4

Loan No. 2924-IND: Uttarakhand Power Sector Investment Program - Project 4 [ICB No. 3-P/ADB/PTCUL/2012-13]




4

Loan No. 3411-AZE: Water Supply and Sanitation Investment Program - Tranche 4 [MFF42408-044-T4-ICB-1.02]




4

Loan Nos. 3020/3021-TIM: Road Network Upgrading Sector Project [ICB/04/MPW-2014]




4

Loan No. 42486-IND: Madhya Pradesh Urban Services Improvement Program [MPUSIP 6D REBIDDING]




4

Loan Nos. 2787/2788-IND: National Grid Improvement Project [CD14: CC-CS/421-NR1/CD-2709/7/G2-CD15: CC-CS/421-NR1/CD-2711/7/G2-CD16: CC-CS/421-NR1/CD-2713/7/G2-CD17: CC-CS/421-NR1/CD-2715/7/G2] EXTENDED




4

Loan Nos. 3076/3077-PNG: Highland Region Road Improvement Investment Program [CSTB No. 2946]




4

Loan No.46049-PRC: Akesu Integrated Urban Development and Environment Improvement Project[Contract No.: WRH-CW01]




4

Loan No. 42401-AZE: Power Distribution Enhancement Investment Program - Tranche 1 [AI/ADB-10.1 and AI/ADB-10.2]




4

Loan No. 3203-PAK: Power Transmission Enhancement Investment Program Tranche 4 [ADB-79-2015] EXTENDED




4

Loan No. 2492/2493-UZB (SF): Water Resources Management Sector Project [WRMSP/ICB/03]




4

Loan No. 2517-VIE: Renewable Energy Development and Network Expansion and Rehabilitation for Remote Communes Sector Project [G04]




4

Loan No. 2462-BAN: Second Urban Governance and Infrastructure Improvement (Sector) Project [UGIIP-II /LGED/ICB/ G-53]




4

Asia-Pacific Trade Facilitation Report 2024: Promoting Sustainability and Resilience of Global Value Chains

This report examines the progress of trade facilitation in Asia and the Pacific, highlights recent trends in paperless trade, and evaluates the impact of trade facilitation initiatives on trade costs and overall trade.




4

Asian Development Outlook (ADO) July 2024: Steady Growth, Slowing Inflation

Asia and the Pacific’s developing economies are projected to grow 5.0% this year on the back of resilient domestic demand and strong export growth, particularly in the electronics sector.




4

Key Indicators for Asia and the Pacific 2024: Data for Climate Action

This publication provides updated statistics on a comprehensive set of economic, financial, social, and environmental measures as well as select indicators for the Sustainable Development Goals (SDGs).




4

Peter Higgs, physicist who theorised the Higgs boson, has died aged 94

Nobel prizewinning theoretical physicist Peter Higgs has died aged 94. He proposed the particle that gives other particles mass – now named the Higgs boson and discovered by the Large Hadron Collider at CERN in 2012




4

Quantum 'Schrödinger's cat' survives for a stunning 23 minutes

A typically fragile quantum superposition has been made to last exceptionally long, and could eventually be used as a probe for discovering new physics




4

We might officially enter the Anthropocene epoch in 2024

Scientific bodies are due to make an official decision in the coming year about whether to declare a new geochronological unit precipitated by the impact of humans on Earth




4

Huge crater in India hints at major meteorite impact 4000 years ago

The Luna structure, a 1.8-kilometre-wide depression in north-west India, may have been caused by the largest meteorite to strike Earth in the past 50,000 years




4

Watch Philippines typhoon disaster film winner of Earth Photo 24 award

A documentary film about three young survivors of super-typhoon Odette, a tropical cyclone that hit the Philippines in 2021, wins the New Scientist Editors Award at Earth Photo 2024




4

El Niño pattern can bring wet weather to UK one year later

El Niño and La Niña cycles driven by ocean temperatures in the Pacific can influence weather in the North Atlantic 12 months later – a finding that could improve long-range forecasts




4

Quantum 'Schrödinger's cat' survives for a stunning 23 minutes

A typically fragile quantum superposition has been made to last exceptionally long, and could eventually be used as a probe for discovering new physics




