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배경 및 목적: 알레르기 비염 (Allergic Rhinitis, AR)은 특정 알레르겐에 감작된 개인의 비강 점막에서 유발되는 대표적인 제2형 면역 반응 질환이다. 알러지 비염의 유병률 및 질환 조절 정도에 신체적 운동이나 활동운동이 어린이의 알러지비염 또는 천식 조절을 개선할 수 있다는 연구 결과가 있는 반면, 일부에서는 운동이 기도 염증을 악화시킬 수 있다고 보고된 바 있지만, 운동이 알러지 비염의 병태생리 및 알러지 조절 정도에 대하여 기존 연구는 없는 실정이다. 따라서, 본 연구는 자발적 신체 운동이 알레르겐 감작 및 알레르기 반응에 미치는 영향을 알러지비염 유도 생쥐 모델에서 분석하여 알레르기 비염 조절에 있어 운동의 역할을 규명하고자 계획하였다. 방법: 4주령 BALB/c 암컷 생쥐를 사용하여 주사와 비강 도전을 통해 AR 유도 모델을 개발하였다. 감작군에는 매주 Dermatophagoides pteronyssinus (Der-p1; Dp) 25 µg과 수산화알루미늄 겔 1 mg을 복강 주사하고 매일 Der-p1 20 µg을 비강에 투여하였으며, 대조군은 PBS를 주사 및 투여하였다. 총 96마리의 생쥐를 4개의 그룹으로 나누어 1부와 2부로 나누어 실험을 진행하였다. 생쥐는 회전 횟수를 측정할 수 있는 설치류 전용 운동 휠에서 운동하였으며, 1부에서는 알레르겐 감작 및 비강 도전과 동시에 4주간 운동을 수행하였고, 2부에서는 감작 후 4주 후부터 4주간 운동을 진행하였다. 체중과 운동량은 매일 기록하였고, 생쥐는 8주와 12주에 희생되었다. 혈청 총 IgE 및 알레르겐 특이 IgE, IgG1은 ELISA로, IL-4, IL-5, eotaxin-1 MBAA법으로 분석하였다. 비강 조직은 전비중격의 비강 상피를 대상으로 조직학적 분석을 수행하였으며, 비강점막 조직의 염증성 사이토카인 유전자 발현은 RT-qPCR로 평가하였다. IL-6의 mRNA 발현은 비강점막, 대퇴사두근, 백색 지방조직(WAT)에서 분석하였으며, 그룹 간 차이는 t-검정을 통해 평가하였다. 결과: 운동은 체중에 유의미한 영향을 미치지 않았지만, 알레르기 감작 생쥐는 체중이 유의미하게 감소하였다 (p<0.05). 1부에서는 알레르기 및 비-알레르기 그룹 간 운동량 차이가 없었으나, 2부에서는 알레르기 생쥐의 운동량이 비-알레르기 생쥐보다 유의미하게 적었다 (10,607회 대 16,765회, p<0.05). 알레르겐 감작은 혈청 총 IgE, Dp-특이 IgE, IgG1 수치를 유의미하게 증가시켰으며 (p<0.05), 운동은 비-알레르기 모델에서 이러한 수치에 영향을 미치지 않았다. 알레르기 모델에서는 1부에서 운동이 혈청 총 IgE, Dp-특이 IgE, IgG1 수치를 비-알레르기 수준으로 유의미하게 감소시켰으나 (p<0.001), 2부에서는 이러한 감소가 관찰되지 않았다. 조직학적 분석 결과, 비강 상피에서 운동 및 알레르겐 도전에 의해 조직 내 호산구 침윤이 유의미하게 증가하였으나, 운동을 통해 Part 1과 Part 2 모두에서 감소가 관찰되었다(p<0.05). 그러나 상피 두께와 술잔세포 수와 같은 조직 재형성은 Part 1에서만 상피 두께가 유의미하게 감소하였고, Part 2에서는 감소가 관찰되지 않았다. RT-qPCR 분석에서는 비강 IL-4 mRNA 발현이 Part 1과 Part 2 모두에서 유의미하게 감소하였으며(p<0.001), eotaxin-1 발현 감소는 Part 1에서만(p<0.001), IL-17 감소는 Part 2에서만 관찰되었다. 운동으로 유도된 IL-6는 대퇴사두근과 비강점막에서 mRNA 발현이 유의미하게 증가하였으며, 알레르기군의 비강에서도 IL-6 발현이 상승함이 관찰되었으며, 운동을 실시한 알레르기 모델에서는 비강점막과 백색지방조직에서 IL-6 발현이 유의미하게 감소하였고, 이는 운동으로 인해 근육에서 분비된 IL-6가 지방조직의 Th2 염증을 억제하고, 알러젠 감작 단계에서의 감소 및 비강 점막 내 알러지 염증 반응을 억제하는 데 관여하는 매개체 중 하나가 될 수 있음을 시사한다. 결론 : 자발적 신체 운동은 알러지 비염 유도 생쥐 모델에서 알레르기 감작 정도 및 알러젠에 노출 시 전신 및 비강 알러지 반응을 완화시킬 수 있으며, 이러한 효과는 알레르겐에 감작되기 이전 또는 감작 초기부터 운동을 시작했을 때 더 강하게 나타난다. Background: Allergic rhinitis (AR) is a type 2 immune response in the nasal mucosa triggered by allergen exposure in sensitized individuals. While increased physical activity or exercise may improve AR or asthma control in children, some evidence suggests it could worsen allergic inflammation in the airway. This study investigates the impact of spontaneous exercise on allergen sensitization and allergic responses in an AR-induced mouse model to clarify its role in modulating allergic rhinitis. Materials and Methods: An AR-induced mouse model was developed using 4-week-old BALB/c female mice sensitized with weekly intraperitoneal injections of 25 µg Dermatophagoides pteronyssinus (Der-p1; Dp) and 1 mg aluminum hydroxide gel, followed by daily nasal challenges with 20 µg Der-p1. Control mice received PBS injections and challenges. The study comprised two parts, each with four groups of 12 mice, making total of 96 mice. Mice exercised on a rodent-specific wheel with a revolution counter. Part 1 involved simultaneous exercise during sensitization and nasal provocation for 4 weeks, while