Wednesday, April 22, 2020

How Much Does It Cost To Give Birth At Home

A home birth cost is significantly lower than a hospital birth. We have met our deductible for other health issues for the last 8 years.

How Much Does A Doula Cost Midwife Cost Water Birth Cost Magnolia Birth House

Soccer star Hope Solo gave birth to twins near her home in North Carolina in April 2020.

How much does it cost to give birth at home. Unsure if insurance will apply any of that toward our deductible until after baby is here and they try to bill. The cost varies depending on where you live and the center you choose. This price includes prenatal care and often a home visit after birth.

Among these positives however its important to note that there are downsides to giving birth at home. The average cost of having a baby without complications ranges from almost 5000 to 11000 for vaginal delivery. Home birth cost vs.

So the thought of a 65004000. Birth kits range in cost but average between 50 and 90. A planned home birth might also be more affordable as home births cost about one-third as much as hospital births cost before you factor in insurance coverage.

In general prenatal care and delivery at a birth center is about 3000 to 4000 typically much less than the grand total for a hospital birth. The only midwife near us costs 6500. Cash option is 4000.

The average doctor charges for a vaginal delivery with no complications in the US. You will not have as many options for pain control. Total Cost For Pregnancy Care Birth Postpartum.

This could go over 30000 if you include care provided before and after pregnancy such as checkups and tests. Again check with your insurance company to determine coverage and out-of-pocket expenses. It costs an average of 12910 to give birth in a North Carolina hospital.

Is 3035 according to data from FAIR Health a health care nonprofit that keeps a national database of insurance claims. So I thought having a video about it would clear things up. It may cost less.

How much does your home birth cost. Knowing that its going to be. She says that most midwives charge anywhere from 3000 to 6000 depending on the area they live in supply and demand which includes the.

Ive gotten a few questions about how much a home birth actually costs. In most cases insurance aside uncomplicated home births are cheaper costing an average of one-third the price of a hospital birth. The Cost of a Home Birth for Leah.

One study looking at Medicaid claims in Washington State reported that vaginal hospital deliveries cost 2971 more than at-home births. They contain items like cord clamps sterile gloves mesh underwear plastic-backed pads and other basic medical supplies. These tax-advantaged accounts can help you to cover out-of-pocket costs for giving birth.

Out-of-hospital births which includes those conducted at a birthing center or at home are 68 percent less expensive than those in a hospital. The cost is anywhere between 2000-4000 depending on your location extent of your home birth plans and the availability and price of a midwife which we will be discussing in this article. Midwifery care on the other hand puts birth cost at about 2000-4000 depending on where you live.

I paid 4500 out of pocket Goldstein says. Ask about financial aid. 547099 The nicest thing about a home birth is that its your space.

Women are increasingly likely to get a C-section which is more costly. No Hidden Costs. I gave birth in my room in my bed.

Another estimate from the International Federation of Health Plans put the average amount insurers paid for a vaginal birth in the US at 10808 in 2015. When American mothers take their newborns home from the hospital big bills can follow. You usually have to pay for extra interventions out of pocket but this also means.

Hospital cesarean deliveries cost. One of the many benefits of having a home birth is that it cost exceptionally less to have your baby at home than. Giving birth at home is great for a mother with a low-risk pregnancy.

If you cant afford to pay the average cost of 15675 with or without insurance most hospitals and clinics offer financial aid programs that. They are the least expensive option for giving birth.

Tuesday, April 21, 2020

How Late Can You Take Plan B

Some think Plan B works in other ways but the Manufacturer does not claim that. Each dose contains 075 mg of levonorgestrel.

How To Figure Out If You Should Take Plan B

It is important to take emergency contraception as early as possible after having unprotected sex.

How late can you take plan b. Taking Plan B aka Levonorgestrel Emergency contraception can cause you period to be early late or on time. So if the egg has already been released Plan B wont be effective and it wont end an existing pregnancy. Anyone can take it on as-needed basisthere is no age restriction.

Plan b can seriously screw up your cycle my second period after taking plan b was two weeks late i have heard it can mess up to three cycles after you take it. How it works depends where you are in your menstrual cycle. The Plan B you took was too late.

However Plan B does not work in general after you ovulate. So the late could also be pregnant. Talk to your doctor and have a pregnancy test done.

