{"id":899,"date":"2019-12-17T07:44:09","date_gmt":"2019-12-17T07:44:09","guid":{"rendered":"http:\/\/192.168.0.11\/wordpress\/?page_id=899"},"modified":"2025-01-24T00:04:38","modified_gmt":"2025-01-23T22:04:38","slug":"tutkimustietoa","status":"publish","type":"page","link":"https:\/\/memoera.fi\/index.php\/tutkimustietoa\/","title":{"rendered":"Tutkimustietoa"},"content":{"rendered":"<div data-colibri-id=\"899-c1\" class=\"style-1222 style-local-899-c1 position-relative\">\n  <!---->\n  <div data-colibri-component=\"section\" data-colibri-id=\"899-c2\" id=\"custom\" class=\"h-section h-section-global-spacing d-flex align-items-lg-center align-items-md-center align-items-center style-1234 style-local-899-c2 position-relative\">\n    <!---->\n    <!---->\n    <div class=\"h-section-grid-container h-section-boxed-container\">\n      <div data-colibri-id=\"899-c33\" class=\"h-row-container gutters-row-lg-3 gutters-row-md-3 gutters-row-0 gutters-row-v-lg-3 gutters-row-v-md-3 gutters-row-v-3 style-2709 style-local-899-c33 position-relative\">\n        <!---->\n        <div class=\"h-row justify-content-lg-center justify-content-md-center justify-content-center align-items-lg-stretch align-items-md-stretch align-items-stretch gutters-col-lg-3 gutters-col-md-3 gutters-col-0 gutters-col-v-lg-3 gutters-col-v-md-3 gutters-col-v-3\">\n          <!---->\n          <div class=\"h-column h-column-container d-flex h-col-lg-auto h-col-md-auto h-col-auto style-2710-outer style-local-899-c34-outer\">\n            <div data-colibri-id=\"899-c34\" class=\"d-flex h-flex-basis h-column__inner h-px-lg-3 h-px-md-3 h-px-3 v-inner-lg-3 v-inner-md-3 v-inner-3 style-2710 style-local-899-c34 position-relative\">\n              <!---->\n              <!---->\n              <div class=\"w-100 h-y-container h-column__content h-column__v-align flex-basis-100 align-self-lg-start align-self-md-start align-self-start\">\n                <!---->\n                <div data-colibri-id=\"899-c35\" class=\"h-global-transition-all h-heading style-2711 style-local-899-c35 position-relative h-element\">\n                  <!---->\n                  <div class=\"h-heading__outer style-2711 style-local-899-c35\">\n                    <!---->\n                    <!---->\n                    <h1 class=\"\">Tutkimustietoa<\/h1>\n                  <\/div>\n                <\/div>\n                <div data-colibri-id=\"899-c36\" class=\"h-text h-text-component style-2712 style-local-899-c36 position-relative h-element\">\n                  <!---->\n                  <!---->\n                  <div class=\"\">\n                    <p>Alta l\u00f6yd\u00e4t tutkimustietoa muistikuntoutuksesta ja pelaamisesta.<\/p>\n                  <\/div>\n                <\/div>\n              <\/div>\n            <\/div>\n          <\/div>\n        <\/div>\n      <\/div>\n      <div data-colibri-id=\"899-c3\" class=\"h-row-container gutters-row-lg-2 gutters-row-md-2 gutters-row-0 gutters-row-v-lg-2 gutters-row-v-md-2 gutters-row-v-2 style-1237 style-local-899-c3 position-relative\">\n        <!---->\n        <div class=\"h-row justify-content-lg-center justify-content-md-center justify-content-center align-items-lg-stretch align-items-md-stretch align-items-stretch gutters-col-lg-2 gutters-col-md-2 gutters-col-0 gutters-col-v-lg-2 gutters-col-v-md-2 gutters-col-v-2\">\n          <!---->\n          <div class=\"h-column h-column-container d-flex h-col-lg-auto h-col-md-auto h-col-auto style-1238-outer style-local-899-c4-outer\">\n            <div data-colibri-id=\"899-c4\" class=\"d-flex h-flex-basis h-column__inner h-px-lg-2 h-px-md-2 h-px-2 v-inner-lg-2 v-inner-md-2 v-inner-2 style-1238 style-local-899-c4 position-relative\">\n              <!---->\n              <!---->\n              <div class=\"w-100 h-y-container h-column__content h-column__v-align flex-basis-100 align-self-lg-start align-self-md-start align-self-start\">\n                <!