Part 2 began exercise 4 weeks post-sensitization with continued nasal provocation for 4 weeks. Body weight and wheel revolutions were recorded daily, and mice were sacrificed at 8 and 12 weeks. Systemic sensitization was evaluated using ELISA for serum total and specific IgE and multiplex bead assay array for IL-4, IL-5, and eotaxin-1. Local AR responses were assessed via nasal histology at the nasal epithelium at the anterior part of the septum, and nasal mucosa tissue RT-qPCR for inflammatory cytokine gene expression levels. The mRNA expression of IL-6 was quantified in the nasal mucosa, quadriceps muscle, and white adipose tissue (WAT) to assess changes induced by physical exercise. Group differences were analyzed using t-tests. Results: Physical exercise did not significantly affect body weight, but allergy-sensitized mice showed a significant reduction in weight (p<0.05). In Part 1, no significant differences in wheel revolutions were observed between allergy and non-allergy groups. In Part 2, allergy mice had significantly fewer revolutions (10,607 vs. 16,765, p<0.05). Allergen sensitization significantly elevated serum total IgE, Dp-specific IgE, and Dp-specific IgG1 levels in allergy models (p<0.05), while physical exercise had no effect on these markers in non-allergy models. In allergy models, physical exercise significantly reduced serum total IgE, Dp-specific IgE, and Dp-specific IgG1 levels in Part 1 (p<0.001) to non-allergy levels, but no such reductions were observed in Part 2, where Dp-specific IgE remained elevated. Histological examination showed a significant increase in tissue eosinophils in the nasal respiratory mucosa with exercise and allergen challenge, with reductions observed in both Part 1 and Part 2 (p<0.05). However, tissue remodeling, indicated by increased epithelial thickness and goblet cell counts, showed a significant reduction in epithelial thickness only in Part 1, but not in Part 2. RT- qPCR analysis showed a significant decrease in nasal IL-4 mRNA expression with exercise in allergy models in both Part 1 and Part 2 (p<0.001), while reductions in nasal eotaxin-1 were observed only in Part 1 (p<0.001) and IL-17 only in Part 2. IL-6, induced by physical exercise in skeletal muscles and known for reducing inflammation, showed increased mRNA expression in the quadriceps and nasal tissue in exercise-only groups. In allergy-only groups, IL-6 also rose in nasal tissue and WAT. However, when the exercise was combined with allergy induction, IL-6 expression significantly increased in the quadriceps muscle, but showed significant decrease in nasal tissue and WAT. Conclusion: Spontaneous exercise may mitigate allergic responses in AR-induced mice, with stronger effects on systemic allergies than local nasal allergies, particularly when the physical exercised is initiated with or prior to allergen sensitization. Allergic response attenuation with exercise was highlighted only in acute nasal allergy reaction, but did not reverse chronically remodeled nasal mucosa. The increased release of IL-6 from skeletal muscle during physical exercise may cautiously suggest that IL-6 may play a role in attenuating systemic allergen sensitization and nasal allergic inflammation, potentially explaining our results.
