ABO Incompatibility - Hemolytic Disease Of The Newborn (HDN) - Hematology & Pathology

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ABO Incompatibility - Hemolytic Disease Of The Newborn (HDN) - Hematology, Immunology & Pathology.
There are two main types of hemolytic disease of the newborn; ABO incompatibility and Rh incompatibility.
Anti-A and anti-B antibodies - most of the time - are IgM (i.e. they don't cross the placenta, but some mothers, naturally, have IgG anti-A or IgG anti-B antibodies, (i.e. can cross the placenta causing problems to the fetal RBCs.)
Did you like my explanation of ABO incompatibility and hemolytic disease of the newborn? Let me know in the comments.
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Комментарии : 222

@MedicosisPerfectionalis 3 года назад

💊🦠 Antibiotics Course: www.medicosisperfectionalis.com/ 🧠 Autonomic Pharmacology Course: www.medicosisperfectionalis.com/

@stereotonemusic6705 2 года назад

Unfortunately I had to learn about all this only after the death of my son due to medical negligence. They mis-matched my blood and said my rh was positive. Only to find out I'm actually O negative. Had they diagnosed my rhesus correctly, I should have been treated for the abo incompatibility at a high risk medical institution. Unfortunately my son passed 6days after birth. Still struggling with it. Was my 1st baby. I'm still scared to try get pregnant in the near future. This all happened just 3months ago. My your soul continue to rest in peace my beautiful son.

@stephanicrandall7797 2 года назад

I'm so sorry this happened to you. ❤

@emanfatima5385 Год назад

Can you please tell the blood group of your son?

@Sharanzadmukhe117k 3 года назад

Indian students are happy of this content From my bottom of my heart Thankyou sir For your efforts

@MedicosisPerfectionalis 3 года назад

My pleasure 😇

@shiwamukete 11 месяцев назад

Thank you for your work Medicosis. You deserve a noble prize

@eldiabloArgentinaa 6 лет назад

This is the best explanation for ABO incompatibility that I've ever seen! Keep it up

@MedicosisPerfectionalis 6 лет назад

Glad to hear that...Thanks and best of luck!

@csaswinibaradwaj4501 3 года назад

I completely agree 👍

@اسماءهاشم-ل1ع 2 года назад

For me also

@pradhyumnanramesh5135 5 месяцев назад

I don't comment often, but just had to here: I want to thank you so much for your videos, they are extremely well made and helpful!

@binknbaby 4 года назад

Thank you for this explanation! I'm a student midwife and have struggled with texts explaining ABO Incompatibility, but this visual really helped to put the pieces together and understand it better.

@MedicosisPerfectionalis 4 года назад

Awesome 👏 Thank you so much 😊

@duai7090 4 года назад

You literally the reason why I’m talking good grades after God’s grace. Thank you and plz keep going

@MedicosisPerfectionalis 4 года назад

Thanks, dear 😊

@duai7090 4 года назад

Hey, I wanna ask if you have endocrine system videos on your website because I couldn’t find any here. I don't really mind to pay you but I must pass this exam :)

@supernono7970 4 года назад

Where are you from doaa

@MedicosisPerfectionalis 4 года назад

I don’t have endocrinology videos yet. They’re coming at the end of 2020

@maysmays4299 4 года назад

The type of anti ABO antibodies is IgM so it does not cross the placenta in contrast with anti-Rhesus is IgG that cross the placenta .

@PriyanshiSatapathy Год назад

It may not affect the baby but won't it affect the mother?

@giripurabi8512 Год назад

but few anit a,anti b may ig g type so incompatibility may happen but it is rare

@Pati_Ang 11 месяцев назад

Antibodies in ABO are IgM, but there are exceptions in blood group O the antibodies are IgG, they are known as Anti-A,B

@nancykandu7668 Год назад

you are so Brilliant...Making my Midwifery training so easy. God bless you

@MedicosisPerfectionalis Год назад

God bless you too!

@abubakarbusati7731 4 года назад

so what i got from your lecture is that as a man with AB+ Blood type i should avoid marrying a woman with a O- Blood type.