You only have 3 days72 hours in which it may help. If your ovaries havent released an egg yet Plan B will prevent them from doing so. Theyll be able to tell you whether or not the medication has been effective much quicker than a home pregnancy test.

But if youre not sure where you are in your menstrual cycle wait 3. Plan B The Plan B package instructions state that you should take 1 white pill within 72 hours after unprotected sex and 1 more white pill 12 hours later. The manufacturers label states that Plan B One Step should be taken within 72 hours after having unprotected sex.

Plan B works by taking a single dose of the pill within 72 hours three days of having unprotected sex. Plan B is recommended for use within 72 hours of. If your period is more than a week late or you havent had a period within three weeks of taking Plan B it is possible that youre pregnant.

Enter the date and time you had unprotected sex below. If youve taken Plan B its a good idea to schedule an appointment with your doctor within three weeks of taking it. Especially since you had a double dose im sure your body is in over drive.

Take one straight away if you keep track of your cycle and know that your period is at least a week late. If youre already ovulating then it cant do that. 95 effective when treatment is taken within 24 hours of unprotected sex.

The two pills are identical. A 2019 review suggests that those who use morning-after pills as a. Keep in mind that if youve already ovulated Plan B wont be effective so while Plan B is recommended for use within 72 hours of having unprotected sex you should take it the sooner the.

It is possible to take Plan B up to 5 days after having sex but it becomes less effective the longer a person waits. The sooner you take it the better it works Plan B helps prevent pregnancy before it starts by temporarily delaying ovulation when taken within 72 hours 3 days after unprotected sex. While you should take Plan B as soon as possible within 72 hours of having sex without a condom or other barrier method you can take Ella as soon as possible within 120 hours 5 days.

Even if that wasnt the case Plan B works by delaying your ovulation until the sperm leaves your body. Can taking Plan B cause your period to be more than a week late. Its Ella that can be effective up to 5 days120 hours later.

Wondering whether youre within the window to take Plan B. It proves effective when taken within 72 hours of having unprotected sex. It does not matter which pill you take first.

In order for any emergency contraceptive to have the most chance of effectiveness then it should certainly be taken as soon as possible after unprotected sex and it is recommended that 72 hours is the amount of time you have for optimal pregnancy prevention.

Monday, April 20, 2020

Used To Treat Snake Bites

Are you looking for never-ending fun in this exciting logic-brain app. Do not apply a tourniquet cut the wound or attempt to suck the venom poison out.

Medicinal Plants Used For The Treatment Of Jaundice And Snakebite By Download Table

I just opened the Google Play Link of this game and found that until now April 2019 this game has more than 10000000 installations.

Used to treat snake bites. We are pleased to help you find the word you searched for. Anti snake venom is used to treat snake bite poisoning. Each world has more than 20 groups with 5 puzzles each.

Used To Treat Snake Bites Seasons CodyCross Answers CodyCross Crossword Puzzles is first released in March 2017. If you cant use a pressure immobilisation bandage because the bite is on the trunk or stomach apply constant firm pressure. It has many crosswords divided into different worlds and groups.

CodyCross Used to treat snake bites Answers. CodyCross is a famous newly released game which is developed by Fanatee. Some of the worlds are.

Symptoms like symbol of teeth on siteskin started decolorationshortness of breath Paracetamol tramadol atropine injection is. When snake bites some symptoms are seen. Apply a pressure immobilisation bandage see below.

If your pet requires treatment it usually involves. Find out Used to treat snake bites Answers. It is a type of antivenom.

Each world has more than 20 groups with 5 puzzles each. The treatment of non-venomous snake bites includes local wound care at the site of the bite removing snake teeth if left in the bite site attending to any trauma at the bite site and a tetanus booster if needed. We found 208 species spread across 74 plant families used to treat snakebites in Central America.

From Wikipedia the free encyclopedia Snake antivenom is a medication made up of antibodies used to treat snake bites by venomous snakes. All snake bites require medical attention even if the snake is nonvenomous. The common allergy drug Benadryl can be used to treat rattlesnake bites.

The first targeting black snake venom was developed in 1897. Antivenom is commonly administered but in most cases its recommended to hospitalize your pet for additional support care. Some wounds may become infected and require additional treatment with antibiotics.

CodyCross is an addictive game developed by Fanatee. Check out this topic below if you are seeking to solve another level answers. Here are all the Used to treat snake bites answers.

