1
|
Li F, Tu YT, Yeh HC, Ho CA, Yang CP, Kuo YC, Ho CS. Feasibility of predicting maximal oxygen uptake by using the efficiency factor in healthy men. Sci Rep 2023; 13:16760. [PMID: 37798330 PMCID: PMC10556004 DOI: 10.1038/s41598-023-43307-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/21/2023] [Indexed: 10/07/2023] Open
Abstract
Conventionally, efficiency is indirectly estimated through a respiratory gas analyser (oxygen, carbon dioxide), which is a complex and rather costly calculation method that is difficult to perform in many situations. Therefore, the present study proposed a modified definition of efficiency, called the efficiency factor (EF) (i.e., the ratio of work to the corresponding exercise intensity), and evaluated the relation between the EF and maximal oxygen uptake ([Formula: see text]), as well as compared the prediction models established based on the EF. The heart rate (maximal heart rate: 186 ± 6 beats min-1), rating of perceived exertion (19 ± 1), and [Formula: see text] (39.0 ± 7.1 mL kg-1 min-1) of 150 healthy men (age: 20 ± 2 years; height: 175.0 ± 6.0 cm; weight: 73.6 ± 10.7 kg; body mass index [BMI]: 24.0 ± 3.0 kg m-2; percent body fat [PBF]: 17.0 ± 5.7%) were measured during the cardiopulmonary exercise test (CPET). Through multiple linear regression analysis, we established the BMI model using age and BMI as parameters. Additionally, we created the PBF modelHRR utilizing weight, PBF, and heart rate reserve (HRR) and developed PBF modelEF6 and PBF modelEF7 by incorporating EF6 from the exercise stage 6 and EF7 from the exercise stage 7 during the CPET, respectively. EF6 (r = 0.32, p = 0.001) and EF7 (r = 0.31, p = 0.002) were significantly related to [Formula: see text]. Among the models, the PBF modelEF6 showed the highest accuracy, which could explain 62.6% of the variance in the [Formula: see text] at with a standard error of estimate (SEE) of 4.39 mL kg-1 min-1 (%SEE = 11.25%, p < 0.001). These results indicated that the EF is a significant predictor of [Formula: see text], and compared to the other models, the PBF modelEF6 is the best model for estimating [Formula: see text].
Collapse
Affiliation(s)
- Fang Li
- School of Physical Education, Central China Normal University, Wuhan, People's Republic of China
- Postdoctoral Research Mobile Station of Physical Education, Central China Normal University, Wuhan, People's Republic of China
| | - Yu-Tsai Tu
- Graduate Institute of Sports Science, Guishan District, National Taiwan Sport University, No. 250, Wenhua 1st Rd., Taoyuan City, Taiwan
- Department of Physical Medicine and Rehabilitation, Taipei City Hospital, Zhengzhou Branch, Taipei City, Taiwan
| | - Hung-Chih Yeh
- Graduate Institute of Sports Science, Guishan District, National Taiwan Sport University, No. 250, Wenhua 1st Rd., Taoyuan City, Taiwan
| | - Chia-An Ho
- Graduate Institute of Sports Science, Guishan District, National Taiwan Sport University, No. 250, Wenhua 1st Rd., Taoyuan City, Taiwan
| | - Cheng-Pang Yang
- Graduate Institute of Sports Science, Guishan District, National Taiwan Sport University, No. 250, Wenhua 1st Rd., Taoyuan City, Taiwan
- Department of Orthopedic Surgery, Division of Sports Medicine Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Linkou, Taiwan
| | - Ying-Chen Kuo
- Graduate Institute of Sports Science, Guishan District, National Taiwan Sport University, No. 250, Wenhua 1st Rd., Taoyuan City, Taiwan
- Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Chin-Shan Ho
- Graduate Institute of Sports Science, Guishan District, National Taiwan Sport University, No. 250, Wenhua 1st Rd., Taoyuan City, Taiwan.
