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  1. Article ; Online: An analytical model for light backscattering by coccoliths and coccospheres of Emiliania huxleyi.

    Fournier, Georges / Neukermans, Griet

    Optics express

    2017  Volume 25, Issue 13, Page(s) 14996–15009

    Abstract: We present an analytical model for light backscattering by coccoliths and coccolithophores of the marine calcifying phytoplankter Emiliania huxleyi. The model is based on the separation of the effects of diffraction, refraction, and reflection on ... ...

    Abstract We present an analytical model for light backscattering by coccoliths and coccolithophores of the marine calcifying phytoplankter Emiliania huxleyi. The model is based on the separation of the effects of diffraction, refraction, and reflection on scattering, a valid assumption for particle sizes typical of coccoliths and coccolithophores. Our model results match closely with results from an exact scattering code that uses complex particle geometry and our model also mimics well abrupt transitions in scattering magnitude. Finally, we apply our model to predict changes in the spectral backscattering coefficient during an Emiliania huxleyi bloom with results that closely match in situ measurements. Because our model captures the key features that control the light backscattering process, it can be generalized to coccoliths and coccolithophores of different morphologies which can be obtained from size-calibrated electron microphotographs. Matlab codes of this model are provided as supplementary material.
    Language English
    Publishing date 2017-06-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1491859-6
    ISSN 1094-4087 ; 1094-4087
    ISSN (online) 1094-4087
    ISSN 1094-4087
    DOI 10.1364/OE.25.014996
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  2. Article: Inter-Rater Variability of Prostate Lesion Segmentation on Multiparametric Prostate MRI.

    Jeganathan, Thibaut / Salgues, Emile / Schick, Ulrike / Tissot, Valentin / Fournier, Georges / Valéri, Antoine / Nguyen, Truong-An / Bourbonne, Vincent

    Biomedicines

    2023  Volume 11, Issue 12

    Abstract: Introduction: External radiotherapy is a major treatment for localized prostate cancer (PCa). Dose escalation to the whole prostate gland increases biochemical relapse-free survival but also acute and late toxicities. Dose escalation to the dominant ... ...

    Abstract Introduction: External radiotherapy is a major treatment for localized prostate cancer (PCa). Dose escalation to the whole prostate gland increases biochemical relapse-free survival but also acute and late toxicities. Dose escalation to the dominant index lesion (DIL) only is of growing interest. It requires a robust delineation of the DIL. In this context, we aimed to evaluate the inter-observer variability of DIL delineation.
    Material and methods: Two junior radiologists and a senior radiation oncologist delineated DILs on 64 mpMRIs of patients with histologically confirmed PCa. For each mpMRI and each reader, eight individual DIL segmentations were delineated. These delineations were blindly performed from one another and resulted from the individual analysis of the T2, apparent diffusion coefficient (ADC), b2000, and dynamic contrast enhanced (DCE) sequences, as well as the analysis of combined sequences (T2ADC, T2ADCb2000, T2ADCDCE, and T2ADCb2000DCE). Delineation variability was assessed using the DICE coefficient, Jaccard index, Hausdorff distance measure, and mean distance to agreement.
    Results: T2, ADC, T2ADC, b2000, T2 + ADC + b2000, T2 + ADC + DCE, and T2 + ADC + b2000 + DCE sequences obtained DICE coefficients of 0.51, 0.50, 0.54, 0.52, 0.54, 0.55, 0.53, respectively, which are significantly higher than the perfusion sequence alone (0.35,
    Conclusion: Our study showed that the contours of prostatic lesions were more reproducible on certain sequences but confirmed the great variability of prostatic contours with a maximum DICE coefficient calculated at 0.55 (joint analysis of T2, ADC, and perfusion sequences).
    Language English
    Publishing date 2023-12-14
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2720867-9
    ISSN 2227-9059
    ISSN 2227-9059
    DOI 10.3390/biomedicines11123309
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  3. Article ; Online: The habits of European urologists in the field of cryopreservation before the urological cancers treatment.

