Prevalence of digital dermatitis in young stock in Alberta, Canada, using pen walks

Adherence and metal-ion acquisition gene expression increases during infection with Treponema phagedenis strains from bovine digital dermatitis

Digital dermatitis (DD) is an ulcerative foot lesion on the heel bulbs of dairy cattle. DD is a polymicrobial disease with no precise etiology, although Treponema spirochetes are found disproportionally abundant in diseased tissue. Within Treponema, several different species are found in DD; however, the species Treponema phagedenis is uniformly found in copious quantities and deep within the skin layers of the active, ulcerative stages of disease. The pathogenic mechanisms these bacteria use to persist in the skin and the precise role they play in the pathology of DD are widely unknown. To explore the pathogenesis and virulence of Treponema phagedenis, newly isolated strains of this species were investigated in a subcutaneous murine abscess model. In the first trial, a dosage study was conducted to compare the pathogenicity of different strains across three different treponemes per inoculum (TPI) doses based on abscess volumes. In the second trial, the expression levels of 11 putative virulence genes were obtained to gain insight into their involvement in pathogenesis. During the RT-qPCR analysis, it was determined that genes encoding for two metal-ion import lipoproteins and two adherence genes were found highly upregulated during infection. Conversely, two genes involved in motility and chemotaxis were found to not be significantly upregulated or utilized during infection. These results were supported by gene expression data from natural M2 lesions of dairy cattle. This gene expression analysis could highlight the preference in strategy for T. phagedenis to persist and adhere in the host rather than engage in motility and disseminate.

Evaluating the impact of application of anaerobic bacterial fermentation enhancer on digital dermatitis

The control of digital dermatitis (DD) among cattle is crucial; however, effective and environmentally-sound control measures have yet to be identified. From the monitoring data of DD which were recorded during regular hoof trimmings in a farm in Hokkaido, Japan, we detected a decrease in the DD prevalence in a herd where an anaerobic bacterial fermentation enhancer (ABFE) was distributed. The possible effect of ABFE was analyzed using a retrospective repeated cross-sectional design. The prevalence of DD decreased over time in the ABFE-distributed group. Furthermore, a selected regression model indicated the time-dependent enhancement of the decreasing trend. While potential coincidental factors may influence, this study provides a basis for further research on the preventive effect of ABFE against DD.

Management of Digital Dermatitis in Dairy Herds: Optimization and Time Allocation

The objective of this study is to determine the most effective time allocation for digital dermatitis management and to quantify the marginal economic gain from extra time devoted to digital dermatitis management. The model simulating foot disease occurrence and the associated management was Dairy Health Simulator©. Then, an econometric model was applied to identify the relationship between the dairy workshop's gross margin and time for lameness management as well as the hourly marginal gain curve associated with lameness management. The gross margin was optimized under two constraints, i.e., the overall time spent for lameness management and the mean lameness duration (mimicking cow welfare). The results show that allocating less time to lameness detection and more to footbath application can contribute as follows: (i) reduces time spent for lameness management, (ii) maintains the best welfare level, and (iii) obtains the highest gross margin. The optimal time to devote to footbath application ranged from 17.8 to 22.3 h/month. A hiring strategy was investigated, and the break-even point ranged from 16.1 to 19.8 h/month. The recommended time to spend on footbath application is relatively important; therefore, stakeholders should consider the importance of lameness to the dairy industry and should devote enough time for footbath applications.

Comparison of ozonated water and acidified copper sulphate in prevention of digital dermatitis in dairy cows