Piper amalago Cissampelos pareira Aristolochia trilobata Sansevieria hyacinthoides Scoparia dulcis Strychnos panamensis Dorstenia contrajerva Hamelia patens and Simaba cedron. In Colorado it tends to be a first-line treatment as rattlesnake bites are common in our area. However only nine of these species were reported independently in at least three studies.

It reduces snake poison. Experimental tiger snake antivenene followed in 1902. But antivenenes are tricky to produce distribute and store.

In the same year CodyCross won the Best of 2017 Google Play store. Planet Earth Under The Sea Inventions Seasons Circus Transports and Culinary Arts. Planet Earth Under The Sea Inventions Seasons Circus Transports and Culinary Arts.

Some of the worlds are. Proper wound care can help prevent infection and limit how severe the injury becomes. Dont wash the bite area venom left on the skin can help identify the snake.

16 rows Drugs used to treat Venomous Snake Bite The following list of medications are in some. It is a biological product that typically consists of venom neutralizing antibodies derived from a host animal such as a horse or sheep.

How Do They Test For Blood Clots

Blood tests can in some cases be used to rule out a blood clot. A dye is injected into the catheter and will show up on an x-ray.

7 Dvt Early Symptoms Tests Prevention Causes Treatments

To test for Disseminated Intravascular CoagulationD-dimer can also be used to help test for whats called disseminated intravascular coagulation DIC in.

How do they test for blood clots. Because a clot can block blood flow in your leg it may cause a backup of blood. A blood clot that occurs in a vein is called a venous clot. It will effectively signal a blood clot risk though it may not mean that you have a blood clot.

In my opinion any patient who is on Tamoxifen and who is already at a high risk of blood clots see the list of risk factors below should be offered this test. You can get tested for the FVL mutation. In fact 274 people die every day from blood clots according to the National Blood Clot Alliance.

Blood clotting tests Blood count. A full blood count is a routine blood test that can count the number of red cells white cells and. How to Detect a Blood Clot in the Leg.

D-dimers are protein fragments produced as the result of the dissolving of blood clots. Ask your oncologist about it. This test involves insertion of a catheter into one of the large veins in the groin and one into an artery that services the lung.

These types of clots may build up more slowly over time but they can still be life-threatening. It can even lead to a heart attack stroke or death. Ultrasound provides a clear view of your veins and blood flow.

Immobile blood clots are usually harmless but they can become dangerous if they break free. In this test a tiny cut is made in your earlobe or forearm and the time taken for the bleeding to stop. General blood clotting tests.

CT scan of the head abdomen or chest may be used to confirm that you have a blood clot. Treatment with alternate medications needs to be individualized doctors say because these patients dont simply have blood clots they also have lower levels of platelets. Its a simple blood test.

This article is part of Harvard Medical Schools continuing coverage of medicine biomedical research medical education and policy related to the SARS-CoV-2 pandemic and the disease COVID-19. The most serious type of venous clot is. This imaging test can help rule out other potential causes of your symptoms.

According to the American Society of Hematology nearly 900000 Americans develop deep vein. The D-Dimer test is the first step of a thorough check for blood clots. A blood clot can travel to the heart or lungs which is life-threatening.

A blood clot can be a serious medical problem. When blood clots form inside the veins they do not always dissolve on their own. Doctors may use a CT angiography test to check for clots in the head neck chest or abdomen.

Watch your leg for swelling. Patients hospitalized with severe COVID-19 infections who have high levels of the blood clotting protein factor V are at elevated risk for serious injury from blood clots such as deep vein. The test involves the injection of a contrast material into the blood and computer imaging to.

One of the most definitive test to determine presence of a pulmonary embolism is a test called a ventilationperfusion scan otherwise known as VQ. Any lack of proper blood flow due to.

Tobacco And Vapor

Tobacco and vapor shop Cigar hookah CBD and more Guarantee lowest price in town. Tobacco CBD Products Shop Premium Cigars Pipes and Glass Premium mix of Vapor and the latest Mods and Devices.

Mr Tobacco Vapor Vaporizer Store In Raleigh

Some resemble pens USB sticks and other everyday items.

