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Chemosynthesis
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Some of you may find the unprecedented rate of mutation data we have been getting this epidemic interesting. Estimated 50 mutations in one month in
one strain. Now remember there is more than one concurrent strain. Considering that many of these mutations are in diagnostic proteins where
antibodies bind for immunofluorescence, we may end up with even more strain on our biotech/pharm sectors as new diagnostic testing may need to be
investigated in the future.
http://www.nature.com/news/ebola-virus-mutating-rapidly-as-i...
While I have no reason to suspect this as inherently likely, it does make questions of transmissibility, therapeutic intervention, vaccination, and
the establishment of reservoirs even more founded. Worst case scenarios: this could be very problematic with co-infections during flu season, which
not only burden the healthcare system, but reduce host immune responses. If there were an established reservoir in your country (assuming you are not
endemic region), you face the medical security risk of continual spillover and the need for continual medical intelligence to avoid diagnostic and/or
therapeutic "escape mutants."
Just as with economics, there is always an unseen effect to our actions. If we avoid a catastrophy, rarely will we be able to see that in hindsight,
and will instead enjoy the benefits in ignorance.
Rosco, in keeping with the "creepiness" factor, I have to wonder how much, under some circumstances, a healthcare education and
intimate knowledge of the disease progression may foster denial in the face of exposure; after all, we are seeing two nurses (one a lab worker) who
knew themselves to be exposed to confirmed Ebola infectious material (BSL-3 allowed for diagnostic testing out of sheer logistical necessity, BSL-4
for confirmed material).
Both traveled. The CDC is questioning details of one's sign/symptoms timeline. The Hot Zone details how in another instance, Mayinga, a nurse who knew
she was infected, tried to flee to Europe and apparently even shared a drinking glass with someone. We can't write off these individual cases as
ignorance.
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S.C. Wack
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It's not unfair at all as the comparison is obviously unrelated to type or origin of disorder. You might as well dismiss heat and darkness after
having bad hot black coffee. We've scrubbed our schools of all traces of peanuts due to this same sort of keeping our kids safe conservatism, instead
of making the peanut-allergic kid eat something else prepared elsewhere; had AIDS happened with today's mentality, all HIV-positives would still be
exiled somewhere. What's next? Might as well exile the homosexual and drug using as well just to be safe, like random people who've been in Nigeria.
[Edited on 18-10-2014 by S.C. Wack]
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Texium
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First, I feel like it's rather necessary to point this out: illegal immigrants are not bringing Ebola into the United States!
I don't know why such a stupid rumor seems to be going around, but it doesn't make any sense. It's unbelievably selfish to not help these people
anyway. Isn't that something that America is supposed to take pride in? Taking care of the poor, tired, huddled masses?
And coming from someone who lives in Texas, nobody is getting sick and nobody is concerned about it other than hysterical hypochondriacs. I'd think it
would be quite obvious if the disease has been spreading since it's been about a week since it came here. We'll just have to wait and see if any more
cases appear in the next couple weeks.
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Rosco Bodine
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It can't be determined or known what exactly illegal aliens (NOT "immigrants") may bring into any country because there is no screening or quarantine
or control for illegal aliens. They are a security breach and threat by their very nature and their crime does not provide any testimony as to their
good intentions or depth of respect for the security of themselves or anyone else, but is an ultimate expression of desperation and/or narcissism that
minimizes any consideration for the safety and concerns of others. That fact alone makes illegal aliens dangerous and the statistics confirm that is
true.
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Chemosynthesis
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Quote: Originally posted by zts16  | | And coming from someone who lives in Texas, nobody is getting sick and nobody is concerned about it other than hysterical hypochondriacs. I'd think it
would be quite obvious if the disease has been spreading since it's been about a week since it came here. We'll just have to wait and see if any more
cases appear in the next couple weeks. |
I think there is a definite need to distinguish between concern and fear.
