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Abstract Background Metabolic syndrome (MetS) in older adults with hypertension, diabetes, and hyperlipidemia increases the risks of cardiovascular diseases by 2.5 times and type 2 diabetes by five times. This study aimed to explain the multilevel relationships between health service system factors and individual-level factors influencing the control of MetS among older adults with NCDs receiving health care services at the NCD Plus clinics of hospitals in 1 year. Methods This cross-sectional analytical study employed a systematic sampling method to have two groups of samples from 4 regions of Thailand: (1) 600 older adults having at least one diagnosis of NCDs receiving services at NCD Plus clinics and (2) 12 nurses in charge of the NCD Plus clinics at the hospitals providing services to these patient samples. Data were analyzed using multilevel logistic regression analysis. Results 24% of older adults with NCDs can control MetS within one year. The MetS escalation from the initial assessment to 1-year follow-up varied according to the level of the hospitals. The transition from MetS to non-MetS status was rare in older adults with NCDs. Among health service system factors, complete screening for MetS influenced 1-year MetS control (95% CI [1.06, 2.92]). Older adults who were female and who had polypharmacy had a 66% (95% CI [0.22, 0.53]) and a 54% (95% CI [0.29 − 0.71]) reduction chance in MetS control. Older adults, who were ≥ 80 years old, labor-employed, healthy dietary patterns, and medication adherence increased chances of controlling MetS by 2.38 times (95% CI [1.12, 5.05]), 2.14 times (95% CI [1.03, 4.42]), 1.61 times (95% CI [1.06–2.46]), and 3.18 times (95% CI [1.51, 6.70]), respectively. Conclusions NCDs Plus clinics that provide complete screening for MetS significantly enhance their effectiveness in reducing the proportion of older adults with MetS. In addition, the service should pay attention to older adults who are female, are retired, and take multiple medications to achieve MetS control better. The insights gained from such an analysis could be instrumental in pinpointing the resources necessary to bolster the efficacy of NCD Plus clinics.

Ten-Eleven Translocation methylcytosine dioxygenase 1 (TET1) is known to play a broad tumor suppressor role through demethylating and activating tumor suppressor genes. TET1 missense mutations are previously reported in many types of leukemia. Here, the human induced pluripotent stem cell line MURAi001-A was generated from skin fibroblasts derived from a 56-year-old female patient carrying the TET1 gene mutation c.4404A > G (p.I1468M), who had a history of ovarian germ cell tumor. The MURAi001-A cell line demonstrated embryonic-like characteristics as it expressed specific stemness markers, differentiated into the three germ layers, and retained normal karyotyping.

ABSTRACT Purpose: To develop and assess three-dimensional models of physeal fractures in dog femurs (3D MPFDF) using radiographic imaging. Methods: The study was conducted in three phases: development of 3D MPFDF; radiographic examination of the 3D MPFDF; and comparative analysis of the anatomical and radiographic features of the 3D MPFDF. Results: The base model and the 3D MPFDF achieved high fidelity in replicating the bone structures, accurately maintaining the morphological characteristics and dimensions such as length, width, and thickness, closely resembling natural bone. The radiographs of the 3D MPFDF displayed distinct radiopaque and radiolucent areas, enabling clear visualization of the various anatomical structures of the femur. However, in these radiographs, it was challenging to distinguish between the cortical and medullary regions due to the use of 99% internal padding in the printing process. Despite this limitation, the radiographs successfully demonstrated the representation of the Salter-Harris classification. Conclusions: This paper presents a pioneering project focused on technological advancement aimed at developing a method for the rapid and cost-effective production of three-printed models and radiographs of physeal fractures in dogs.

Abstract Background Food taxation and food marketing policy are very cost-effectiveness to improve healthy diets among children. The objective of this study was to investigate the socio-demographic characteristics of Thais and attitude towards on policy unhealthy food marketing restriction and sodium taxation which influence high fat, sodium, and sugar (FHSS) food eating. Methods The data were obtained from the 2021 Health Behavior of Population Survey, four-stage sampling method of the Thai people, aged 15 years and above, using a offline survey application-assisted face-to-face interview. Logistic Regression were used to analyze the explanatory variables on agreement and HFSS food intake. Results Almost half (48.4%) of samples disagreed with sodium taxation, and 42.7% of the samples disagreed with food marketing restriction. Most (99.6%) of Thai respondents consumed HFSS food, including sugar sweetened beverages (SSB). Gender, age, education, income, BMI, and health status were associated with agreement with food marketing restriction policy and sodium taxation policy. There is no association between agreement with policy on sodium taxation and food marketing and HFSS food consumption. Conclusion Nearly half of Thais indicated that they disagreed with policy on food marketing restriction and sodium taxation. Therefore, understanding and awareness of the two policies among Thais should be further investigated in order to develop better policy communication for increased public understanding and engagement.