Tobacco and vapor. E-cigarette aerosol generally contains fewer harmful chemicals than the smoke from burned tobacco products. Tobacco andor vapor product registration permanently revoked and you will not be allowed to obtain a new registration to sell tobacco andor vapor products and herbal cigarettes. Full line of smoking and vaping devices and accessories.

Contrary to what anti-vapers posit. CBD Kratom Tobacco Vape Mods Hookah Water. If you do not have a valid tobacco andor vapor product registration.

Should e-cigarettes be classified as tobacco products. Linkshare our site at. Full line of smoking and vaping devices and accessories.

Uniform Tobacco and Vapor Products Transaction Schedule 719 TT-104S Instructions. Moving forward Golden State lawmakers should avoid relying on increasing e-cigarette and vapor taxes to fund programs other than tobacco cessation and education efforts. Using an e-cigarette is commonly referred to as vaping.

Using an e-cigarette is sometimes called vaping E-cigarettes can be used to deliver marijuana and other drugs. Rather than applying sin taxes to products that have aided millions of smokers in quitting combustible cigarettes lawmakers should celebrate the benefits of electronic. In 2014 the Food and Drug Administration FDA in the United States concluded that they are 1 and we regularly receive submissions describing e-cigarettes as tobacco products.

All above violations will be published in the local newspaper. The aerosol is commonly referred to as vapour. Flavored Tobacco products Flavored Cigars Premium Cigars Pipes Vape Mods and E.

If Cigarette Retailer Tobacco Product Retailer and Vapor Product Retailer endorsements are all applied for at the same time and business location the endorsement fees will be 25000. E-cigarettes are batteryoperated and may look like cigarettes cigars pipes pens or memory sticks. E-cigarettes are devices that deliver an aerosol by heating a solution that users breath in.

Most quitline participants who reported vaping also used combustible or smokeless tobacco 97 of public quitline and 83 of commercial quitline e-cigarette users. Daily vapers 30 of the past 30 days were 207 of public and 300 of commercial quitline enrollees who reported vaping. Wisconsin Combined Tobacco and Vapor Products Use Taxes Return 819 Schedule TT-106S Tobacco Products excluding moist snuff cigars and vapor products 819 Schedule TT-107S Moist Snuff 819 Schedule TT-108S Cigars 819 Schedule TT-109S Vapor Products 819 TT-114.

Effective August 1 2020 the vapor products tax rate on closed vaping systems is 150 per cartridge and the rate on open vaping systems is 15 of the actual price at which the distributor sells the product. Mr Tobacco and Vapor Chesapeake Virginia. Most e-cigarettes contain nicotine the.

Cigarette Tobacco and Vapor Learn more about the Liquor and Cannabis Boards response to COVID-19. However e-cigarette aerosol can contain cancer-causing chemicals and tiny particles that reach deep into the lungs. Some e-cigarettes are made to look like regular cigarettes cigars or pipes.

As British health officials have recognized vaping is a highly effective way for people to give up cigarette smoking thereby saving numerous lives. Tobacco Regulatory Science Program TRSP NIHFDA collaboration Preventing and Reducing Teen Tobacco Use HHS Online Guide to Quit Smoking NCI - smokefreegov Results from 2018 National Youth Tobacco Survey show dramatic increase in e-cigarette use. However this judgment is the product of policy developments around the role of the FDA and their ability to provide regulative guidance and.

Taxable items include both nicotine and non-nicotine. Larger devices such as tank systems or mods do not resemble other tobacco products. Tobacco CBD Products Shop Premium Cigars Pipes and Glass Premium mix of Vapor and the latest Mods and Devices.

401 5th Ave Suite 1110. MAXX Tobacco and VAPOR Raleigh North Carolina. 1245 Cedar rd ste H Open Now.

The liquids used in e-cigarettes. Tobacco and Vapor Age of Sale Goes to 21 on 112020 Engrossed House Bill 1074 was signed into law in 2019 raising the minimum sales age of tobacco and vapor products to 21 years of age. The law goes into effect on January 1 2020 and applies to all tobacco and vapor products.

Get email updates when new info is available. Flavored Tobacco products Flavored Cigars Premium Cigars Pipes Vape Mods and E.

What Cancels Out Vitamin D

Increases Bone Strength Builds Bone Density Stimulates Bone Growth. Depending on what supplements you are taking this step may include more than just avoiding taking your vitamin D capsules.