---->\n                <div data-colibri-id=\"899-c5\" class=\"h-text h-text-component style-1239 style-local-899-c5 position-relative h-element\">\n                  <!---->\n                  <!---->\n                  <div class=\"\">\n                    <p>&#8211; L\u00f6fberg L (2018) Voiko pelimuotoisilla kognitiivisilla harjoitteilla edesauttaa muistipotilaiden toimintakyky\u00e4? <\/p>\n                  <\/div>\n                <\/div>\n                <div data-colibri-id=\"899-c6\" class=\"h-global-transition-all h-heading style-1240 style-local-899-c6 position-relative h-element\">\n                  <!---->\n                  <div class=\"h-heading__outer style-1240 style-local-899-c6\">\n                    <!---->\n                    <!---->\n                    <a href=\"https:\/\/memoera.fi\/index.php\/tutkimus\/\" h-use-smooth-scroll=\"true\">\n                      <h6 class=\"\">Maallikolle laadittu tiivis vastaus<\/h6>\n                    <\/a>\n                  <\/div>\n                <\/div>\n                <div data-colibri-id=\"899-c7\" class=\"h-text h-text-component style-1245 style-local-899-c7 position-relative h-element\">\n                  <!---->\n                  <!---->\n                  <div class=\"\">\n                    <p>&#8211; George Savulich, PhD; Thomas Piercy, BSc; Chris Fox, MD, MRCPsych; John Suckling, PhD; James B. Rowe, PhD; John T. O\u2019Brien, DM; FMedSci, Barbara J. Sahakian, DSc, FMedSci (2017) Cognitive training using a novel memory game on iPad\n                      in patients with Amnestic Mild Cognitive impairment (aMCI). International journal of Neuropsychopharmacology (2017) 20(8): 624-633.<\/p>\n                  <\/div>\n                <\/div>\n                <div data-colibri-id=\"899-c8\" class=\"h-global-transition-all h-heading style-1246 style-local-899-c8 position-relative h-element\">\n                  <!---->\n                  <div class=\"h-heading__outer style-1246 style-local-899-c8\">\n                    <!---->\n                    <!---->\n                    <a href=\"https:\/\/memoera.fi\/wp-content\/uploads\/2020\/01\/Kognitive-training-using-a-novel-memory-game.pdf\" h-use-smooth-scroll=\"true\">\n                      <h6 class=\"\">Kognitive training using a novel memory game<\/h6>\n                    <\/a>\n                  <\/div>\n                <\/div>\n                <div data-colibri-id=\"899-c9\" class=\"h-text h-text-component style-1250 style-local-899-c9 position-relative h-element\">\n                  <!---->\n                  <!---->\n                  <div class=\"\">\n                    <p>&#8211; Djabelkhir L, Wu YH, Vidal JS, Cristancho-Lacroix, V, Marlats F, Lenoir H, et al. Computerized cognitive stimulation and engagement programs in older adults with mild cognitive impairment: comparing feasibility, acceptability, and\n                      cognitive and psychosocial effects. Clinical Interventions in Aging 2017;12:1967\u201375.&nbsp;<\/p>\n                  <\/div>\n                <\/div>\n                <div data-colibri-id=\"899-c10\" class=\"h-text h-text-component style-1251 style-local-899-c10 position-relative h-element\">\n                  <!---->\n                  <!---->\n                  <div class=\"\">\n                    <p>Liev\u00e4st\u00e4 kognitiivisesta heikentymisest\u00e4 (MCI) k\u00e4rsiv\u00e4t henkil\u00f6t joko tekiv\u00e4t kolme kuukautta joko tietokoneavusteista kognitiivista harjoittelua (koeryhm\u00e4) tai opettelivat uusia tietotekniikkataitoja (kontrolliryhm\u00e4). Koeryhm\u00e4n suorituskyky\n                      kognitiivista toiminnanohjausta mittaavassa Trail making testiss\u00e4 parani enemm\u00e4n kuin kontrolliryhm\u00e4ss\u00e4.