The associations between religiosity and the Big-Five personality traits in college students from Sudan.

Research on the association between religiosity and personality with Arab participants is rare. The aim of the present study was to explore this association using a sample (N = 623) of college students from Sudan. They responded to the Arabic Scale of Intrinsic Religiosity and the Arabic Big-Five Personality Inventory. The results indicated that men obtained a significantly higher mean score than did women for extraversion, whereas women obtained higher mean total scores for religiosity and neuroticism than did men. For both genders, religiosity was significantly and positively associated with agreeableness and conscientiousness. In college men only, religiosity was significantly correlated with extraversion. A principal components analysis of the combined sample of men and women retained two components and labeled "Positive traits" and "Neuroticism and Introversion". Predictors of religiosity were Agreeableness and Conscientiousness. The model explains 42% of the variance. It was concluded that the associations observed in the Sudanese sample reflect the general pattern observed in other international samples.

The effect of Er, Cr:YSGG laser debonding on the bond strength of two ceramic materials to dentin.

OBJECTIVES: Evaluating the bond strength of two ceramic materials to dentin after Er,Cr:YSGG laser debonding. Would laser debonding affect the bond strength of ceramic to dentin? MATERIALS AND METHODS: Recently extracted human molars were ground to expose dentin. Forty square shaped samples were prepared from CAD/CAM ceramic blocks. Samples were divided into two groups according to the type of ceramic material; group E: Lithium disilicate and group T: Ultra-translucent Zirconia (n = 20) Each group was divided into two subgroups (n = 10) according to the laser debonding effect (subgroup B: bonded samples, subgroup R: re-bonded samples after laser debonding). Ceramic samples were bonded to dentin using dual cure self-adhesive resin cement. Laser debonding of ceramic samples of subgroups R using Er, Cr:YSGG laser, were then re-bonded again to dentin surface with same resin cement. The Shear bond strength test using Universal testing machine was done. The failure mode was analyzed. Two-way analysis of variance was used to compare the mean bond strength and re-bond strength of two materials. The significance level was set at P ≤ 0.05. RESULTS: Two-Way ANOVA showed that ceramic type had a significant effect on the re-bond strength to dentin. The predominant failure mode was adhesive. CONCLUSIONS: Laser debonding of Lithium disilicate and Ultra translucent Zirconia decreased the re-bond strength to dentin. Deterioration in re-bond strength for Lithium disilicate ceramics was more pronounced than for Ultra translucent Zirconia. Clinical Relevance Deterioration in the bond strength between ceramics & dentin after laser debonding still needs improvement to allow its clinical use.

Effect of dietary chitosan supplementation on productive and physiological performance parameters of growing New Zealand white rabbits.

This study aimed to investigate the effects of dietary chitosan supplementation on the growth performance, carcass traits, and some physiological parameters of weaned New Zealand White rabbits (NZW). Sixty-four NZWs were randomly distributed into four dietary experimental groups (n = 16) and fed a basal diet ad libitum for eight weeks: under Egyptian conditions. The basal diet without chitosan served as the control group, while the other three groups were fed diets containing 0.2, 0.4 and 0.6 g chitosan/kg diet. We observed significant (P ≤ 0.05) differences among chitosan treatments. Specifically, groups supplemented with chitosan in their diets had significantly (P ≤ 0.05) higher final body weight and weight gain, as well as an improved feed conversion ratio compared to the control group. Rabbits fed chitosan at 0.2 g/kg diet performed the best in growth traits compared to other treatment groups. Rabbits fed chitosan at 0.4 g/kg diet had significantly (P ≤ 0.05) higher levels of total protein in their blood than in the control group. However, levels did not differ significantly from that in the 0.2 group. Likewise, the highest (P ≤ 0.05) levels of glucose and HDL concentrations were detected in rabbits fed chitosan at a 0.2 g/kg diet. All chitosan-supplemented groups (especially at 0.2 g/kg diet) had higher economic efficiency and relative profit levels than the control group. Moreover, morphometric evaluations of the small intestine revealed higher villi number and crypt depth values in chitosan-treated animals compared to the control group. We conclude that using chitosan at levels of 0.2 or 0.4 g/kg diet can effectively improve the body weight gain, feed conversion ratio and economic efficiency, as well as the overall health status of NZW under Egyptian conditions.

