{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T22:09:09Z","timestamp":1761948549016},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,3,2]],"date-time":"2020-03-02T00:00:00Z","timestamp":1583107200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2020,3,2]],"date-time":"2020-03-02T00:00:00Z","timestamp":1583107200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology in Taiwan","doi-asserted-by":"crossref","award":["107-2320-B-006-034"],"award-info":[{"award-number":["107-2320-B-006-034"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,4,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>There is a lack of studies that rigorously and systematically assess the economic burden of cardiovascular diseases (CVDs) related to the use of antiretroviral therapy (ART). We aimed to assess the association between adherence to ART and economic burden of CVDs in an HIV-infected population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Taiwan's National Health Insurance Research Database 2000\u20132011 was utilized for analyzing 18,071 HIV-infected patients free of CVDs before HIV diagnosis. The level of adherence to ART was measured by the medication possession ratio (MPR). Generalized estimating equations analysis was applied to estimate the cost impact of a variety of CVDs. All costs were presented in 2018 US dollars.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The incidence of CVDs ranged from 0.17\/1000 person-years (cardiogenic shock) to 2.60\/1000 person-years (ischemic heart diseases (IHDs)). The mean annual medical cost for a base-case patient without CVDs was US$3000. Having cerebrovascular diseases, myocardial infarction, heart failure, arrhythmia, and IHDs increased annual costs by 41%, 33%, 30%, 16%, and 14%, respectively. The cost impact of incident CVDs in years with high adherence to ART (MPR\u2009\u2265\u20090.8) was significantly lower than that in years with low adherence (MPR\u2009&amp;lt;\u20090.1) (e.g. having cerebrovascular diseases in the high- versus low-adherence years increased annual costs by 21% versus 259%, respectively).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The economic burden of incident CVDs in an HIV-infected population was compelling and varied by the extent of using ART. A reduced economic impact of CVDs was found in years when patients possessed a greater adherence to ART.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1177\/2047487320908085","type":"journal-article","created":{"date-parts":[[2020,3,3]],"date-time":"2020-03-03T04:48:57Z","timestamp":1583210937000},"page":"326-334","update-policy":"http:\/\/dx.doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Association of adherence to antiretroviral therapy with economic burden of cardiovascular disease in HIV-infected population"],"prefix":"10.1093","volume":"28","author":[{"given":"Chia-Te","family":"Liao","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Chimei Medical Center, USA"},{"name":"Department of Public Health, College of Medicine, National Cheng Kung University, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun-Ting","family":"Yang","sequence":"additional","affiliation":[{"name":"Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pin-Hao","family":"Chen","sequence":"additional","affiliation":[{"name":"Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Han Siong","family":"Toh","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Chimei Medical Center, USA"},{"name":"Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shihchen","family":"Kuo","sequence":"additional","affiliation":[{"name":"Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, USA"},{"name":"Michigan Center for Diabetes Translational Research, University of Michigan, Ann Arbor, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhih-Cherng","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Chimei Medical Center, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huang-Tz","family":"Ou","sequence":"additional","affiliation":[{"name":"Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, USA"},{"name":"Department of Pharmacy, College of Medicine, National Cheng Kung University, USA"},{"name":"Department of Pharmacy, National Cheng Kung University Hospital, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nai-Ying","family":"Ko","sequence":"additional","affiliation":[{"name":"Department of Nursing, College of Medicine, National Cheng Kung University, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jung-Der","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Public Health, College of Medicine, National Cheng Kung University, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,3,2]]},"reference":[{"key":"2021070804565470400_bibr1","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.amjcard.2015.10.030","article-title":"Patterns of Cardiovascular mortality for HIV-infected adults in the United States: 1999 to 2013","volume":"117","author":"Feinstein","year":"2016","journal-title":"Am J Cardiol"},{"key":"2021070804565470400_bibr2","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1001\/jamainternmed.2013.3728","article-title":"HIV infection and the risk of acute myocardial infarction","volume":"173","author":"Freiberg","year":"2013","journal-title":"JAMA