This work aimed to synthesize and characterize the calcium acetate monohydrate (Ca(CH3COO)2·H2O) from the exothermic reaction between CaCO3 powder derived from cockle shells with three different acetic acids (8, 10, and 12 mol L−1) concentrations by the rapid and easy process without pH and temperature control to lead to cheap chemical production. The physicochemical characteristics of all synthesized Ca(CH3COO)2·H2O samples are investigated based on the chemical compositions, crystal structures, vibrational characteristics, morphologies, and thermal behavior to confirm the target compound. A suitable concentration of 10 mol L−1 CH3COOH was chosen to produce Ca(CH3COO)2·H2O with the highest yield (96.30 %), maximum calcium content (96.2 % CaO) with lower impurities, and time consumption of 17 h. The calcium acetate product obtained from cockle shells in this work shows differences in thermal stability, morphological structure purity, %yield, and metal contamination with those reported obtained from other sources and another shell type in the previous work. This research investigates the transformation of cockle shell waste into CaCO3 for the production of calcium acetate, aiming to address environmental sustainability concerns by reducing the use of calcium ore resources and greenhouse gas emissions.

Abstract Background Food marketing is a key factor that influences children’s dietary behaviors. This study assessed the nature and extent of food and beverage advertising on television (TV) in 2014 and 2022 in Thailand. Methods TV was recorded for one week in March 2014 and in May 2022 from 7-9am and 3-7 pm on weekends, and 3-7 pm on weekdays across two channels (64 h recorded each year). The nutrient profile model from Bureau of Nutrition, Ministry of Public Health Thailand was used to classify food and non-alcoholic beverages as: Group A (‘healthy’), Group B (‘less unhealthy’) or Group C (‘unhealthy’). Results In 2014, 475 food advertisements were identified, with on average of 6.3 unhealthy food advertisements per hour. In 2022, 659 food advertisements were identified, with an average of 9.2 unhealthy food advertisement per hour. In both time periods, the most frequently advertised food products were non-alcoholic beverages. The rate of unhealthy food advertising per hour of broadcast was significantly higher than for other moderately unhealthy and healthy foods, and was also significantly higher in 2022 than in 2014. Conclusions Food and beverage advertising on Thai television is predominantly promotes unhealthy foods and, in particular, sugar-sweetened beverages. Therefore, Thai Government should enact new legislation to protect children from food TV ads in order to control both the frequency and nature of unhealthy TV food marketing to protect the health of Thai children.

Waste oyster shells were utilized to produce calcium carbonate (CaCO3) by grinding. This CaCO3 was then reacted with acetic acid to yield calcium acetate monohydrate (Ca(CH3COO)2·H2O). Both CaCO3 and Ca(CH3COO)2·H2O were used as precursors for synthesizing calcium oxide (CaO) through thermal decomposition at 900 °C and 750 °C, respectively. The yields of CaO from both precursors, determined through calcination experiments and thermogravimetric analysis (TGA), exceeded 100% due to the high purity of the raw agents and the formation of calcium hydroxide (Ca(OH)2). X-ray fluorescence (XRF) analysis revealed a CaO content of 87.8% for CaO-CC and 91.5% for CaO-CA, indicating the purity and contamination levels. X-ray diffraction (XRD) patterns confirmed the presence of CaO and minor peaks of Ca(OH)2, attributed to moisture adsorption. Fourier-transform infrared (FTIR) spectroscopy identified the vibrational characteristics of the Ca-O bond. Scanning electron microscopy (SEM) showed similar morphologies for both CaO-CC and CaO-CA, with CaO-CA displaying a significant amount of rod-like crystals. Based on these results, calcium acetate monohydrate (CA) is recommended as the superior precursor for synthesizing high-purity CaO, offering advantages for various applications.