    Degraeve, Amandine / Roumeguere, Thierry / Tilmans, Gilles / Marotta, Marie-Laura / Huyghe, Eric / Fournier, Georges / Faix, Antoine / Spinoit, Anne-Françoise / Decaestecker, Karel / Herve, François / Boitrelle, Florence / Lahdensuo, Kanerva / Tosco, Lorenzo / Van Damme, Julien

    Andrology

    2024  

    Abstract: Introduction: Treatments against urogenital cancers frequently have fertility side-effects. The strategy to preserve fertility after oncologic treatments is still a matter of debate with a lack of evidence and international guidelines. The aim of this ... ...

    Abstract Introduction: Treatments against urogenital cancers frequently have fertility side-effects. The strategy to preserve fertility after oncologic treatments is still a matter of debate with a lack of evidence and international guidelines. The aim of this study is to investigate fertility preservation practices before urogenital cancer treatments and to compare national habits.
    Material and methods: An online anonymous survey was submitted from January to June 2021 to six European urological societies. The 31-items questionnaire included questions about demography, habits of evaluation, and management of fertility preservation in case of urogenital cancer treatments.
    Results: Two hundred twenty-eight urologists from six urological societies in five different countries (Belgium, The Netherlands, Luxembourg, France, Finland) filled out the survey. Three quarter (74%; n = 166) usually propose a cryopreservation before orchidectomy. In case of oligo/azoo-spermia, the technique performed for the sperm extraction during orchidectomy varies among the sample: 70.5% (n = 160) of the responders do not perform a Testicular Sperm Extraction (TESE) nor a Percutaneous Epididymal Sperm Aspiration (PESA). The cryopreservation for prostate cancer treatments is never proposed in 48.17% (n = 105) of responders but conversely it is always proposed in 5.05% (n = 11). The cryopreservation before bladder cancer treatments is not commonly proposed (67.5%, n = 154).
    Conclusion: Our study showed variable country specific tendencies in terms of fertility preservation in the period of treatment of urological cancers. These differences seem to be related to national guidelines recommendations. Standardization of international guidelines is urgently needed in the field of fertility for urological cancer patients.
    Language English
    Publishing date 2024-01-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 2696108-8
    ISSN 2047-2927 ; 2047-2919
    ISSN (online) 2047-2927
    ISSN 2047-2919
    DOI 10.1111/andr.13577
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    Zs.A 6983: Show issues Location:
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  4. Article ; Online: Predicting contralateral extraprostatic extension in unilateral high-risk prostate cancer: a multicentric external validation study.

    Diamand, Romain / Roche, Jean-Baptiste / Lacetera, Vito / Simone, Giuseppe / Windisch, Olivier / Benamran, Daniel / Fourcade, Alexandre / Fournier, Georges / Fiard, Gaelle / Ploussard, Guillaume / Roumeguère, Thierry / Peltier, Alexandre / Albisinni, Simone

    World journal of urology

    2024  Volume 42, Issue 1, Page(s) 247

    Abstract: Purpose: Accurate prediction of extraprostatic extension (EPE) is crucial for decision-making in radical prostatectomy (RP), especially in nerve-sparing strategies. Martini et al. introduced a three-tier algorithm for predicting contralateral EPE in ... ...

    Abstract Purpose: Accurate prediction of extraprostatic extension (EPE) is crucial for decision-making in radical prostatectomy (RP), especially in nerve-sparing strategies. Martini et al. introduced a three-tier algorithm for predicting contralateral EPE in unilateral high-risk prostate cancer (PCa). The aim of the study is to externally validate this model in a multicentric European cohort of patients.
    Methods: The data from 208 unilateral high-risk PCa patients diagnosed through magnetic resonance imaging (MRI)-targeted and systematic biopsies, treated with RP between January 2016 and November 2021 at eight referral centers were collected. The evaluation of model performance involved measures such as discrimination (AUC), calibration, and decision-curve analysis (DCA) following TRIPOD guidelines. In addition, a comparison was made with two established multivariable logistic regression models predicting the risk of side specific EPE for assessment purposes.
    Results: Overall, 38%, 48%, and 14% of patients were categorized as low, intermediate, and high-risk groups according to Martini et al.'s model, respectively. At final pathology, EPE on the contralateral prostatic lobe occurred in 6.3%, 12%, and 34% of patients in the respective risk groups. The algorithm demonstrated acceptable discrimination (AUC 0.68), comparable to other multivariable logistic regression models (p = 0.3), adequate calibration and the highest net benefit in DCA. The limitations include the modest sample size, retrospective design, and lack of central revision.
    Conclusion: Our findings endorse the algorithm's commendable performance, supporting its utility in guiding treatment decisions for unilateral high-risk PCa patients.
    MeSH term(s) Humans ; Male ; Prostatic Neoplasms/pathology ; Prostatic Neoplasms/surgery ; Aged ; Middle Aged ; Risk Assessment ; Prostatectomy/methods ; Retrospective Studies ; Neoplasm Invasiveness ; Algorithms ; Extranodal Extension ; Prostate/pathology
    Language English
    Publishing date 2024-04-22
    Publishing country Germany
    Document type Journal Article ; Multicenter Study ; Validation Study
    ZDB-ID 380333-8
    ISSN 1433-8726 ; 0724-4983
    ISSN (online) 1433-8726
    ISSN 0724-4983
    DOI 10.1007/s00345-024-04966-7
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  5. Article ; Online: Interpretation of scattering by oceanic particles around 120 degrees and its implication in ocean color studies.

