Vitamin D DeficiencyNCT07479303
Vitamin D Status in Young Medical Residents
An observational study of Vitamin D Deficiency, run by Maimónides Biomedical Research Institute of Córdoba at 1 site in Spain.
Trial summary
Retrospective, observational, and anonymous study to assess vitamin D status in young medical residents of both sexes who joined the staff of the Reina Sofia University Hospital (HURS) in Cordoba, Spain, in March 2020. Subjects with vitamin D deficiency were treated with calcifediol and reevaluated. Read more about this study
- Who is it for?
- Any age
- Conditions the study is for
- Vitamin D Deficiency
- What is being tested?
- Calcifediol (Vitamin D)
- Type of treatment
- Pill or oral medicine
- How many people
- 30 participants
- Where
- 1 siteSpain
- Study dates
- 29 Oct 2025to 1 Dec 2025
- How long will I take part?
- 1 Day
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Study population: Medical residents admitted to the Reina Sofia University Hospital Residency Program
Who may be able to join
- Physicians admitted to the Residency Programme at Reina Sofía University Hospital
Who cannot join
- Subjects for whom there is no data collected in the occupational medicine medical recordrds
Trial locations and contacts
1 site in 1 country.
Spain1 site
Hospital Universitario Reina Sofía, Edificio IMIBIC, Avd. Menedez Pidal, s/n
Córdoba, 14004
About this study
Official title: Evaluation of Vitamin D Status in Young Medical Residents at the Reina Sofia University Hospital in Cordoba
Retrospective, observational, and anonymous study to assess vitamin D status in young medical residents of both sexes who joined the staff of the Reina Sofia University Hospital (HURS) in Cordoba, Spain, in March 2020. Subjects with vitamin D deficiency were treated with calcifediol and reevaluated. The retrospective cohort study was approved (October 29, 2025) by the Provincial Committee on Ethics in Drug Research (CEIm) of Córdoba (Spain), [committee reference number 6337) Communication/application code: SICEIA-2025-002858]. Data Based on the files of the HURS occupational medicine service.
Read the detailed description
Vitamin D deficiency, expressed as circulating levels of 25-hydroxyvitamin D (25OHD), the sum of 25OHD2 and 25OHD3, is highly prevalent worldwide. Regardless of geographical location and climate, 88% of the world's population has serum 25OHD concentrations below 30 ng/ml; 37% have values below 20 ng/ml and up to 7% have levels below 10 ng/ml. In all regions of Spain, there is a prevalence of vitamin D deficiency similar to that in the rest of the world, which is also high in patients undergoing treatment for osteoporosis. All studies of different population and age subgroups, such as those grouped in the Asturias and Pizarra (Málaga) cohorts, as reported in a recent review , support this fact. It should be noted that the prevalence of 25OHD deficiency is high in winter, even in southern provinces of Spain .
High levels of hypovitaminosis D have been reported in young, healthy adults, medical residents beginning their specialisation training at the Doce de Octubre Hospital in Madrid (Spain), where the majority, aged between 21 and 41, suffered from vitamin D deficiency or insufficiency. Studies with similar characteristics reveal similar data worldwide. A review by McKenna of 117 studies published between 1971 and 1990 on vitamin D concentrations in 27 different regions of the world, 42 of them in young adults, revealed that more than 40% of young adults in Western and Central Europe suffered from vitamin D deficiency during the winter. A study conducted in Boston with healthcare workers aged 18-49 revealed serum concentrations of 25OHD < 20ng/ml in 36% of subjects aged 18-29 at the end of winter (March and April). Another study conducted on internal medicine residents at a hospital in Portland, Oregon, with an average age of 30.1 years for women and 30.6 years for men, revealed 25OHD levels < 20ng/ml in 47% of resident doctors during the months of March and April, and 74% of participants had lower serum 25OHD concentrations in spring than in autumn.
Resident doctors who joined HURS in the spring of 2020 may be vulnerable to low 25OHD levels due to long hours of study preparing for competitive examinations, compounded by lockdown and the subsequent lack of exposure to sunlight The hospital's Occupational Medicine Service assessed vitamin D (25OHD) levels to identify vitamin D deficiency. This deficiency can have functional repercussions in addition to its effects on musculoskeletal metabolism and the innate and adaptive immune systems, among other important functional repercussions. Treatment with calcifediol was initiated in those with deficiencies with the aim of normalising serum 25OHD levels.
