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https://www.readbyqxmd.com/read/27896442/regional-citrate-anticoagulation-for-continuous-renal-replacement-therapy-in-children
#1
Mayerly Prada Rico, Jaime Fernández Sarmiento, Ana María Rojas Velasquez, Luz Stella González Chaparro, Ricardo Gastelbondo Amaya, Hernando Mulett Hoyos, Daniel Tibaduiza, Ana Maria Quintero Gómez
BACKGROUND: Anticoagulation of the continuous renal replacement therapy (CRRT) circuit is an important technical aspect of this medical procedure. Most studies evaluating the efficacy and safety of citrate use have been carried out in adults, and little evidence is available for the pediatric patient population. The aim of this study was to compare regional citrate anticoagulation versus systemic heparin anticoagulation in terms of the lifetime of hemofilters in a pediatric population receiving CRRT at a pediatric center in Bogota, Colombia...
November 28, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27892735/delivery-route-determines-the-presence-of-immune-complexes-on-umbilical-cord-erythrocytes
#2
Andrés de Lima, Luis C Franco, Andrés Sarmiento, John M González
OBJECTIVE: Umbilical cord blood offers a unique opportunity to study the basal level of immunoglobulin complexes. This study aims to determine the presence of immune complexes and complement deposition on erythrocytes from umbilical cord blood from normal, full-term pregnancies. METHODS: In vitro pre-formed IgA, IgG, and IgM complexes were used as positive control for flow cytometry detection, and for C3d deposition. Blood samples (34) of umbilical cord blood taken from vaginal and cesarean deliveries were tested for the presence of immunoglobulin complexes...
November 28, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27887654/proportion-of-children-meeting-recommendations-for-24-hour-movement-guidelines-and-associations-with-adiposity-in-a-12-country-study
#3
Blanca Roman-Viñas, Jean-Philippe Chaput, Peter T Katzmarzyk, Mikael Fogelholm, Estelle V Lambert, Carol Maher, Jose Maia, Timothy Olds, Vincent Onywera, Olga L Sarmiento, Martyn Standage, Catrine Tudor-Locke, Mark S Tremblay
BACKGROUND: The Canadian 24-h movement guidelines were developed with the hope of improving health and future health outcomes in children and youth. The purpose of this study was to evaluate adherence to the 3 recommendations most strongly associated with health outcomes in new 24-h movement guidelines and their relationship with adiposity (obesity and body mass index z-score) across countries participating in the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE)...
November 25, 2016: International Journal of Behavioral Nutrition and Physical Activity
https://www.readbyqxmd.com/read/27866926/evaluation-of-humoral-immunity-profiles-to-identify-heart-recipients-at-risk-for-development-of-severe-infections-a-multicenter-prospective-study
#4
Elizabeth Sarmiento, Maria Jaramillo, Leticia Calahorra, Juan Fernandez-Yañez, Miguel Gomez-Sanchez, Maria G Crespo-Leiro, Maria Paniagua, Luis Almenar, Monica Cebrian, Gregorio Rabago, Beltran Levy, Javier Segovia, Manuel Gomez-Bueno, Javier Lopez, Sonia Mirabet, Joaquin Navarro, Juan Jose Rodriguez-Molina, Eduardo Fernandez-Cruz, Javier Carbone
BACKGROUND: New biomarkers are necessary to improve detection of the risk of infection in heart transplantation. We performed a multicenter study to evaluate humoral immunity profiles that could better enable us to identify heart recipients at risk of severe infections. METHODS: We prospectively analyzed 170 adult heart recipients at 8 centers in Spain. Study points were before transplantation and 7 and 30 days after transplantation. Immune parameters included IgG, IgM, IgA and complement factors C3 and C4, and titers of specific antibody to pneumococcal polysaccharide antigens (anti-PPS) and to cytomegalovirus (CMV)...
