Ignite Creation Date:
2025-12-24 @ 12:20 PM
Ignite Modification Date:
2026-04-29 @ 5:12 PM
Study NCT ID:
NCT00090961
Status:
TERMINATED
Last Update Posted:
2012-11-01
First Post:
2004-09-07
Is Gene Therapy:
True
Has Adverse Events:
False
Brief Title:
S0229, Pulmonary Rehabilitation Education w/wo Exercise Training in Improving Physical Function in Patients Who Are Undergoing Chemo & RT for Locally Advanced Lung Cancer
Sponsor:
Organization:
Raw JSON
{'hasResults': False, 'derivedSection': {'miscInfoModule': {'versionHolder': '2025-12-24'}, 'conditionBrowseModule': {'meshes': [{'id': 'D008175', 'term': 'Lung Neoplasms'}, {'id': 'D002289', 'term': 'Carcinoma, Non-Small-Cell Lung'}, {'id': 'D000077192', 'term': 'Adenocarcinoma of Lung'}, {'id': 'D002282', 'term': 'Adenocarcinoma, Bronchiolo-Alveolar'}], 'ancestors': [{'id': 'D012142', 'term': 'Respiratory Tract Neoplasms'}, {'id': 'D013899', 'term': 'Thoracic Neoplasms'}, {'id': 'D009371', 'term': 'Neoplasms by Site'}, {'id': 'D009369', 'term': 'Neoplasms'}, {'id': 'D008171', 'term': 'Lung Diseases'}, {'id': 'D012140', 'term': 'Respiratory Tract Diseases'}, {'id': 'D002283', 'term': 'Carcinoma, Bronchogenic'}, {'id': 'D001984', 'term': 'Bronchial Neoplasms'}, {'id': 'D000230', 'term': 'Adenocarcinoma'}, {'id': 'D002277', 'term': 'Carcinoma'}, {'id': 'D009375', 'term': 'Neoplasms, Glandular and Epithelial'}, {'id': 'D009370', 'term': 'Neoplasms by Histologic Type'}]}, 'interventionBrowseModule': {'meshes': [{'id': 'D018479', 'term': 'Early Intervention, Educational'}], 'ancestors': [{'id': 'D002662', 'term': 'Child Health Services'}, {'id': 'D003153', 'term': 'Community Health Services'}, {'id': 'D006296', 'term': 'Health Services'}, {'id': 'D005159', 'term': 'Health Care Facilities Workforce and Services'}, {'id': 'D011314', 'term': 'Preventive Health Services'}]}}, 'protocolSection': {'designModule': {'phases': ['NA'], 'studyType': 'INTERVENTIONAL', 'designInfo': {'allocation': 'RANDOMIZED', 'maskingInfo': {'masking': 'NONE'}, 'interventionModel': 'PARALLEL'}, 'enrollmentInfo': {'type': 'ACTUAL', 'count': 2}}, 'statusModule': {'whyStopped': 'Closed early due to poor accrual.', 'overallStatus': 'TERMINATED', 'startDateStruct': {'date': '2004-09'}, 'expandedAccessInfo': {'hasExpandedAccess': False}, 'statusVerifiedDate': '2012-10', 'completionDateStruct': {'date': '2008-10', 'type': 'ACTUAL'}, 'lastUpdateSubmitDate': '2012-10-31', 'studyFirstSubmitDate': '2004-09-07', 'studyFirstSubmitQcDate': '2004-09-07', 'lastUpdatePostDateStruct': {'date': '2012-11-01', 'type': 'ESTIMATED'}, 'studyFirstPostDateStruct': {'date': '2004-09-08', 'type': 'ESTIMATED'}, 'primaryCompletionDateStruct': {'date': '2008-10', 'type': 'ACTUAL'}}, 'outcomesModule': {'primaryOutcomes': [{'measure': 'Exercise tolerance', 'timeFrame': 'Baseline and at 6 months', 'description': 'comparison between the control and intervention arms in the percent change in the 6-minute walk distance between baseline and 6 months.'}], 'secondaryOutcomes': [{'measure': 'Health-related quality of life', 'timeFrame': 'Baseline and at 6 months.', 'description': 'The difference in total score between pre-study and 6 months for the FACT-L Quality of Life measure.'}]}, 'oversightModule': {'oversightHasDmc': False}, 'conditionsModule': {'keywords': ['pulmonary complications', 'stage IIIA non-small cell lung cancer', 'stage IIIB non-small cell lung cancer', 'squamous cell lung cancer', 'large cell lung cancer', 'adenocarcinoma of the lung', 'bronchoalveolar cell lung cancer', 'limited stage small cell lung cancer'], 'conditions': ['Lung Cancer', 'Pulmonary Complications']}, 'descriptionModule': {'briefSummary': 'RATIONALE: Pulmonary rehabilitation education and exercise training may improve physical function and quality of life in patients who are receiving treatment for lung cancer.