Plenty of people in the medical/epidemic intelligence and scientific community are concerned about Ebola spreading, as the current multiple confirmed
outbreaks have yet to die down globally. Concern, not necessarily fear, is absolutely warranted. No one I know is afraid, though I am sure many people
out there are.
From the Nature news link I posted above.
"[…]Goba's team confirmed that Ebola was probably imported to Sierra Leone by 12 people who attended the funeral in Guinea, and that the West
African outbreak originated in a single event in which the virus passed from an animal into a person." Several study authors died of Ebola. It's
uncertain how they contracted it, or where.
Additional source: http://www.scientificamerican.com/article/patient-zero-belie...
The evidence points towards this epidemic being strongly person-to-person transmitted, rather than animal-to-person. The downside to this is that it
necessitates quarantine of and possible isolation from people, rather than an emphasis on isolation from animals.
As I have said before, what happens in Africa doesn't necessarily have epidemiological bearing in Europe of the U.S. due to demographics, but there
are so many unknowns and possibilities that to dispell all concern is as unreasonable as buying special Ebola life insurance. One index case can cause
a West African epidemic. There is no reason to believe any U.S. or European genetic resistance to this, but medical resources are far superior and
demographics are different. If you overwhelm medical resources, which are by and large not particularly capable of implementing widespread BLS-4
protocols for patients with associated labs, that can be a problem.
Training in the appropriate use of BSL-4 gear is time consuming, it is uncomfortable, it is laborious to use. People working in BSL-4 environments
have less autonomy than those in other levels because people often need help suiting up, sterilizing, spotting contaminants, etc. Suits are too
insulating for comfort. They are bulky and loud, which makes movement and communication an issue for colleagues. It is extremely expensive to set up
and operate these protocols. You run into ethical problems with people refusing to want to work in these conditions.
Hospital space is often at a premium, and trying to set up a new ICU, appropriate secondary diagnostic laboratories, and staff everything is very,
very difficult.
What happens if your hospital shutdown due to contamination like the one in Houston? Where do your sick go? This becomes a logistical issue that no
one prepared for. Hospital overflow wards have to be prepared in advance, and may be forced to make use of local school buildings or nearby facilities
in the case of "normal" emergencies at community hospitals. I remember swine flu pandemic discussions about sticking patients in nursing homes, old
schools or college dorms, and asking about local school health services' availabilities in the event of school closures.
http://www.nytimes.com/1990/01/07/nyregion/patient-overflow-...
http://www.mcknights.com/snfs-may-not-be-able-to-take-on-hos...
Additionally, for any horror authors among us, imagine the ecological implications of bats/rodents becoming a reservoir in the U.S. leading to
recurrent endemic spillovers. Elimination of a wild animal species rather than isolated lab animals would be a disaster, if even remotely possible.
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Rosco Bodine
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| Quote: Originally posted by Chemosynthesis |
Rosco, in keeping with the "creepiness" factor, I have to wonder how much, under some circumstances, a healthcare education and
intimate knowledge of the disease progression may foster denial in the face of exposure; after all, we are seeing two nurses (one a lab worker) who
knew themselves to be exposed to confirmed Ebola infectious material (BSL-3 allowed for diagnostic testing out of sheer logistical necessity, BSL-4
for confirmed material).
Both traveled. The CDC is questioning details of one's sign/symptoms timeline. The Hot Zone details how in another instance, Mayinga, a nurse who knew
she was infected, tried to flee to Europe and apparently even shared a drinking glass with someone. We can't write off these individual cases as
ignorance. |
There is probably a branch of psychology that could be dedicated to stress induced neurosis / denial type of behaviors involving ebola and other
things.
Reading the link about Typhoid Mary you get the picture she had to know she was a carrier but kept about her "business" like it was some kind of an
identity crisis she could internalize as others dropped dead everywhere she went. That behavior could identify a syndrome. And there are other
aspects of an associated stress induced neurosis where there could be a lot of that craziness and denial going around, so much of it that even a
president could be affected.