| |
Collapse
|
2
|
Visco V, Izzo C, Bonadies D, Di Feo F, Caliendo G, Loria F, Mancusi C, Chivasso P, Di Pietro P, Virtuoso N, Carrizzo A, Vecchione C, Ciccarelli M. Interventions to Address Cardiovascular Risk in Obese Patients: Many Hands Make Light Work. J Cardiovasc Dev Dis 2023; 10:327. [PMID: 37623340 PMCID: PMC10455377 DOI: 10.3390/jcdd10080327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/26/2023] [Accepted: 07/28/2023] [Indexed: 08/26/2023] Open
Abstract
Obesity is a growing public health epidemic worldwide and is implicated in slowing improved life expectancy and increasing cardiovascular (CV) risk; indeed, several obesity-related mechanisms drive structural, functional, humoral, and hemodynamic heart alterations. On the other hand, obesity may indirectly cause CV disease, mediated through different obesity-associated comorbidities. Diet and physical activity are key points in preventing CV disease and reducing CV risk; however, these strategies alone are not always sufficient, so other approaches, such as pharmacological treatments and bariatric surgery, must support them. Moreover, these strategies are associated with improved CV risk factors and effectively reduce the incidence of death and CV events such as myocardial infarction and stroke; consequently, an individualized care plan with a multidisciplinary approach is recommended. More precisely, this review explores several interventions (diet, physical activity, pharmacological and surgical treatments) to address CV risk in obese patients and emphasizes the importance of adherence to treatments.
Collapse
Affiliation(s)
- Valeria Visco
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (V.V.); (C.I.); (D.B.); (F.D.F.); (G.C.); (F.L.); (P.D.P.); (A.C.); (C.V.)
| | - Carmine Izzo
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (V.V.); (C.I.); (D.B.); (F.D.F.); (G.C.); (F.L.); (P.D.P.); (A.C.); (C.V.)
| | - Davide Bonadies
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (V.V.); (C.I.); (D.B.); (F.D.F.); (G.C.); (F.L.); (P.D.P.); (A.C.); (C.V.)
| | - Federica Di Feo
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (V.V.); (C.I.); (D.B.); (F.D.F.); (G.C.); (F.L.); (P.D.P.); (A.C.); (C.V.)
| | - Giuseppe Caliendo
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (V.V.); (C.I.); (D.B.); (F.D.F.); (G.C.); (F.L.); (P.D.P.); (A.C.); (C.V.)
| | - Francesco Loria
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (V.V.); (C.I.); (D.B.); (F.D.F.); (G.C.); (F.L.); (P.D.P.); (A.C.); (C.V.)
| | - Costantino Mancusi
- Department of Advanced Biomedical Sciences, Federico II University of Naples, 80138 Naples, Italy;
| | - Pierpaolo Chivasso
- Department of Emergency Cardiac Surgery, Cardio-Thoracic-Vascular, University Hospital “San Giovanni di Dio e Ruggi D’Aragona”, 84131 Salerno, Italy;
| | - Paola Di Pietro
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (V.V.); (C.I.); (D.B.); (F.D.F.); (G.C.); (F.L.); (P.D.P.); (A.C.); (C.V.)
| | - Nicola Virtuoso
- Cardiology Unit, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, Italy;
| | - Albino Carrizzo
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (V.V.); (C.I.); (D.B.); (F.D.F.); (G.C.); (F.L.); (P.D.P.); (A.C.); (C.V.)
- Vascular Physiopathology Unit, IRCCS Neuromed, 86077 Pozzilli, Italy
| | - Carmine Vecchione
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (V.V.); (C.I.); (D.B.); (F.D.F.); (G.C.); (F.L.); (P.D.P.); (A.C.); (C.V.)
- Vascular Physiopathology Unit, IRCCS Neuromed, 86077 Pozzilli, Italy
| | - Michele Ciccarelli
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (V.V.); (C.I.); (D.B.); (F.D.F.); (G.C.); (F.L.); (P.D.P.); (A.C.); (C.V.)