\n\nPURPOSE: This randomized clinical trial is studying pulmonary rehabilitation education and exercise training to see how well they work compared to exercise training alone in improving physical function and quality of life in patients who are undergoing chemotherapy and radiation therapy for locally advanced lung cancer.', 'detailedDescription': 'OBJECTIVES:\n\n* Compare improvement in physiologic function, in terms of exercise tolerance, in patients with inoperable locally advanced lung cancer undergoing chemoradiotherapy and randomized to pulmonary rehabilitation comprising education with vs without supervised exercise training.\n* Compare the health-related quality of life, in terms of multidimensional functioning and patient perception of respiratory difficulties, in patients undergoing these pulmonary rehabilitation interventions.\n\nOUTLINE: This is a randomized, multicenter study. Patients are stratified according to Zubrod performance status (0-1 vs 2); FEV\\_1 (≥ 70% of predicted vs \\< 70% of predicted); and smoking status\\* (never smoked or former smoker vs current smoker). Approximately 20 weeks into treatment on SWOG-S0023, patients are randomized to 1 of 2 intervention arms.\n\nNOTE: \\* Never smoked is defined as \\< 100 cigarettes in a lifetime and former smoker is defined as no smoking for ≥ 1 year.\n\n* Arm I: Patients participate in a supervised structured exercise program (i.e., walking on a treadmill OR using a stationary exercise bicycle) 3 times a week for 12 weeks. Patients also receive educational materials on how to improve breathing and conserve energy.\n* Arm II: Patients receive educational materials as in arm I. In both arms, patients undergo exercise testing using 6-minute walks to measure exercise tolerance at initial evaluation (after randomization but prior to intervention), 12 weeks, and then at 6 and 9 months.\n\nIn both arms, intervention continues in the absence of disease progression or the development of other medical conditions that would preclude study participation.\n\nQuality of life is assessed at baseline, 12 weeks, and then at 6 and 9 months.\n\nPROJECTED ACCRUAL: A total of 164 patients (82 per treatment arm) will be accrued for this study.'}, 'eligibilityModule': {'sex': 'ALL', 'stdAges': ['CHILD', 'ADULT', 'OLDER_ADULT'], 'healthyVolunteers': False, 'eligibilityCriteria': 'DISEASE CHARACTERISTICS:\n\n* Histologically or cytologically confirmed single, primary bronchogenic lung cancer\n\n * Inoperable, locally advanced disease (unresectable stage IIIA OR stage IIIB disease)\n* The following histologies are eligible:\n\n * Adenocarcinoma\n * Large cell carcinoma\n * Squamous cell carcinoma\n * Non-lobar and non-diffuse bronchoalveolar carcinoma\n * Small cell lung cancer\n* Must have received chemotherapy (platinum based) and radiotherapy for locally advanced unresectable lung cancer\n\n * Must have achieved a complete response, partial response, or stable disease after treatment\n\nPATIENT CHARACTERISTICS:\n\nAge\n\n* Not specified\n\nPerformance status\n\n* Zubrod 0-2\n\nLife expectancy\n\n* Not specified\n\nHematopoietic\n\n* Not specified\n\nHepatic\n\n* Not specified\n\nRenal\n\n* Not specified\n\nCardiovascular\n\n* No