Anyway, what I observed about the economic impact of people being "creeped out" about ebola is absolutely true.
The ebola infected nurse travelled using a particular airline and now that airline company has a big problem with selling tickets to other passengers.
For some strange reason prospective passengers are not just lined up and chomping at the bit to buy seats on any of that airlines flights.
Mysteriously it seems "business is dead" suddenly for some odd reason. Yeah ....go figure.
[Edited on 18-10-2014 by Rosco Bodine]
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Amos
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That your argument on how dangerous Ebola is was in part based on false claims and you need to make a better one. The only real similarity it shares
with HIV is that they are both viruses.
Oh, and illegal immigrants bringing bad stuff over wouldn't be a problem if we legalized all immigration provided anyone coming over undergoes a
background check, search, and medical checkup.
[Edited on 10-18-2014 by No Tears Only Dreams Now]
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Chemosynthesis
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Here, members of the UK government equate thd current outbreaks of Ebola with nuclear weapons.
http://www.independent.co.uk/life-style/health-and-families/...
It will be interesting to try and find out how accurate these epidemiological projections are in hindsight. They were predicated on initial massive
underreporting. It also requires the quarantine of 70% of Ebola patients and cultural changes in African burial practices in all projections.
http://www.cdc.gov/mmwr/preview/mmwrhtml/su6303a1.htm?mobile...
| Quote: | Oh, and illegal immigrants bringing bad stuff over wouldn't be a problem if we legalized all immigration provided anyone coming over undergoes a
background check, search, and medical checkup.
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Completely untenable. Thorough background checks are prohibitively expensive, and get complicated when dealing with multinationals or foreign
citizens. Adequate medical evaluations can also be costly (one aspect of the recent healthcare insurance reform attempts), and are predicated on
getting an accurate personal history from a patient.
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Texium
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| Quote: Originally posted by Chemosynthesis | | Quote: Originally posted by zts16 | | And coming from someone who lives in Texas, nobody is getting sick and nobody is concerned about it other than hysterical hypochondriacs. I'd think it
would be quite obvious if the disease has been spreading since it's been about a week since it came here. We'll just have to wait and see if any more
cases appear in the next couple weeks. |
I think there is a definite need to distinguish between concern and fear.
Plenty of people in the medical/epidemic intelligence and scientific community are concerned about Ebola spreading, as the current multiple confirmed
outbreaks have yet to die down globally. Concern, not necessarily fear, is absolutely warranted. No one I know is afraid, though I am sure many people
out there are. |
Yes, that's very true, thank you for correcting me. "Afraid" would fit much better in my
statement than "concerned."
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franklyn
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@ No Tears Only Dreams Now
I do not understand you conflating ebola with Aids. The epidemiology is different. I'm still asking myself , what are you saying , which claims you
attribute are false.
That Aids may resemble cancer in the time it takes to kill doesn't diminish it's threat , cancer is not communicable. Ebola is virulently contagious ,
akin to Yersinia Pestis.
As for the transmission by organic matter , you should ask of medical personnel what is Red Bag waste and why does it display a biohazard warning.
http://www.avert.org/hiv-blood-safety.htm
http://www.aids.gov/hiv-aids-basics/prevention/reduce-your-r...
I highlighted the dismissive general public attitude at the inception of the Aids epidemic as a major contributor
to it's dissemination.
http://en.wikipedia.org/wiki/And_the_Band_Played_On
It is precisely what you and zts16 engenders now regarding ebola. Communication of infection with ebola no matter how low the
occurrence , is dangerous to those infected , and is a constant source for continued spreading. What number of preventable deaths are acceptable ,
before you consider it enough risk to do the sensible thing without regard to offending people. Assuming chronic presence of the disease in the
population could be controlled.
Ellis Island the gateway for the tired and poor huddled masses , quarantined people until such time they were not deemed a source of communicable
disease.
In Panama the Darién Gap of the Pan American Highway intentionally physically separates North America from South America to prevent the transmission
of livestock diseases.