Sexual behaviour response, testicular development and semen quality of New Zealand white rabbit bucks as influenced by dietary chitosan.

The present study was conducted to determine the effects of dietary chitosan supplementation on sexual behaviour responses, testicular development, and semen quality traits of New Zealand White (NZW) rabbit bucks. Twenty-four 5-week-old rabbit bucks were used in this experiment. Animals were grouped into four equal experimental groups: the control group was fed only on a basal diet, whereas the other groups were fed the basal diet supplemented with three levels of chitosan at 0.2, 0.4, or 0.6 g/kg, respectively. Also, bucks that received chitosan at 0.2 and 0.4 g/kg had a significantly earlier time of sexual libido (p ≤ .05) and had significantly higher ejaculate volume and sperm concentration than other groups (p ≤ .001). Furthermore, basic and sexual behaviours were significantly improved in bucks fed chitosan at 0.2 and 0.4 g/kg compared with other groups. Therefore, it could be concluded that using chitosan at 0.2 and 0.4 g/kg enhanced sexual behaviour, improved semen quality, and reproductive efficiency in the NZW rabbit bucks.

Are Nonfatal Suicide Attempts Instrumental in Achieving Personal and Interpersonal Goals?

This study focused on the well-being of the survivors of suicide attempts and the well-being of their interpersonal relationships after the attempt. The data came from a sample of 392 college students from 10 Muslim majority countries who reported having attempted suicide in the last 4 years. Suicide was conceptualized as a goal-directed behavior embedded in a sociocultural context and motivated by personal or interpersonal goals. We tested a process that linked culturally shaped self-construal to the postsuicidal personal and interpersonal well-being. We posited that this process would operate through the attitudes towards suicide, motives for suicide, the strength of the intention to die. Our model indicated that the acceptability of suicide was positively associated with escape motives, and this association was even stronger for the individuals with interdependent self-construals. Escape motives were negatively associated with postsuicidal personal and interpersonal well-being, but communication motives were not associated with these outcomes. We also found evidence that having an interdependent self-construal might be beneficial for postsuicidal personal and interpersonal well-being. Our results further suggested that the postsuicidal personal and interpersonal well-being of highly interdependent individuals may depend on the interpretation of their act of suicide by their close others.

Outcome of percutaneous drainage for septic complications coexisted with COVID-19.

BACKGROUND: The resulting tissue hypoxia and increased inflammation secondary to severe coronavirus disease 2019 (COVID-19) combined with viral load, and other baseline risk factors contribute to an increased risk of severe sepsis or co-existed septic condition exaggeration. AIM: To describe the clinical, radiological, and laboratory characteristics of a small cohort of patients infected by severe acute respiratory syndrome coronavirus 2 who underwent percutaneous drainage for septic complications and their post-procedural outcomes. METHODS: This retrospective study consisted of 11 patients who were confirmed to have COVID-19 by RT-PCR test and required drain placement for septic complications. The mean age ± SD of the patients was 48.5 ± 14 years (range 30-72 years). Three patients underwent cholecystostomy for acute acalculous cholecystitis. Percutaneous drainage was performed in seven patients; two peripancreatic collections; two infected leaks after hepatic resection; one recurrent hepatic abscess, one psoas abscess and one lumbar abscess. One patient underwent a percutaneous nephrostomy for acute pyelonephritis. RESULTS: Technical success was achieved in 100% of patients, while clinical success was achieved in 4 out of 11 patients (36.3%). Six patients (54.5%) died despite proper percutaneous drainage and adequate antibiotic coverage. One patient (9%) needed operative intervention. Two patients (18.2%) had two drainage procedures to drain multiple fluid collections. Two patients (18.2%) had repeat drainage procedures due to recurrent fluid collections. The average volume of the drained fluid immediately after tube insertion was 85 mL. Follow-up scans show a reduction of the retained content and associated inflammatory changes after tube insertion in all patients. There was no significant statistical difference (P = 0.6 and 0.4) between the mean of WBCs and neutrophils count before drainage and seven days after drainage. The lymphocyte count shows significant increased seven days after drainage (P = 0.03). CONCLUSION: In this study, patients having septic complications associated with COVID-19 showed relatively poor clinical outcomes despite technically successful percutaneous drainage.