Regulation Of Immune Function By Vitamin D And Its Use In Diseases Of Immunity Endocrinology And Metabolism Clinics

People with darker.

What cancels out vitamin d. And vitamin D deficiency is associated with greater gut problems more autoimmune disease and greater infection 2. Magnesium will cancel calcium. So putting these 3 things in a multivitamin is worthless.

Magnesium is a natural calcium channel blocker. Should be taken at separate times during the day. To give you an example multivitamins often contain vitamin D.

Increases Bone Strength Builds Bone Density Stimulates Bone Growth. For example not having a well-balanced diet or not getting enough sunlight may cause you to have a vitamin D deficiency. Low plasma Vitamin D levels are associated with an increased risk of cancer cardiovascular disease strokes dementia DVT diabetes MS colds flu infection and a greater risk of death from Covid 3.

Vitamin D has a half-life of 15 days. Signaling between cells calcium Hormonal secretion calcium Blood vessel flow calcium Without enough vitamin D or calcium your parathyroid glands compensate by producing too much of their hormone a condition called hyperparathyroidism. Calcifediol is cheap readily available and has minimal side effects making it an ideal therapeutic if it works.

We will only be able to isolate vitamin D as a cause by running properly conducted randomised controlled. Depending on the UV index and your skin type 530 minutes of unprotected sun exposure to the hands face and arms at least three times a week between 11 am. 3 Also some studies suggest that increasing vitamin A can reduce the calcium buildup that can happen with higher levels of vitamin D.

Although egg yolks do contain a nice amount of D we highly caution against eating egg whites as the protein in them called albumin is very hard to break down and causes lymphatic acne in many of us. 1415 Vitamin A can prevent vitamin D toxicity and vice versa. Pereira is currently leading a study at FM-USP to find out whether subjects with sufficient circulating levels of vitamin D combat infection by SARS-CoV-2 better than those with insufficient.

This means that in about two weeks your circulating vitamin D levels should drop dramatically. Small amounts are found in egg yolk and beef liver but your best bet is fish. Selenium is needed when you take iodine but should not be taken at the same time.

Salmon swordfish and mackerel can provide a healthy amount of vitamin D in just one serving. Ascorbic acid will cancel iodine transforms it into iodide. Research shows that taking magnesium with vitamin D is more effective at correcting a vitamin D deficiency than vitamin D supplementation alone.

Even people with a healthy lifestyle may have a deficiency if they other health issues that affect vitamin D production such as kidney disease or vitamin D. Serum 25-hydroxyvitamin D 25OHD level is widely used as a biomarker of a persons vitamin D status for it is the main circulating form of vitamin D and the best estimator of both endogenous vitamin D synthesis in the skin upon exposure to UV-B light and dietary intake of foods and supplements containing vitamin D. Vitamin D toxicity officially referred to by the Mayo Clinic as hypervitaminosis D is rare but can cause a buildup of calcium in your blood hypercalcemia which can cause nausea and.

To maintain healthy blood levels aim to get 1030 minutes of midday sunlight several times per week. Vitamin D can modulate both the Innate and Adaptive immune systems in humans. Vitamin D deficiency is common amongst critically ill patients and there has been ample speculation about a possible role for supplementation with calcifediol in the treatment of patients with COVID19.

To give you an example multivitamins often contain vitamin D. Ad Clinically proven to increase your height naturally. Other fatty fish like tuna and sardines also have some D but in lower amounts.

Stop supplementing with vitamin D. Other good sources of vitamin D are mushrooms in the form of vitamins D2 D3 and D4 fatty fish and eggs in the form of vitamin D3 which is not readily available. Between all of these D-getting tips you should be set up for success in the D-epartment.

And 3 pm should be enough to keep your vitamin D levels out of the deficient range. Regular sun exposure is the most natural way to get enough vitamin D. The same is true.

1 Therefore the diagnosis of vitamin D deficiency is based on the measurement of circulating 25OHD. Levels of the vitamin can also fall as a consequence rather than a cause of illness. Ad Clinically proven to increase your height naturally.

Stop Supplementing With Vitamin D Depending on what supplements you are taking this step may include more than just avoiding taking your vitamin D capsules. That can lead to bone weakening osteoporosis and increased fracture risk. Sunscreen can decrease your bodys ability to produce vitamin D but generally to a small degree.