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Amos
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franklyn, the claims you made that are either factually incorrect or logically unsound:
That HIV can be transmitted from somebody cutting themselves on the same surface days, weeks, months, etc. after an HIV positive person's blood
encountered that surface.
That HIV and Ebola are even remotely similar in their transmission, presentation, or contagiousness.
That monkeys are the natural host of Ebola. Monkeys may become infected from time to time, but the most-supported hypothesis is that the reservoir is
the bat.
If you want to hear the argument as to why those things were incorrect or unwise to say, read back through the first two long-winded posts I made on
the subject. If you are unable to glean the meaning from those words, then there is nothing more I can do.
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franklyn
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@ No Tears Only Dreams Now
These attributions you make to me exists in your mind alone.
As we note , you do not show direct quote of this.
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Chemosynthesis
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To be even more specific on my immigration backvround check point, USCIS has been continually or continuously backlogged for at least 8 years, and I
doubt state DOJ is any better. Keep in mind this is for legal immigrants only. Even with overlap, when you look at illegal immigrants this will
necessitate more personnel. Hiring qualified personnel for sensitive investigative positions, getting them computers, bandwidth, salaries, desks,
parking space... all expensive.
| Quote: Originally posted by zts16 | | Yes, that's very true, thank you for correcting me. "Afraid" would fit much better in my statement than "concerned." |
No problem. It will be really interesting to see how public opinion varies throughout the country.
Apparently Texas has had more Ebola training for nurses than most regions, but 73% of nurses report not having been offered any training, and many
lack appropriate BSL gear (assuming level B is counted with level A hazmat for the story). Training is time away from treating patients. Given how
many medical staff members get respiratory infections during flu season despite innoculations (can't vaccinate every flu strain, but you can run into
them at a hospital), epidemiological estimates could change rapidly. Transmissions may increase and co-morbid fatalities would be expected to.
http://qz.com/282247/american-nurses-lack-the-most-important...
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Amos
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Here's an edited version, with quotes from you to back it up. franklyn, the claims you made that are either factually incorrect or logically unsound:
| Quote: | | That's exactly how the AIDS pandemic got started. I remember in 1984 when it was casually mentioned nothing to worry it's a gay disease ( contagion
was largely due to their outrageously promiscuous conduct ). No one had yet thought about blood transfusion. I recall one time I was racing down a
flight of stairs hand on the banister and felt a tug on my hand , moments after I felt it was wet , and saw I was bleeding. How many before me could
have cut themselves there in the same way. No need to be stuck with a needle of an intravenous drug user for someone to be at risk if contagion is
present in the environment. |
-That HIV can be transmitted from somebody cutting themselves on the same surface days, weeks, months, etc. after an HIV positive person's blood
encountered that surface. There is no way for the HIV contagion to be "present in the environment" unless there was blood spilled from an HIV positive
person mere minutes ago.
-That HIV and Ebola are even remotely similar in their transmission, presentation, or contagiousness. Unless you were simply typing words for the sake
of typing them, I believe you were trying to compare our understanding and our tactics with regards to Ebola to those of HIV in the 1980s. As I said
earlier, an Ebola patient is usually very noticeably sick, which makes it harder for them to infect others, and they are sick for a much shorter time,
giving them less of a chance to infect others. Therefore it is much more easily identifiable as well as less contagious than HIV is.
| Quote: | | It's natural host is monkeys. People in the afflicted countries eat monkeys. |
-That monkeys are the natural host of Ebola. Monkeys may become infected from time to time, but the most-supported hypothesis is that the reservoir is
the bat.
If you want to hear the argument as to why those things were incorrect or unwise to say, read back through the first two long-winded posts I made on
the subject that were directed to you. If you are unable to glean the meaning from those words, then there is nothing more I can do.
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franklyn
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No Tears Only Dreams Now
I understand now , you're delusional.