An analysis of age-standardized suicide rates in Muslim-majority countries in 2000-2019.

BACKGROUND: This study examines the 20-year trend of suicide in 46 Muslim-majority countries throughout the world and compares their suicide rates and trends with the global average. Ecological-level associations between the proportion of the Muslim population, the age-standardized suicide rates, male-to-female suicide rate ratio, and the Human Development Index (HDI) in 2019 were examined. METHODS: Age-standardized suicide rates were extracted from the WHO Global Health Estimates database for the period between 2000 and 2019. The rates in each country were compared with the age-standardized global average during the past 20 years. The countries were further grouped according to their regions/sub-regions to calculate the regional and sub-regional weighted age-standardized suicide rates involving Muslim-majority countries. Correlation analyses were conducted between the proportion of Muslims, age-standardized suicide rate, male: female suicide rate ratio, and the HDI in all countries. Joinpoint regression was used to analyze the age-standardized suicide rates in 2000-2019. RESULTS: The 46 countries retained for analysis included an estimated 1.39 billion Muslims from a total worldwide Muslim population of 1.57 billion. Of these countries, eleven (23.9%) had an age-standardized suicide rate above the global average in 2019. In terms of regional/sub-regional suicide rates, Muslim-majority countries in the Sub-Saharan region recorded the highest weighted average age-standardized suicide rate of 10.02/100,000 population, and Southeastern Asia recorded the lowest rate (2.58/100,000 population). There were significant correlations between the Muslim population proportion and male-to-female rate ratios (r=-0.324, p=0.028), HDI index and age-standardized suicide rates (r=-0.506, p<0.001), and HDI index and male-to-female rate ratios (r=0.503, p<0.001) in 2019. Joinpoint analysis revealed that seven Muslim-majority countries (15.2%) recorded an increase in the average annual percentage change regarding age-standardized suicide rates during 2000-2019. CONCLUSIONS: Most Muslim-majority countries had lower age-standardized suicide rates than the global average, which might reflect religious belief and practice or due to Muslim laws in their judicial and social structure which may lead to underreporting. This finding needs further in-depth country and region-specific study with regard to its implication for public policy.

Cultural and interpersonal risk factors for suicide ideation and suicide attempts among Muslim college students from 11 nations.

BACKGROUND: Research on suicidality in low to middle-income countries is scarce. We addressed this issue by investigating suicidality in a cross-national college student samples from 11 predominantly low to middle-income majority Muslim countries. METHODS: The sample consisted of 7427 college students (56% female) who reported to be affiliated with Islam. Data on self-construal, social support, negative life-events, acceptability of suicide, suicidal ideation, and suicide attempts were collected with self-administered questionnaires. RESULTS: Acceptability of suicide and the experience of negative life-events were positively, and perceived social support was negatively associated with suicidal ideation. Interdependent self-construal was negatively related to the acceptability of suicide and positively associated with perceived social support, implying a negative indirect effect on suicidal ideation although its direct effect was positive. The number of negative life-events was the strongest positive predictor of ever attempting suicide. The interdependent self-construal moderated the association of negative life-events with suicide attempts. LIMITATIONS: Cross-sectional and self-report nature of the study were its major limitations. Participants may have suppressed their responses about suicide because of religious and legal reasons. CONCLUSION: Remarkable similarities across 11 country samples emerged in the linkages between cultural and interpersonal factors with suicidality. Our findings highlight the value of a nuanced approach to suicidality, that can recognize the differences in the processes associated with suicidal ideation and suicide attempts, as well as the need to consider the interplay of a broad range of personal, interpersonal, and cultural influences.

Religiosity as a predictor of mental health in Egyptian teenagers in preparatory and secondary school.

BACKGROUND: There have been few studies of religiosity in adolescents and even fewer in Muslim cultures. AIMS: The present study investigated the associations of religiosity with subjective well-being (WB, and mental and physical health) using samples of Egyptian children and adolescents. METHOD: Samples of Egyptian preparatory school children and secondary school children were administered questions concerning religiosity, mental and physical health and satisfaction with life. RESULTS: In study 1, boys obtained significantly higher mean scores than girls did on the self-rating scales of religiosity, mental health, physical health and satisfaction with life. In study 2, boys obtained significantly higher mean scores on the Arabic Scale of Mental Health and the self-rating scales of physical health and happiness. All the Pearson correlation coefficients between religiosity, WB and health were significant and positive in both studies. Predictors of mental health differed for boys and girls, but religiosity played a significant role in the prediction of mental health for the younger boys and for the older girls. CONCLUSION: Religion plays an important role in the lives of the present two samples of Egyptian adolescents.