본 연구는 연관분석(linkage analysis)중 Non-parametric한 방법으로 많이 알려져 있는 (개정된)Haseman-Elston 형제 쌍 회귀분석 모형에 계층적 일반화 선형 모형 (Hierarchical Generalized Linear Model : HGLM) 적용하여 제안하고 평가하고자 한다. 이 기법을 통해, 정확한 염색체를 확인하는 동시에 목표하는 유전자에 가장 가깝게 위치한 유전자 좌위들을 그 염색체 상에 위치시키고자 한다. 본 연구방법을 우리나라의 SNP 전장유전체 자료들에 적용하여 활용도를 높여 발전시켜 나갈 것이다. 본 연구의 결과는 가족적 질환 발병에 관련이 있는 다수의 표지 유전자들을 발굴하고, 질병예측을 정확히 할 수 있도록 모형을 찾는 데에 활용하게 될 것이다. 향후 가족적 질환의 원인이 되는 새로운 유전자 지표를 개발하는 데에도 사용할 수 있고, 가족적 질환의 조기 진단을 위한 질병예측 모형을 개발하는 데에 적용할 수도 있을 것이다.
슬관절 재치환술에서 인공삽입물의 장기 추시 결과 및 생존율 분석
국문초록 슬관절 재치환술에서 인공삽입물의 장기 추시 결과 및 생존율 분석 박 만 준 (지도교수: 서 승 석) 인제대학교 대학원 의학과 연구목적: 슬관절 재치환술에서 장기 추시 결과, 삽입물의 생존율 및 생존율에 영향을 미치는 요인들을 분석하고자 한다. 대상 및 방법: 1982년 12월부터 2007년 3월까지 재치환술 후 2년 이상 추시 가능하였던 232예, 195명의 환자를 대상으로 하였고, 평균 추시 기간은 8.1년(2.0~18.5년)이었다. 임상적 평가를 위해 미국 슬관절 학회의 임상적 평가법을 이용하였다. 생존율 분석은 생명표법과 Kaplan-Meier 방법을 사용하였고, 나이, 원인, 시멘트 기법, 동종골 이식술 여부에 따른 생존율을 비교하였다. 결과: 슬관절 점수와 기능 점수는 술 전 39.1과 33.2였고, 최종 추시 시 86.9와 74.0이었다. 5년, 8년, 10년, 13년 생존율은 97.1%, 92.1%, 88.2%, 81.4%였다. 원인, 시멘트 기법, 동종골 이식술 여부에 따른 생존율의 차이는 없었으나, 65세 미만군에서 생존율이 낮았다(P=0.007). 결 론 : 재치환술의 임상적 장기 추시 결과와 생존율은 만족스러웠다. 생존율은 시간이 지남에 따라 감소하며 10년을 기점으로 연 실패율이 의미 있게 증가하므로, 이 시기 후 합병증의 조기 발견을 위해 추시 관찰이 자주 필요하리라 생각된다. 주제어: 슬관절, 재치환술, 장기 추시 결과, 생존율 Abstract Long-term Results and Survivorship Analysis of Implants in Revision Total Knee Arthroplasty Man-Jun Park (Director : Prof. Seung Suk Seo, M.D.) Department of Medicine Graduate School, Inje University Purpose: To analyze the long-term results, survivorship of implants, and factors influencing survivorship of revision total knee arthroplasty. Material and Methods: From December 1982 to March 2007, 232 revision TKAs were performed in 195 patients by one surgeon. The mean follow-up period was 8.1 years (range, 2.0-18.5 years). For clinical assessment, the Knee Society clinical rating system was used. Survivorship analysis was done according to the method of life-table and Kaplan-Meier. In order to evaluate factors influencing survival rate, each survival rate was compared according to patient age, cause of revision, cementation technique, and use of bulk allograft. Results: The mean knee score and function score improved from 39.1 and 33.2 preoperatively to 86.9 and 74.0 at last follow-up. The 5-, 8-, 10-, and 13-year implant survivorship was 97.1%, 92.1%, 88.2%, and 81.4%, respectively. Implant survivorship