Calcifediol offers pharmacokinetic advantages that give it a certain functional superiority over native vitamin D3. It is highly hydrophilic and, therefore, after oral ingestion, it is absorbed through the portal venous system and does not require hydroxylation at position 25, which immediately increases the optimal circulating concentrations of 25(OH)D3. Therefore, when administered orally, it is available in high concentrations within a few hours, and in a stable form, to be a substrate for the synthesis of calcitriol in the kidney and other target organs.
This is not a patient registry. This study is a retrospective observational cohort analysis based on existing occupational health records. No prospective data collection or registry infrastructure was established
- Conditions
- Vitamin D Deficiency
- Being tested
- Calcifediol (Vitamin D)
- Keywords
- Calcifediol, Cholecalciferol, Vitamin D, Vitamin D endocrine system, Vitamin D3, VDR Vitamin D, Vitamin D3-sulphate, 25(OH)D3-Sulphate, 25(OH)D- Glucuronide
- Medical subject headings
- Vitamin D Deficiency
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Calcifediol (Vitamin D)Drug
They were evaluated at the start of the study and after oral treatment with calcidiol (Hidroferol® Faes-Farma, Spain).
What is being measured
The primary outcome is the main question the study is designed to answer.
Vitamin D endocrine system
Assess the status of the vitamin D endocrine system
Measured: Change from Baseline in the 25OH vitamin D through study completion, an average of 1 year
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Mar 2026
- Study start29 Oct 2025
- Primary completion1 Nov 2025
- Study completion1 Dec 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (14)Papers the sponsor has linked to this study.
- Other trials for Vitamin D DeficiencyStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Other
- Enrolment
- 30 participants (actual)
- Target duration
- 1 Day
Sponsor and investigators
- Lead sponsor
- Maimónides Biomedical Research Institute of Córdoba
- Sponsor type
- University, hospital or other
- Collaborators
- Hospital Universitario Reina Sofia de Cordoba
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07479303
- Sponsor's protocol ID
- VitD_6337
- Status last verified
- Dec 2025
- First submitted
- 18 Dec 2025
- Last updated
- 18 Mar 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: The information collected will be of public access by request
Publications
Quesada-Gomez JM, Bouillon R. Is calcifediol better than cholecalciferol for vitamin D supplementation? Osteoporos Int. 2018 Aug;29(8):1697-1711. doi: 10.1007/s00198-018-4520-y. Epub 2018 Apr 30.
PubMed 29713796Bouillon R, Quesada Gomez JM. Comparison of calcifediol with vitamin D for prevention or cure of vitamin D deficiency. J Steroid Biochem Mol Biol. 2023 Apr;228:106248. doi: 10.1016/j.jsbmb.2023.106248. Epub 2023 Jan 13.
PubMed 36646151Bouillon R, Marcocci C, Carmeliet G, Bikle D, White JH, Dawson-Hughes B, Lips P, Munns CF, Lazaretti-Castro M, Giustina A, Bilezikian J. Skeletal and Extraskeletal Actions of Vitamin D: Current Evidence and Outstanding Questions. Endocr Rev. 2019 Aug 1;40(4):1109-1151. doi: 10.1210/er.2018-00126.
PubMed 30321335Haney EM, Stadler D, Bliziotes MM. Vitamin D insufficiency in internal medicine residents. Calcif Tissue Int. 2005 Jan;76(1):11-6. doi: 10.1007/s00223-004-0025-0. Epub 2004 Oct 14.
PubMed 15478001Tangpricha V, Pearce EN, Chen TC, Holick MF. Vitamin D insufficiency among free-living healthy young adults. Am J Med. 2002 Jun 1;112(8):659-62. doi: 10.1016/s0002-9343(02)01091-4.
PubMed 12034416McKenna MJ. Differences in vitamin D status between countries in young adults and the elderly. Am J Med. 1992 Jul;93(1):69-77. doi: 10.1016/0002-9343(92)90682-2.
PubMed 1385673Calatayud M, Jodar E, Sanchez R, Guadalix S, Hawkins F. [Prevalence of deficient and insufficient vitamin D levels in a young healthy population]. Endocrinol Nutr. 2009 Apr;56(4):164-9. doi: 10.1016/S1575-0922(09)70980-5. Epub 2009 Jun 11. Spanish.