Abstract Background and Aims Knee support, frequently made from sponge, is used to reduce injury. Sponge has less elasticity and durability compared with natural rubber. To our knowledge, there was no study that demonstrated the effectiveness of natural rubber and sponge in prevention of injury in children with bleeding disorders. The study aimed to demonstrate the effectiveness and satisfaction of natural rubber knee support compared with sponge knee support among children with bleeding disorders. Methods The study consisted of three phases: (I) measuring reduced compression force, (II) producing size‐appropriate knee support prototypes, and (III) conducting a randomized crossover trial, including 8 weeks wearing natural rubber knee support and sponge knee support with a 4‐week wash‐out period. The number of knee bleeds and user satisfaction were recorded. Results A better compression force reduction in natural rubber (60%) than sponge (12%) was demonstrated. Knee support comprised a body part, made from natural‐stretchable cotton and a protection part, made from either natural rubber or sponge. They were produced in four sizes: S, M, L, and XL and appropriately applied to 42 patients (21 hemophilia, 21 platelet disorders) with a mean (SD) age of 7.0 (2.9) years. The results from randomization showed no significant difference in the number of knee bleeds between the two knee support groups (10 vs. 7, p = 0.37). In terms of satisfaction score, the natural rubber knee supports were more durable (45.2% vs. 23.8%, p = 0.04) and easier to use (28.5% vs. 14.3%, p = 0.03). In addition, a higher percentage of parents chose natural rubber knee support when compared with sponge knee supports (71.0% vs. 29.0%, p = 0.006). Conclusion Natural rubber knee support showed comparable effectiveness in the prevention of knee bleeding but was superior to sponge knee support in compression force reduction and satisfaction.

Gypsum products (calcium sulfate dihydrate, CaSO4·2H2O) were synthesized through an eco-friendly and low-cost process by two different renewable calcium carbonate sources (CaCO3), hen and duck eggshell wastes, with product yields obtained of 84.73 and 87.74%, respectively. The X-ray fluorescence results indicated that calcium oxide (CaO) and sulfur trioxide (SO3) are the major elemental components of CaSO4·2H2O prepared from both calcium sources. The Fourier transform infrared results confirmed the vibrational characteristics of SO42− and H2O functional groups in the chemical structure of the prepared samples. The X-ray diffraction patterns of CaSO4·2H2O prepared from both calcium sources confirmed the sample’s crystal structure as well as the chemical formula, after comparing them to the standard powder diffraction file. The crystallite sizes of CaSO4·2H2O products were calculated from the experimental diffraction peak through the Scherrer equation and found to be 19–20 nm. The positive preferential growth (Pg) value highlighted the excellent stability of the synthesized CaSO4·2H2O. The scanning electron microscopic results showed the agglomeration particles of hen- and duck-CaCO3 raw agents, whereas plate-like particles were observed for hen- and duck-CaSO4·2H2O products but the particle sizes were different.

Stroke and Alzheimer’s disease (AD) are prevalent age-related diseases; however, the relationship between these two diseases remains unclear. In this study, we aimed to investigate the ability of melatonin, a hormone produced by the pineal gland, to alleviate the effects of ischemic stroke leading to AD by observing the pathogenesis of AD hallmarks. We utilized SH-SY5Y cells under the conditions of oxygen–glucose deprivation (OGD) and oxygen-glucose deprivation and reoxygenation (OGD/R) to establish ischemic stroke conditions. We detected that hypoxia-inducible factor-1α (HIF-1α), an indicator of ischemic stroke, was highly upregulated at both the protein and mRNA levels under OGD conditions. Melatonin significantly downregulated both HIF-1α mRNA and protein expression under OGD/R conditions. We detected the upregulation of β-site APP-cleaving enzyme 1 (BACE1) mRNA and protein expression under both OGD and OGD/R conditions, while 10 µM of melatonin attenuated these effects and inhibited beta amyloid (Aβ) production. Furthermore, we demonstrated that OGD/R conditions were able to activate the BACE1 promoter, while melatonin inhibited this effect. The present results indicate that melatonin has a significant impact on preventing the aberrant development of ischemic stroke, which can lead to the development of AD, providing new insight into the prevention of AD and potential stroke treatments.