was lower in the patients younger than 65 years. There was no difference in survivorship according to cause of revision, cementation technique and use of bulk allograft. Conclusion: Clinical results and long-term survivorship of revision TKA were satisfactory. Overall survivorship decreased over time and annual failure rate markedly increased 10 years after implantation. So, we recommend more frequent follow-up for earlier detection of complication after this period. Key Word : Knee, revision arthroplasty, long-term results, survivorship
성형된 형상을 갖는 이온성 고분자 금속 복합물 액추에이터의 제작
간단한 열처리 공정 방법을 이용하여, 다양한 형상의 이온성 고분자 금속 복합물 액추에이터를 제작할 수 있는 공정 방법을 제안하였다. 일반적인 이온성 고분자 금속 복합물 액추에이터는 다양한 형상으로 제작하는 것이 어렵고 작은 발생력을 보인다는 단점을 갖고 있다. 그러나 열처리 공정 방법을 이용하여 이온성 고분자 금속 복합물 액추에이터를 성형하게 되면 성형된 모양에 따라 전압 인가로 발생되는 발생력에 추가하여 성형의 형태로 인해 액추에이터 자체가 갖는 복원력이 더해지기 때문에 발생력이 작은 이온성 고분자 금속 복합물 액추에이터의 단점을 개선할 수 있으며 다양한 형상으로 제작이 가능해진다. 또한 열처리 공정 방법을 통하여 액추에이터에 직접적으로 열을 가하여도 이온성 고분자 금속 복합물 액추에이터의 기본적인 특성인 전압 인가 시의 변위, 지속적인 휘어짐, 빠른 반응 시간, 젖은 환경에서의 동작 등의 특성은 변화없이 그대로 유지할 수 있다. 기존의 이온성 고분자 금속 복합물 액추에이터는 액추에이터의 제작 후 필요에 따라 개별적인 액추에이터로 잘라서 휘 어짐만을 이용하는 단편적인 활용에 사용되었던 반면에 열처리 공정 방법을 이용하여 제작한 성형된 형상을 갖는 이온성 고분자 금속 복합물 액추에이터는 다양한 형태로 액추에이터를 제작하는 것이 가능하기 때문에 여러 분야의 응용이 가능할 것으로 판단된다. 본 논문에서는 이상과 같은 내용을 실험적으로 구현하였으며 열처리 공정을 이용하여 제작한 성형된 형상을 갖는 이온성 고분자 금속 복합물 액추에이터의 특성을 측정하여 기존의 액추에이터의 특성은 그대로 유지하면서 개선된 발생력을 갖고 이를 이용한 응용이 가능하다는 것을 실험적으로 입증하였다. We propose a new method to fabricate the Ionic Polymer Metal Composite(IPMC) actuator, which can actuate various forms. Generally, the IPMC actuator is difficult to fabricate with various shapes and it has a very small tip force. We used heat treatment method that can fabricate IPMC actuator with various shapes. Pre-shaped IPMC actuator by heat treatment has enhanced tip force by applying voltage and added restoring force. Also, the heat treated IPMC actuator does not show any degration of its actuation abilities such as bending displacement, reliability in bending motion, fast response time and can be operated in wet condition. Various pre-shaped IPMC actuators have been fabricated by the proposed heat treatment method and the characteristics of pre-shaped IPMC actuator have been measured. The measured characteristics of the fabricated pre-shaped IPMC actuator show the possibility for practical applications where complicated actuators are required.