Digital dermatitis (DD) is the most significant infectious hoof disorder of cattle in Europe. Hoof baths are one of the most common control methods. Copper sulphate and formalin are commonly used in hoof baths, but their use is problematic in many European countries for health, environmental and safety reasons. Ozonated water and acidified copper sulphate were tested as prevention of DD in a 5-month study. Data were derived from 302 hind feet of Holstein and Estonian Red cows (no. of cows = 151) from a commercial dairy farm in Estonia. Altogether 168 hind feet were included in the acidified copper sulphate group and 134 feet in the ozonated water group. Hoof bathing was carried out three days a week (Mon, Wed, Fri) for two months and then two days a week (Mon, Wed) for three and a half months, in both groups. Ozonated water was sprayed on to the digital skin of hind feet of cows twice a day on treatment days, while the cows were eating. The copper sulphate bath consisted of copper sulphate (2%) mixed with an organic acid compound to acidify and ionize the solution. Cows walked through acidified copper sulphate solution twice a day on treatment days as they were exiting the milking parlor. DD negative and DD positive test results in both groups were compared and statistically tested for differences. The copper sulphate solution was more effective than ozonated water at preventing acute DD lesions. A random maximum likelihood model demonstrated that the odds ratio for DD in the ozonated water group was six times higher compared with DD in the acidified copper sulphate group. Most of the cows that were initially without any DD lesions (M0 + no other severe hoof lesion), remained lesion-free in both groups (copper sulphate group 97% and ozonated water group 88%). Despite trial design deficiencies, the findings indicate that acidified copper sulphate was a more effective solution in preventing DD than ozonated water.

An experimental model to induce digital dermatitis in beef calves

Background

Digital dermatitis (DD) is a multifactorial infectious disease affecting the skin on feet of cattle causing erosion and inflammation above the heel bulbs. Some cases of DD cause lameness and significantly impact animal welfare and productivity. While DD has emerged as a concern for the beef industry, key information regarding early detection and its impact on cattle behaviour is lacking. The primary objective of this study was to determine if an established DD experimental model for dairy calves could be used to induce DD lesions in beef calves. A secondary objective was to describe changes in behaviour and pain associated with induction of DD lesions. Eight beef calves acquired from a single cow-calf operator were enrolled in the study. Upon enrolment, calves were evaluated and determined to be free of foot lesions. Within the experimental environment, calves were housed in individual pens and assigned to two groups (mock-inoculated and inoculated). Both hind feet of each calf were enrolled. Within calf, inoculation protocol was consistent, and a 28-day experimental protocol was employed. Two days prior to inoculation, both hind feet of each calf were abraded (area above the heel bulbs and below the dewclaws), moistened, and wrapped to facilitate an anaerobic condition. Feet were inoculated with macerated DD lesion material or mock inoculum and remained wrapped until clinical signs of DD or protocol endpoint.

Results

After a period of 14 to 18 days post inoculation, three of five inoculated calves developed clinical signs (lameness), and upon close inspection, DD lesions were present on at least one hind foot. Two of five inoculated calves did not develop lesions within 28 days. Zero of three mock-inoculated calves developed DD. Treponema spp. were detected by quantitative polymerase chain reaction from biopsies of induced lesions. Measurements of behaviour prior to disease induction were numerically different between DD affected and mock-inoculated calves.

Conclusions

An experimental infection model established for dairy cattle was used to successfully induce acute DD lesions in three of five inoculated beef calves. This model can provide a framework to study intervention protocols and to evaluate the impact of DD on behaviour and pain.

Prevalence of digital dermatitis using mirror scoring in Finnish freestall dairy herds

Digital dermatitis (DD) is a severe bacterial hoof disease found worldwide. The disease can be classified into 5 different stages, denoted as M1 to M4 and M4.1, by clinical examination. The main objective of this study was to estimate prevalence of DD lesions in Finnish freestall dairy cattle population through hind feet inspection of standing cows with a mirror. Another aim was to estimate the sensitivity and specificity of mirror scoring on standing cows in a pen or in a milking parlor without washing the feet. Three veterinarians visited 81 randomly selected herds across the country. During the herd visits, hind feet of standing cows (n = 7,010) were scored with a mirror without washing the feet, either when the cows were standing in a pen (n = 4,992) or in the milking parlor (n = 2018). In total, 128 cows (111 from pen and 17 from milking parlor) including 256 feet were chosen with cross-sectional sampling and scored in a trimming chute. Animal-level sensitivity for scoring M2 lesions with a mirror was 55% and specificity was 97%; for all active DD lesions (M1, M2, or M4.1), sensitivity was 36% and specificity was 96%. Sensitivity for scoring any DD lesions was 90% and specificity was 82%. The bias-corrected sensitivity and specificity for scoring any DD lesions were 79% and 92%, respectively. The bias-corrected sensitivity and specificity for scoring M2 DD lesions were 10% and 100%. We found M2 lesions in 12.1% of the study herds, and true herd-level prevalence was the same. Altogether, 33.3% (true prevalence 28.4%) of the herds had either M1, M2, or M4.1 DD lesions. However, only 0.7% (true prevalence 5.4%) of cows in total had active M2 lesions. The within-herd prevalence of M2 lesions (in herds where at least 1 cow had a M2 lesion) was 5.7% and varied between 0.4% and 18.8%. Herds with active DD lesions also had more any DD lesions than herds without active DD lesions. The herd-level prevalence was higher than previously thought, with only 1 herd without any DD lesions. However, the animal-level prevalence of active DD lesions was relatively low. Farmers and veterinarians need to be informed of the disease and possible control measures. Because of the low within-herd prevalence, the control of the disease might be easier than in countries where DD is widespread. Further studies are needed to identify factors associated with DD prevalence in Finnish dairy herds.