    Zhang, Xiaodong / Fournier, Georges R / Gray, Deric J

    Optics express

    2017  Volume 25, Issue 4, Page(s) A191–A199

    Abstract: Field observations and theoretical studies have found that the volume scattering functions (VSFs) of oceanic particles exhibit minimum variability at angles near 120°. However, its physical interpretation is still unknown. We find this minimum ... ...

    Abstract Field observations and theoretical studies have found that the volume scattering functions (VSFs) of oceanic particles exhibit minimum variability at angles near 120°. However, its physical interpretation is still unknown. We find this minimum variability angle represents the intersection of two backscattering-normalized VSFs, one representing particles of sizes smaller than the wavelength of light and the other larger than the wavelength of light. This also suggests that the VSFs of oceanic particles at angles between 90° and 180°, which play a critical role in ocean color study, can be modeled by linear mixing of these two end members. We further validate this mixing model using measured VSFs in coastal and oceanic waters around the US and develop a two-component model predicting the backward shapes of the VSFs.
    Language English
    Publishing date 2017-02-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1491859-6
    ISSN 1094-4087 ; 1094-4087
    ISSN (online) 1094-4087
    ISSN 1094-4087
    DOI 10.1364/OE.25.00A191
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  6. Article ; Online: Optimal PSA density threshold and predictive factors for the detection of clinically significant prostate cancer in patient with a PI-RADS 3 lesion on MRI.

    Nguyen, Truong-An / Fourcade, Alexandre / Zambon, Audrey / Saout, Kevin / Deruelle, Charles / Joulin, Vincent / Tissot, Valentin / Doucet, Laurent / Rozet, François / Fournier, Georges / Valeri, Antoine

    Urologic oncology

    2023  Volume 41, Issue 8, Page(s) 354.e11–354.e18

    Abstract: Introduction: While Prostate Imaging Reporting and Data System (PI-RADS) 4 and 5 lesions usually justify prostate biopsy (PBx), the management of a PI-RADS 3 lesion can be discussed. The aim of our study was to determine the optimal prostate-specific ... ...

    Abstract Introduction: While Prostate Imaging Reporting and Data System (PI-RADS) 4 and 5 lesions usually justify prostate biopsy (PBx), the management of a PI-RADS 3 lesion can be discussed. The aim of our study was to determine the optimal prostate-specific antigen density (PSAD) threshold and predictive factors of clinically significant prostate cancer (csPCa) in patients with a PI-RADS 3 lesion on MRI.
    Patients and methods: Using our prospectively maintained database, we conducted a monocentric retrospective study, including all patients with a clinical suspicious of prostate cancer (PCa), all of them had a PI-RADS 3 lesion on the mpMRI prior to PBx. Patients under active surveillance or displaying suspicious digital rectal examination were excluded. Clinically significant (csPCa) was defined as PCa with any ISUP grade group ≥ 2 (Gleason ≥ 3 + 4).
    Results: We included 158 patients. The detection rate of csPCa was 22.2%. In case of PSAD ≤ 0.15 ng/ml/cm
    Conclusion: Our result suggests that the optimal PSAD threshold was 0.15 ng/ml/cm
    MeSH term(s) Male ; Humans ; Prostatic Neoplasms/diagnostic imaging ; Prostatic Neoplasms/pathology ; Prostate-Specific Antigen ; Magnetic Resonance Imaging/methods ; Retrospective Studies ; Image-Guided Biopsy/methods
    Chemical Substances Prostate-Specific Antigen (EC 3.4.21.77)
    Language English
    Publishing date 2023-06-28
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1336505-8
    ISSN 1873-2496 ; 1078-1439
    ISSN (online) 1873-2496
    ISSN 1078-1439
    DOI 10.1016/j.urolonc.2023.05.005
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    Zs.A 4817: Show issues Location:
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  7. Article: Restaging the Biochemical Recurrence of Prostate Cancer with [