비 기저부 비대칭의 빈도와 주변 비-안면구조와의 관계 분석
Background and Objectives : The nasal floor tilting (NFT) is an incidental finding shown on the ostiomeatal computed tomography (OMU CT) image, created by an asymmetry in the levels of both nasal floors. Despite its frequent appearance, this finding has never been properly defined, and its correlation with asymmetry of the adjacent nasofacial structures was never investigated. This study aimed to reveal the incidence of nasal floor tilting in patients with sinonasal symptoms and find out its correlation with structures of the nasofacial skeleton. Materials and Methods : From January 2008 to July 2017, patients who had taken preoperative OMU CT as well as facial photograph were investigated. Patients under age of 20, with a history of craniofacial anomaly, prior nasofacial trauma or surgery, neoplasm in the head and neck area were excluded. The incidence of NFT and the degree of NFT angle was measured in 265 patients. Asymmetries shown on the adjacent nasofacial skeleton as well as in the external face were evaluated. Analysis on the incidental difference of adjacent nasofacial asymmetry upon the presence of the NFT was performed. The NFT, asymmetry in the orbital level, maxillary sinus level, and maxillary sinus size was evaluated along with bony nasal septal deviation (NSD) shown on the OMU CT was measured. In the frontal facial photograph, perceived overall facial asymmetry in addition to the anthropometric measurement of the each upper, middle, lower facial asymmetry was measured. Results : The incidence of nasal floor tilting (NFT) was shown as 51 % (136 in 265 patients), defined as the tilted group. The mean NFT angle in the tiled group showed 7.7°with a standard deviation (SD) of 4.4°, ranging from 2.4° to 22.4°. The tilted group showed a higher incidence of NSD, asymmetrical orbit levels, asymmetrical maxillary sinus levels along with the size (P < .001) than the non-tilted group. The perceived facial asymmetry and perceived horizontal level asymmetry of the face were associated with a higher incidence in the tilted group (P < .01), whereas the external nasal deviation and asymmetry in each upper, middle, and lower face showed no difference in between two groups. Conclusions : The tilting of the nasal floor can be seen in half of the patients complaining nasal symptoms. The incidence of asymmetry in the nasal skeleton as well as the in the face were shown to be higher in the NFT patients compared to patients not presenting a NFT. In addition, a higher nasofacial structures corresponded with the higher side of the nasal floor.
中國宗敎政策的形成及其變遷過程硏究 : The research of Chinese religious policy making and variance
Religion is a kind of social phenomenon. It does not have any ability to resolve social conflicts by itself. During a modernizing advance, Religion helped the social governing group to have social control right. This is the reason that Marxist criticizes religion. In the view of Marxism, religion is based on human beings' ignorance, personification and fear of the supernatural, and remains by consoling socially alienated people or answering the governing group's needs. So, when human beings resolve social alienation and the ignorance for super nature through scientific development and social advance, religion naturally passes away. But in the course of religious existence for a long time, a person can choose what religion, if any, to believe in. Because everyone has a capacity of self consciousness. So, there are religious tolerance for the choice of religious belief between person and person. In the modern age, the social development on the base of economical structure brings the social structure of non-caesaropapism and the social segmentation of religion. Moreover, the reacting process of socialist religious cognition and the individualization of choosing religious belief result in a corporative relationship between socialism and religion. In the view of Chinese socialism, pre-religious tradition and traditional religion were the cord of patriarch maintenance. In the modern age, The Western Christian Mission Strategy of Propagator Culture Centric for the Chinese mainland has brought the independence management movement of religious magisterium, it has become a basic viewpoint of Chinese communism about Western religion. Since Chinese communism inherited the religious view of Marxism and cognizes the historical experience of traditional religion, the Chinese Government sums up four basic principles about religious policy. For instance, non-caesaropapism, the independent management of religious magisterium, a person believing in religion or not, antitheism education on socialism. From the founding of the Republic of china to the Great Culture Revolution, the government affairs of religion and the five social associations of Taoism, Buddhism, Islam, Christianity, Catholism have been built up by the central committee of the Chinese communist party and the State Council on the base of the May 4th Constitution and the Common Program. This is the basis of Chinese religious policy. But the Great Culture Revolution broke off from this for 10 years. After Chinas reform and opening-up, setting up a market economy and resetting religious policy brought new challenges and experience to religious policy makers. Since the Chinese government instituted the 1982 19th document and 1991 9th document describing the four principle of Chinese religious policy, all levels of local government and social religious associations basically have rebuilt the foundation of the religious active realm and governing institutions. Especially from 1991 to 1998, the central committee of the communist party of china and the State Council have been building the legal foundation of religious policy management through "the management measure of registering religious association", "the management byelaw of registering religious stage", "the management prescript of foreigner's religious activity in china", "the management measure of Career man engagement in religious academy" and so on. On the foundation