Background: Metabolic syndrome (MetS) in older adults with hypertension, diabetes, and hyperlipidemia increases the risks of cardiovascular diseases by 2.5 times and type 2 diabetes by five times. This study aimed to explain the multilevel relationships between health service system factors and individual-level factors influencing the control of MetS among older adults with NCDs receiving health care services at the NCD Plus clinics of hospitals in 1 year. Methods: This cross-sectional analytical study employed a systematic sampling method to have two groups of samples from 4 regions of Thailand: (1) 600 older adults having at least one diagnosis of NCDs receiving services at NCD Plus clinics and (2) 12 nurses in charge of the NCD Plus clinics at the hospitals providing services to these patient samples. Data were analyzed using multilevel logistic regression analysis. Results: 24% of older adults with NCDs can control MetS within one year. The MetS escalation from the initial assessment to 1-year follow-up varied according to the level of the hospitals. The transition from MetS to non-MetS status was rare in older adults with NCDs. Among health service system factors, complete screening for MetS influenced 1-year MetS control (95% CI [1.06, 2.92]). Older adults who were female and who had polypharmacy had a 66% (95% CI [0.22, 0.53]) and a 54% (95% CI [0.29 − 0.71]) reduction chance in MetS control. Older adults, who were ≥ 80 years old, labor-employed, healthy dietary patterns, and medication adherence increased chances of controlling MetS by 2.38 times (95% CI [1.12, 5.05]), 2.14 times (95% CI [1.03, 4.42]), 1.61 times (95% CI [1.06–2.46]), and 3.18 times (95% CI [1.51, 6.70]), respectively. Conclusions: NCDs Plus clinics that provide complete screening for MetS significantly enhance their effectiveness in reducing the proportion of older adults with MetS. In addition, the service should pay attention to older adults who are female, are retired, and take multiple medications to achieve MetS control better. The insights gained from such an analysis could be instrumental in pinpointing the resources necessary to bolster the efficacy of NCD Plus clinics. [ABSTRACT FROM AUTHOR]

Telomere length (TL) is associated with the reduction in physical activity and muscular performance, while increasing TL by physical activity may beneficially impact health and longevity. Information on TL changes induced by Qigong exercise is scarce. Thus, this study determined the effects of Qigong training on TL and its relationship with muscle strength and antioxidants in young sedentary females. Using a quasi-experimental design, 36 women were assigned to an 8-week period of Qigong training (Qigong Group, QG, n = 17) or Control observation (Control Group, CG, n = 19). Relative TL was significantly increased after 8 weeks of Qigong training (P < 0.05), but no significant changes were seen in the CG; TL changes between Groups were significantly different (P < 0.05). These changes in relative TL were positively correlated with changes in leg-back muscle strength (r = 0.413, P = 0.012), but negatively with changes in catalase enzyme activity (r = -0.343, P = 0.040). The findings suggest that 8 weeks of Qigong training increased TL in sedentary young females. Also, the positive association between changes in relative TL and leg-back strength and the negative association with changes in antioxidant activity may indicate mechanisms mediating Qigong effects on TL. [ABSTRACT FROM AUTHOR]

The custom-designed robotic gait aid "I-Walk" was developed to enhance ambulation and facilitate cost-effective repetitive training. However, empirical evidence regarding its impact on cardiovascular endurance remains scarce. This study assessed the beneficial effects of 8 weeks of I-Walk gait training on walking endurance and aerobic capacity in 11 subacute stroke patients 45 to 70 years of age within 6 months of their first stroke. They were randomly assigned to the Control Group (n = 5) and the I-Walk Gait Training Group (n = 6). All underwent a daily 60-min session, 3 d·wk-1 for 8 wks. The program included a 30-min PT session, and 30 min of gait training (overground or using the I-Walk). Walking distance and aerobic capacity were measured using the 6 Minute Walk Test (6MWT) before and after the intervention. After the 8 weeks of I-Walk Gait Training, the average walking distance increased by 60 m (P = 0.039) with a mean peak VO2 increase of 1.38 ml·kg-1 ·min-1 (0.11-2.65 ml·kg-1 ·min-1, P = 0.039) vs. an average increase of 44 m (P = 0.107) with overground training. The I-Walk with a conventional PT program increased the 6MWT performance in the subacute stroke patients with progressive improvement over the intervention period. [ABSTRACT FROM AUTHOR]