acute EKG changes, arrhythmia, or other cardiac abnormality that would preclude study participation\n* No uncontrolled cardiac disease\n* No recent myocardial infarction\n\nPulmonary\n\n* Any FEV\\_1 level by pulmonary function testing\n\nOther\n\n* Willing to participate in 12-week long exercise program\n* Chemotherapy-induced neuropathy ≤ grade 2\n* No uncontrolled diabetes mellitus\n* No other medical condition that would preclude study participation\n\nPRIOR CONCURRENT THERAPY:\n\nBiologic therapy\n\n* Not specified\n\nChemotherapy\n\n* See Disease Characteristics\n\nEndocrine therapy\n\n* Not specified\n\nRadiotherapy\n\n* See Disease Characteristics\n\nSurgery\n\n* Not specified'}, 'identificationModule': {'nctId': 'NCT00090961', 'briefTitle': 'S0229, Pulmonary Rehabilitation Education w/wo Exercise Training in Improving Physical Function in Patients Who Are Undergoing Chemo & RT for Locally Advanced Lung Cancer', 'organization': {'class': 'NETWORK', 'fullName': 'SWOG Cancer Research Network'}, 'officialTitle': 'A Randomized Trial Assessing the Effects of Exercise on Patients With Locally Advanced Lung Cancer Undergoing Curative Intent Combined Modality Therapy', 'orgStudyIdInfo': {'id': 'CDR0000380928'}, 'secondaryIdInfos': [{'id': 'U10CA012027', 'link': 'https://reporter.nih.gov/quickSearch/U10CA012027', 'type': 'NIH'}, {'id': 'SWOG-S0229'}]}, 'armsInterventionsModule': {'armGroups': [{'type': 'EXPERIMENTAL', 'label': '12-week exercise program + education', 'description': 'A 12-week supervised exercise program consisting of 3 days a week on a stationary bike or treadmill. In addition, at the time of enrollment patients are provided educational materials focusing on breathing and energy conservation.', 'interventionNames': ['Other: educational intervention', 'Other: supervised exercise program']}, {'type': 'OTHER', 'label': 'Education', 'description': 'At the time of enrollment patients are provided educational materials focusing on breathing and energy conservation.', 'interventionNames': ['Other: educational intervention']}], 'interventions': [{'name': 'educational intervention', 'type': 'OTHER', 'armGroupLabels': ['12-week exercise program + education', 'Education']}, {'name': 'supervised exercise program', 'type': 'OTHER', 'armGroupLabels': ['12-week exercise program + education']}]}, 'contactsLocationsModule': {'locations': [{'zip': '80524', 'city': 'Fort Collins', 'state': 'Colorado', 'country': 'United States', 'facility': 'Poudre Valley Hospital', 'geoPoint': {'lat': 40.58526, 'lon': -105.08442}}, {'zip': '62526', 'city': 'Decatur', 'state': 'Illinois', 'country': 'United States', 'facility': 'Decatur Memorial Hospital Cancer Care Institute', 'geoPoint': {'lat': 39.84031, 'lon': -88.9548}}, {'zip': '60153', 'city': 'Maywood', 'state': 'Illinois', 'country': 'United States', 'facility': 'Cardinal Bernardin Cancer Center at Loyola University Medical Center', 'geoPoint': {'lat': 41.8792, 'lon': -87.84312}}, {'zip': '62781-0001', 'city': 'Springfield', 'state': 'Illinois', 'country': 'United States', 'facility': 'Regional Cancer Center at Memorial Medical Center', 'geoPoint': {'lat': 39.80172, 'lon': -89.64371}}, {'zip': '66720', 'city': 'Chanute', 'state': 'Kansas', 'country': 'United States', 'facility': 'Cancer Center of Kansas, PA - Chanute', 'geoPoint': {'lat': 37.67921, 'lon': -95.4572}}, {'zip': '67801', 'city': 'Dodge City', 'state': 'Kansas', 'country': 'United States', 'facility': 'Cancer Center of Kansas, PA - Dodge City', 'geoPoint': {'lat': 37.7528, 