@Abo-alod Год назад

Thank you for your amazing efforts,, but i have one concern about the type of ABO abs > IgG .as you mintions in the video I had learned that its IgM , Rh abs are IgG

@rokenangel7070 Год назад

First time I discovered your channel was before 2years in haematology lectures And it was a great discover 😊😻😻😻😻

@MedicosisPerfectionalis Год назад

Wow 🤩

@mewmannamwem6087 8 месяцев назад

Thanks Doctor !! you helped me in my journey !

@MedicosisPerfectionalis 8 месяцев назад

Glad to hear that!

@musicandhappinessbyjo795 3 года назад

After I start making money You will be first guy to whom I will donate money.....Coz You are helping me so much man

@MedicosisPerfectionalis 3 года назад

Thank you so much ☺️ It means a lot!

@mrsamandabernier 3 года назад

Ik this playlist is several years old already, but seriously, thank-you! This is amazing.

@MedicosisPerfectionalis 3 года назад

My pleasure 😇

@swatiM722 4 года назад

I Can't thanku enough for helping out and explaining medicine so perfectly!! ❤️💯

@MedicosisPerfectionalis 4 года назад

You’re very welcome 😊

@TheX7mood 4 года назад

6:16 Actually the mother can be Rh sensitized even before pregnancy if get get previous Rh incompatibility blood transfusion

@zjengle6878 Год назад

Thanks so much for this fun, concise and well-organized review! 🌹

@MedicosisPerfectionalis Год назад

My pleasure 😇

@nurrasyidah4334 4 года назад

This video clarify my confusion toward this topic! Keep this up!

@MedicosisPerfectionalis 4 года назад

Thanks 🙏

@fatimazahrarahali458 6 лет назад

Yes, hemostasis disorders are very interesting as well as hematological malignancies. I will stay tuned for sure.

@MedicosisPerfectionalis 6 лет назад

Of course...You are one of the great subscribers...Thank you :)

@fatimazahrarahali458 6 лет назад

It's a pleasure !

@MedicosisPerfectionalis 6 лет назад

Thank You!

@zohoorz2010 3 года назад

YOU ARE THE BESSSSST, I FINALLY UNDERSTOOD ITTTTTTTTT

@MedicosisPerfectionalis 3 года назад

Thank you 🙏

@nandinimalhi9433 4 года назад

You are brilliant! You make topics easier to understand which we can’t get this from lecture. Please do more videos, on biochemistry and immunology.

@MedicosisPerfectionalis 4 года назад

Thanks a million! I will Please help me by sharing!

@KaoruMina 5 лет назад

Thanks 🙏🏼 this an excellent complement to my lectures ! ❤️

@MedicosisPerfectionalis 5 лет назад

You’re very welcome 😊

@gudlikeplan182 4 года назад

I'm confused. We know that blood group O is universal donor as the blood has no antigen. That means we can give blood group O to a person having blood group A. Q1. Why the Anti A antibody present in blood group O do not react with the recipient's blood group A? Q2. Why the Anti A antibody present in mommy blood group O react with the baby's blood group A?

@teyrbeats8450 2 года назад

I really want you to make videos about blood banking. I love watching your videos. It makes me laugh while learning. It really is "Learning should be fun."

@afuadecardi-nelson1234 2 года назад

You make medicine so beautiful

@MedicosisPerfectionalis 2 года назад

Thank you 😊

@ioanabeatriceneamtu5666 3 года назад

Bless your heart, man! When i finally can work as a biomed, im donating half of my salary to your patreon!

@MedicosisPerfectionalis 3 года назад

Thank you ☺️

@majdmuhannad7254 3 года назад

I watched many of your videos back in my first year of med school. I'm now in third year revising my basics and came back to rewatch them. YOU ARE AMAZING, Thank you soooooooo much! just want to make sure of a point. the IgGs here that cross the placenta to attack the fetus's RBCs are a result of the mismatches transfusion and they're not the same as the IgMs that naturally occur in the plasma, right?

@intertechelectronicsrepair 3 года назад

My wife blood type O+ and I'm blood type A+ , our fist baby is A+ but for our scond baby blood type is B+ and he was diagnosed with Jundice. Question; how did the baby got B+ type of blood If father A+ and mother O+?