Intern Med"},{"key":"2021070804565470400_bibr3","doi-asserted-by":"crossref","first-page":"1911","DOI":"10.1097\/QAD.0000000000000352","article-title":"HIV infection and incidence of ischemic stroke","volume":"28","author":"Marcus","year":"2014","journal-title":"AIDS"},{"key":"2021070804565470400_bibr4","first-page":"737","article-title":"Risk of heart failure with human immunodeficiency virus in the absence of prior diagnosis of coronary heart disease","volume":"171","author":"Butt","year":"2011","journal-title":"Arch Intern Med"},{"key":"2021070804565470400_bibr5","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1097\/QAI.0b013e3181c6c4b7","article-title":"The association between alcohol consumption and prevalent cardiovascular diseases among HIV-infected and HIV-uninfected men","volume":"53","author":"Freiberg","year":"2010","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2021070804565470400_bibr6","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1146\/annurev-med-042909-093756","article-title":"HIV infection, inflammation, immunosenescence, and aging","volume":"62","author":"Deeks","year":"2011","journal-title":"Annu Rev Med"},{"key":"2021070804565470400_bibr7","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.atherosclerosis.2011.03.011","article-title":"T cell activation predicts carotid artery stiffness among HIV-infected women","volume":"217","author":"Kaplan","year":"2011","journal-title":"Atherosclerosis"},{"key":"2021070804565470400_bibr8","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1056\/NEJMra041811","article-title":"Cardiovascular risk and body-fat abnormalities in HIV-infected adults","volume":"352","author":"Grinspoon","year":"2005","journal-title":"N Engl J Med"},{"key":"2021070804565470400_bibr9","doi-asserted-by":"crossref","first-page":"1993","DOI":"10.1056\/NEJMoa030218","article-title":"Combination antiretroviral therapy and the risk of myocardial infarction","volume":"349","author":"Friis-Moller","year":"2003","journal-title":"N Engl J Med"},{"key":"2021070804565470400_bibr10","doi-asserted-by":"crossref","first-page":"e007107","DOI":"10.1161\/JAHA.117.007107","article-title":"Disparities in the quality of cardiovascular care between HIV-infected versus HIV-uninfected adults in the United States: a cross-sectional study","volume":"6","author":"Ladapo","year":"2017","journal-title":"J Am Heart Assoc"},{"key":"2021070804565470400_bibr11","doi-asserted-by":"crossref","first-page":"1550","DOI":"10.1093\/cid\/cis752","article-title":"Underutilization of aspirin for primary prevention of cardiovascular disease among HIV-infected patients","volume":"55","author":"Burkholder","year":"2012","journal-title":"Clin Infect Dis"},{"key":"2021070804565470400_bibr12","doi-asserted-by":"crossref","first-page":"2093","DOI":"10.1016\/S0140-6736(98)08468-2","article-title":"Diagnosis, prediction, and natural course of HIV-1 protease-inhibitor-associated lipodystrophy, hyperlipidaemia, and diabetes mellitus: a cohort study","volume":"353","author":"Carr","year":"1999","journal-title":"Lancet"},{"key":"2021070804565470400_bibr13","doi-asserted-by":"crossref","first-page":"2283","DOI":"10.1056\/NEJMoa062360","article-title":"CD4\u2009+\u2009count-guided interruption of antiretroviral treatment","volume":"355","author":"El-Sadr","year":"2006","journal-title":"N Engl J Med"},{"key":"2021070804565470400_bibr14","doi-asserted-by":"crossref","first-page":"200","DOI":"10.3390\/v11030200","article-title":"Immune activation, inflammation, and non-AIDS co-morbidities in HIV-infected patients under long-term ART","volume":"11","author":"Zicari","year":"2019","journal-title":"Viruses"},{"key":"2021070804565470400_bibr15","doi-asserted-by":"crossref","first-page":"e3361","DOI":"10.1097\/MD.0000000000003361","article-title":"Adherence to antiretroviral therapy and virologic failure: a meta-analysis","volume":"95","author":"Bezabhe","year":"2016","journal-title":"Medicine (Baltimore)"},{"key":"2021070804565470400_bibr16","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1056\/NEJMoa1506816","article-title":"Initiation of antiretroviral therapy in early asymptomatic HIV infection","volume":"373","author":"Lundgren","year":"2015","journal-title":"N Engl J Med"},{"key":"2021070804565470400_bibr17","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.1007\/s10461-011-9942-x","article-title":"Adherence to highly active antiretroviral therapy (HAART): a meta-analysis","volume":"15","author":"Ortego","year":"2011","journal-title":"AIDS Behav"},{"key":"2021070804565470400_bibr18","doi-asserted-by":"crossref","first-page":"e1002183","DOI":"10.1371\/journal.pmed.1002183","article-title":"Patient-reported barriers to adherence to antiretroviral therapy: a systematic review and meta-analysis","volume":"13","author":"Shubber","year":"2016","journal-title":"PLoS Med"},{"key":"2021070804565470400_bibr19","doi-asserted-by":"crossref","first-page":"1788","DOI":"10.1086\/652749","article-title":"Markers of inflammation, coagulation, and renal function are elevated in adults with HIV infection","volume":"201","author":"Neuhaus","year":"2010","journal-title":"J Infect Dis"},{"key":"2021070804565470400_bibr20","doi-asserted-by":"crossref","first-page":"1433","DOI":"10.1097\/QAD.0b013e32835f6b0c","article-title":"Predicting