<\/p>\n                  <\/div>\n                <\/div>\n                <div data-colibri-id=\"899-c11\" class=\"h-text h-text-component style-1252 style-local-899-c11 position-relative h-element\">\n                  <!---->\n                  <!---->\n                  <div class=\"\">\n                    <p>&#8211; Fiatarone Singh MA, Gates N, Saigal N, Wilson GC, Meiklejohn J, Brodaty H, et al. The Study of Mental and Resistance Training (SMART) study-resistance training and\/or cognitive training in mild cognitive impairment: a randomized,\n                      double-blind, double-sham controlled trial. Journal of the American Medical Directors Association 2014; 15(12):873\u201380.<\/p>\n                  <\/div>\n                <\/div>\n                <div data-colibri-id=\"899-c12\" class=\"h-text h-text-component style-1253 style-local-899-c12 position-relative h-element\">\n                  <!---->\n                  <!---->\n                  <div class=\"\">\n                    <p>Verrattiin sek\u00e4 6 kk kest\u00e4v\u00e4n lihaskuntoharjoittelun (intensiivinen treeni vs. venyttely) ja tietokoneavusteisen kognitiivisen harjoittelun (intensiivinen harjoittelu vs. pelkk\u00e4 viihdek\u00e4ytt\u00f6) vaikutuksia kognitiiviseen toimintaan.\n                      Kognitiivinen harjoittelu loivensi ajan my\u00f6t\u00e4 tapahtuvaa muistin heikkenemist\u00e4. (Lihaskuntoharjoittelusta oli enemm\u00e4n hy\u00f6ty\u00e4, verrattuna venyttelyyn, lihaskuntoharjoittelu paransi yleist\u00e4 kognitiota huomattavasti).<\/p>\n                  <\/div>\n                <\/div>\n                <div data-colibri-id=\"899-c13\" class=\"h-text h-text-component style-1256 style-local-899-c13 position-relative h-element\">\n                  <!---->\n                  <!---->\n                  <div class=\"\">\n                    <p>&#8211; Gooding AL, Choi J, Fiszdon JM, Wilkins K, Kirwin PD, van Dyck CH, et al. Comparing three methods of computerised cognitive training for older adults with subclinical cognitive decline. Neuropsychological Rehabilitation 2016;26(5-6):810\u201321.<\/p>\n                  <\/div>\n                <\/div>\n                <div data-colibri-id=\"899-c14\" class=\"h-text h-text-component style-1257 style-local-899-c14 position-relative h-element\">\n                  <!---->\n                  <!---->\n                  <div class=\"\">\n                    <p> 16 viikon tietokoneavusteinen kognitiivinen harjoittelu nosti yleisen kognition pistem\u00e4\u00e4r\u00e4\u00e4 kontrolliryhm\u00e4\u00e4n verrattuna.<\/p>\n                  <\/div>\n                <\/div>\n                <div data-colibri-id=\"899-c15\" class=\"h-text h-text-component style-1258 style-local-899-c15 position-relative h-element\">\n                  <!---->\n                  <!---->\n                  <div class=\"\">\n                    <p>&#8211; Herrera C, Chambon C, Michel BF, Paban V, Alescio-Lautier B. Positive effects of computer-based cognitive training in adults with mild cognitive impairment. Neuropsychologia 2012;50(8):1871\u201381.<\/p>\n                  <\/div>\n                <\/div>\n                <div data-colibri-id=\"899-c16\" class=\"h-text h-text-component style-1259 style-local-899-c16 position-relative h-element\">\n                  <!---->\n                  <!---->\n                  <div class=\"\">\n                    <p>Koeryhm\u00e4n koehenkil\u00f6iden muistitoiminnot paranivat 12 viikon harjoittelujakson my\u00f6t\u00e4 kontrolliryhm\u00e4\u00e4 enemm\u00e4n. Vaikutus oli havaittavissa viel\u00e4 6 kuukautta intervention j\u00e4lkeen.<\/p>\n                  <\/div>\n                <\/div>\n              <\/div>\n            <\/div>\n          <\/div>\n        <\/div>\n      <\/div>\n      <div data-colibri-id=\"899-c17\" class=\"h-row-container gutters-row-lg-2 gutters-row-md-2 gutters-row-0 gutters-row-v-lg-2 gutters-row-v-md-2 gutters-row-v-2 style-1260 style-local-899-c17 position-relative\">\n        <!