@fatimahaider8096 2 года назад

The best🌹 Thank you so much 👏🏻👏🏻

@MedicosisPerfectionalis 2 года назад

My pleasure 😇

@زينبحسنحجازي 7 месяцев назад

Thank you very much it's so informative

@sebbi2716 4 года назад

Thanks for putting 7 ads in this video, awesome

@michellebutterchew3678 4 года назад

I mean it's literally a free youtube video with excellent, accurate, content. If the most you have to pay is sitting through a few ads, it's not a bad deal

@WilliamGoo98 Год назад

Wow this was very helpful. Thanks.

@majadbassam1032 6 лет назад

plz do evry thing about hematology

@MedicosisPerfectionalis 6 лет назад

Will do...I hope to do everything about medicine one day 😁😊

@majadbassam1032 6 лет назад

you are amazinnnng thank youuuuu tooooo muchhhh

@MedicosisPerfectionalis 6 лет назад

Thanks again! Please share! 👍

@aloukikshakya9610 4 года назад

Nice video i have ever seen, keep it up dear .from this video i understood everything about the topic.LOVE FROM INDIA ....From where are u?

@MedicosisPerfectionalis 4 года назад

Thanks 😊

@aloukikshakya9610 4 года назад

@@MedicosisPerfectionalis love from INDIA

@MedicosisPerfectionalis 4 года назад

Thanks 🙏 Love from Egypt!

@kumbakumba794 Год назад

Thank you so much.since my son was born in 1996 in Czech republic I was a Guinean international students there when I had my son.i was told that he has "abo" incompatibilité.please do explain to me.i'm sicke cells anemia but nobody told me.

@shabbirhussain8217 6 лет назад

very good lecture

@MedicosisPerfectionalis 6 лет назад

Thanks a lot! Glad you enjoyed it!

@ahmedrahman7019 6 лет назад

you are the best , keep going

@MedicosisPerfectionalis 6 лет назад

Thank you, brother!

@madhukardeshpande563 5 лет назад

Thanks for excellent lectures

@MedicosisPerfectionalis 5 лет назад

You’re very welcome 😊

@veenac6780 5 лет назад

Sunlight will not work for jaundice. Because for phototherapy, you need wavelength of 460-490 UV light's wavelength is only 10-400nm

@rachitachugh9965 4 года назад

Ur video are relly great!!

@MedicosisPerfectionalis 4 года назад

Thank you so much 😊

@bilalahmedbilalahmed3212 5 лет назад

Sir I am BDS student. It will be our pleasure if you will make videos on dental topics too.

@MedicosisPerfectionalis 5 лет назад

I will try.

@suziebee2945 4 года назад

I had this as a child my mum was rh neg and my dad rh positive, I’ve had three blood transfusions and had a bowel blockage as a new born , has a bowel operation at at week old ( 1971 ) was on iron meds as a toddler, I’ve had two other bowel surgery in my 20’s now at 49 I was put on pregabalin, naproxen, Sulphasalazine I had another bowel blockage but I had been feeling really unwell , tired , yellow eyes , pale skin, chills, back pain, pain under ribs on left side, also after my second child he was jaundice and after I had hypothyroidism

@mumugugu8033 4 года назад

It sounds like you may be talking about a condition in this video. ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-0nOc-441XUI.html

@forozanmo7520 Год назад

You are the best teacher lol

@MedicosisPerfectionalis Год назад

Thank you!

@1995nicat 5 лет назад

Sir, thanks. Why didnt we develop AntiA or AntiB Antibodies? So theoretically can we inject these antibodies into Blood of mother and they should prevent Agglutination ?

@humilitybringsglory 3 года назад

thank you so much

@MedicosisPerfectionalis 3 года назад

My pleasure 😇

@Android982 6 лет назад

Does incompatibility occurs if the mother is let's say B+ and baby is either A+/A-/AB+/AB-? (or is ABO incompatibility only occurs if mom is O blood group and baby is either A or B blood group?)

@argumentumadbaculum 5 лет назад

It is still an incompatibity. How ever the hemolysis occurs only if mum is 0+ve as only these mum's produce IgG antibodies which cross the placenta, A and B mums produce IgM, which does not cross the placenta.

@1995nicat 5 лет назад

@@argumentumadbaculum Thanks. Why A and B antigen having People produce IgM not IgG?