risk of cancer during HIV infection: the role of inflammatory and coagulation biomarkers","volume":"27","author":"Borges","year":"2013","journal-title":"AIDS"},{"key":"2021070804565470400_bibr21","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1093\/infdis\/jiw173","article-title":"Interleukin 6 is a stronger predictor of clinical events than high-sensitivity c-reactive protein or d-dimer during HIV infection","volume":"214","author":"Borges","year":"2016","journal-title":"J Infect Dis"},{"key":"2021070804565470400_bibr22","doi-asserted-by":"crossref","first-page":"e98","DOI":"10.1161\/CIR.0000000000000695","article-title":"Characteristics, prevention, and management of cardiovascular disease in people living with HIV: a scientific statement from the American Heart Association","volume":"140","author":"Feinstein","year":"2019","journal-title":"Circulation"},{"key":"2021070804565470400_bibr23","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/S0213-005X(09)73444-5","article-title":"Evaluaci\u00f3n del riesgo cardiovascular e intervenci\u00f3n en los pacientes con VIH","volume":"27","author":"Hern\u00e1ndez","year":"2009","journal-title":"Enfermedades Infecciosas y Microbiolog\u00eda Cl\u00ednica"},{"key":"2021070804565470400_bibr24","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.atherosclerosis.2018.11.026","article-title":"NUtraceutical TReatment for hYpercholesterolemia in HIV-infected patients: the NU-TRY (HIV) randomized cross-over trial","volume":"280","author":"Pirro","year":"2019","journal-title":"Atherosclerosis"},{"key":"2021070804565470400_bibr25","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1161\/CIRCULATIONAHA.117.033369","article-title":"Global burden of atherosclerotic cardiovascular disease in people living with HIV","volume":"138","author":"Shah","year":"2018","journal-title":"Circulation"},{"key":"2021070804565470400_bibr26","doi-asserted-by":"crossref","first-page":"217047","DOI":"10.1155\/2015\/217047","article-title":"Medication adherence measures: an overview","volume":"2015","author":"Lam","year":"2015","journal-title":"BioMed Res Int"},{"key":"2021070804565470400_bibr27","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1001\/jama.2016.12195","article-title":"Recommendations for conduct, methodological practices, and reporting of cost-effectiveness analyses: second panel on cost-effectiveness in health and medicine","volume":"316","author":"Sanders","year":"2016","journal-title":"JAMA"},{"key":"2021070804565470400_bibr28","doi-asserted-by":"crossref","first-page":"1836","DOI":"10.1007\/s10461-016-1580-x","article-title":"the association between changes in alcohol use and changes in antiretroviral therapy adherence and viral suppression among women living with HIV","volume":"21","author":"Barai","year":"2017","journal-title":"AIDS Behav"},{"key":"2021070804565470400_bibr29","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1097\/QAI.0b013e3182084b5a","article-title":"Association between medication possession ratio, virologic failure and drug resistance in HIV-1-infected adults on antiretroviral therapy in Cote d'Ivoire","volume":"56","author":"Messou","year":"2011","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"Suppl 1","key":"2021070804565470400_bibr30","doi-asserted-by":"crossref","first-page":"S34","DOI":"10.1097\/QAI.0b013e3182208003","article-title":"Medication possession ratio: predicting and decreasing loss to follow-up in antiretroviral treatment programs in Cote d'Ivoire","volume":"57","author":"Messou","year":"2011","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2021070804565470400_bibr31","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1177\/1094428104263672","article-title":"Using generalized estimating equations for longitudinal data analysis","volume":"7","author":"Ballinger","year":"2004","journal-title":"Organ Res Methods"},{"key":"2021070804565470400_bibr32","first-page":"1","article-title":"Generalized estimating equations in longitudinal data analysis: a review and recent developments","volume":"2014","author":"Wang","year":"2014","journal-title":"Adv Stat"},{"key":"2021070804565470400_bibr33","doi-asserted-by":"crossref","first-page":"971","DOI":"10.2337\/dc17-1763","article-title":"Health care costs associated with incident complications in patients with type 2 diabetes in Germany","volume":"41","author":"Kahm","year":"2018","journal-title":"Diabetes Care"},{"key":"2021070804565470400_bibr34","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1002\/sim.6743","article-title":"A flexible model for correlated medical costs, with application to medical expenditure panel survey data","volume":"35","author":"Chen","year":"2016","journal-title":"Stat Med"},{"key":"2021070804565470400_bibr35","doi-asserted-by":"crossref","first-page":"e000844","DOI":"10.1161\/JAHA.114.000844","article-title":"Severity of cardiovascular disease outcomes among patients with HIV is related to markers of inflammation and coagulation","volume":"3","author":"Nordell","year":"2014","journal-title":"J Am Heart Assoc"},{"key":"2021070804565470400_bibr36","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.1093\/eurheartj\/eht528","article-title":"HIV infection and cardiovascular