    Fourquet, Aloÿse / Lahmi, Lucien / Rusu, Timofei / Belkacemi, Yazid / Créhange, Gilles / de la Taille, Alexandre / Fournier, Georges / Cussenot, Olivier / Gauthé, Mathieu

    Cancers

    2021  Volume 13, Issue 7

    Abstract: Background: Detection rates of [: Methods: Retrospective analysis of PCa patients presenting with BCR and referred for [: Results: We included 294 patients. The detection rate was 69%. Per-patient sensitivity and specificity were both 70%. Patient ...

    Abstract Background: Detection rates of [
    Methods: Retrospective analysis of PCa patients presenting with BCR and referred for [
    Results: We included 294 patients. The detection rate was 69%. Per-patient sensitivity and specificity were both 70%. Patient disease management was changed in 68% of patients, and [
    Conclusions: [
    Language English
    Publishing date 2021-03-30
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2527080-1
    ISSN 2072-6694
    ISSN 2072-6694
    DOI 10.3390/cancers13071594
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  8. Article ; Online: Eliciting men's preferences for decision-making relative to treatments of localized prostate cancer with a good or moderate prognosis.

    Lejeune, Catherine / Bourredjem, Abderrahmane / Binquet, Christine / Cussenot, Olivier / Boudrant, Guillaume / Papillon, Frédéric / Bruyère, Franck / Haillot, Olivier / Koutlidis, Nicolas / Bassard, Sébastien / Fournier, Georges / Valeri, Antoine / Moreau, Jean-Luc / Pierfitte, Bruno / Moulin, Morgan / Berchi, Célia / Cormier, Luc

    World journal of urology

    2023  Volume 41, Issue 6, Page(s) 1541–1549

    Abstract: Purpose: In diseases where there is no real consensus regarding treatment modalities, promoting shared decision-making can contribute to improving safety and quality of care. This is the case in low- or intermediate-risk localized prostate cancer (PC) ... ...

    Abstract Purpose: In diseases where there is no real consensus regarding treatment modalities, promoting shared decision-making can contribute to improving safety and quality of care. This is the case in low- or intermediate-risk localized prostate cancer (PC) treatment. The aim of this study was to investigate the preferences guiding men's decisions regarding the characteristics of the treatment strategies for PC to help physicians adopt a more patient-centered approach.
    Methods: This prospective multicenter study used a discrete choice experiment (DCE). The attributes and the modalities were identified from a qualitative study and a literature review. Relative preferences were estimated using a logistic regression model. Interaction terms (demographic, clinical and socio-economic characteristics) were added to the model to assess heterogeneity in preferences.
    Results: 652 men were enrolled in the study and completed a questionnaire with 12 pairs of hypothetical therapeutic alternatives between which they had to choose. Men's choices were significantly negatively influenced by the risk of impotence and urinary incontinence, death, and the length and frequency of care. They preferred treatments with a rescue possibility in case of deterioration or recurrence and the use of innovative technology. Surprisingly, the possibility of undergoing prostate ablation negatively influenced their choice. The results also highlighted differences in trade-offs according to socio-economic level.
    Conclusion: This study confirmed the importance of considering patients' preferences in the decision-making process. It appears essential to better understand these preferences to allow physicians to improve communication and promote case-by-case decision-making.
    MeSH term(s) Male ; Humans ; Prospective Studies ; Prostatic Neoplasms/drug therapy ; Prognosis ; Erectile Dysfunction ; Urinary Incontinence ; Multicenter Studies as Topic
    Language English
    Publishing date 2023-05-12
    Publishing country Germany
    Document type Review ; Journal Article
    ZDB-ID 380333-8
    ISSN 1433-8726 ; 0724-4983
    ISSN (online) 1433-8726
    ISSN 0724-4983
    DOI 10.1007/s00345-023-04416-w
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  9. Article ; Online: A Novel Nomogram to Identify Candidates for Focal Therapy Among Patients with Localized Prostate Cancer Diagnosed via Magnetic Resonance Imaging-Targeted and Systematic Biopsies: A European Multicenter Study.