of these prescriptions, all levels of local government think over real cases and make the synthesis law or the single law of local government based on the different institutional circumstances, protecting the same basic legal rights of religious stage. On the basis of these institutions, all levels of local government and religious associations are making efforts to accommodate religion to socialism. In the case of Shang-hai city and the Gan-Nan Tibetan municipality, the local government affairs for religions plays an important role in sponsoring religious association management and averting religious disputes. After China's reform and opening-up, the largest problem regarding religious activity is the financial independence for oneself. In the base of 1980 "Notifying the religious associations' house property policy" the central committee of the communist party of china and the State Council initiated and "attaching religious house property" that local government has initiated, the house property rights of every temple and church very have returned to religious associations and religious activity stage. Through deputizing the governing of rental affairs about religious house management and dismissing the religious house property tax, all levels of local government help religious realms to solve financial problems. And through occasionally sponsoring a fund for the rebuilding of religious stages and academies, helps religious groups to do religious activities. On the base of local government sustain, the religious associations in national area and non-national area have different roles in dissimilar social circumstances. In the case of the Shang-hai city Christian association and Islamic association, non-national religious association for common people organize the religious activity of exceeding denomination and the religious culture build of accommodating to Chinese socialism. Otherwise, Islamic association delegates Islamic people and endocentric Islamic culture. These are the important roles of a non-national religious association and a national religious association in non-national area. Regarding the foci of Gan-Nan Buddhism association and Christian association, the Gan-Nan Buddhist association has an important role of the leading Tibetan cultural inheritance and Tibetan Buddhism activity. The Gan-Nan Christian association have a characteristic behavior of doing christen activity looks like cell point and is depending on the provincial Christian association for it's christen organization activity. In the view of the main actor of socialist religious policy and religious activity, four cases of religious association similarly have a role of dual direction client. There is a symbiotic corporative relationship between all levels of local government and religious associations for building religious culture that accommodates to Chinese socialism and religious organization's financial independence. But as a result of different social circumstances and the degree of social segmentation of religion, there are different corporative relationships between all levels of government religious bureaus and religious associations. For example, we can find a semi social corporative relationship and semi state corporative relationship between local government and religious associations in the case of Shang-hai city and Gan-Nan Tibetan Municipality. In the religious view of Marxist, the degree of social segmentation of religion that social inner conflict brings decides the corporative relationship and the characteristics of actors. In the various corporative relationships and social circumstance, religious organizing activity and institutions have a representative model about non-government social organizations and the institutions. In this research of Sino-Religious Policy, there are three progenies of the investigation and hints of political theories. Firstly, the policy makers' cognition for religion decides the institutional context of religious policy. In the process of policy making, the most important explanatory variables are the cognition formation of policy makers and building institutions variables. Compared with other research cases, the theoretical frame for researching religious policy is fit for researching the policy making process for State-Society relationship. Through analyzing the influences of socialist cognition about making institutions, we can find a research case and theoretical frame of relationship between the cognition structure of policymakers and the terms of institutional choices. Secondly, this research explains the variable of institutional change and the effect that it has on actor's roles or relationships. Actor role and institution circumstance variables are the most important of explanatory variables about state and society relationship. These include the degree of social segmentation of religion, the corporative relationship between actors and the term of actor's institution choice. These provide us with the theory frame of social circumstance variables having an effect on actors' corporative relationship. In a word, the degree of social inner conflict decides the degree of social segmentation of religion and the corporative relationship between actors. These case studies of socialist religious policy research provide us with the theory frame of state religion and society. Thirdly, the case studies of religious organizations' activity provide us with the theory frame of researching NGO concerned social institutions in the third realm. In the social advance of Communist State, the needs of the state and society relationship creates social organizations' activity in the third realm. In socialism, social organizations, including religious association, have important roles of centralizing social resources in the process of social reproduction. The corporative relation between local governments and religious associations, the research of those institutions' making and variance provide us with the some theory frame for analyzing social voluntary associations' activity in the third sector.