@michellethomas6557 4 года назад

@@argumentumadbaculum thanks for the answer. I was worried cause I'm A (and I carry O) and my husband is B

@princessshosho1176 4 года назад

Thank you so much 🙌🏼🙌🏼🙌🏼🙌🏼🙌🏼🙌🏼🙌🏼

@MedicosisPerfectionalis 4 года назад

My pleasure 😇

@abdulrahaman0157 2 года назад

Bro you are Godsent !

@MedicosisPerfectionalis 2 года назад

Thank you 🙏

@devanshimehta7416 4 года назад

Isnt the anti A and anti B "IgM" type of antibody? And they cannot cross the placenta. Pls resppnd to this.

@rehamelwardany9125 2 года назад

Also they are naturally occuring, they don't develop during pregnancy or blood transfusion or anything.. And they don't cross the placenta, they meet baby's RBCs during labour 🤔

@rehamelwardany9125 2 года назад

You need to revise your information here, also blood group O means you have H Ag, not "no Ag"

@kellyaviguetero5876 2 года назад

Although IgM is the most common antibody against ABO blood group, there is still a small percentage of serum IgG anti-A and anti-B.

@hridhyababuraj2793 2 года назад

Yess it is true

@madhukardeshpande563 5 лет назад

Fine explanation sir, thanks

@اميراحمدعبدالكاظمحسن 4 года назад

You are really brilliant🥰😇😊😍

@MedicosisPerfectionalis 4 года назад

Thank you 😊

@marissamcginnis2311 4 года назад

Rh antigens are so sparsely scattered on the erythrocyte surface that IgG molecules bound to the Rh antigens are too far apart to fix C1q. Therefore, complement-mediated hemolysis cannot be invoked to explain hemolytic disease of the newborn. By what mechanism are the red cells destroyed?

@banaalani7216 5 лет назад

Perfect as usual! Thanks

@MedicosisPerfectionalis 5 лет назад

My pleasure 😇

@MedicosisPerfectionalis 5 лет назад

And thanks for your support 😉

@MedicosisPerfectionalis 5 лет назад

Thanks 🙏

@aimanaslam9981 8 месяцев назад

This guy is such a cutiee patootie❤ thank youu..

@dhshdy3858 6 лет назад

Help. AntiA antibody is igm. AntiB antibody is igm How is antiA and AntiB antibody found in o gp individuals of igG type?

@MedicosisPerfectionalis 6 лет назад

The majority of them are IgM but those don’t cross the placenta...Only IgGs (the minority) cross the placenta.

@terrytessnanjalah9930 4 года назад

Thank you

@ranjithking4335 2 года назад

Thank you sir🙏

@ashleyramey3789 Год назад

I am blood type A+ but had a blood transfusion oct 4th 2022 and now my blood work came back abnormal with 1:8 ratio . I’m waiting to hear from the specialist so Me and baby can be seen. I’m kind of scared.

@beiruyrg2122 10 месяцев назад

How ABO incompatibility decrese the incidence of alluminization

@chandramoulis.g7202 4 года назад

Comment on bombay blood group please

@lostSempaiWissame 2 года назад

but the Antibodies of the ABO system are IgM and IgM don't pass through the placenta so where do they igG come from ??? I think it is necessary for the mother to have previous exposure to synthesis igG ??????

@sharifahnorshahirah7883 3 года назад

Thank you TT

@sayarali1268 Год назад

Amazing ❤❤❤❤

@jackgreen7273 5 лет назад

AGAIN EXCELLENT EXCELLENT!!! I got your reply. And I would just like to say that I await your leukemia videos. But I take a time to suggest that you put an address where I could send a CASH MONEY to you directly...no BS. I really like what you do with the blood lessons.

@MedicosisPerfectionalis 5 лет назад

If you don’t mind, you can support my work here: www.paypal.me/perfectionalis/ ...I can’t thank you enough, in advance:)

@MedicosisPerfectionalis 5 лет назад

By the way, all of my leukemia videos are here: Leukemias ru-vid.com/group/PLYcLrRDaR8_fwCavyYfgXlptvBWQgPb-r

@bikramadityakumar3612 5 лет назад

Nice video

@MedicosisPerfectionalis 5 лет назад

Thank you :)

@GospodinJean 5 лет назад

the Khan Academy of Medicine, :D

@doczeelkodia 5 лет назад

Hey I have a doubt here Normally the Ab’s are of IgM type which can’t cross the placenta How the Ab’s turn IgG?