October 17, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27865396/mycobacterium-smegmatis-proteoliposome-induce-protection-in-a-murine-progressive-pulmonary-tuberculosis-model
#5
Yanely Tirado, Alina Puig, Nadine Alvarez, Reinier Borrero, Alicia Aguilar, Frank Camacho, Fatima Reyes, Sonsire Fernandez, Jose Luis Perez, Reynaldo Acevedo, Dulce Mata Espinoza, Jorge Alberto Barrios Payan, Maria de Los A Garcia, Ramlah Kadir, María E Sarmiento, Rogelio Hernandez-Pando, Mohd-Nor Norazmi, Armando Acosta
Tuberculosis (TB) remains an important cause of mortality and morbidity. The TB vaccine, BCG, is not fully protective against the adult form of the disease and is unable to prevent its transmission although it is still useful against severe childhood TB. Hence, the search for new vaccines is of great interest. In a previous study, we have shown that proteoliposomes obtained from Mycobacterium smegmatis (PLMs) induced cross reactive humoral and cellular response against Mycobacterium tuberculosis (Mtb) antigens...
December 2016: Tuberculosis
https://www.readbyqxmd.com/read/27858429/testing-hadronic-interactions-at-ultrahigh-energies-with-air-showers-measured-by-the-pierre-auger-observatory
#6
A Aab, P Abreu, M Aglietta, E J Ahn, I Al Samarai, I F M Albuquerque, I Allekotte, J D Allen, P Allison, A Almela, J Alvarez Castillo, J Alvarez-Muñiz, M Ambrosio, G A Anastasi, L Anchordoqui, B Andrada, S Andringa, C Aramo, F Arqueros, N Arsene, H Asorey, P Assis, J Aublin, G Avila, A M Badescu, C Baus, J J Beatty, K H Becker, J A Bellido, C Berat, M E Bertaina, X Bertou, P L Biermann, P Billoir, J Biteau, S G Blaess, A Blanco, J Blazek, C Bleve, H Blümer, M Boháčová, D Boncioli, C Bonifazi, N Borodai, A M Botti, J Brack, I Brancus, T Bretz, A Bridgeman, F L Briechle, P Buchholz, A Bueno, S Buitink, M Buscemi, K S Caballero-Mora, B Caccianiga, L Caccianiga, A Cancio, F Canfora, L Caramete, R Caruso, A Castellina, G Cataldi, L Cazon, R Cester, A G Chavez, A Chiavassa, J A Chinellato, J C Chirinos Diaz, J Chudoba, R W Clay, R Colalillo, A Coleman, L Collica, M R Coluccia, R Conceição, F Contreras, M J Cooper, S Coutu, C E Covault, J Cronin, R Dallier, S D'Amico, B Daniel, S Dasso, K Daumiller, B R Dawson, R M de Almeida, S J de Jong, G De Mauro, J R T de Mello Neto, I De Mitri, J de Oliveira, V de Souza, J Debatin, L Del Peral, O Deligny, N Dhital, C Di Giulio, A Di Matteo, M L Díaz Castro, F Diogo, C Dobrigkeit, J C D'Olivo, A Dorofeev, R C Dos Anjos, M T Dova, A Dundovic, J Ebr, R Engel, M Erdmann, M Erfani, C O Escobar, J Espadanal, A Etchegoyen, H Falcke, K Fang, G R Farrar, A C Fauth, N Fazzini, A P Ferguson, B Fick, J M Figueira, A Filevich, A Filipčič, O Fratu, M M Freire, T Fujii, A Fuster, F Gallo, B García, D Garcia-Pinto, F Gate, H Gemmeke, A Gherghel-Lascu, P L Ghia, U Giaccari, M Giammarchi, M Giller, D Głas, C Glaser, H Glass, G Golup, M Gómez Berisso, P F Gómez Vitale, N González, B Gookin, J Gordon, A Gorgi, P Gorham, P Gouffon, N Griffith, A F Grillo, T D Grubb, F Guarino, G P Guedes, M R Hampel, P Hansen, D Harari, T A Harrison, J L Harton, Q Hasankiadeh, A Haungs, T Hebbeker, D Heck, P Heimann, A E Herve, G C Hill, C Hojvat, N Hollon, E Holt, P Homola, J R Hörandel, P Horvath, M Hrabovský, T Huege, J Hulsman, A Insolia, P G Isar, I Jandt, S Jansen, C Jarne, J A Johnsen, M Josebachuili, A Kääpä, O Kambeitz, K H Kampert, P Kasper, I Katkov, B Keilhauer, E Kemp, R M Kieckhafer, H O Klages, M Kleifges, J Kleinfeller, R Krause, N