4

War-era sugar rationing boosted health of UK people conceived in 1940s

People conceived during the UK's 1940s and 50s sugar rationing have a lower risk of type 2 diabetes and high blood pressure than those conceived after rationing ended




4

The best new science fiction books of November 2024

From Harlan Ellison to Haruki Murakami, via an intergalactic cooking competition, this month has plenty of science fictional treats on offer




4

2024 is set to be the first year that breaches the 1.5°C warming limit

This year’s average global temperature is almost certain to exceed 1.5°C above pre-industrial times – a milestone that should spur urgent action, say climate scientists




4

Modern humans were already in northern Europe 45,000 years ago

DNA from bones found in a cave in Germany has been identified as from Homo sapiens, showing that our species endured frigid conditions there as they expanded across the continent




4

Early humans spread as far north as Siberia 400,000 years ago

A site in Siberia has evidence of human presence 417,000 years ago, raising the possibility that hominins could have reached North America much earlier than we thought




4

Health Highlights: Aug. 24, 2010

Title: Health Highlights: Aug. 24, 2010
Category: Health News
Created: 8/24/2010 12:10:00 PM
Last Editorial Review: 8/25/2010 12:00:00 AM




4

Even Before Recession, 14 Million Kids 'Underinsured': Study

Title: Even Before Recession, 14 Million Kids 'Underinsured': Study
Category: Health News
Created: 8/25/2010 6:10:00 PM
Last Editorial Review: 8/26/2010 12:00:00 AM




4

Report: 164 Million Obese Adults by 2030

Title: Report: 164 Million Obese Adults by 2030
Category: Health News
Created: 8/26/2011 11:00:00 AM
Last Editorial Review: 8/26/2011 12:00:00 AM




4

4 Eating Habits May Help Older Women Maintain Weight Loss

Title: 4 Eating Habits May Help Older Women Maintain Weight Loss
Category: Health News
Created: 8/28/2012 2:05:00 PM
Last Editorial Review: 8/29/2012 12:00:00 AM




4

Unhappy at Work in Your 20s, Unhealthy in Your 40s?

Title: Unhappy at Work in Your 20s, Unhealthy in Your 40s?
Category: Health News
Created: 8/22/2016 12:00:00 AM
Last Editorial Review: 8/23/2016 12:00:00 AM




4

Salmonella Outbreak in 4 States Linked to Kosher Chicken: CDC

Title: Salmonella Outbreak in 4 States Linked to Kosher Chicken: CDC
Category: Health News
Created: 8/30/2018 12:00:00 AM
Last Editorial Review: 8/30/2018 12:00:00 AM




4

AHA News: Star Wrestler-Turned-Coach Discovers Serious Heart Problem at 24

Title: AHA News: Star Wrestler-Turned-Coach Discovers Serious Heart Problem at 24
Category: Health News
Created: 8/24/2021 12:00:00 AM
Last Editorial Review: 8/24/2021 12:00:00 AM




4

One Activity Causes 4 Out of 5 Sports-Linked Spinal Injuries

Title: One Activity Causes 4 Out of 5 Sports-Linked Spinal Injuries
Category: Health News
Created: 8/25/2021 12:00:00 AM
Last Editorial Review: 8/25/2021 12:00:00 AM




4

What Are the 4 Stages of Congestive Heart Failure?

Title: What Are the 4 Stages of Congestive Heart Failure?
Category: Diseases and Conditions
Created: 6/24/2020 12:00:00 AM
Last Editorial Review: 8/26/2022 12:00:00 AM




4

84 People Now Sickened in E. Coli Outbreak Tied to Wendy's Restaurant Lettuce

Title: 84 People Now Sickened in E. Coli Outbreak Tied to Wendy's Restaurant Lettuce
Category: Health News
Created: 8/26/2022 12:00:00 AM
Last Editorial Review: 8/26/2022 12:00:00 AM




4

Stay Independent of Asthma, Allergies This July 4th

Title: Stay Independent of Asthma, Allergies This July 4th
Category: Health News
Created: 7/1/2022 12:00:00 AM
Last Editorial Review: 7/1/2022 12:00:00 AM




4

What Are 4 Symptoms of Seasonal Affective Disorder?