@bennykelpenco8405 4 года назад

Your knowledge is shallow! the fact that ABs are predominantly IgM doesn't mean that they're the only ABs. There are also IgG antibodies: IgG1, IgG2 and IgG3, but it is only the IgG1 which have the ability to cross the placental barrier.

@mawadsalem867 3 года назад

So nice

@sanfazsanfaz5696 2 года назад

Thanks alot

@MedicosisPerfectionalis 2 года назад

My pleasure 😇

@zahraajamal1902 5 лет назад

@Medicosis perfectionally. Please can u tell us about blood component in details

@MedicosisPerfectionalis 5 лет назад

What do you mean?

@zahraajamal1902 5 лет назад

Medicosis Perfectionalis I meant Rbc , platelet ,fresh frozen plasma , doses indication of uses

@naomigideons9935 Год назад

Can cesarean section help to prevent ABO incompatibility because I heard blood of the fetus meet with mothers during labour an birth?

@2801eveliin 6 лет назад

PLEASE i need help i had 3 blood transfussions once a year and 3 pints each time... now im pregnant and the doctor said i have antibodies that can affect the baby im 12 weeks.. does that mean i cant have children im very sad

@MedicosisPerfectionalis 6 лет назад

Hey, I am so sorry you’re going through all of this...But, I couldn’t tell from your comment what your condition is...Can you tell me more? Also, talk to your doctor and get a second opinion. All the best!

@ericichinose1210 5 лет назад

Ummm... I thought Anti-A and Anti-B cannot cross the placenta, but there is an Anti-A,B produced by type O people which can cross the placenta, which can affect the baby who is A, B or AB. This Anti-A,B cannot dissociate to Anti-A and Anti-B, meaning it's not simply saying Anti-A + Anti-B = Anti-A,B.

@tabijozwick 5 лет назад

If the mother is blood type O, her kid will NOT be blood type AB.

@ericichinose1210 5 лет назад

@@tabijozwick what? I never said the baby WILL be Type AB.

@shelan7058 3 года назад

@@tabijozwick why?

@jesussalvadorgonzalezlopez3678 4 года назад

HI. WHY Mom already had igG, instead of igM first? How did she get sensitized first of ABO?

@remashleycometa9993 6 лет назад

I thought anti a is igm in nature, so it doesnt cross the placenta

@Sevendandra 4 года назад

Anti-A,B in group O individuals tend to be predominantly IgG.

@rollo48 3 года назад

Will there be incompatibility between a type A mother and a type AB baby or does it only work when the mother is type O?

@moazmorouj5681 4 года назад

I have a question here, In such case dose Anti-A ALWAYS cross the placenta to attach to Rbcs antigen or it might not cross the placenta and nothing will happen!?

@TatianaLMY 5 лет назад

Hi thanks for the well verse video, im quite confused with why O blood group can donate blood to A blood group however via blood transfusion. Is it due to when the blood is donated, they will remove the antibody b from plasma ( if they want to transfuse plasma) or they will just transfuse red cell pack? hope u can answer me, thank you very much

@Mefrenchygirl 5 лет назад

Hi! When you donate your blood, they separate plasma and red blood cells so: Blood transfusion = red blood cells + no plasma so no antibodies : hemolysis if the receiver has antibodies against the donor (O has no antibodies so can donate to anyone) Plasma transfusion = plasma (duh) + antibodies from the donor: hemolysis if the receiver has the corresponding antigen (a group O donor has both A and B antibodies so cannot donate to group A, B or AB) Hope this was sufficiently clear ;)

@TatianaLMY 5 лет назад

@@Mefrenchygirl helps a lot thank you

@idmanmohamed6066 2 года назад

How can i get your chemotherapy pharmacology sir

@mohammedalameri4753 3 года назад

Video starts at 1:30. U R welcome!

@kadijahal-jahdli251 2 месяца назад

He said I have to see another video before this one Where is it? I need the link

@MedicosisPerfectionalis 2 месяца назад

Here: ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-xXgzXXUEbFU.htmlsi=_lHBQx8sVIXx-EI3

@wyverntheterrible 3 года назад

So if i am A Positive & my pregnant girlfriend is O Negative, is that a potential problem?