Waste oyster shells were utilized to produce calcium carbonate (CaCO3) by grinding. This CaCO3 was then reacted with acetic acid to yield calcium acetate monohydrate (Ca(CH3COO)2·H2O). Both CaCO3 and Ca(CH3COO)2·H2O were used as precursors for synthesizing calcium oxide (CaO) through thermal decomposition at 900 °C and 750 °C, respectively. The yields of CaO from both precursors, determined through calcination experiments and thermogravimetric analysis (TGA), exceeded 100% due to the high purity of the raw agents and the formation of calcium hydroxide (Ca(OH)2). X-ray fluorescence (XRF) analysis revealed a CaO content of 87.8% for CaO-CC and 91.5% for CaO-CA, indicating the purity and contamination levels. X-ray diffraction (XRD) patterns confirmed the presence of CaO and minor peaks of Ca(OH)2, attributed to moisture adsorption. Fourier-transform infrared (FTIR) spectroscopy identified the vibrational characteristics of the Ca-O bond. Scanning electron microscopy (SEM) showed similar morphologies for both CaO-CC and CaO-CA, with CaO-CA displaying a significant amount of rod-like crystals. Based on these results, calcium acetate monohydrate (CA) is recommended as the superior precursor for synthesizing high-purity CaO, offering advantages for various applications. [ABSTRACT FROM AUTHOR]

Gypsum products (calcium sulfate dihydrate, CaSO4·2H2O) were synthesized through an eco-friendly and low-cost process by two different renewable calcium carbonate sources (CaCO3), hen and duck eggshell wastes, with product yields obtained of 84.73 and 87.74%, respectively. The X-ray fluorescence results indicated that calcium oxide (CaO) and sulfur trioxide (SO3) are the major elemental components of CaSO4·2H2O prepared from both calcium sources. The Fourier transform infrared results confirmed the vibrational characteristics of SO42− and H2O functional groups in the chemical structure of the prepared samples. The X-ray diffraction patterns of CaSO4·2H2O prepared from both calcium sources confirmed the sample's crystal structure as well as the chemical formula, after comparing them to the standard powder diffraction file. The crystallite sizes of CaSO4·2H2O products were calculated from the experimental diffraction peak through the Scherrer equation and found to be 19–20 nm. The positive preferential growth (Pg) value highlighted the excellent stability of the synthesized CaSO4·2H2O. The scanning electron microscopic results showed the agglomeration particles of hen- and duck-CaCO3 raw agents, whereas plate-like particles were observed for hen- and duck-CaSO4·2H2O products but the particle sizes were different. [ABSTRACT FROM AUTHOR]

Diabetes is a disease that has been experiencing a continuous increase in terms of pervasiveness. Controlling diet and exercise is critical for controlling blood sugar and reducing long-term complications. This quasi-experimental study aimed to assess the effects of a dietary and exercise promotion program to control the blood sugar of diabetic patients. Thirty patients were stratified by gender and randomly selected from three consecutive days at the diabetes clinic with ten patients per day. They were required to participate in the study program for eight weeks. The program was developed based on a self-regulation model to control chronic diseases. Similarity among patients regarding gender, age, years of having diabetes, and blood sugar level was considered before the study group was recruited. A self-administered questionnaire and blood sugar test were used to collect pretest and posttest data. The data were analyzed by percentage, mean, standard deviation, independent t-test, and Paired sample t-test. The findings concluded the effectiveness of the program since the blood sugar levels of the experimental group decreased significantly from a high level (162.3 mg/dl) to a nearly controllable level (128.9 mg/dl) (p <.01). This was due to the experimental group having more appropriate dietary and exercise behaviors, having better knowledge and perceived self-efficacy to perform the behaviors than before the experiment, and being better than the control group (p <.01). The self-regulation theory application model developed in this study was recommended for modification of health behaviors related to setting desired goal behaviors and glycemic control of type-2 diabetes patients. [ABSTRACT FROM AUTHOR]