| |
Collapse
|
3
|
Matsuo T, So R, Murai F. Estimation methods to detect changes in cardiorespiratory fitness due to exercise training and subsequent detraining. Eur J Appl Physiol 2023; 123:877-889. [PMID: 36550384 DOI: 10.1007/s00421-022-05113-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE To determine whether estimated maximal oxygen consumption ([Formula: see text]) can detect cardiorespiratory fitness (CRF) changes by behavioral modifications. This study compared changes in measured [Formula: see text]O2max (m[Formula: see text]O2max) through exercise intervention with e[Formula: see text]O2max using a multiple regression model (MRM) and linear extrapolation method (LEM). METHODS A cross-sectional analysis involving 173 adults was conducted to establish an MRM by including age, sex, body mass index, questionnaire score, heart rate (HR) from step test, and m[Formula: see text]O2max. Subsequently, 15 men participated in an intervention experiment comprising an 8-week, high-intensity interval training, followed by 8-week detraining, and completed anthropometric measurements, questionnaires, step tests, and m[Formula: see text]O2max tests. m[Formula: see text]O2max changes throughout the intervention were compared to e[Formula: see text]O2max changes calculated using the MRM and LEM. The LEM used the HR during the step test with constant values (predetermined [Formula: see text]O2), such as the Chester step test. RESULTS Inclusion of the step test HR in a questionnaire-based MRM improved the estimation power, although the MRM underestimated higher m[Formula: see text]O2max values. In the intervention, m[Formula: see text]O2max increased by 20.0 ± 14.1% (P < 0.01) and subsequently decreased by 9.5 ± 6.6% (P < 0.01) after exercise training and detraining, respectively. Significant method × time interactions were observed between m[Formula: see text]O2max and e[Formula: see text]O2max in the MRM but not in the LEM, i.e., an apparent systematic error (underestimation of high values) of the MRM was absent in the LEM, although the correlation between m[Formula: see text]O2max and e[Formula: see text]O2max using the LEM was moderate. CONCLUSION e[Formula: see text]O2max, particularly using the MRM with HR as an explanatory factor, is not an appropriate method for detecting CRF changes along with behavioral modifications. CLINICAL TRIAL REGISTRATION Registered number, UMIN000041031; Registered date, 2020/07/08; URL, https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000046855.
Collapse
Affiliation(s)
- Tomoaki Matsuo
- Ergonomics Research Group, National Institute of Occupational Safety and Health, Japan, Kawasaki, Japan.
- Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health, Japan, Kawasaki, Japan.
| | - Rina So
- Ergonomics Research Group, National Institute of Occupational Safety and Health, Japan, Kawasaki, Japan
- Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health, Japan, Kawasaki, Japan
| | - Fumiko Murai
- Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health, Japan, Kawasaki, Japan
| |
Collapse
|
4
|
Matsuo T, So R, Murai F. Improved VO 2max Estimation by Combining a Multiple Regression Model and Linear Extrapolation Method. J Cardiovasc Dev Dis 2022; 10:jcdd10010009. [PMID: 36661904 PMCID: PMC9865627 DOI: 10.3390/jcdd10010009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/22/2022] [Accepted: 12/24/2022] [Indexed: 12/29/2022] Open
Abstract
Maximal oxygen consumption (VO2max) is an important health indicator that is often estimated using a multiple regression model (MRM) or linear extrapolation method (LEM) with the heart rate (HR) during a step test. Nonetheless, both methods have inherent problems. This study investigated a VO2max estimation method that mitigates the weaknesses of these two methods. A total of 128 adults completed anthropometric measurements, a physical activity questionnaire, a step test with HR measurements, and a VO2max treadmill test. The MRM included step-test HR, age, sex, body mass index, and questionnaire scores, whereas the LEM included step-test HR, predetermined constant VO2 values, and age-predicted maximal HR. Systematic differences between estimated and measured VO2max values were detected using Bland-Altman plots. The standard errors of the estimates of the MRM and LEM were 4.15 and 5.08 mL·kg-1·min-1, respectively. The range of 95% limits of agreement for the LEM was wider than that for the MRM. Fixed biases were not significant for both methods, and a significant proportional bias was observed only in the MRM. MRM bias was eliminated using the LEM application when the MRM-estimated VO2max was ≥45 mL·kg-1·min-1. In conclusion, substantial proportional bias in the MRM may be mitigated using the LEM within a limited range.