Transcellular penetration of Treponema phagedenis isolated from papillomatous digital dermatitis in polarized normal human epidermal keratinocytes in vitro

Papillomatous digital dermatitis (PDD) is a polymicrobial infection causing lameness in dairy cattle. Culture-independent analysis has shown that Treponema phagedenis is present consistently and predominantly in the lesions. However, the pathogenesis of PDD, especially the tissue penetration pathway, has not been examined. In the present study, we investigated whether T. phagedenis strains isolated from PDD produce proteolytic enzyme (s) for disruption of the epithelial cell barrier and have the ability to translocate in polarized normal human epidermal keratinocytes (NHEK) in vitro. Ten strains of T. phagedenis isolated from lesions did not show proteolytic activity on modified skim milk agar, although a human strain of T. denticola used as a control showed such activity. The integrity of tight junctions was monitored by measurement of transepithelial electrical resistance (TER). The TER values after inoculation of the T. phagedenis strains examined did not change during the experimental period; however, apical to basolateral translocation of T. phagedenis was confirmed after 24 hr by microscopy and Treponema-specific PCR. We further confirmed that translocation of T. phagedenis was accelerated by co-inoculation with live T. denticola, but not with heat-killed organisms. Furthermore, tight junction ZO-1 protein was not lost intensity after inoculation with T. phagedenis and the organism was observed in NHEK cells using a florescence microscope. These results suggest that T. phagedenis strains may translocate via a transcellular route in vitro and that the invasion is accelerated by other bacteria, such as T. denticola, producing proteolytic activity.

Impact of Nutrients on the Hoof Health in Cattle

Lameness is currently one of the most important and economically demanding diseases in cattle. It is manifested in a change in locomotion that is associated with lesions, especially the pelvic limbs. The disease of the hoof is painful, affecting the welfare of dairy cows. Important factors that influence the health of the limbs include nutrition, animal hygiene, stable technology, and genetic and breeding predispositions. Nutrition is one of the basic preventive factors affecting the quality and growth of the hoof horn, and the associated prevalence of hoof disease. The strength and structure of the hoof horn are affected by the composition of the feed ration (amino acids, minerals, vitamins, and toxic substances contaminating the feed ration, or arising in the feed ration as metabolites of fungi).

Bayesian assessment of diagnostic accuracy of a commercial borescope and of trimming chute exams for diagnosing digital dermatitis in dairy cows