Introduction: Hereditary pyropoikilocytosis (HPP) is the most common cause of non‐thalassemic severe inherited hemolytic anemia in Thai population. Up to 90% of affected patients harbor biallelic mutations of SPTB Providence (SPTB c.6055T>C), SPTB Buffalo (SPTB c.6074T>G), and SPTB Chiang Mai (SPTB c.6224A>G). This study aimed to develop a simple assay for mass screening of the three common SPTB mutations and to study their carrier frequencies in a healthy Thai population. Methods: We combined multiplex amplification refractory mutation system‐PCR (ARMS‐PCR) and high‐resolution melting (HRM) curve analysis to create a one‐step single‐tube assay. The primers were designed to generate products with different melting temperatures in the presence of 6055C, 6074G, and 6224G. Internal control primers were added for quality control. Residual samples from blood donors and healthy adolescents were collected and tested for the three common SPTB mutations using the newly developed assay. Results: Optimized multiplex ARMS‐PCR/HRM curve assay yielded well‐separated melt curves to detect the three SPTB mutations with 4‐h turnaround time. The assay was validated in screening of 2261 non‐repetitive blood donors and 89 adolescents, in which 10 (0.43%), 2 (0.09%), and 3 (0.13%) individuals were identified as carriers of SPTB Providence, SPTB Buffalo, and SPTB Chiang Mai, respectively. All mutated SPTB and 20 random wild‐type samples were confirmed using Sanger sequencing with 100% accuracy. Conclusion: The novel ARMS‐PCR/HRM curve assay is simple, accurate, and time‐effective for mass screening of the common SPTB mutations. This can be employed to prevent HPP birth in a Thai population. [ABSTRACT FROM AUTHOR]

Background: Qigong exercise training has been suggested to elicit beneficial effects on physical functioning, reduction of oxidative stress, and improved antioxidant capacity in women. However, regular exercise training may support the development of antioxidant defense mechanisms and beneficially modulate oxidant/antioxidant responses. Objective: To evaluate the effects of an 8-week qigong exercise training on exercise performance and oxidative stress responses in sedentary middle-aged and elderly women suffering from type 2 diabetic mellitus (T2DM). Method/design: Quasi-experimental design, placebo-controlled study. Setting: The Department of Physical Therapy, Faculty of Allied Health Science, Burapha University, Thailand. Participants: Thirty-six sedentary middle-aged and elderly women with T2DM. Intervention: Participants were allocated to qigong exercise (n = 20) or to the control group (CG, n = 20). Primary outcome measures: Muscle strengths, flexibility, VO2 max predicted, and walking intensity derived from the 6-minute walk test. Secondary outcome measures: Fasting plasma glucose, antioxidant/oxidant stress parameters, and body composition. Results: Leg strength and trunk flexibility were improved after qigong training and changes were significantly different compared with the CG (all p < 0.05). VO2 max predicted, 6-min walking distance, and walking intensity were all increased (p < 0.05), and oxidative stress markers were diminished after qigong training (p < 0.05). The antioxidant/oxidant balance was improved after qigong training (p < 0.05). Conclusion: The presented findings indicate that 8 weeks of qigong training significantly improved leg strength and trunk flexibility in middle-aged and elderly women with T2DM, partly associated with a more favorable antioxidant/oxidant balance. These effects may beneficially impact on health in this specific population. Clinical Trial Number: TCTR20221003001. [ABSTRACT FROM AUTHOR]

Background: Food taxation and food marketing policy are very cost-effectiveness to improve healthy diets among children. The objective of this study was to investigate the socio-demographic characteristics of Thais and attitude towards on policy unhealthy food marketing restriction and sodium taxation which influence high fat, sodium, and sugar (FHSS) food eating. Methods: The data were obtained from the 2021 Health Behavior of Population Survey, four-stage sampling method of the Thai people, aged 15 years and above, using a offline survey application-assisted face-to-face interview. Logistic Regression were used to analyze the explanatory variables on agreement and HFSS food intake. Results: Almost half (48.4%) of samples disagreed with sodium taxation, and 42.7% of the samples disagreed with food marketing restriction. Most (99.6%) of Thai respondents consumed HFSS food, including sugar sweetened beverages (SSB). Gender, age, education, income, BMI, and health status were associated with agreement with food marketing restriction policy and sodium taxation policy. There is no association between agreement with policy on sodium taxation and food marketing and HFSS food consumption. Conclusion: Nearly half of Thais indicated that they disagreed with policy on food marketing restriction and sodium taxation. Therefore, understanding and awareness of the two policies among Thais should be further investigated in order to develop better policy communication for increased public understanding and engagement. [ABSTRACT FROM AUTHOR]