'lon': -100.01708}}, {'zip': '67042', 'city': 'El Dorado', 'state': 'Kansas', 'country': 'United States', 'facility': 'Cancer Center of Kansas, PA - El Dorado', 'geoPoint': {'lat': 37.81724, 'lon': -96.86225}}, {'zip': '67301', 'city': 'Independence', 'state': 'Kansas', 'country': 'United States', 'facility': 'Cancer Center of Kansas-Independence', 'geoPoint': {'lat': 37.22424, 'lon': -95.70831}}, {'zip': '67068', 'city': 'Kingman', 'state': 'Kansas', 'country': 'United States', 'facility': 'Cancer Center of Kansas, PA - Kingman', 'geoPoint': {'lat': 37.64585, 'lon': -98.11367}}, {'zip': '67901', 'city': 'Liberal', 'state': 'Kansas', 'country': 'United States', 'facility': 'Southwest Medical Center', 'geoPoint': {'lat': 37.04308, 'lon': -100.921}}, {'zip': '67114', 'city': 'Newton', 'state': 'Kansas', 'country': 'United States', 'facility': 'Cancer Center of Kansas, PA - Newton', 'geoPoint': {'lat': 38.04668, 'lon': -97.34504}}, {'zip': '67357', 'city': 'Parsons', 'state': 'Kansas', 'country': 'United States', 'facility': 'Cancer Center of Kansas, PA - Parsons', 'geoPoint': {'lat': 37.34034, 'lon': -95.26108}}, {'zip': '67124', 'city': 'Pratt', 'state': 'Kansas', 'country': 'United States', 'facility': 'Cancer Center of Kansas, PA - Pratt', 'geoPoint': {'lat': 37.64391, 'lon': -98.73759}}, {'zip': '67042', 'city': 'Salina', 'state': 'Kansas', 'country': 'United States', 'facility': 'Cancer Center of Kansas, PA - Salina', 'geoPoint': {'lat': 38.84028, 'lon': -97.61142}}, {'zip': '67401', 'city': 'Salina', 'state': 'Kansas', 'country': 'United States', 'facility': 'Tammy Walker Cancer Center at Salina Regional Health Center', 'geoPoint': {'lat': 38.84028, 'lon': -97.61142}}, {'zip': '67152', 'city': 'Wellington', 'state': 'Kansas', 'country': 'United States', 'facility': 'Cancer Center of Kansas, PA - Wellington', 'geoPoint': {'lat': 37.2653, 'lon': -97.37171}}, {'zip': '67208', 'city': 'Wichita', 'state': 'Kansas', 'country': 'United States', 'facility': 'Associates in Womens Health, PA - North Review', 'geoPoint': {'lat': 37.69224, 'lon': -97.33754}}, {'zip': '67208', 'city': 'Wichita', 'state': 'Kansas', 'country': 'United States', 'facility': 'Cancer Center of Kansas, PA - Medical Arts Tower', 'geoPoint': {'lat': 37.69224, 'lon': -97.33754}}, {'zip': '67214', 'city': 'Wichita', 'state': 'Kansas', 'country': 'United States', 'facility': 'Cancer Center of Kansas, PA - Wichita', 'geoPoint': {'lat': 37.69224, 'lon': -97.33754}}, {'zip': '67214', 'city': 'Wichita', 'state': 'Kansas', 'country': 'United States', 'facility': 'CCOP - Wichita', 'geoPoint': {'lat': 37.69224, 'lon': -97.33754}}, {'zip': '67214', 'city': 'Wichita', 'state': 'Kansas', 'country': 'United States', 'facility': 'Via Christi Cancer Center at Via Christi Regional Medical Center', 'geoPoint': {'lat': 37.69224, 'lon': -97.33754}}, {'zip': '67156', 'city': 'Winfield', 'state': 'Kansas', 'country': 'United States', 'facility': 'Cancer Center of Kansas, PA - Winfield', 'geoPoint': {'lat': 37.23975, 'lon': -96.99559}}, {'zip': '48201-1379', 'city': 'Detroit', 'state': 'Michigan', 'country': 'United States', 'facility': 'Barbara Ann Karmanos Cancer Institute', 'geoPoint': {'lat': 42.33143, 'lon': -83.04575}}, {'zip': '39581', 'city': 'Pascagoula', 'state': 'Mississippi', 'country': 'United States', 'facility': 'Regional Cancer Center at Singing River Hospital', 'geoPoint': {'lat': 30.36576, 'lon': -88.55613}}, {'zip': '65802', 'city': 'Springfield', 'state': 'Missouri', 'country': 'United States', 'facility': 'CCOP - Cancer Research for the Ozarks', 'geoPoint': {'lat': 37.21533, 'lon': -93.29824}}, {'zip': '65804', 'city': 'Springfield', 'state': 'Missouri', 'country': 'United States', 'facility': "St. John's Regional Health Center", 'geoPoint': {'lat': 37.21533, 'lon': -93.29824}}, {'zip': '65807', 'city': 'Springfield', 'state': 'Missouri', 'country': 'United States', 'facility': 'Hulston Cancer Center at Cox Medical Center South', 'geoPoint': {'lat': 37.21533, 'lon': -93.29824}}, {'zip': '59101', 'city': 'Billings', 'state': 'Montana', 'country': 'United States', 'facility': 'CCOP - Montana Cancer Consortium', 'geoPoint': {'lat': 45.78329, 'lon': -108.50069}}, {'zip': '59101', 'city': 'Billings', 'state': 'Montana', 'country': 'United States', 'facility': 'Hematology-Oncology Centers of the Northern Rockies - Billings', 'geoPoint': {'lat': 45.78329, 'lon': -108.50069}}, {'zip': '59101', 'city': 'Billings', 'state': 'Montana', 'country': 'United States', 'facility': 'Northern Rockies Radiation Oncology Center', 'geoPoint': {'lat': 45.78329, 'lon': -108.50069}}, {'zip': '59101', 'city': 'Billings', 'state': 'Montana', 'country': 'United States', 'facility': 'St. Vincent Healthcare Cancer Care Services', 'geoPoint': {'lat': 45.78329, 'lon': -108.50069}}, {'zip': '59107-7000', 'city': 'Billings', 'state': 'Montana', 'country': 'United States', 'facility': 'Billings Clinic - Downtown', 'geoPoint': {'lat': 45.78329, 'lon': -108.50069}}, {'zip': '59715', 'city': 'Bozeman', 'state': 'Montana', 'country': 'United States', 'facility': 'Bozeman Deaconess Cancer Center', 'geoPoint': {'lat': 45.67965, 'lon': -111.03856}}, {'zip': '59701', 'city': 'Butte', 'state': 'Montana', 'country': 'United States', 'facility': 'St. James Healthcare Cancer Care', 'geoPoint': {'lat': 46.00382, 'lon': -112.53474}}, {'zip': '59405-5309', 'city': 'Great Falls', 'state': 'Montana', 'country': 'United States', 'facility': 'Big Sky Oncology', 'geoPoint': {'lat': 47.50024, 'lon': -111.30081}}, {'zip': '59405', 'city': 'Great Falls', 'state': 'Montana', 'country': 'United States', 'facility': 'Great Falls Clinic - Main Facility', 'geoPoint': {'lat': 47.50024, 'lon': -111.30081}}, {'zip': '59405', 'city': 'Great Falls', 'state': 'Montana', 'country': 'United States', 'facility': 'Sletten Cancer Institute at Benefis Healthcare', 'geoPoint': {'lat': 47.50024, 'lon': -111.30081}}, {'zip': '59405', 'city': 'Great Falls', 'state': 'Montana', 'country': 'United States', 'geoPoint': {'lat': 47.50024, 'lon': -111.30081}}, {'zip': '59501', 'city': 'Havre', 'state': 'Montana', 'country': 'United States', 'facility': 'Northern Montana Hospital', 'geoPoint': {'lat': 48.55, 'lon': -109.68409}}, {'zip': '59601', 'city': 'Helena', 'state': 'Montana', 'country': 'United States', 'facility': "St. Peter's Hospital", 'geoPoint': {'lat': 46.59271, 'lon': -112.03611}}, {'zip': '59901', 'city': 'Kalispell', 'state': 'Montana', 'country': 'United States', 'facility': 'Glacier Oncology, PLLC', 'geoPoint': {'lat': 48.19579, 'lon': -114.31291}}, {'zip': '59901', 'city': 'Kalispell', 'state': 'Montana', 'country': 'United States', 'facility': 'Kalispell Medical Oncology at KRMC', 'geoPoint': {'lat': 48.19579, 'lon': -114.31291}}, {'zip': '59901', 'city': 'Kalispell', 'state': 'Montana', 'country': 'United States', 'facility': 'Kalispell Regional Medical Center', 'geoPoint': {'lat': 48.19579, 'lon': -114.31291}}, {'zip': '59801', 'city': 'Missoula', 'state': 'Montana', 'country': 'United States', 'facility': 'Community Medical Center', 