Digital dermatitis (DD) is a worldwide infectious disease of cattle that causes lameness, discomfort, and economic losses. The reference standard test to diagnose DD is visual observation in a trimming chute, which cannot be practically performed daily on dairy farms. Moreover, some lesion misclassification may occur using this standard diagnostic method. The possibility of misclassification makes the use of a trimming chute debatable as a perfect reference standard test. The objective of this study was, therefore, to assess the diagnostic accuracy of a commercial borescope and trimming chute exam. The accuracy (sensitivity and specificity) of the tests and DD prevalence were investigated using Bayesian latent class analyses. Our hypothesis was that a commercial borescope can be routinely used to diagnose DD in a milking parlor without previous feet cleaning. A cross-sectional study was performed in a freestall facility. The lesions were scored (M0, M1, M2, M3, M4, M4.1) in the milking parlor with a borescope, followed by an examination in the trimming chute 48 to 72 h after the borescope exam. A total of 870 hind feet were scored during 2 sessions of trimming chute exams and borescope exams in the milking parlor. The data were analyzed in 2 ways. First, data were dichotomized into DD lesions (M1, M2, M3, M4, M4.1) and absence of DD lesions (M0). Second, data were dichotomized into active DD lesions (M1, M2, M4.1) and inactive lesions (M0, M3, M4). A Bayesian latent class model allowing for conditional dependence between tests was used to estimate tests' accuracy, likelihood ratio, and DD prevalence. When the data were dichotomized into DD lesions (M1-M4.1) versus absence of DD (M0) lesions, the sensitivity and specificity of the borescope was 55% [95% credible interval (CrI) 40-71%] and 81% (95% CrI 75-88%). The sensitivity of trimming chute exams was 79% (95% CrI 68-88%), and specificity was 80% (95% CrI 71-89%). When the data were dichotomized into active lesions (M1, M2, M4.1) versus inactive lesions or absence of lesions (M3, M4, M0), the sensitivity and specificity of the borescope were, respectively, 32% (95% CrI 13-58%) and 91% (95% CrI 88-95%). The sensitivity and specificity of trimming chute exams were 91% (95% CrI 81-97%) and 81% (95% CrI 75-89%), respectively. In conclusion, it is possible to use the borescope in the milking parlor without cleaning the feet to monitor prevalence of DD lesions. However, an isolated borescope examination, especially for diagnosing active DD lesions, has low sensitivity for use as a surveillance method. For such use, the sensitivity could be improved by repeating the borescope exam on a regular basis.

Bovine digital dermatitis in Victoria, Australia

AIMS

The objectives of this study were to estimate the prevalence of digital dermatitis (DD) in Victoria, Australia, and to investigate which organisms are consistent with typical DD lesions. The prevalence and causative pathogens of DD are not clear yet in Australia and this paper is one of the first to explore these questions in this country.

METHODS

Examination and sampling of limbs was undertaken at three knackeries in Victoria, Australia. Limbs were classified as normal (N), active DD-lesion (A), dried or chronic DD-lesion (D) or suspected case of DD (S). A total of 823 cows were examined. Six skin biopsies were taken at each knackery, from which DNA was extracted for diversity profiling. Histochemical staining of samples was performed on eight of the skin biopsies.

RESULTS

DD was detected in 29.8% of all cows. The prevalence of DD was significantly higher in dairy cows (32.2%) than in beef cows (10.8%). The differential abundance of Treponema-species was significantly increased in dried lesions, compared with the normal skin biopsies. Actinobacteria, Proteobacteria, Firmicutes and Tenericutes were found to be significantly different in abundance in the DD lesions compared with normal skin biopsies. Silver staining of samples showed only mild inflammation and in two samples organisms with morphology consistent with Spirochaetes were detected.

CONCLUSIONS

The calculated prevalence indicates that DD is present in Victoria, Australia. The results of diversity profiling showed that the presence of Treponema-species was significantly different between the samples of DD lesions and normal skin.

Isolation and identification of Treponema pedis and Treponema phagedenis-like organisms from bovine digital dermatitis lesions found in dairy cattle in Turkey

The isolation and identification of microorganisms associated with digital dermatitis (DD) in Turkish dairy cattle was investigated using punch skin biopsy samples from typical clinical lesions; they were collected from dairy farms and abattoirs in 5 different geographical locations in Turkey. Morphological characteristics and flagellation types were examined using a transmission electron microscope, and their enzyme profiles by enzyme activation kits; their catalase reaction characteristics were evaluated by the addition of 3% H₂O₂. Their phylogenies were identified using 16S rRNA and the results compared with known gene bank data. Bacterial cells were 5.0 to 18.2 µm long, 0.2 to 0.5 µm wide, and their minimum number of periplasmic flagellum was 4 (4:8:4) with a maximum of 8 (8:16:8). All isolates were catalase negative. Of the spirochetes isolated and identified, group I organisms showed close similarity with Treponema pedis (99% genetic homology), whereas those in group II were similar to Treponema phagedenis (98% homology). This is the first report of specific sub-groups of Treponema spp., isolated from Turkish dairy cattle presenting with DD lesions, being associated with this disease; these morphotypes were similar to those found globally in housed dairy cattle units and are probably significant microorganisms associated with the aetiopathogensis of this infectious disease causing acute bovine lameness. These results suggest that the distribution of DD-associated treponemes is not specific to particular geographic regions of Turkey.