PubMed 19627732Mata-Granados JM, Luque de Castro MD, Quesada Gomez JM. Inappropriate serum levels of retinol, alpha-tocopherol, 25 hydroxyvitamin D3 and 24,25 dihydroxyvitamin D3 levels in healthy Spanish adults: simultaneous assessment by HPLC. Clin Biochem. 2008 Jun;41(9):676-80. doi: 10.1016/j.clinbiochem.2008.02.003. Epub 2008 Feb 15.
PubMed 18313404Navarro Valverde C, Quesada Gómez JM. Deficiencia de vitamina D en España. ¿Realidad o mito? Rev Osteoporos Metab Miner 2014; 6 (Supl1):S5-10 doi: 10.4321/S1889-836X2014000500002.
Gomez-Alonso C, Naves-Diaz ML, Fernandez-Martin JL, Diaz-Lopez JB, Fernandez-Coto MT, Cannata-Andia JB. Vitamin D status and secondary hyperparathyroidism: the importance of 25-hydroxyvitamin D cut-off levels. Kidney Int Suppl. 2003 Jun;(85):S44-8. doi: 10.1046/j.1523-1755.63.s85.11.x.
PubMed 12753264Gonzalez-Molero I, Morcillo S, Valdes S, Perez-Valero V, Botas P, Delgado E, Hernandez D, Olveira G, Rojo G, Gutierrez-Repiso C, Rubio-Martin E, Menendez E, Soriguer F. Vitamin D deficiency in Spain: a population-based cohort study. Eur J Clin Nutr. 2011 Mar;65(3):321-8. doi: 10.1038/ejcn.2010.265. Epub 2010 Dec 22.
PubMed 21179052Quesada-Gomez JM, Diaz-Curiel M, Sosa-Henriquez M, Malouf-Sierra J, Nogues-Solan X, Gomez-Alonso C, Rodriguez-Manas L, Neyro-Bilbao JL, Cortes X, Delgadillo J. Low calcium intake and inadequate vitamin D status in postmenopausal osteoporotic women. J Steroid Biochem Mol Biol. 2013 Jul;136:175-7. doi: 10.1016/j.jsbmb.2012.10.013. Epub 2012 Nov 8.
PubMed 23142144Hilger J, Friedel A, Herr R, Rausch T, Roos F, Wahl DA, Pierroz DD, Weber P, Hoffmann K. A systematic review of vitamin D status in populations worldwide. Br J Nutr. 2014 Jan 14;111(1):23-45. doi: 10.1017/S0007114513001840. Epub 2013 Aug 9.
PubMed 23930771Giustina A, Bilezikian JP, Adler RA, Banfi G, Bikle DD, Binkley NC, Bollerslev J, Bouillon R, Brandi ML, Casanueva FF, di Filippo L, Donini LM, Ebeling PR, Fuleihan GE, Fassio A, Frara S, Jones G, Marcocci C, Martineau AR, Minisola S, Napoli N, Procopio M, Rizzoli R, Schafer AL, Sempos CT, Ulivieri FM, Virtanen JK. Consensus Statement on Vitamin D Status Assessment and Supplementation: Whys, Whens, and Hows. Endocr Rev. 2024 Sep 12;45(5):625-654. doi: 10.1210/endrev/bnae009.
PubMed 38676447
Study at a glance
From the registry record, last updated by the sponsor on 18 Mar 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Evaluation of Vitamin D Status in Young Medical Residents at the Reina Sofia University Hospital in Cordoba
- ClinicalTrials.gov ID
- NCT07479303
- Acronym / sponsor ID
- VitD_6337
- Conditions
- Vitamin D Deficiency
- Keywords
- Calcifediol, Cholecalciferol, Vitamin D, Vitamin D endocrine system, Vitamin D3, VDR Vitamin D, Vitamin D3-sulphate, 25(OH)D3-Sulphate
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 30 participants (actual)
- Lead sponsor
- Maimónides Biomedical Research Institute of CórdobaUniversity, hospital or other
- Collaborators
- Hospital Universitario Reina Sofia de Cordoba
- Study start
- 29 Oct 2025 (actual)
- Primary completion
- 1 Nov 2025 (actual)
- Study completion
- 1 Dec 2025 (actual)
- First posted
- 18 Mar 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Retrospective, observational, and anonymous study to assess vitamin D status in young medical residents of both sexes who joined the staff of the Reina Sofia University Hospital (HURS) in Cordoba, Spain, in March 2020. Subjects with vitamin D deficiency were treated with calcifediol and reevaluated. The retrospective cohort study was approved (October 29, 2025) by the Provincial Committee on Ethics in Drug Research (CEIm) of Córdoba (Spain), [committee reference number 6337) Communication/application code: SICEIA-2025-002858]. Data Based on the files of the HURS occupational medicine service.