    Mjaess, Georges / Peltier, Alexandre / Roche, Jean-Baptiste / Lievore, Elena / Lacetera, Vito / Chiacchio, Giuseppe / Beatrici, Valerio / Mastroianni, Riccardo / Simone, Giuseppe / Windisch, Olivier / Benamran, Daniel / Fourcade, Alexandre / Nguyen, Truong An / Fournier, Georges / Fiard, Gaelle / Ploussard, Guillaume / Roumeguère, Thierry / Albisinni, Simone / Diamand, Romain

    European urology focus

    2023  Volume 9, Issue 6, Page(s) 992–999

    Abstract: Background: Suitable selection criteria for focal therapy (FT) are crucial to achieve success in localized prostate cancer (PCa).: Objective: To develop a multivariable model that better delineates eligibility for FT and reduces undertreatment by ... ...

    Abstract Background: Suitable selection criteria for focal therapy (FT) are crucial to achieve success in localized prostate cancer (PCa).
    Objective: To develop a multivariable model that better delineates eligibility for FT and reduces undertreatment by predicting unfavorable disease at radical prostatectomy (RP).
    Design, setting, and participants: Data were retrospectively collected from a prospective European multicenter cohort of 767 patients who underwent magnetic resonance imaging (MRI)-targeted and systematic biopsies followed by RP in eight referral centers between 2016 and 2021. The Imperial College of London eligibility criteria for FT were applied: (1) unifocal MRI lesion with Prostate Imaging-Reporting and Data System score of 3-5; (2) prostate-specific antigen (PSA) ≤20 ng/ml; (3) cT2-3a stage on MRI; and (4) International Society of Urological Pathology grade group (GG) 1 and ≥6 mm or GG 2-3. A total of 334 patients were included in the final analysis.
    Outcome measurements and statistical analysis: The primary outcome was unfavorable disease at RP, defined as GG ≥4, and/or lymph node invasion, and/or seminal vesicle invasion, and/or contralateral clinically significant PCa. Logistic regression was used to assess predictors of unfavorable disease. The performance of the models including clinical, MRI, and biopsy information was evaluated using the area under the receiver operating characteristic curve (AUC), calibration plots, and decision curve analysis. A coefficient-based nomogram was developed and internally validated.
    Results and limitations: Overall, 43 patients (13%) had unfavorable disease on RP pathology. The model including PSA, clinical stage on digital rectal examination, and maximum lesion diameter on MRI had an AUC of 73% on internal validation and formed the basis of the nomogram. Addition of other MRI or biopsy information did not significantly improve the model performance. Using a cutoff of 25%, the proportion of patients eligible for FT was 89% at the cost of missing 30 patients (10%) with unfavorable disease. External validation is required before the nomogram can be used in clinical practice.
    Conclusions: We report the first nomogram that improves selection criteria for FT and limits the risk of undertreatment.
    Patient summary: We conducted a study to develop a better way of selecting patients for focal therapy for localized prostate cancer. A novel predictive tool was developed using the prostate-specific antigen (PSA) level measured before biopsy, tumor stage assessed via digital rectal examination, and lesion size on magnetic resonance imaging (MRI) scans. This tool improves the prediction of unfavorable disease and may reduce the risk of undertreatment of localized prostate cancer when using focal therapy.
    MeSH term(s) Male ; Humans ; Nomograms ; Prostate-Specific Antigen ; Retrospective Studies ; Prospective Studies ; Prostatic Neoplasms/diagnostic imaging ; Prostatic Neoplasms/surgery ; Biopsy/methods ; Magnetic Resonance Imaging/methods
    Chemical Substances Prostate-Specific Antigen (EC 3.4.21.77)
    Language English
    Publishing date 2023-05-03
    Publishing country Netherlands
    Document type Multicenter Study ; Journal Article
    ISSN 2405-4569
    ISSN (online) 2405-4569
    DOI 10.1016/j.euf.2023.04.008
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  10. Article ; Online: Risk stratification for early biochemical recurrence of prostate cancer in the era of multiparametric magnetic resonance imagining-targeted biopsy.