Krohm, D Kuempel, G Kukec Mezek, N Kunka, A Kuotb Awad, D LaHurd, L Latronico, M Lauscher, P Lautridou, P Lebrun, R Legumina, M A Leigui de Oliveira, A Letessier-Selvon, I Lhenry-Yvon, K Link, L Lopes, R López, A López Casado, A Lucero, M Malacari, M Mallamaci, D Mandat, P Mantsch, A G Mariazzi, V Marin, I C Mariş, G Marsella, D Martello, H Martinez, O Martínez Bravo, J J Masías Meza, H J Mathes, S Mathys, J Matthews, J A J Matthews, G Matthiae, D Maurizio, E Mayotte, P O Mazur, C Medina, G Medina-Tanco, V B B Mello, D Melo, A Menshikov, S Messina, M I Micheletti, L Middendorf, I A Minaya, L Miramonti, B Mitrica, L Molina-Bueno, S Mollerach, F Montanet, C Morello, M Mostafá, C A Moura, G Müller, M A Muller, S Müller, I Naranjo, S Navas, P Necesal, L Nellen, A Nelles, J Neuser, P H Nguyen, M Niculescu-Oglinzanu, M Niechciol, L Niemietz, T Niggemann, D Nitz, D Nosek, V Novotny, H Nožka, L A Núñez, L Ochilo, F Oikonomou, A Olinto, D Pakk Selmi-Dei, M Palatka, J Pallotta, P Papenbreer, G Parente, A Parra, T Paul, M Pech, F Pedreira, J Pękala, R Pelayo, J Peña-Rodriguez, I M Pepe, L A S Pereira, L Perrone, E Petermann, C Peters, S Petrera, J Phuntsok, R Piegaia, T Pierog, P Pieroni, M Pimenta, V Pirronello, M Platino, M Plum, C Porowski, R R Prado, P Privitera, M Prouza, E J Quel, S Querchfeld, S Quinn, J Rautenberg, O Ravel, D Ravignani, B Revenu, J Ridky, M Risse, P Ristori, V Rizi, W Rodrigues de Carvalho, J Rodriguez Rojo, M D Rodríguez-Frías, D Rogozin, J Rosado, M Roth, E Roulet, A C Rovero, S J Saffi, A Saftoiu, H Salazar, A Saleh, F Salesa Greus, G Salina, J D Sanabria Gomez, F Sánchez, P Sanchez-Lucas, E M Santos, E Santos, F Sarazin, B Sarkar, R Sarmento, C Sarmiento-Cano, R Sato, C Scarso, M Schauer, V Scherini, H Schieler, D Schmidt, O Scholten, H Schoorlemmer, P Schovánek, F G Schröder, A Schulz, J Schulz, J Schumacher, S J Sciutto, A Segreto, M Settimo, A Shadkam, R C Shellard, G Sigl, O Sima, A Śmiałkowski, R Šmída, G R Snow, P Sommers, S Sonntag, J Sorokin, R Squartini, D Stanca, S Stanič, J Stapleton, J Stasielak, F Strafella, A Stutz, F Suarez, M Suarez Durán, T Sudholz, T Suomijärvi, A D Supanitsky, M S Sutherland, J Swain, Z Szadkowski, O A Taborda, A Tapia, A Tepe, V M Theodoro, C Timmermans, C J Todero Peixoto, L Tomankova, B Tomé, A Tonachini, G Torralba Elipe, D Torres Machado, P Travnicek, M Trini, R Ulrich, M Unger, M Urban, A Valbuena-Delgado, J F Valdés Galicia, I Valiño, L Valore, G van Aar, P van Bodegom, A M van den Berg, A van Vliet, E Varela, B Vargas Cárdenas, G Varner, J R Vázquez, R A Vázquez, D Veberič, V Verzi, J Vicha, M Videla, L Villaseñor, S Vorobiov, H Wahlberg, O Wainberg, D Walz, A A Watson, M Weber, A Weindl, L Wiencke, H Wilczyński, T Winchen, D Wittkowski, B Wundheiler, S Wykes, L Yang, T Yapici, D Yelos, E Zas, D Zavrtanik, M Zavrtanik, A Zepeda, B Zimmermann, M Ziolkowski, Z Zong, F Zuccarello
Ultrahigh energy cosmic ray air showers probe particle physics at energies beyond the reach of accelerators. Here we introduce a new method to test hadronic interaction models without relying on the absolute energy calibration, and apply it to events with primary energy 6-16 EeV (E_{CM}=110-170  TeV), whose longitudinal development and lateral distribution were simultaneously measured by the Pierre Auger Observatory. The average hadronic shower is 1.33±0.16 (1.61±0.21) times larger than predicted using the leading LHC-tuned models EPOS-LHC (QGSJetII-04), with a corresponding excess of muons...