---->\n        <div class=\"h-row justify-content-lg-center justify-content-md-center justify-content-center align-items-lg-stretch align-items-md-stretch align-items-stretch gutters-col-lg-2 gutters-col-md-2 gutters-col-0 gutters-col-v-lg-2 gutters-col-v-md-2 gutters-col-v-2\">\n          <!---->\n          <div class=\"h-column h-column-container d-flex h-col-lg-auto h-col-md-auto h-col-auto style-1261-outer style-local-899-c18-outer\">\n            <div data-colibri-id=\"899-c18\" class=\"d-flex h-flex-basis h-column__inner h-px-lg-2 h-px-md-2 h-px-2 v-inner-lg-2 v-inner-md-2 v-inner-2 style-1261 style-local-899-c18 position-relative\">\n              <!---->\n              <!---->\n              <div class=\"w-100 h-y-container h-column__content h-column__v-align flex-basis-100 align-self-lg-start align-self-md-start align-self-start\">\n                <!---->\n                <div data-colibri-id=\"899-c19\" class=\"h-text h-text-component style-1262 style-local-899-c19 position-relative h-element\">\n                  <!---->\n                  <!---->\n                  <div class=\"\">\n                    <p>Bamidis, P. D., Fissler, P., Papageorgiou, S. G., Zilidou, V., Konstantinidis, E. I., Billis, A. S., Romanopoulou, E., Karagianni, M., Beratis, I., Angeliki, T., Tsilikopoulou, G., Grigoriadou, E., Ladas, A., Kyrillidou, A., Tsolaki,\n                      A., Frantzidis, C., Sidiropoulos, E., Siountas, A., Matsi, S., Papatriantafyllou, J., Margioti, E., Nika, A., Schlee, W., Elbert, T., Tsolaki, M., Vivas, A. B. &amp; Kolassa I. (2015) Gains in cognition through combined cognitive\n                      and physical training: the role of training dosage and severity of neurocognitive disorder. Front Aging Neurosci., 7:152.<\/p>\n                    <p>Mura, G., Carta, M. G., Sancassiani, F., Machado, S. &amp; Prosperini, L. (2017) Active exergames to improve cognitive functioning in neurological disabilities: a systematic review and meta-analysis. Eur J Phys Rehabil Med., DOI: 10.23736\/S1973-9087.17.04680-9.<\/p>\n                  <\/div>\n                <\/div>\n                <div data-colibri-id=\"899-c20\" class=\"h-global-transition-all h-heading style-1263 style-local-899-c20 position-relative h-element\">\n                  <!---->\n                  <div class=\"h-heading__outer style-1263 style-local-899-c20\">\n                    <!---->\n                    <!---->\n                    <a href=\"https:\/\/www.minervamedica.it\/en\/journals\/europa-medicophysica\/article.php?cod=R33Y9999N00A17102501\" h-use-smooth-scroll=\"true\">\n                      <h6 class=\"\">https:\/\/www.minervamedica.it\/en\/journals\/europa-medicophysica\/article.php?cod=R33Y9999N00A17102501 (viitattu 26.1.2018)<\/h6>\n                    <\/a>\n                  <\/div>\n                <\/div>\n              <\/div>\n            <\/div>\n          <\/div>\n        <\/div>\n      <\/div>\n      <div data-colibri-id=\"899-c21\" class=\"h-row-container gutters-row-lg-2 gutters-row-md-2 gutters-row-0 gutters-row-v-lg-2 gutters-row-v-md-2 gutters-row-v-2 style-1264 style-local-899-c21 position-relative\">\n        <!---->\n        <div class=\"h-row justify-content-lg-center justify-content-md-center justify-content-center align-items-lg-stretch align-items-md-stretch align-items-stretch gutters-col-lg-2 gutters-col-md-2 gutters-col-0 gutters-col-v-lg-2 gutters-col-v-md-2 gutters-col-v-2\">\n          <!---->\n          <div class=\"h-column h-column-container d-flex h-col-lg-auto h-col-md-auto h-col-auto style-1265-outer style-local-899-c22-outer\">\n            <div data-colibri-id=\"899-c22\" class=\"d-flex h-flex-basis h-column__inner h-px-lg-2 h-px-md-2 h-px-2 v-inner-lg-2 v-inner-md-2 v-inner-2 style-1265 style-local-899-c22 position-relative\">\n              <!