Title: What Are 4 Symptoms of Seasonal Affective Disorder?
Category: Diseases and Conditions
Created: 12/10/2021 12:00:00 AM
Last Editorial Review: 7/6/2022 12:00:00 AM




4

Colorectal Cancer Screening: A Multicomponent Intervention to Increase Uptake in Patients Aged 45-49

Purpose:

Colorectal cancer (CRC) screening is recommended starting at age 45, but there has been little research on strategies to promote screening among patients younger than 50. This study assessed the effect of a multicomponent intervention on screening completion in this age group.

Methods:

The intervention consisted of outreach to patients aged 45 to 49 (n = 3,873) via mailed fecal immunochemical test (FIT) (sent to 46%), text (84%), e-mail (53%), and the extension to this age group of an existing standing order protocol allowing primary care nurses and medical assistants to order FIT at primary care clinics in an urban safety-net system. We used segmented linear regression to assess changes in CRC screening completion trends. Patients aged 51 to 55 were included as a comparison group (n = 3,943). Data were extracted from the EHR.

Results:

The percentage of patients aged 45 to 49 who were up-to-date with CRC screening (colonoscopy in 10 years or FIT in last year) increased an average of 0.4% (95% CI 0.3, 0.6)) every 30 days before intervention rollout and 2.8% (95% CI 2.5, 3.1) after (slope difference 2.3% [95% CI 2.0, 2.7]). This difference persisted after accounting for small changes in the outcome observed in the comparison group (slope difference 1.7% [95% CI 1.2, 2.2]).

Conclusions:

These results suggest that the intervention increased CRC screening completion among patients 45 to 49. Health care systems seeking to improve CRC screening participation among patients aged 45 to 49 should consider implementing similar interventions.




4

Performance Evaluation of the Generative Pre-trained Transformer (GPT-4) on the Family Medicine In-Training Examination

Objective:

In this study, we sought to comprehensively evaluate GPT-4 (Generative Pre-trained Transformer)’s performance on the 2022 American Board of Family Medicine’s (ABFM) In-Training Examination (ITE), compared with its predecessor, GPT-3.5, and the national family residents’ performance on the same examination.

Methods:

We utilized both quantitative and qualitative analyses. First, a quantitative analysis was employed to evaluate the model's performance metrics using zero-shot prompt (where only examination questions were provided without any additional information). After this, qualitative analysis was executed to understand the nature of the model's responses, the depth of its medical knowledge, and its ability to comprehend contextual or new information through chain-of-thoughts prompts (interactive conversation) with the model.

Results:

This study demonstrated that GPT-4 made significant improvement in accuracy compared with GPT-3.5 over a 4-month interval between their respective release dates. The correct percentage with zero-shot prompt increased from 56% to 84%, which translates to a scaled score growth from 280 to 690, a 410-point increase. Most notably, further chain-of-thought investigation revealed GPT-4’s ability to integrate new information and make self-correction when needed.

Conclusions:

In this study, GPT-4 has demonstrated notably high accuracy, as well as rapid reading and learning capabilities. These results are consistent with previous research indicating GPT-4's significant potential to assist in clinical decision making. Furthermore, the study highlights the essential role of physicians' critical thinking and lifelong learning skills, particularly evident through the analysis of GPT-4's incorrect responses. This emphasizes the indispensable human element in effectively implementing and using AI technologies in medical settings.




4

2024 September/October Editorial




4

NEAT1 promotes genome stability via m6A methylation-dependent regulation of CHD4 [Research Papers]

Long noncoding (lnc)RNAs emerge as regulators of genome stability. The nuclear-enriched abundant transcript 1 (NEAT1) is overexpressed in many tumors and is responsive to genotoxic stress. However, the mechanism that links NEAT1 to DNA damage response (DDR) is unclear. Here, we investigate the expression, modification, localization, and structure of NEAT1 in response to DNA double-strand breaks (DSBs). DNA damage increases the levels and N6-methyladenosine (m6A) marks on NEAT1, which promotes alterations in NEAT1 structure, accumulation of hypermethylated NEAT1 at promoter-associated DSBs, and DSB signaling. The depletion of NEAT1 impairs DSB focus formation and elevates DNA damage. The genome-protective role of NEAT1 is mediated by the RNA methyltransferase 3 (METTL3) and involves the release of the chromodomain helicase DNA binding protein 4 (CHD4) from NEAT1 to fine-tune histone acetylation at DSBs. Our data suggest a direct role for NEAT1 in DDR.