'geoPoint': {'lat': 46.87215, 'lon': -113.994}}, {'zip': '59804', 'city': 'Missoula', 'state': 'Montana', 'country': 'United States', 'facility': 'Guardian Oncology and Center for Wellness', 'geoPoint': {'lat': 46.87215, 'lon': -113.994}}, {'zip': '59807-7877', 'city': 'Missoula', 'state': 'Montana', 'country': 'United States', 'facility': 'Montana Cancer Specialists at Montana Cancer Center', 'geoPoint': {'lat': 46.87215, 'lon': -113.994}}, {'zip': '59807', 'city': 'Missoula', 'state': 'Montana', 'country': 'United States', 'facility': 'Montana Cancer Center at St. Patrick Hospital and Health Sciences Center', 'geoPoint': {'lat': 46.87215, 'lon': -113.994}}, {'zip': '27534', 'city': 'Goldsboro', 'state': 'North Carolina', 'country': 'United States', 'facility': 'Wayne Memorial Hospital, Incorporated', 'geoPoint': {'lat': 35.38488, 'lon': -77.99277}}, {'zip': '98225', 'city': 'Bellingham', 'state': 'Washington', 'country': 'United States', 'facility': 'St. Joseph Cancer Center', 'geoPoint': {'lat': 48.75955, 'lon': -122.48822}}, {'zip': '98310', 'city': 'Bremerton', 'state': 'Washington', 'country': 'United States', 'facility': 'Olympic Hematology and Oncology', 'geoPoint': {'lat': 47.56732, 'lon': -122.63264}}, {'zip': '99336', 'city': 'Kennewick', 'state': 'Washington', 'country': 'United States', 'facility': 'Columbia Basin Hematology', 'geoPoint': {'lat': 46.21125, 'lon': -119.13723}}, {'zip': '98104', 'city': 'Seattle', 'state': 'Washington', 'country': 'United States', 'facility': 'Fred Hutchinson Cancer Research Center', 'geoPoint': {'lat': 47.60621, 'lon': -122.33207}}, {'zip': '98104', 'city': 'Seattle', 'state': 'Washington', 'country': 'United States', 'facility': 'Harborview Medical Center', 'geoPoint': {'lat': 47.60621, 'lon': -122.33207}}, {'zip': '98104', 'city': 'Seattle', 'state': 'Washington', 'country': 'United States', 'facility': 'Minor and James Medical, PLLC', 'geoPoint': {'lat': 47.60621, 'lon': -122.33207}}, {'zip': '98112', 'city': 'Seattle', 'state': 'Washington', 'country': 'United States', 'facility': 'Group Health Central Hospital', 'geoPoint': {'lat': 47.60621, 'lon': -122.33207}}, {'zip': '98122-4307', 'city': 'Seattle', 'state': 'Washington', 'country': 'United States', 'facility': 'Swedish Cancer Institute at Swedish Medical Center - First Hill Campus', 'geoPoint': {'lat': 47.60621, 'lon': -122.33207}}, {'zip': '98122', 'city': 'Seattle', 'state': 'Washington', 'country': 'United States', 'facility': 'Polyclinic First Hill', 'geoPoint': {'lat': 47.60621, 'lon': -122.33207}}, {'zip': '98195-6043', 'city': 'Seattle', 'state': 'Washington', 'country': 'United States', 'facility': 'University Cancer Center at University of Washington Medical Center', 'geoPoint': {'lat': 47.60621, 'lon': -122.33207}}, {'zip': '99202', 'city': 'Spokane', 'state': 'Washington', 'country': 'United States', 'facility': 'Cancer Care Northwest - Spokane South', 'geoPoint': {'lat': 47.65966, 'lon': -117.42908}}, {'zip': '82801', 'city': 'Sheridan', 'state': 'Wyoming', 'country': 'United States', 'facility': 'Welch Cancer Center at Sheridan Memorial Hospital', 'geoPoint': {'lat': 44.79719, 'lon': -106.95618}}], 'overallOfficials': [{'name': 'Antoinette J. Wozniak, MD', 'role': 'STUDY_CHAIR', 'affiliation': 'Barbara Ann Karmanos Cancer Institute'}]}, 'sponsorCollaboratorsModule': {'leadSponsor': {'name': 'SWOG Cancer Research Network', 'class': 'NETWORK'}, 'collaborators': [{'name': 'National Cancer Institute (NCI)', 'class': 'NIH'}], 'responsibleParty': {'type': 'SPONSOR'}}}}