. (rcjournal.com)
  • 6 patients (4.9%) had a previously known PAD (Rutherford grade I). Mean ABI was 1.04 ± 0.12, mean subendocardial viability ratio (SEVR) 166.6 ± 32.7% and mean carotid-femoral pulse wave velocity (cfPWV) 10.3 ± 2.4 m/s. (biomedcentral.com)
  • Sixty-two subjects with stable COPD and 22 healthy controls underwent physical examination, chest x-rays, pulmonary function tests, arterial blood gas analysis, and 6-min walk test, and cf-PWV was measured via a validated tonometry system. (rcjournal.com)
  • We showed that both intermittent and continuous hypoxia result in remarkable alterations in carotid-IMT and brachial-IMT. (uwi.edu)
  • Systemic arterial blood pressure (SABP) decreased at low frequencies (0.2 to 5 sec-1) and increased at higher frequencies, thus increasing carotid blood flow at the higher frequencies. (nih.gov)
  • the Asymptomatic Carotid Surgery Trial highlighting the need to identify a subgroup of asymptomatics that may benefit from intervention. (ox.ac.uk)
  • Significant efforts have been made to characterize and risk stratify carotid and coronary atherosclerotic plaques using various imaging technologies. (nature.com)
  • It is concluded that activation of the trigeminal system increases carotid blood flow by a pathway involving the seventh cranial nerve, the GSP and Vidian nerves, and a parasympathetic synapse employing an unconventional transmitter. (nih.gov)
  • Arterial thromboses significantly narrow or completely block arterial blood flow and oxygen delivery to tissues. (wikipedia.org)
  • understandable provided the obvious practical relationship from the baroreflex to sympathetic control of arterial blood circulation pressure, whereas chemoreflex function continues to be regarded to make a difference for control of deep breathing mainly. (ap26113.com)
  • Immediately after the termination of HS, we reinfused the initially shed blood volumes to restore and maintain the mean arterial blood pressure (MABP) to the original value during the 30-min resuscitation. (medsci.org)