Death depression in Egyptian clinical and non-clinical groups.

Aim: The main aims of this study were to explore the differences between seven Egyptian clinical and non-clinical samples in death depression, as well as to estimate gender-related differences. Design: A cross-sectional study. Methods: The Death Depression Scale (DDS) was administered to seven groups (N = 765) of Egyptian normal (non-clinical) patients, anxiety outpatients, schizophrenic inpatients (men and women) and addicts (men only) in individual sessions. Results: Anxiety outpatients of both sexes obtained significantly and greatly higher death depression scores than did the other five groups, whereas the male schizophrenics, the male addicts, and the male and female non-clinical groups had the lowest death depression scores. Female schizophrenics obtained a significantly higher death depression scores than did male schizophrenics, addicts and non-clinical participants. Female anxiety outpatients and schizophrenics had higher death depression mean scores than did their male counterparts. Discussion: The present finding is consistent, in general, with previous studies on death anxiety and death obsession. What applied to death anxiety was consistent also with death depression and death obsession. That is, the death distress concept.

Associations of religiosity, attitudes towards suicide and religious coping with suicidal ideation and suicide attempts in 11 muslim countries.

OBJECTIVE: The study investigated the associations of religiosity, religious coping and suicide acceptance to suicide ideation and attempts in 7427 young adults affiliating with Islam from 11 Muslim countries. METHOD: A self-administered questionnaire was used to collect the data. We used F and χ2 tests and correlation analyses to report descriptive statistics. Multi-group path models with (i) a zero-inflated Poisson distribution and, (ii) a Binomial distribution were used to model the number of occurrences of suicidal ideation, and occurrence of a suicide attempt, respectively. RESULTS: Religiosity was negatively associated with acceptability of suicide, but it was positively related to punishment after death across the 11 countries. Religiosity was negatively associated with ever experiencing suicidal ideation, both directly and indirectly through its association with attitudes towards suicide, especially the belief in acceptability of suicide. Neither positive nor negative religious coping were related to suicidal ideation. However, religiosity was negatively related to suicide attempts among those who experienced suicidal ideation at least once. This association was mediated through the belief in acceptability of suicide and religious coping. Negative religious coping was positively associated with suicide attempts probably because it weakened the protective effects of religiosity. CONCLUSIONS: Findings from this study suggest that the effects of religiosity in the suicidal process operate through attitudes towards suicide. We therefore conclude that clinical assessment as well as research in suicidology may benefit from paying due attention to attitudes towards suicide.

Love of life and its association with well-being in Iranian psychiatric outpatients.

Aim: The aims of this study were as follows: (a) to investigate the psychometric properties of the Love of Life Scale (LLS); (b) to explore sex differences in LLS scores; (c) to explore LLS correlations with spiritual health and psychological well-being; and (d) to compare the mean LLS score with previous studies. Design: A cross-sectional study. Methods: A sample of 191 Iranian psychiatric outpatients was recruited from clinics at the School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), which is affiliated with the Iran University of Medical Sciences. They responded to the Farsi versions of the LLS, the Spiritual Well-Being Scale (SWS) and the World Health Organization-five Well-Being Index (WHO-5). Results: Cronbach alpha for the LLS was 0.95, and a principal component analysis (PCA) of the LLS items extracted one component labelled "Love of life." The sex difference in LLS scores was not significant. All the correlations between the scales were statistically significant and positive. Patients who had high scores for their love of life had better spiritual health and psychological well-being. Discussion: The present sample obtained a lower mean LLS score than college students from eight countries except one. Further research should explore predictors of the love of life.

Universal Patterns in Color-Emotion Associations Are Further Shaped by Linguistic and Geographic Proximity.