4

Dysregulating mTORC1-4E-BP2 signaling in GABAergic interneurons impairs hippocampus-dependent learning and memory [RESEARCH PAPERS]

Memory formation is contingent on molecular and structural changes in neurons in response to learning stimuli—a process known as neuronal plasticity. The initiation step of mRNA translation is a gatekeeper of long-term memory by controlling the production of plasticity-related proteins in the brain. The mechanistic target of rapamycin complex 1 (mTORC1) controls mRNA translation, mainly through phosphorylation of the eukaryotic initiation factor 4E (eIF4E)-binding proteins (4E-BPs) and ribosomal protein S6 kinases (S6Ks). mTORC1 signaling decreases throughout brain development, starting from the early postnatal period. Here, we discovered that in mice, the age-dependent decrease in mTORC1 signaling occurs selectively in excitatory but not inhibitory neurons. Using a gene conditional knockout (cKO) strategy, we demonstrate that either up- or downregulating the mTORC1-4E-BP2 axis in GAD65 inhibitory interneurons, but not excitatory neurons, results in long-term object recognition and object location memory deficits. Our data indicate that the mTORC1 pathway in inhibitory but not excitatory neurons plays a key role in memory formation.




4

DNAJA2 and Hero11 mediate similar conformational extension and aggregation suppression of TDP-43 [REPORT]

Many RNA-binding proteins (RBPs) contain low-complexity domains (LCDs) with prion-like compositions. These long intrinsically disordered regions regulate their solubility, contributing to their physiological roles in RNA processing and organization. However, this also makes these RBPs prone to pathological misfolding and aggregation that are characteristic of neurodegenerative diseases. For example, TAR DNA-binding protein 43 (TDP-43) forms pathological aggregates associated with amyotrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration (FTLD). While molecular chaperones are well-known suppressors of these aberrant events, we recently reported that highly disordered, hydrophilic, and charged heat-resistant obscure (Hero) proteins may have similar effects. Specifically, Hero proteins can maintain the activity of other proteins from denaturing conditions in vitro, while their overexpression can suppress cellular aggregation and toxicity associated with aggregation-prone proteins. However, it is unclear how these protective effects are achieved. Here, we used single-molecule FRET to monitor the conformations of the aggregation-prone prion-like LCD of TDP-43. While we observed high conformational heterogeneity in wild-type LCD, the ALS-associated mutation A315T promoted collapsed conformations. In contrast, an Hsp40 chaperone, DNAJA2, and a Hero protein, Hero11, stabilized extended states of the LCD, consistent with their ability to suppress the aggregation of TDP-43. Our results link single-molecule effects on conformation to macro effects on bulk aggregation, where a Hero protein, like a chaperone, can maintain the conformational integrity of a client protein to prevent its aggregation.




4

Accuracy of CAD4TB (Computer-Aided Detection for Tuberculosis) on paediatric chest radiographs

Background

Computer-aided detection (CAD) systems hold promise for improving tuberculosis (TB) detection on digital chest radiographs. However, data on their performance in exclusively paediatric populations are scarce.

Methods

We conducted a retrospective diagnostic accuracy study evaluating the performance of CAD4TBv7 (Computer-Aided Detection for Tuberculosis version 7) using digital chest radiographs from well-characterised cohorts of Gambian children aged <15 years with presumed pulmonary TB. The children were consecutively recruited between 2012 and 2022. We measured CAD4TBv7 performance against a microbiological reference standard (MRS) of confirmed TB, and also performed Bayesian latent class analysis (LCA) to address the inherent limitations of the MRS in children. Diagnostic performance was assessed using the area under the receiver operating characteristic curve (AUROC) and point estimates of sensitivity and specificity.

Results

A total of 724 children were included in the analysis, with confirmed TB in 58 (8%), unconfirmed TB in 145 (20%) and unlikely TB in 521 (72%). Using the MRS, CAD4TBv7 showed an AUROC of 0.70 (95% CI 0.60–0.79), and demonstrated sensitivity and specificity of 19.0% (95% CI 11–31%) and 99.0% (95% CI 98.0–100.0%), respectively. Applying Bayesian LCA with the assumption of conditional independence between tests, sensitivity and specificity estimates for CAD4TBv7 were 42.7% (95% CrI 29.2–57.5%) and 97.9% (95% CrI 96.6–98.8%), respectively. When allowing for conditional dependence between culture and Xpert assay, CAD4TBv7 demonstrated a sensitivity of 50.3% (95% CrI 32.9–70.0%) and specificity of 98.0% (95% CrI 96.7–98.9%).