November 4, 2016: Physical Review Letters
https://www.readbyqxmd.com/read/27848732/results-from-colombia-s-2016-report-card-on-physical-activity-for-children-and-youth
#7
Silvia A González, Maria A Castiblanco, Luis F Arias-Gómez, Andrea Martinez-Ospina, Daniel D Cohen, Gustavo A Holguin, Adriana Almanza, Diana Marina Camargo Lemos, Jorge Enrique Correa-Bautista, Iván D Escobar, Johnattan García, Rocio Gámez, Mauricio Garzon, Yaneth Herazo Beltrán, Hernan Hurtado, Oscar Lozano, Diana C Páez, Robinson Ramírez-Vélez, Nubia Ruiz, Gustavo Tovar, Olga L Sarmiento
BACKGROUND: Physical activity (PA) is vital to the holistic development of young people. Regular participation in PA is associated with substantial benefits for health, cognitive function, and social inclusion. Recognizing the potential of PA in the context of the current peace process in Colombia, the purpose of this article is to present the methodology and results of Colombia's second Report Card on PA for children and youth. METHODS: A group of experts on PA graded 14 PA indicators based on data from national surveys and policy documents...
November 2016: Journal of Physical Activity & Health
https://www.readbyqxmd.com/read/27847217/assessing-the-effect-of-physical-activity-classes-in-public-spaces-on-leisure-time-physical-activity-al-ritmo-de-las-comunidades-a-natural-experiment-in-bogota-colombia
#8
Andrea Torres, María Paula Díaz, Matthew J Hayat, Rodney Lyn, Michael Pratt, Deborah Salvo, Olga L Sarmiento
The Recreovia program provides free physical activity (PA) classes in public spaces in Bogota, Colombia. The purpose of this study was to assess the effectiveness of the Recreovia program in increasing PA among users of nine parks in Bogota. This study was a natural experiment conducted between 2013 and 2015 in Bogota. Community members and park users living nearby three groups of parks were compared: Group 1 were parks implementing new Recreovias (n=3), Group 2 were control parks (n=3) without Recreovias, and Group 3 were parks with existing Recreovías...
November 12, 2016: Preventive Medicine
https://www.readbyqxmd.com/read/27823781/native-herbaceous-plant-species-with-potential-use-in-phytoremediation-of-heavy-metals-spotlight-on-wetlands-a-review
#9
REVIEW
Mayerly Alexandra Oyuela Leguizamo, Wilmar Darío Fernández Gómez, Martha Cecilia Gutiérrez Sarmiento
Soil, air and water pollution caused by the mobility and solubility of heavy metals significantly damages the environment, human health, plants and animals. One common in situ method used for the decontamination of heavy metals is phytoremediation. This usually involves the use of exotic species. However, these species may exhibit invasive behavior, thereby, affect the environmental and ecological dynamics of the ecosystem into which they are introduced. This paper focuses on some native herbaceous plant species reported on the wetlands of Bogota, Colombia, with potential use in phytoremediation of heavy metals...