Many of us "see red," "feel blue," or "turn green with envy." Are such color-emotion associations fundamental to our shared cognitive architecture, or are they cultural creations learned through our languages and traditions? To answer these questions, we tested emotional associations of colors in 4,598 participants from 30 nations speaking 22 native languages. Participants associated 20 emotion concepts with 12 color terms. Pattern-similarity analyses revealed universal color-emotion associations (average similarity coefficient r = .88). However, local differences were also apparent. A machine-learning algorithm revealed that nation predicted color-emotion associations above and beyond those observed universally. Similarity was greater when nations were linguistically or geographically close. This study highlights robust universal color-emotion associations, further modulated by linguistic and geographic factors. These results pose further theoretical and empirical questions about the affective properties of color and may inform practice in applied domains, such as well-being and design.

The diagnostic role of diffusional kurtosis imaging in glioma grading and differentiation of gliomas from other intra-axial brain tumours: a systematic review with critical appraisal and meta-analysis.

PURPOSE: We aim to illustrate the diagnostic performance of diffusional kurtosis imaging (DKI) in the diagnosis of gliomas. METHODS: A review protocol was developed according to the (PRISMA-P) checklist, registered in the international prospective register of systematic reviews (PROSPERO) and published. A literature search in 4 databases was performed using the keywords 'glioma' and 'diffusional kurtosis'. After applying a robust inclusion/exclusion criteria, included articles were independently evaluated according to the QUADAS-2 tool and data extraction was done. Reported sensitivities and specificities were used to construct 2 × 2 tables and paired forest plots using the Review Manager (RevMan®) software. A random-effect model was pursued using the hierarchical summary receiver operator characteristics. RESULTS: A total of 216 hits were retrieved. Considering duplicates and inclusion criteria, 23 articles were eligible for full-text reading. Ultimately, 19 studies were eligible for final inclusion. The quality assessment revealed 9 studies with low risk of bias in the 4 domains. Using a bivariate random-effect model for data synthesis, summary ROC curve showed a pooled area under the curve (AUC) of 0.92 and estimated sensitivity of 0.87 (95% CI 0.78-0.92) in high-/low-grade gliomas' differentiation. A mean difference in mean kurtosis (MK) value between HGG and LGG of 0.22 (95% CI 0.25-0.19) was illustrated (p value = 0.0014) with moderate heterogeneity (I2 = 73.8%). CONCLUSION: DKI shows good diagnostic accuracy in the differentiation of high- and low-grade gliomas further supporting its potential role in clinical practice. Further exploration of DKI in differentiating IDH status and in characterising non-glioma CNS tumours is however needed.

The Relationship Between Religiosity and Anxiety: A Meta-analysis.

Several research studies from the USA and Western industrialized countries have reported a negative association between religiosity and anxiety. However, Arabic studies using mainly Muslim samples are limited. The objective of the present study was to apply meta-analysis statistical techniques to 10 Arabic studies of this association. All of the respondents were Arab citizens, ranging in age between 14 and 43 years, and the vast majority of them were Muslims. Religiosity and anxiety were assessed with seven different scales. In all of the studies, the administration of the scales was in small group sessions and in the Arabic language. Pearson correlation coefficients were calculated between the religiosity and anxiety scale scores. All the correlations were negative. All but one were statistically significant, ranging from - 0.16 to - 0.43. The mean effect size was - 0.22, and the impact of age and gender on the correlation was not significant. This result suggests that religiosity may affect anxiety by providing buffering and coping mechanisms.

Diagnostic Accuracy of Multiparametric Magnetic Resonance Imaging for Differentiation Between Parotid Neoplasms.

PURPOSE: This study was designed to evaluate the role of multiparametric magnetic resonance imaging (MRI) for differentiation of parotid gland neoplasms. METHODS: Prospective study was conducted upon 52 consecutive patients (30 men, 22 women; aged 24-78 years; mean, 51 years) with parotid tumours that underwent multiparametric MRI using combined static MRI, dynamic contrast enhanced (DCE) MRI, and diffusion-weighted imaging (DWI). The static MRI parameter, time signal intensity curves (TIC) derived from DCE-MRI, and apparent diffusion coefficient (ADC) values of parotid tumours were correlated with histopathological findings. RESULTS: Static MRI revealed a significant difference between both benign and malignant lesions in regards to margin definition (P < .001) and T2 hypointensity (P < .013), with a diagnostic accuracy 95% and 78.33% respectively. Study of the TIC type on DCE-MRI revealed statistically significant difference between benign and malignant lesions (P < .001) and diagnostic accuracy 96.55%. There was no statistically significant difference (P = .181) between the ADC values of benign and malignant lesions. ROC curve analysis revealed that by using ADC cut-off value of 1 × 10-3 mm2/s had accuracy of 84.62% respectively for differentiating Warthin from malignant tumours that could be modified to higher value (94.28%) by excluding lymphoma from malignant lesions. By using cutoff value of 1.3 × 10-3 mm2/s to differentiate pleomorphic adenoma from malignancy, ROC curve analysis had high accuracy of 97.06%. CONCLUSION: Multiparametric MRI can be used for differentiation of malignant from benign parotid tumours and characterization of some benign parotid tumours.