Detailed description
Vitamin D deficiency, expressed as circulating levels of 25-hydroxyvitamin D (25OHD), the sum of 25OHD2 and 25OHD3, is highly prevalent worldwide. Regardless of geographical location and climate, 88% of the world's population has serum 25OHD concentrations below 30 ng/ml; 37% have values below 20 ng/ml and up to 7% have levels below 10 ng/ml. In all regions of Spain, there is a prevalence of vitamin D deficiency similar to that in the rest of the world, which is also high in patients undergoing treatment for osteoporosis. All studies of different population and age subgroups, such as those grouped in the Asturias and Pizarra (Málaga) cohorts, as reported in a recent review , support this fact. It should be noted that the prevalence of 25OHD deficiency is high in winter, even in southern provinces of Spain .
High levels of hypovitaminosis D have been reported in young, healthy adults, medical residents beginning their specialisation training at the Doce de Octubre Hospital in Madrid (Spain), where the majority, aged between 21 and 41, suffered from vitamin D deficiency or insufficiency. Studies with similar characteristics reveal similar data worldwide. A review by McKenna of 117 studies published between 1971 and 1990 on vitamin D concentrations in 27 different regions of the world, 42 of them in young adults, revealed that more than 40% of young adults in Western and Central Europe suffered from vitamin D deficiency during the winter. A study conducted in Boston with healthcare workers aged 18-49 revealed serum concentrations of 25OHD < 20ng/ml in 36% of subjects aged 18-29 at the end of winter (March and April). Another study conducted on internal medicine residents at a hospital in Portland, Oregon, with an average age of 30.1 years for women and 30.6 years for men, revealed 25OHD levels < 20ng/ml in 47% of resident doctors during the months of March and April, and 74% of participants had lower serum 25OHD concentrations in spring than in autumn.
Resident doctors who joined HURS in the spring of 2020 may be vulnerable to low 25OHD levels due to long hours of study preparing for competitive examinations, compounded by lockdown and the subsequent lack of exposure to sunlight The hospital's Occupational Medicine Service assessed vitamin D (25OHD) levels to identify vitamin D deficiency. This deficiency can have functional repercussions in addition to its effects on musculoskeletal metabolism and the innate and adaptive immune systems, among other important functional repercussions. Treatment with calcifediol was initiated in those with deficiencies with the aim of normalising serum 25OHD levels.
Calcifediol offers pharmacokinetic advantages that give it a certain functional superiority over native vitamin D3. It is highly hydrophilic and, therefore, after oral ingestion, it is absorbed through the portal venous system and does not require hydroxylation at position 25, which immediately increases the optimal circulating concentrations of 25(OH)D3. Therefore, when administered orally, it is available in high concentrations within a few hours, and in a stable form, to be a substrate for the synthesis of calcitriol in the kidney and other target organs.
This is not a patient registry. This study is a retrospective observational cohort analysis based on existing occupational health records. No prospective data collection or registry infrastructure was established
Study design
- Observational model
- Cohort
- Time perspective
- Other
- Target follow-up
- 1 Day
Who may qualify
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
- Study population
- Medical residents admitted to the Reina Sofia University Hospital Residency Program
Key inclusion criteria (1 listed)
- Physicians admitted to the Residency Programme at Reina Sofía University Hospital
Key exclusion criteria (1 listed)
- Subjects for whom there is no data collected in the occupational medicine medical recordrds
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Calcifediol (Vitamin D)They were evaluated at the start of the study and after oral treatment with calcidiol (Hidroferol® Faes-Farma, Spain). | Drug | – |
Primary outcome
Vitamin D endocrine system
Time frame: Change from Baseline in the 25OH vitamin D through study completion, an average of 1 year
Assess the status of the vitamin D endocrine system
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 Mar 2026.
- Background: PubMed 29713796Quesada-Gomez JM, Bouillon R. Is calcifediol better than cholecalciferol for vitamin D supplementation? Osteoporos Int. 2018 Aug;29(8):1697-1711. doi: 10.1007/s00198-018-4520-y. Epub 2018 Apr 30.
- Background: PubMed 36646151Bouillon R, Quesada Gomez JM. Comparison of calcifediol with vitamin D for prevention or cure of vitamin D deficiency. J Steroid Biochem Mol Biol. 2023 Apr;228:106248. doi: 10.1016/j.jsbmb.2023.106248. Epub 2023 Jan 13.