Conclusion

Although CAD4TBv7 demonstrated high specificity, its suboptimal sensitivity underscores the crucial need for optimisation of CAD4TBv7 for detecting TB in children.




4

Correlations of Long Noncoding RNA HNF4A-AS1 Alternative Transcripts with Liver Diseases and Drug Metabolism [Articles]

Hepatocyte nuclear factor 4 alpha antisense 1 (HNF4A-AS1) is a long noncoding RNA (lncRNA) gene physically located next to the transcription factor HNF4A gene in the human genome. Its transcription products have been reported to inhibit the progression of hepatocellular carcinoma (HCC) and negatively regulate the expression of cytochrome P450s (CYPs), including CYP1A2, 2B6, 2C9, 2C19, 2E1, and 3A4. By altering CYP expression, lncRNA HNF4A-AS1 also contributes to the susceptibility of drug-induced liver injury. Thus, HNF4A-AS1 lncRNA is a promising target for controlling HCC and modulating drug metabolism. However, HNF4A-AS1 has four annotated alternative transcripts in the human genome browsers, and it is unclear which transcripts the small interfering RNAs or small hairpin RNAs used in the previous studies are silenced and which transcripts should be used as the target. In this study, four annotated and two newly identified transcripts were confirmed. These six transcripts showed different expression levels in different liver disease conditions, including metabolic dysfunction-associated steatotic liver disease, alcohol-associated liver disease, and obesity. The expression patterns of all HNF4A-AS1 transcripts were further investigated in liver cell growth from human embryonic stem cells to matured hepatocyte-like cells, HepaRG differentiation, and exposure to rifampicin treatment. Several HNF4A-AS1 transcripts highly displayed correlations with these situations. In addition, some of the HNF4A-AS1 transcripts also showed a strong correlation with CYP3A4 during HepaRG maturation and rifampicin exposure. Our findings provide valuable insights into the specific roles of HNF4A-AS1 transcripts, paving the way for more targeted therapeutic strategies for liver diseases and drug metabolism.

SIGNIFICANCE STATEMENT

This study explores the alternative transcripts of HNF4A-AS1, showing how their expression changes in different biological conditions, from various liver diseases to the growth and differentiation of hepatocytes and drug metabolism. The generated knowledge is essential for understanding the independent roles of different transcripts from the same lncRNA in different liver diseases and drug metabolism situations.




4

Effects of Compound Probiotics on Pharmacokinetics of Cytochrome 450 Probe Drugs in Rats [Articles]

Compound probiotics have been widely used and commonly coadministered with other drugs for treating various chronic illnesses, yet their effects on drug pharmacokinetics remain underexplored. This study elucidated the impact of VSL#3 on the metabolism of probe drugs for cytochrome P450 enzymes (P450s), specifically omeprazole, tolbutamide, midazolam, metoprolol, phenacetin, and chlorzoxazone. Male Wistar rats were administered drinking water containing VSL#3 or not for 14 days and then intragastrically administered a P450 probe cocktail; this was done to investigate the host P450’s metabolic phenotype. Stool, liver/jejunum, and serum samples were collected for 16S ribosomal RNA sequencing, RNA sequencing, and bile acid profiling. The results indicated significant differences in both α and β diversity of intestinal microbial composition between the probiotic and vehicle groups in rats. In the probiotic group, the bioavailability of omeprazole increased by 269.9%, whereas those of tolbutamide and chlorpropamide decreased by 28.1% and 27.4%, respectively. The liver and jejunum exhibited 1417 and 4004 differentially expressed genes, respectively, between the two groups. In the probiotic group, most of P450 genes were upregulated in the liver but downregulated in the jejunum. The expression of genes encoding metabolic enzymes and drug transporters also changed. The serum-conjugated bile acids in the probiotic group were significantly reduced. Shorter duodenal villi and longer ileal villi were found in the probiotic group. In summary, VSL#3 administration altered the gut microbiota, host drug–processing gene expression, and intestinal structure in rats, which could be reasons for pharmacokinetic changes.