---->\n              <!---->\n              <div class=\"w-100 h-y-container h-column__content h-column__v-align flex-basis-100 align-self-lg-start align-self-md-start align-self-start\">\n                <!---->\n                <div data-colibri-id=\"899-c23\" class=\"h-text h-text-component style-1266 style-local-899-c23 position-relative h-element\">\n                  <!---->\n                  <!---->\n                  <div class=\"\">\n                    <p>Rinne, J., Rosenvall, A., Erkinjuntti, T., Koponen, H., L\u00f6pp\u00f6nen, M., Raivio, M., Strandberg, T., Vanninen, R., Vataja, R., Tuunainen, A., Hartikainen, S., Hietanen, M., H\u00e4nninen, T., Kivipelto, M., Melkas, S., Ojala, M., Pitk\u00e4l\u00e4,\n                      K., Voutilainen, P. (2017) Suomalaisen L\u00e4\u00e4k\u00e4riseuran Duodecimin, Societas Gerontologica Fennican, Suomen Geriatrit -yhdistyksen, ja Suomen Yleisl\u00e4\u00e4ketieteen yhdistyksen asettama ty\u00f6ryhm\u00e4. Muistisairaudet (online). K\u00e4yp\u00e4 hoito -suositus.\n                      Helsinki: Suomalainen L\u00e4\u00e4k\u00e4riseura Duodecim, 133 (8),756-7.<\/p>\n                  <\/div>\n                <\/div>\n                <div data-colibri-id=\"899-c24\" class=\"h-global-transition-all h-heading style-1267 style-local-899-c24 position-relative h-element\">\n                  <!---->\n                  <div class=\"h-heading__outer style-1267 style-local-899-c24\">\n                    <!---->\n                    <!---->\n                    <a href=\"http:\/\/www.terveysportti.fi\/xmedia\/duo\/duo13663a.pdf\" h-use-smooth-scroll=\"true\">\n                      <h6 class=\"\">http:\/\/www.terveysportti.fi\/xmedia\/duo\/duo13663a.pdf (viitattu 26.1.2018)<\/h6>\n                    <\/a>\n                  <\/div>\n                <\/div>\n              <\/div>\n            <\/div>\n          <\/div>\n        <\/div>\n      <\/div>\n      <div data-colibri-id=\"899-c25\" class=\"h-row-container gutters-row-lg-2 gutters-row-md-2 gutters-row-0 gutters-row-v-lg-2 gutters-row-v-md-2 gutters-row-v-2 style-1268 style-local-899-c25 position-relative\">\n        <!---->\n        <div class=\"h-row justify-content-lg-center justify-content-md-center justify-content-center align-items-lg-stretch align-items-md-stretch align-items-stretch gutters-col-lg-2 gutters-col-md-2 gutters-col-0 gutters-col-v-lg-2 gutters-col-v-md-2 gutters-col-v-2\">\n          <!---->\n          <div class=\"h-column h-column-container d-flex h-col-lg-auto h-col-md-auto h-col-auto style-1269-outer style-local-899-c26-outer\">\n            <div data-colibri-id=\"899-c26\" class=\"d-flex h-flex-basis h-column__inner h-px-lg-2 h-px-md-2 h-px-2 v-inner-lg-2 v-inner-md-2 v-inner-2 style-1269 style-local-899-c26 position-relative\">\n              <!---->\n              <!---->\n              <div class=\"w-100 h-y-container h-column__content h-column__v-align flex-basis-100 align-self-lg-start align-self-md-start align-self-start\">\n                <!---->\n                <div data-colibri-id=\"899-c27\" class=\"h-text h-text-component style-1270 style-local-899-c27 position-relative h-element\">\n                  <!---->\n                  <!---->\n                  <div class=\"\">\n                    <p>Stanmore, E., Stubbs, B., Vancampfort, D., de Bruin, E. D. &amp; Firth, J. (2017) The effect of active video games on cognitive functioning in clinical and non-clinical populations: A meta-analysis of randomized controlled trials.\n                      Neurosci Biobehav Rev., 78: 34-43.