- Background: PubMed 30321335Bouillon R, Marcocci C, Carmeliet G, Bikle D, White JH, Dawson-Hughes B, Lips P, Munns CF, Lazaretti-Castro M, Giustina A, Bilezikian J. Skeletal and Extraskeletal Actions of Vitamin D: Current Evidence and Outstanding Questions. Endocr Rev. 2019 Aug 1;40(4):1109-1151. doi: 10.1210/er.2018-00126.
- Background: PubMed 15478001Haney EM, Stadler D, Bliziotes MM. Vitamin D insufficiency in internal medicine residents. Calcif Tissue Int. 2005 Jan;76(1):11-6. doi: 10.1007/s00223-004-0025-0. Epub 2004 Oct 14.
- Background: PubMed 12034416Tangpricha V, Pearce EN, Chen TC, Holick MF. Vitamin D insufficiency among free-living healthy young adults. Am J Med. 2002 Jun 1;112(8):659-62. doi: 10.1016/s0002-9343(02)01091-4.
- Background: PubMed 1385673McKenna MJ. Differences in vitamin D status between countries in young adults and the elderly. Am J Med. 1992 Jul;93(1):69-77. doi: 10.1016/0002-9343(92)90682-2.
- Background: PubMed 19627732Calatayud M, Jodar E, Sanchez R, Guadalix S, Hawkins F. [Prevalence of deficient and insufficient vitamin D levels in a young healthy population]. Endocrinol Nutr. 2009 Apr;56(4):164-9. doi: 10.1016/S1575-0922(09)70980-5. Epub 2009 Jun 11. Spanish.
- Background: PubMed 18313404Mata-Granados JM, Luque de Castro MD, Quesada Gomez JM. Inappropriate serum levels of retinol, alpha-tocopherol, 25 hydroxyvitamin D3 and 24,25 dihydroxyvitamin D3 levels in healthy Spanish adults: simultaneous assessment by HPLC. Clin Biochem. 2008 Jun;41(9):676-80. doi: 10.1016/j.clinbiochem.2008.02.003. Epub 2008 Feb 15.
- BackgroundNavarro Valverde C, Quesada Gómez JM. Deficiencia de vitamina D en España. ¿Realidad o mito? Rev Osteoporos Metab Miner 2014; 6 (Supl1):S5-10 doi: 10.4321/S1889-836X2014000500002.
- Background: PubMed 12753264Gomez-Alonso C, Naves-Diaz ML, Fernandez-Martin JL, Diaz-Lopez JB, Fernandez-Coto MT, Cannata-Andia JB. Vitamin D status and secondary hyperparathyroidism: the importance of 25-hydroxyvitamin D cut-off levels. Kidney Int Suppl. 2003 Jun;(85):S44-8. doi: 10.1046/j.1523-1755.63.s85.11.x.
- Background: PubMed 21179052Gonzalez-Molero I, Morcillo S, Valdes S, Perez-Valero V, Botas P, Delgado E, Hernandez D, Olveira G, Rojo G, Gutierrez-Repiso C, Rubio-Martin E, Menendez E, Soriguer F. Vitamin D deficiency in Spain: a population-based cohort study. Eur J Clin Nutr. 2011 Mar;65(3):321-8. doi: 10.1038/ejcn.2010.265. Epub 2010 Dec 22.
- Background: PubMed 23142144Quesada-Gomez JM, Diaz-Curiel M, Sosa-Henriquez M, Malouf-Sierra J, Nogues-Solan X, Gomez-Alonso C, Rodriguez-Manas L, Neyro-Bilbao JL, Cortes X, Delgadillo J. Low calcium intake and inadequate vitamin D status in postmenopausal osteoporotic women. J Steroid Biochem Mol Biol. 2013 Jul;136:175-7. doi: 10.1016/j.jsbmb.2012.10.013. Epub 2012 Nov 8.
- Individual participant dataSharing planned: Yes. The information collected will be of public access by request
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Vitamin D Deficiency, run by Maimónides Biomedical Research Institute of Córdoba at 1 site in Spain.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 18 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Vitamin D endocrine system (time frame: Change from Baseline in the 25OH vitamin D through study completion, an average of 1 year). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07479303, which also lists 14 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Mar 2026; AzTrials last refreshed its copy on 7 Nov 2026.