Suicidal Thoughts, Attempts and Motives Among University Students in 12 Muslim-Majority Countries.

There is a scarcity of research on suicidal phenomena in the Muslim world. Therefore, this study aimed at investigating the self-reported prevalence of suicidal thoughts, attempts and motives in 12 Muslim countries. A total of 8417 (54.4% women) university students were surveyed by means of a self-report questionnaire. Overall, 22% of the participants reported suicidal ideation and 8.6% reported attempting suicide. The odds of suicidal thoughts were elevated in Azerbaijan, Indonesia and Saudi Arabia, while reduced ORs were recorded in Egypt, Jordan, Lebanon and Malaysia. While odds of suicide attempts were high in Azerbaijan, Palestine and Saudi Arabia reduced odds ratios (OR) were detected in Indonesia, Iran, Jordan, Lebanon, Malaysia and Tunisia. Taking drugs and using a sharp instrument were the two most frequently used methods to attempt suicide. Only 32.7% of attempts required medical attention. Escape motives were endorsed more than social motives by participants who attempted suicide. Suicidal behaviors were more frequent in women than in men. Compered to men, fewer attempts by women required medical attention. Moreover, our results show that making suicide illegal does not reduce the frequency of suicidal behavior. Results from this comparative study show that suicidal thoughts and attempts are frequent events in young adults in countries where religious scripture explicitly prohibit suicide and the frequencies of nonfatal suicidal behavior show large variation in nations adhering to the same religion.

Death anxiety in Lebanese college students in 1998 and 2015.

The present investigation sought to explore the difference in death anxiety between two different samples of students who studied at the same university in Lebanon in 1998 and 2015. Based on the changes in the social, economic, and political conditions that took place over these 17 years, it is possible to predict the change in death anxiety during this period. The participants in the 1998 study included 228 undergraduates, whereas the 2015 sample consisted of 292 students. All participants responded to Templer's Death Anxiety Scale (DAS). Sex-related differences on the DAS were statistically significant in the 1998 group where women obtained a higher mean than the men. The t-test was significant at 0.001. Among women, the 2015 group obtained a significantly lower mean score than did their female counterparts in the 1998 group, whereas the difference between the two years in men was not significant. In sum, the hypothesis of the study was partially verified, i.e., a change in death anxiety level in some groups has happened as a result of the passage of time and other factors. In this case, death anxiety may be considered a fluid entity influenced by different environmental conditions.

Validation of the Farsi version of the Death Obsession Scale among nurses.

OBJECTIVES: Obsession is one of the important aspects in death distress. The objective of this study was to estimate the reliability, validity, and factorial structure of the Farsi version of the Death Obsession Scale (DOS). METHODS: A convenience sample of 106 Iranian nurses from two hospitals at Tehran city, Iran was recruited. They completed the DOS, Death Concern Scale, Collett-Lester Fear of Death Scale, Death Anxiety Scale, Reasons for Death Fear Scale, and Death Depression Scale. RESULTS: Cronbach's α for the DOS was 0.95, and 2-week test-retest reliability was 0.74. The DOS correlated 0.48, 0.46, 0.47, 0.39 and 0.44 with the last mentioned scales, respectively (P < 0.01), indicating good construct and criterion-related validity. Principle components analysis of the DOS identified three factors accounted for 74.82% of the variance. Factor 1 labeled "Death rumination" (34.78% of the variance), Factor 2 labeled "Death dominance" (29.65% of the variance), and Factor 3 labeled "Death idea repetition" (10.38% of the variance). CONCLUSIONS: The DOS has good validity and reliability, and it could be recommended for use in clinical and research settings to assess the death obsession in Iranian nurses.