November 4, 2016: Chemosphere
https://www.readbyqxmd.com/read/27822386/correlation-between-arterial-lactate-and-central-venous-lactate-in-children-with-sepsis
#10
Jaime Fernández Sarmiento, Paula Araque, María Yepes, Hernando Mulett, Ximena Tovar, Fabio Rodriguez
Introduction. Lactate is an important indicator of tissue perfusion. The objective of this study is to evaluate if there are significant differences between the arterial and central venous measurement of lactate in pediatric patients with sepsis and/or septic shock. Methods. Longitudinal retrospective observational study. Forty-two patients were included between the age of 1 month and 17 years, with a diagnosis of sepsis and septic shock, who were admitted to the intensive care unit of a university referral hospital...
2016: Critical Care Research and Practice
https://www.readbyqxmd.com/read/27820821/a-cluster-randomized-controlled-trial-to-reduce-diarrheal-disease-and-dengue-entomological-risk-factors-in-rural-primary-schools-in-colombia
#11
Hans J Overgaard, Neal Alexander, Maria Ines Matiz, Juan Felipe Jaramillo, Victor Alberto Olano, Sandra Vargas, Diana Sarmiento, Audrey Lenhart, Thor Axel Stenström
BACKGROUND: As many neglected tropical diseases are co-endemic and have common risk factors, integrated control can efficiently reduce disease burden and relieve resource-strained public health budgets. Diarrheal diseases and dengue fever are major global health problems sharing common risk factors in water storage containers. Where provision of clean water is inadequate, water storage is crucial. Fecal contamination of stored water is a common source of diarrheal illness, but stored water also provides breeding sites for dengue vector mosquitoes...
November 2016: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/27815673/erratum-to-patient-derived-mammosphere-and-xenograft-tumour-initiation-correlates-with-progression-to-metastasis
#12
Rachel Eyre, Denis G Alférez, Kath Spence, Mohamed Kamal, Frances L Shaw, Bruno M Simões, Angélica Santiago-Gómez, Aida Sarmiento-Castro, Maria Bramley, Mohammed Absar, Zahida Saad, Sumohan Chatterjee, Cliona Kirwan, Ashu Gandhi, Anne C Armstrong, Andrew M Wardley, Ciara S O'Brien, Gillian Farnie, Sacha J Howell, Robert B Clarke
No abstract text is available yet for this article.
November 4, 2016: Journal of Mammary Gland Biology and Neoplasia
https://www.readbyqxmd.com/read/27807119/what-s-important-putting-patients-first
#13
EDITORIAL
Augusto Sarmiento
No abstract text is available yet for this article.
November 2, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27802074/gestational-chronodisruption-impairs-circadian-physiology-in-rat-male-offspring-increasing-the-risk-of-chronic-disease
#14
Natalia Mendez, Diego Halabi, Carlos Spichiger, Esteban R Salazar, Karina Vergara, Pamela Alonso-Vasquez, Pamela Carmona, Jose M Sarmiento, Hans G Richter, Maria Seron-Ferre, Claudia Torres-Farfan
Chronic exposure to light at night, as in shift work, alters biological clocks (chronodisruption), negatively impacting pregnancy outcome in humans. Actually the interaction of maternal and fetal circadian systems could be a key factor determining a fitting health in adults. We propose that chronic photoperiod shift (CPS) during pregnancy alter maternal circadian rhythms and impair circadian physiology in the adult offspring, increasing health risks. Pregnant rats were exposed to normal photoperiod (12 h light, 12 h dark) or to CPS until 85% of gestation...
December 2016: Endocrinology
https://www.readbyqxmd.com/read/27796971/geochemical-behavior-of-an-acid-drainage-system-the-case-of-the-amarillo-river-famatina-la-rioja-argentina
#15
K L Lecomte, S N Maza, G Collo, A M Sarmiento, P J Depetris
The Amarillo River (Famatina range, Argentina, ~29° S and ~67° W) is unusual because acid mine drainage (AMD) is superimposed on the previously existing acid rock drainage (ARD) scenario, as a Holocene paleolake sedimentary sequence shows. In a markedly oxidizing environment, its water is currently ferrous and of the sulfate-magnesium type with high electrical conductivity (>10 mS cm(-1) in uppermost catchments). At the time of sampling, the interaction of the mineralized zone with the remnants of mining labors determined an increase in some elements (e...