A Differential Innate Immune Response in Active and Chronic Stages of Bovine Infectious Digital Dermatitis

Digital dermatitis (DD) commonly associated with Treponema spp. infection is a prevalent infectious bovine foot disease characterized by ulcerative and necrotic lesions. Lesions associated with DD are often classified using the M-stage scoring system, with M0 indicating healthy heel skin and M4 indicating chronic lesions. Current treatments utilizing antimicrobials or chemical footbaths are often ineffective and rarely cure DD lesions. Understanding the function of the innate immune response in the pathogenesis of DD will help to identify novel therapeutic approaches. In this study, the expression of the local innate host defense peptides cathelicidins and β-defensins was investigated in cows with DD and associated with the presence of treponemes and inflammatory reactions. Samples from active ulcerative DD lesions (M2) had considerable epidermal neutrophilic infiltration and increased gene expression of β-defensin tracheal antimicrobial peptides compared to control skin. Samples from acute lesions also had elevated local Cxcl-8 and TLR4 gene expression and abundant treponemes as identified by direct visualization, immunohistochemistry, and culture. Conversely, the anti-inflammatory peptide IL-10 was elevated in skin from chronic (M4) lesions, whereas bovine cathelicidin myeloid antimicrobial peptide 28 (Bmap-28) was increased in skin from oxytetracycline-treated M2 lesions. Experiments using cultured human keratinocytes challenged with Treponema spp. isolated from clinical cases of bovine DD showed that structural products from treponemes are able to initiate the innate immune response, in part through TLR2 signaling. These findings indicate that neutrophil influx, Cxcl-8, and β-defensin are key markers of active DD. Cathelicidins and IL-10 seem important in response to treatment or during the chronic proliferative stages of the disease.

The use of infrared thermography for detecting digital dermatitis in dairy cattle: What is the best measure of temperature and foot location to use?

Lameness in dairy cattle is a persistent problem, indicating pain caused by underlying disease states and is associated with reduced milk yields. Digital dermatitis is a common cause of lameness. Thermal imaging is a technique that may facilitate early detection of this disease and has the potential for use in automated detection systems. Previous studies with thermal imaging have imaged either the heels or the coronary band of the foot and typically only used the maximum temperature (Max) value as the outcome measure. This study investigated the utility of other statistical descriptors: 90th percentile (90PCT), 95th percentile (95PCT), standard deviation (SD) and coefficient of variation (CoV) and compared the utility of imaging the heel or coronary band. Images were collected from lame and healthy cows using a high-resolution thermal camera. Analyses were done at the cow and foot level. There were significant differences between lame and healthy feet detectable at the heels (95th percentile: P<0.05; SD: P<0.05) and coronary band (SD: P<0.05). Within lame cows, 95PCT values were higher at the heel (P<0.05) and Max values were higher at the coronary band (P<0.05) in the lame foot compared to the healthy foot. ROC analysis showed an AUC value of 0.72 for Max temperature and 0.68 for 95PCT at the heels. It was concluded that maximum temperature is the most accurate measure, but other statistical descriptors of temperature can be used to detect lameness. These may be useful in certain contexts, such as where there is contamination. Differentiation of lame from healthy feet was most apparent when imaging the heels.

Comparison of effects of routine topical treatments in the milking parlor on digital dermatitis lesions

Digital dermatitis (DD), an infectious bacterial disease affecting the feet of dairy cattle, can cause lameness and decrease milk production, fertility, and animal welfare. Current DD treatment typically involves routine hoof trimming and topical antibiotics. Several nonantibiotic commercial topical products are used for controlling DD lesions; however, there is limited or no evidence regarding their effectiveness. The objectives of this study were to evaluate 2 commercially available topical applications on their ability to (1) clinically cure active DD lesions to nonactive lesions and (2) prevent recurrence of active DD lesions. Ten farms were visited weekly. In the milking parlor, the hind feet of lactating cattle were cleaned and scored (M-stage scoring system). Cattle with DD lesions at the first visit were randomly allocated to 1 of 4 treatment groups: positive control (tetracycline solution), HealMax (AgroChem Inc., Saratoga Springs, NY), HoofSol (Diamond Hoof Care Ltd., Intracare BV, Veghel, the Netherlands), and a negative control (saline). All products were applied to lesions using a spray bottle. Tetracycline, HealMax, and HoofSol had a higher probability of clinical cure for active lesions compared with saline 1 wk after the first treatment (wk 1), with 69, 52, and 79% clinical cure of active lesions, respectively, compared with 34% with saline. At wk 7, the probability of clinical cure for active lesions was 10, 33, 31, and 45% of lesions treated weekly with saline, tetracycline, HealMax, and HoofSol, respectively (no difference among treatments). The substantial clinical cure with saline highlighted the potential importance of cleaning feet. In wk 1, treatment with saline, tetracycline, HealMax, and HoofSol resulted in a probability of recurrence of active DD lesions of 9, 11, 11, and 8%, respectively, with no product being superior to saline. After 7 wk, the probability of recurrence of active lesions was 5, 7, 6, and 6% for saline, tetracycline, HealMax, and HoofSol respectively, with no difference among groups in wk 7. These results provide alternatives to antibiotics for treatment of DD lesions and highlight the potential importance of cleaning feet in the milking parlor.