<\/p>\n                    <p>Wiloth, S., Werner, C., Lemke, N. C., Bauer, J. &amp; Hauer, K. (2017) Motor-cognitive effects of a computerized game-based training method in people with dementia: a randomized controlled trial. Aging Ment Health., DOI: 10.1080\/13607863.2017.1348472<\/p>\n                  <\/div>\n                <\/div>\n                <div data-colibri-id=\"899-c28\" class=\"h-global-transition-all h-heading style-1271 style-local-899-c28 position-relative h-element\">\n                  <!---->\n                  <div class=\"h-heading__outer style-1271 style-local-899-c28\">\n                    <!---->\n                    <!---->\n                    <a href=\"http:\/\/www.tandfonline.com\/doi\/abs\/10.1080\/13607863.2017.1348472?journalCode=camh20\" h-use-smooth-scroll=\"true\">\n                      <h6 class=\"\">http:\/\/www.tandfonline.com\/doi\/abs\/10.1080\/13607863.2017.1348472?journalCode=camh20 (viitattu 26.1.2018)<\/h6>\n                    <\/a>\n                  <\/div>\n                <\/div>\n              <\/div>\n            <\/div>\n          <\/div>\n        <\/div>\n      <\/div>\n      <div data-colibri-id=\"899-c29\" class=\"h-row-container gutters-row-lg-2 gutters-row-md-2 gutters-row-0 gutters-row-v-lg-2 gutters-row-v-md-2 gutters-row-v-2 style-1272 style-local-899-c29 position-relative\">\n        <!---->\n        <div class=\"h-row justify-content-lg-center justify-content-md-center justify-content-center align-items-lg-stretch align-items-md-stretch align-items-stretch gutters-col-lg-2 gutters-col-md-2 gutters-col-0 gutters-col-v-lg-2 gutters-col-v-md-2 gutters-col-v-2\">\n          <!---->\n          <div class=\"h-column h-column-container d-flex h-col-lg-auto h-col-md-auto h-col-auto style-1273-outer style-local-899-c30-outer\">\n            <div data-colibri-id=\"899-c30\" class=\"d-flex h-flex-basis h-column__inner h-px-lg-2 h-px-md-2 h-px-2 v-inner-lg-2 v-inner-md-2 v-inner-2 style-1273 style-local-899-c30 position-relative\">\n              <!---->\n              <!---->\n              <div class=\"w-100 h-y-container h-column__content h-column__v-align flex-basis-100 align-self-lg-start align-self-md-start align-self-start\">\n                <!---->\n                <div data-colibri-id=\"899-c31\" class=\"h-text h-text-component style-1274 style-local-899-c31 position-relative h-element\">\n                  <!---->\n                  <!---->\n                  <div class=\"\">\n                    <p>Oxford: Albert MS, DeKosky ST, Dickson D, Dubois B, Feldman HH, Fox<\/p>\n                    <p>NC, Gamst A, Holtzman DM, Jagust WK, Petersen RC, Snyder<\/p>\n                    <p>PJ, Carrillo MC, Thies B, Phelps CH (2011) The diagnosis of mild<\/p>\n                    <p>cognitive impairment due to Alzheimer\u2019s disease: recommendations from the National Institute on Aging and Alzheimer\u2019s Association workgroup. 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Acta Psychiatr Scand 67:361\u2013370.<\/p>\n                  <\/div>\n                <\/div>\n                <div data-colibri-id=\"899-c32\" class=\"h-global-transition-all h-heading style-1275 style-local-899-c32 position-relative h-element\">\n                  <!---->\n                  <div class=\"h-heading__outer style-1275 style-local-899-c32\">\n                    <!---->\n                    <!---->\n                    <a href=\"http:\/\/www.alzheimerinfo.fi\/\" h-use-smooth-scroll=\"true\">\n                      <h6 class=\"\">http:\/\/www.alzheimerinfo.fi\/<\/h6>\n                    <\/a>\n                  <\/div>\n                <\/div>\n              <\/div>\n            <\/div>\n          <\/div>\n        <\/div>\n      <\/div>\n    <\/div>\n  <\/div>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Tutkimustietoa Alta l\u00f6yd\u00e4t tutkimustietoa muistikuntoutuksesta ja pelaamisesta. &#8211; L\u00f6fberg L (2018) Voiko pelimuotoisilla kognitiivisilla harjoitteilla edesauttaa muistipotilaiden toimintakyky\u00e4? 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