Avoid as many of the foods known to contain vitamin D as you can.

Sunday, April 19, 2020

Will Tylenol Lower Blood Pressure

Active ingredients in tylenol pm simply sleep do not raise blood pressure and do not interfere with certain blood pressure medications the way nsaids sometimes can. Hypotension was observed 30 minutes 95 CI 15-71 after acetaminophen infusion.

Advil Vs Tylenol Which To Use And When Wsj

High blood pressure is found among people who take Tylenol especially for people who are female 60 old have been taking the drug for 1 month.

Will tylenol lower blood pressure. However the intravenous acetaminophen has a serious side effect. 11 TYLENOL wont compromise blood pressure control or interfere with certain high blood pressure medications the way NSAIDs sometimes can67 Visit the Resource Library to explore patient and practice support resources. TYLENOL DOES NOT INTERFERE WITH CERTAIN BLOOD PRESSURE MEDICATIONS THE WAY.

When the participants took acetaminophen average systolic blood pressure the top number of a blood pressure reading increased from 1224 to 1253 while the average diastolic pressure the bottom number increased from 732 to 754 Circulation Nov. UNLIKE SOME NSAIDS THERE IS NO WARNING ON THE TYLENOL PM OTC DRUG FACTS LABEL TO ASK A DOCTOR BEFORE USE IF YOU HAVE HIGH BLOOD PRESSURE. Amanda Brown November 02 2020 CAN ACETAMINOPHEN AFFECT BLOOD PRESSURE Amanda Brown.

Not if you take it. Previous studies suggest it is quite a sizable drop. TYLENOL CONTAINS ACETAMINOPHEN AND MAY BE APPROPRIATE FOR PATIENTS WHO ARE CONCERNED ABOUT THE EFFECTS THAT NSAIDS CAN HAVE ON BLOOD PRESSURE.

Read More Send thanks to the doctor. Of the trials reporting vasopressor use the. The study is created by eHealthMe based on reports of 134734 people who have side effects when taking Tylenol from the FDA and is updated regularly.

Changes in mean arterial pressure were closely correlated with decreases in the diastolic arterial pressure r 092 and to a lesser extent with changes in the pulse pressure r 018 and heart. Does Tylenol raise blood pressure Health related question in topics Medicine TreatmentWe found some answers as below for this question Does Tylenol raise blood pressureyou can compare them. Tylenol acetaminophen is an analgesic pain reliever and antipyretic fever reducer to relieve fever as well as aches and pains associated with many conditions.

TYLENOL may be an appropriate pain relief option for you if you have high blood pressure. NSAIDs can interfere with the blood pressure-lowering efficacy of diuretics and ACE inhibitors. Tylenol relieves pain in mild arthritis but has no effect on the underlying inflammation redness and swelling of the joint.

When used appropriately side effects with Tylenol are not common. In a short period of a time. The amount of acetaminophen used in the study is a standard daily dose for pain.

However alcohol should be avoided when taking acetaminophen as this can increase the likelihood of liver problems. The makers of Tylenol are advertising that their pain reliever Wont raise blood pressure the way that Advil Aleve or Motrin sometimes can That sounds reassuring but you will notice that the commercial does not say acetaminophen Tylenol wont raise blood pressure at all. However acetaminophen like the anti-inflammatory drugs has been linked to high blood pressure according to the researchers.

Your blood pressure can vary from moment to moment plain tylenol acetaminophen has no effect on your blood pressure but still the different readin. Blood pressure stayed steady when participants took the. A temporary large drop in blood pressure.

Tylenol wont increase your blood pressure and does not interfere with certain high blood pressure medications the way other over-the-counter medications sometimes can 5 Get Physically. 26k views Reviewed 2 years ago. A majority of the 19 studies included in this review identified a statistically significant drop in hemodynamic variables after the administration of 500 to 1000 mg IV acetaminophen as measured by changes in systolic blood pressure diastolic blood pressure or mean arterial pressure.

August 15 2005 748 PM AP Women taking daily amounts of non-aspirin painkillers such as an extra-strength Tylenol are more likely to. In patients with acetaminophen-induced hypotension the nadir mean arterial pressure was 64 mm Hg 95 CI 54-74. When used appropriately Tylenol will tend to have a lesser impact on blood pressure when compared with NSAIDs.