Evaluation of agreement among digital dermatitis scoring methods in the milking parlor, pen, and hoof trimming chute

Digital dermatitis (DD) is the most common infectious foot lesion affecting welfare and productivity of dairy cattle. The key to DD control programs is routine and frequent identification of DD lesions. The objective was to evaluate accuracy of detecting and scoring DD lesions in 3 milking parlor designs and in 3 alternative settings compared with scoring in the hoof trimming chute as reference. A total of 552 cows and 1,104 hind feet from 17 freestall farms were scored by 1 observer in the milking parlor and in 1 other setting: pen, headlocks, or management rail. After being scored in the milking parlor and at least 1 other setting, cows were examined in the hoof trimming chute, considered the gold standard. In every setting, all hind feet were inspected visually using a flashlight and without prior washing of feet. Agreement of the scoring settings was assessed using the 5 M-stage scoring system and a dichotomous absence (M0 or M0/M1) or presence (M1 to M4.1 or M2 to M4.1) system. At trimming chute inspection, 44% of feet had a DD lesion, with estimates of 11, 5, 2, 10, and 16% for M1, M2, M3, M4, and M4.1 lesions, respectively. Apparent DD foot-level prevalence at the milking parlor, pen, management rail, and headlocks was 28, 22, 16, and 22%, respectively. M-stages were less discernible in the pen, management rail, and headlocks (apparent prevalence of M1, M2, M3, and M4.1 was ≤1%) compared with the trimming chute and milking parlor. Agreement beyond chance between any scoring setting and trimming chute scoring ranged from 0.48 to 0.70 for the dichotomous scoring system (absence = M0/M1 vs. presence = M2 to M4.1). Diagnostic test performance varied greatly among DD scoring settings but, in general, it had low sensitivity (<70%) and high specificity (>93%) for detecting any DD lesion. Agreement and test characteristics were not affected by the type of milking parlor. Although the milking parlor and headlocks were the most reliable settings in which to detect DD, none of the settings were reliable enough to replace inspection of feet in the trimming chute. However, scoring the presence or absence of DD in the milking parlor, pen, management rail, and headlocks could be used to estimate within-herd DD prevalence, to improve DD surveillance through routine monitoring, and to evaluate effects of interventions at the farm level.

Missing pieces of the puzzle to effectively control digital dermatitis

Since the first report of bovine digital dermatitis (DD) in 1974, there is a large body of the literature published; however, effective prevention and control of the disease remain elusive. Although many aspects of the pathogenesis of DD have been investigated, even some of the most basic questions such as the aetiology of this disease remain under debate. Treponema spp. have been strongly associated with DD lesions and occur in abundance in advanced lesions; however, efforts to induce disease with pure cultures of these organisms have been largely underwhelming and inconsistent. Furthermore, although the disease has been presented for several decades, there is limited scientific evidence regarding effective treatment of DD. Apparent discrepancies between effectiveness in vitro and in vivo have challenged the scientific community to identify new potential treatment options. With no treatment resulting in a 100% cure rate, the current expectation is manageable control, but prospects for the eradication of the disease are unlikely using current approaches. In order to develop more effective approaches to control DD on-farm, there is a critical need for a deeper understanding regarding the causation, ecology, transmission and treatment of this disease. In this article, we attempt to provide insights into specific research needs related to DD in order to assist the industry, researchers, pharmaceutical companies and research sponsors with decision-making and identified research gaps.