Collapse
Affiliation(s)
- Tomoaki Matsuo
- Ergonomics Research Group, National Institute of Occupational Safety and Health, Japan, Kawasaki 214-8585, Japan
- Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health, Japan, Kawasaki 214-8585, Japan
- Correspondence:
| | - Rina So
- Ergonomics Research Group, National Institute of Occupational Safety and Health, Japan, Kawasaki 214-8585, Japan
- Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health, Japan, Kawasaki 214-8585, Japan
| | - Fumiko Murai
- Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health, Japan, Kawasaki 214-8585, Japan
| |
Collapse
|
5
|
The Determination of Step Frequency in 3-min Incremental Step-in-Place Tests for Predicting Maximal Oxygen Uptake from Heart Rate Response in Taiwanese Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010563. [PMID: 35010823 PMCID: PMC8744589 DOI: 10.3390/ijerph19010563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/02/2022] [Accepted: 01/03/2022] [Indexed: 11/17/2022]
Abstract
The maximal oxygen uptake (VO2max) prediction models established by step tests are often used for evaluating cardiorespiratory fitness (CRF). However, it is unclear which type of stepping frequency sequence is more suitable for the public to assess the CRF. Therefore, the main purpose of this study was to test the effectiveness of two 3-min incremental step-in-place (3MISP) tests (i.e., 3MISP30s and 3MISP60s) with the same total number of steps but different step-frequency sequences in predicting VO2max. In this cross-sectional study, a total of 200 healthy adults in Taiwan completed 3MISP30s and 3MISP60s tests, as well as cardiopulmonary exercise testing. The 3MISP30s and 3MISP60s models were established through multiple stepwise regression analysis by gender, age, percent body fat, and 3MISP-heart rate. The statistical analysis included Pearson's correlations, the standard errors of estimate, the predicted residual error sum of squares, and the Bland-Altman plot to compare the measured VO2max values and those estimated. The results of the study showed that the exercise intensity of the 3MISP30s test was higher than that of the 3MISP60s test (% heart rate reserve (HRR) during 3MISP30s vs. %HRR during 3MISP60s = 81.00% vs. 76.81%, p < 0.001). Both the 3MISP30s model and the 3MISP60s model explained 64.4% of VO2max, and the standard errors of the estimates were 4.2043 and 4.2090 mL·kg-1·min-1, respectively. The cross-validation results also indicated that the measured VO2max values and those predicted by the 3MISP30s and 3MISP60s models were highly correlated (3MISP30s model: r = 0.804, 3MISP60s model: r = 0.807, both p < 0.001). There was no significant difference between the measured VO2max values and those predicted by the 3MISP30s and 3MISP60s models in the testing group (p > 0.05). The results of the study showed that when the 3MISP60s test was used, the exercise intensity was significantly reduced, but the predictive effectiveness of VO2max did not change. We concluded that the 3MISP60s test was physiologically less stressful than the 3MISP30s test, and it could be a better choice for CRF evaluation.
Collapse
|
6
|
So R, Murai F, Matsuo T. Association of cardiorespiratory fitness with the risk factors of cardiovascular disease: Evaluation using the Japan step test from the National Institute of Occupational Safety and Health. J Occup Health 2022; 64:e12353. [PMID: 36196597 PMCID: PMC9533039 DOI: 10.1002/1348-9585.12353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 08/04/2022] [Accepted: 08/05/2022] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE Cardiorespiratory fitness (CRF) is an important factor for evaluating cardiovascular disease (CVD) risk. We recently developed a novel method (National Institute of Occupational Safety and Health, Japan step test [JST]) for evaluating CRF in workers; its criterion validity has been investigated. However, its association with health risk must be confirmed before its application in the workplace. Therefore, we aimed to determine the association of JST-evaluated CRF with the prevalence of CVD risk among Japanese workers. METHODS For CRF evaluation, working adults completed the JST, which comprised a 3-minute stepping exercise and a 2-minute recovery period. Data on CVD risk factors and clinical history were collected through medical certification within 1 year from the date of the JST measurements. Participants were divided into three groups for multiple logistic regression analyses based on the JST values (low, moderate, and high). Odds ratios (ORs) for the prevalence of CVD risk were calculated. RESULTS We recruited 885 working adults (46.4% women). The prevalence of CVD risk in the total population was 18.6%. When compared to the reference group (low CRF), the ORs for CVD risk prevalence after adjustments for lifestyle factors (smoking status, alcohol consumption status, and exercise habits) were 0.42 (95% confidence interval [CI], 0.28-0.63) and 0.29 (95% CI, 0.18-0.45) for the moderate and high groups, respectively. CONCLUSION An inverse association was noted between the JST-evaluated CRF and CVD risk prevalence. JST may be helpful for identifying workers at risk for CVD development.