disease","volume":"35","author":"Hemkens","year":"2014","journal-title":"Eur Heart J"},{"key":"2021070804565470400_bibr37","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/1742-6405-10-32","article-title":"Metabolic syndrome in HIV-infected individuals: underlying mechanisms and epidemiological aspects","volume":"10","author":"Paula","year":"2013","journal-title":"AIDS Res Ther"},{"key":"2021070804565470400_bibr38","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1007\/BF03256129","article-title":"The association of adherence to antiretroviral therapy with healthcare utilization and costs for medical care","volume":"6","author":"Gardner","year":"2008","journal-title":"Appl Health Econ Health Policy"},{"key":"2021070804565470400_bibr39","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1002\/pds.2087","article-title":"Validation of the National Health Insurance Research Database with ischemic stroke cases in Taiwan","volume":"20","author":"Cheng","year":"2011","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"2021070804565470400_bibr40","doi-asserted-by":"crossref","first-page":"500","DOI":"10.2188\/jea.JE20140076","article-title":"Validation of acute myocardial infarction cases in the national health insurance research database in Taiwan","volume":"24","author":"Cheng","year":"2014","journal-title":"J Epidemiol"},{"key":"2021070804565470400_bibr41","doi-asserted-by":"crossref","first-page":"e0135834","DOI":"10.1371\/journal.pone.0135834","article-title":"Validity of diagnostic codes for acute stroke in administrative databases: a systematic review","volume":"10","author":"McCormick","year":"2015","journal-title":"PLoS One"},{"key":"2021070804565470400_bibr42","first-page":"157","article-title":"Accuracy of diabetes diagnosis in health insurance claims data in Taiwan","volume":"104","author":"Lin","year":"2005","journal-title":"J Formos Med Assoc"},{"key":"2021070804565470400_bibr43","doi-asserted-by":"crossref","first-page":"e112257","DOI":"10.1371\/journal.pone.0112257","article-title":"Concordance between patient self-reports and claims data on clinical diagnoses, medication use, and health system utilization in Taiwan","volume":"9","author":"Wu","year":"2014","journal-title":"PloS One"},{"key":"2021070804565470400_bibr44"},{"key":"2021070804565470400_bibr45","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1089\/apc.2012.0070","article-title":"Factors associated with nonadherence to antiretroviral therapy in HIV-positive smokers","volume":"26","author":"Marks King","year":"2012","journal-title":"AIDS Patient Care STDs"},{"key":"2021070804565470400_bibr46","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1007\/s10461-014-0762-7","article-title":"The unique challenges facing HIV-positive patients who smoke cigarettes: HIV viremia, ART adherence, engagement in HIV care, and concurrent substance use","volume":"19","author":"O'Cleirigh","year":"2015","journal-title":"AIDS Behav"},{"key":"2021070804565470400_bibr47","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1080\/14622200801908190","article-title":"Cigarette smoking is an independent predictor of nonadherence in HIV-infected individuals receiving highly active antiretroviral therapy","volume":"10","author":"Shuter","year":"2008","journal-title":"Nicotine Tob Res"},{"key":"2021070804565470400_bibr48","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1521\/aeap.2009.21.3_supp.94","article-title":"Medication adherence in HIV-infected smokers: the mediating role of depressive symptoms","volume":"21","author":"Webb","year":"2009","journal-title":"AIDS Educ Prev"},{"key":"2021070804565470400_bibr49","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1086\/655144","article-title":"Low CD4\u2009+\u2009T cell count is a risk factor for cardiovascular disease events in the HIV outpatient study","volume":"51","author":"Lichtenstein","year":"2010","journal-title":"Clin Infect Dis"},{"key":"2021070804565470400_bibr50","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.ijid.2019.11.010","article-title":"Reduced economic burden of AIDS-defining illnesses associated with adherence to antiretroviral therapy","volume":"91","author":"Toh","year":"2019","journal-title":"Int J Infect Dis"}],"container-title":["European Journal of Preventive Cardiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2047487320908085","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2047487320908085","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/academic.oup.com\/eurjpc\/article-pdf\/28\/3\/326\/37315664\/zwaa263.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/eurjpc\/article-pdf\/28\/3\/326\/37315664\/zwaa263.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T08:57:47Z","timestamp":1625734667000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurjpc\/article\/28\/3\/326\/6248070"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,2]]},"references-count":50,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2020,3,2]]},"published-print":{"date-parts":[[2021,4,23]]}},"URL":"https:\/\/doi.org\/10.1177\/2047487320908085","relation":{},"ISSN":["2047-4873","2047-4881"],"issn-type":[{"value":"2047-4873","type":"print"},{"value":"2047-4881","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,3,1]]},"published":{"date-parts":[[2020,3,2]]}}}