    Diamand, Romain / Peltier, Alexandre / Roche, Jean-Baptiste / Lievore, Elena / Lacetera, Vito / Chiacchio, Giuseppe / Beatrici, Valerio / Mastroianni, Riccardo / Simone, Giuseppe / Windisch, Olivier / Benamran, Daniel / Fourcade, Alexandre / Nguyen, Truong A / Fournier, Georges / Fiard, Gaelle / Ploussard, Guillaume / Roumeguère, Thierry / Albisinni, Simone

    The Prostate

    2023  Volume 83, Issue 6, Page(s) 572–579

    Abstract: Background: Multiparametric magnetic resonance imaging (MRI) and MRI-targeted biopsy are nowadays recommended in the prostate cancer (PCa) diagnostic pathway. Ploussard and Mazzone have integrated these tools into novel risk classification systems ... ...

    Abstract Background: Multiparametric magnetic resonance imaging (MRI) and MRI-targeted biopsy are nowadays recommended in the prostate cancer (PCa) diagnostic pathway. Ploussard and Mazzone have integrated these tools into novel risk classification systems predicting the risk of early biochemical recurrence (eBCR) in PCa patients who underwent radical prostatectomy (RP). We aimed to assess available risk classification systems and to define the best-performing.
    Methods: Data on 1371 patients diagnosed by MRI-targeted biopsy and treated by RP between 2014 and 2022 at eight European tertiary referral centers were analyzed. Risk classifications systems included were the European Association of Urology (EAU) and National Comprehensive Cancer Network (NCCN) risk groups, the Cancer of the Prostate Risk Assessment (CAPRA) score, the International Staging Collaboration for Cancer of the Prostate (STAR-CAP) classification, the Ploussard and Mazzone models, and ISUP grade group. Kaplan-Meier analyses were used to compare eBCR among risk classification systems. Performance was assessed in terms of discrimination quantified using Harrell's c-index, calibration, and decision curve analysis (DCA).
    Results: Overall, 152 (11%) patients had eBCR at a median follow-up of 31 months (interquartile range: 19-45). The 3-year eBCR-free survival rate was 91% (95% confidence interval [CI]: 89-93). For each risk classification system, a significant difference among survival probabilities was observed (log-rank test p < 0.05) except for NCCN classification (p = 0.06). The highest discrimination was obtained with the STAR-CAP classification (c-index 66%) compared to CAPRA score (63% vs. 66%, p = 0.2), ISUP grade group (62% vs. 66, p = 0.07), Ploussard (61% vs. 66%, p = 0.003) and Mazzone models (59% vs. 66%, p = 0.02), and EAU (57% vs. 66%, p < 0.001) and NCCN (57% vs. 66%, p < 0.001) risk groups. Risk classification systems demonstrated good calibration characteristics. At DCA, the CAPRA score showed the highest net benefit at a probability threshold of 9%-15%.
    Conclusions: The performance of risk classification systems using MRI and MRI-targeted information was less optimistic when tested in a contemporary set of patients. CAPRA score and STAR-CAP classification were the best-performing and should be preferred for treatment decision-making.
    MeSH term(s) Humans ; Male ; Biopsy ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Prostate-Specific Antigen ; Prostatectomy/methods ; Prostatic Neoplasms/diagnosis ; Prostatic Neoplasms/surgery ; Retrospective Studies ; Risk Assessment/methods
    Chemical Substances Prostate-Specific Antigen (EC 3.4.21.77)
    Language English
    Publishing date 2023-01-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 604707-5
    ISSN 1097-0045 ; 0270-4137
    ISSN (online) 1097-0045
    ISSN 0270-4137
    DOI 10.1002/pros.24490
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