Collapse
Affiliation(s)
- Rina So
- Research Center for Overwork‐Related DisordersNational Institute of Occupational Safety and Health, JapanKawasakiJapan
- Ergonomics Research GroupNational Institute of Occupational Safety and Health, JapanKawasakiJapan
| | - Fumiko Murai
- Research Center for Overwork‐Related DisordersNational Institute of Occupational Safety and Health, JapanKawasakiJapan
| | - Tomoaki Matsuo
- Research Center for Overwork‐Related DisordersNational Institute of Occupational Safety and Health, JapanKawasakiJapan
- Ergonomics Research GroupNational Institute of Occupational Safety and Health, JapanKawasakiJapan
| |
Collapse
|
7
|
Li F, Chang CH, Chung YC, Wu HJ, Kan NW, ChangChien WS, Ho CS, Huang CC. Development and Validation of 3 Min Incremental Step-In-Place Test for Predicting Maximal Oxygen Uptake in Home Settings: A Submaximal Exercise Study to Assess Cardiorespiratory Fitness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010750. [PMID: 34682494 PMCID: PMC8535254 DOI: 10.3390/ijerph182010750] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 11/16/2022]
Abstract
The purpose of this research was to develop the 3 min incremental step-in-place (3MISP) test for predicting maximal oxygen uptake (V.O2max). A total of 205 adults (20–64 years) completed the 3MISP and V.O2max tests. Using age, gender, body composition (BC) including percent body fat (PBF) or body mass index (BMI), and with or without heart rate (HR) at the beginning of exercise (HR0) or difference between HR at the third minute during the exercise and the first minute post exercise (ΔHR3 − HR4) in the 3MISP test, six V.O2max prediction models were derived from multiple linear regression. Age (r = −0.239), gender (r = 0.430), BMI (r = −0.191), PBF (r = −0.706), HR0 (r = −0.516), and ΔHR3 − HR4 (r = 0.563) were significantly correlated to V.O2max. Among the six V.O2max prediction models, the PBF model∆HR3 − HR4 has the highest accuracy. The simplest models with age, gender, and PBF/BMI explained 54.5% of the V.O2max in the PBF modelBC and 39.8% of that in the BMI modelBC. The addition of HR0 and ∆HR3 − HR4 increases the variance of V.O2max explained by the PBF and BMI models∆HR3 − HR4 by 17.98% and 45.23%, respectively, while standard errors of estimate decrease by 10.73% and 15.61%. These data demonstrate that the models established using 3MISP-HR data can enhance the accuracy of V.O2max prediction.
Collapse
Affiliation(s)
- Fang Li
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan City 333325, Taiwan; (F.L.); (C.-H.C.)
| | - Chun-Hao Chang
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan City 333325, Taiwan; (F.L.); (C.-H.C.)
| | - Yu-Chun Chung
- Center of General Education, Taipei Medical University, Taipei 11031, Taiwan; (Y.-C.C.); (N.-W.K.)
| | - Huey-June Wu
- Department of Combat Sports and Chinese Martial Arts, Chinese Culture University, Taipei 11114, Taiwan;
| | - Nai-Wen Kan
- Center of General Education, Taipei Medical University, Taipei 11031, Taiwan; (Y.-C.C.); (N.-W.K.)
| | - Wen-Sheng ChangChien
- Service Systems Technology Center, Industrial Technology Research Institute, Hsinchu 310401, Taiwan;
| | - Chin-Shan Ho
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan City 333325, Taiwan; (F.L.); (C.-H.C.)
- Correspondence: (C.-S.H.); (C.-C.H.); Tel.: +886-3-328-3201 (ext. 2425) (C.-S.H.); +886-3-328-3201 (ext. 2409) (C.-C.H.)
| | - Chi-Chang Huang
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan City 333325, Taiwan; (F.L.); (C.-H.C.)
- Correspondence: (C.-S.H.); (C.-C.H.); Tel.: +886-3-328-3201 (ext. 2425) (C.-S.H.); +886-3-328-3201 (ext. 2409) (C.-C.H.)
| |
Collapse
|