October 28, 2016: Environmental Science and Pollution Research International
https://www.readbyqxmd.com/read/27784884/second-vs-first-generation-drug-eluting-stents-in-complex-lesions-subsets-3-years-follow-up-of-eraci-iv-study
#16
Alfredo E Rodriguez, Omar Santaera, Miguel Larribau, Ricardo Sarmiento, Carlos Haiek, Juan F Del Pozo, Hernan Pavlovsky, Alfredo M Rodriguez-Granillo
BACKGROUND: Although percutaneous coronary intervention (PCI) with first-generation drug-eluting stents (DES-1) did not show a benefit in terms of death rate and myocardial infarction (MI) compared to bypass surgery (coronary artery bypass graft [CABG]), DES platforms have seen a remarkable improvement in the last few years, and a significant increase in their safety and efficacy was observed in randomized controlled trials and observational studies in comparison with DES-1 in patients with coronary artery disease (CAD)...
February 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/27783386/characterization-of-resident-lymphocytes-in-human-pancreatic-islets
#17
Miljana Radenkovic, Kristina Uvebrant, Oskar Skog, Luis Sarmiento, Jeanette Avartsson, Peter Storm, Petter Vickman, Per-Anders Bertilsson, Malin Fex, Olle Korsgren, Corrado M Cilio
The current view of type 1 diabetes (T1D) is that it is an immune-mediated disease where lymphocytes infiltrate the pancreatic islets, promote killing of beta cells and cause overt diabetes. Although tissue resident immune cells have been demonstrated in several organs, the composition of lymphocytes in human healthy pancreatic islets have been scarcely studied. Here we aimed to investigate the phenotype of immune cells associated to human islets of non-diabetic organ donors. A flow cytometry analysis of isolated islets from perfused pancreases (n=38) was employed to identify alpha, beta, T, NK and B cells...
October 26, 2016: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/27774326/accurate-diagnosis-of-severe-hypospadias-using-2d-and-3d-ultrasounds
#18
Vanesa Rodríguez Fernández, Carlos López Ramón Y Cajal, Elena Marín Ortiz, Nerea Sarmiento Carrera
The hypospadias is the most common urogenital anomaly of male neonates but the prenatal diagnosis of this is often missed before birth. We present the prenatal diagnosis of a severe penoscrotal hypospadias using 2D and 3D ultrasounds. 3D sonography allowed us the best evaluation of the genitals and their anatomical relations. This ample detailed study allowed us to show the findings to the parents and the pediatric surgeon and to configure the best information about the prognosis and surgical treatment.
2016: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27770336/a-prospective-multi-center-study-of-intramedullary-nailing-vs-casting-of-stable-tibial-shaft-fractures
#19
William T Obremskey, Norele Cutrera, Christopher M Kidd
BACKGROUND: The purpose of this study was to determine optimal treatment of stable tibial shaft fractures using intramedullary nailing (IMN) or casting. MATERIALS AND METHODS: We performed a multi-center prospective study cohort. Patients with stable tibia shaft fractures meeting Sarmiento's criteria (isolated closed fractures with less than 12 mm of shortening and 10° of angulation) were enrolled prospectively and treated with either a reamed IMN with static interlocking screws or closed reduction followed by long-leg casting...
October 21, 2016: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/27740646/the-effect-of-osteopontin-and-an-osteopontin-derived-synthetic-peptide-coating-on-osseointegration-of-implants-in-a-canine-model
#20
Joseph P Fiorellini, Sven Glindmann, Jairo Salcedo, Hans-Peter Weber, Chang-Joo Park, Hector L Sarmiento
Osteopontin (OPN) and an OPN-derived synthetic peptide, OC-1016, have demonstrated their potential to enhance osseointegration in vitro. The purpose of this study was to evaluate bone-to-implant contact (BIC) and surrounding bone density (BD) of implants coated with either recombinant human OPN (rhOPN) or OC-1016 as compared with noncoated titanium plasma sprayed (TPS) surface in a canine model. Histomorphometric analysis revealed that at 4 weeks, %BIC and %BD of coated implants were significantly higher than those of noncoated TPS implants...
November 2016: International Journal of Periodontics & Restorative Dentistry
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