@777nicole 3 года назад

Yes

@capibara252 3 года назад

Will hemolytic disease of newborns occur, If mummy is A group and fetus is B group?

@medstudywithhf4182 4 года назад

Good

@MedicosisPerfectionalis 4 года назад

Thank you 😊

@Sevendandra 4 года назад

8:56 so since the splenic macrophages eat the rbc's causing the hemolysis is this why we see normal bilirubin values in ABO HDFN?

@lindaluri138 Год назад

The anti A here must be İgM so it can pass the placenta I’m I right.¿

@manaswanimishra5262 5 лет назад

In o blood group individual they have natural occurring anti a anti b antibodies that's why there is abo incompatibility but then how they are also known as universal donor?

@MedicosisPerfectionalis 5 лет назад

Let’s say that we are giving 1 unit of blood from a donor who is blood group O to a recipient who is blood group A, the amount of anti-A antibodies in the blood of the donor will not be sufficient to cause significant hemolysis to the recipient...That’s why O is a universal donor...Also, nowadays we rarely give whole blood, we separate packed red blood cells (contain antigens) from fresh frozen plasma (contains antibodies), but still, the same concept applies. Does that make sense?

@manaswanimishra5262 5 лет назад

@@MedicosisPerfectionalis so anti a donot cause much damage in blood transfusions but in fetus it causes abo incompatibility

@tabijozwick 5 лет назад

@@manaswanimishra5262 the only time blood group O blood is given is if there is not enough time to test the recipient's blood type or if there is not enough blood from the recipient's blood group. I had three pints of blood for a blood transfusion and they had enough time to test for mine since I was conscious and I received my blood type, which is o positive, not the universal donor of O negative.

@leonang421 5 лет назад

thre is no antigen at blood O HOW it produce antibody in mum body?

@aman-pg5hz 4 года назад

Sir igm is antibody abo also So igG turn ab plzz solve

@MedicosisPerfectionalis 4 года назад

????

@annyeongchingu6572 3 года назад

what if I'm O+ and my husband is B. Are we compatible?

@soggy_teabag 11 месяцев назад

my mind is blown

@dhiaeddineyahoui1873 11 месяцев назад

What if the mother is B and the baby is A

@hellobunnybilbo1 8 месяцев назад

Thank you for the video, I have a complex question I pray you get & can answer. I'm an only child born & was about 3-4wks early in 1969 & my mother said we had an ABO blood incompatibility. Im A+ & was severely jaundice & spent time in an incubator under lights for my 1st week. In February of 2023 I had a CVST w/ICH & was finally diagnosed with Prothrombin II G20210A genetic mutation. *Q*Is there a correlation between my genetic blood defect and the ABO blood incompatibility (? misdiagnosed) & the jaundice I suffered as a new born. Idk what parent I inherited the mutation from, but it seems this maybe expressed itself at birth & is this telling to which parent I inherited it from? Thank you!

@musallamlama84 5 лет назад

How O anti A and B are igG, naturally occurring Abs are IgM? Can such senari happen bw O mother and AB baby?

@manaswanimishra5262 5 лет назад

In Maternal system ab are formed as - IgM is1st to appear then Ig G and IgG crosses placenta And these antibodies dont have any effect on Rh-ve fetus

@markdanieltingzon1993 3 года назад

I have a lot of question, because my 1 year old baby has hemolytic anemia. His hemoglobin dropped to 5.0. We just found out last december And stayed at the hospital for 9 days, and also he got blood transfusion once. We are still waiting for the other result to find out if is it severe or not. Im just worried. I am willing to ask in a private message. Thank you.

@kaatraj08 4 года назад

You said ABO simply like ABC..if you can't believe in this...just watch previous videos

@DawnMarie_777 4 года назад

What if I am O+ blood type and the doctor said when I had my daughter that she was RH factor due to ABO incompatibility. What does that mean? Can you explain this to me please? We also had a son 4 years after and he was not incompatible and RH factor. Can you explain please? Thanks

@stephanicrandall7797 2 года назад

This same thing happened to me. I am also confused about it but I am O+ and my baby is AB. So I believe she did not have RH factor but DID have ABO blood incompatibility (I think those are different?). ABO incompatibility is much less serious and usually only results in jaundice or mild anemia. My baby had to be treated for jaundice but that was all.