SIGNIFICANCE STATEMENT

This study focused on the effects of the probiotic VSL#3 on the pharmacokinetic profile of cytochrome P450 probe drugs and the expression of host drug metabolism genes. Compared with previous studies, the present study provides a comprehensive explanation for the host drug metabolism profile modified by probiotics, combined here with the bile acid profile and histopathological analysis.




4

Comparison of the CYP3A Selective Inhibitors CYP3cide, Clobetasol, and Azamulin for Their Potential to Distinguish CYP3A7 Activity in the Presence of CYP3A4/5 [Articles]

The CYP3A7 enzyme accounts for ~50% of the total cytochrome P450 (P450) content in fetal and neonatal livers and is the predominant P450 involved in neonatal xenobiotic metabolism. Additionally, it is a key player in healthy birth outcomes through the oxidation of dehydroepiandrosterone (DHEA) and DHEA-sulfate. The amount of the other hepatic CYP3A isoforms, CYP3A4 and CYP3A5, expressed in neonates is low but highly variable, and therefore the activity of individual CYP3A isoforms is difficult to differentiate due to their functional similarities. Consequently, a better understanding of the contribution of CYP3A7 to drug metabolism is essential to identify the risk that drugs may pose to neonates and developing infants. To distinguish CYP3A7 activity from CYP3A4/5, we sought to further characterize the selectivity of the specific CYP3A inhibitors CYP3cide, clobetasol, and azamulin. We used three substrate probes, dibenzylfluorescein, luciferin-PPXE, and midazolam, to determine the IC50 and metabolism-dependent inhibition (MDI) properties of the CYP3A inhibitors. Probe selection had a significant effect on the IC50 values and P450 inactivation across all inhibitory compounds and enzymes. CYP3cide and azamulin were both identified as MDIs and were most specific for CYP3A4. Contrary to previous reports, we found that clobetasol propionate (CP) was not an MDI of CYP3A5 but was more selective for CYP3A5 over CYP3A4/7. We further investigated CYP3cide and CP’s ability to differentiate CYP3A7 activity in an equal mixture of recombinant CYP3A4, CYP3A5, and CYP3A7, and our results provide confidence of CYP3cide’s and CP’s ability to distinguish CYP3A7 activity in the presence of the other CYP3A isoforms.

SIGNIFICANCE STATEMENT

These findings provide valuable insight regarding in vitro testing conditions to investigate the metabolism of new drug candidates and help determine drug safety in neonates. The results presented here also clearly demonstrate the effect that probe selection may have on CYP3A cytochrome P450 inhibition studies.




4

Early Prediction and Impact Assessment of CYP3A4-Related Drug-Drug Interactions for Small-Molecule Anticancer Drugs Using Human-CYP3A4-Transgenic Mouse Models [Articles]

Early detection of drug-drug interactions (DDIs) can facilitate timely drug development decisions, prevent unnecessary restrictions on patient enrollment, resulting in clinical study populations that are not representative of the indicated study population, and allow for appropriate dose adjustments to ensure safety in clinical trials. All of these factors contribute to a streamlined drug approval process and enhanced patient safety. Here we describe a new approach for early prediction of the magnitude of change in exposure for cytochrome P450 (P450) CYP3A4-related DDIs of small-molecule anticancer drugs based on the model-based extrapolation of human-CYP3A4-transgenic mice pharmacokinetics to humans. Victim drugs brigatinib and lorlatinib were evaluated with the new approach in combination with the perpetrator drugs itraconazole and rifampicin. Predictions of the magnitude of change in exposure deviated at most 0.99- to 1.31-fold from clinical trial results for inhibition with itraconazole, whereas exposure predictions for the induction with rifampicin were less accurate, with deviations of 0.22- to 0.48-fold. Results for the early prediction of DDIs and their clinical impact appear promising for CYP3A4 inhibition, but validation with more victim and perpetrator drugs is essential to evaluate the performance of the new method.

SIGNIFICANCE STATEMENT

The described method offers an alternative for the early detection and assessment of potential clinical impact of CYP3A4-related drug-drug interactions. The model was able to adequately describe the inhibition of CYP3A4 metabolism and the subsequent magnitude of change in exposure. However, it was unable to accurately predict the magnitude of change in exposure of victim drugs in combination with an inducer.