If someone can delineate the connection from my written word
to what - No Tears Only Dreams Now - says that it states ,
let them declare now or forever hold their tongue.
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Chemosynthesis
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| Quote: Originally posted by No Tears Only Dreams Now | | As I said earlier, an Ebola patient is usually very noticeably sick, which makes it harder for them to infect others, and they are sick for a much
shorter time, giving them less of a chance to infect others. Therefore it is much more easily identifiable as well as less contagious than HIV is.
|
I agree there should be no conparison the two from a disease standpoint, which is not what I think Franklyn
meant; I believe he was using the example of a hidden reservoir (transfusions/organ donors) to compare with Ebola in an environment. That is to say
the sharp handrail is a potential Ebola fomite, not an HIV one.
All said, in terms of semantics, I would be leery using "contagious" in this context. What little we do know about Ebola makes it BSL-4 rather than
BSL-2 for a reason.
The reproductive rate of infectivity, or basic reproduction number/R nought does seem lower for the reported values of the current outbreaks (than
HIV)... but it is important to bear in mind that vectors and routes of transmission can confound these measures. Also, note that the CDC feels the
Ebola outbreaks are being underreported by a multiplier of 2.5x, which can't be taken into account yet. Demographics are also very different, so
comparison is difficult. As I said initially, there are really too many unknowns at this point to compare the two accurately, and I believe this
carries over to R nought as well. I think your initial wording about the two not being comparable was safer.
Just in case anyone wants to try to compare for argument's sake, it is known that Ebola has more vectors than witnessed for HIV, each of which is more
likely to zoonotically transmit Ebola than an animal would HIV. The fact that we do not know every vector is another problem in stating HIV as being
categorically more contagious. The virulence of Ebola, however, is indisputably dramatically higher than HIV, and is far more difficult to treat. HIV
has demonstrably useful prophylactic interventions being tested, as well as in place for accidental exposure. This virulence, and the relatively short
latency period relative to HIV, makes treatment much more difficult. I have known people to get exposed to HIV from research use lab blood samples
that were old enough not to have been tested for it, but were not infected. They received immediate gamma globulin and interferon alpha just in case,
with treatment and monitoring throughout a 2-week period before initial testing, repeat testing continued for some time afterwards I wasn't privy to.
They were declared HIV free, though this may have been a dry injection.
http://www.hivandhepatitis.com/recent/2011/0111_2011_c.html Zinc acetate/
antiviral prophylaxis in stage 2b and preclinical primate trials. Not shown: additional promising data in non-primate mammals. MIV-150 appears to
generally require 3 specific mutations for HIV resistance to treatment (PMC3094984). We don't have a single Ebola treatment with that kind of promise.
Until Glaxo finishes phase 2 trials due late this year on its experimental vaccine, we won't have any efficacy days for a prophylaxis to compare with
the MIV/ZnAc or other HIV experimental treatments from CAPRISA trials. Now, with a viable vaccine, epidemiology will change, but handling protocols
will not.
Viral titers in various fluids are also different. Ebola has been detected in tears, sweat, mucous, saliva, etc. in a much more alarming concentration
than HIV and is considered transmissible by contact with any of these fluids in addition to semen and blood. It would be informative if we had
transmissibility data for each, though I can only think of one way to get such data....
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macckone
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R0 is below 1 in the US. At least based on the
information we have. Since it is below 1 there is unlikely
to be sustained transmission. If it becomes airborne that
could change but until it does there is no need to
stop all of the direct flights from west Africa.
Especially since there are no such flights.
The below 1 figure is based on 4 patients infected in africa
And 2 US transmissions to date.
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Little_Ghost_again
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on the plus side inside 3 years 75% of the world population will be gone, good news for the rain Forrest and global warming.
Mass outbreak in USA inside 6 months, France inside 3 months Uk inside 9 months.
China 15 months but with devastating effect same as japan. My source undisclosed but from official papers seen with my very own eyes.
BTW vaccines are being tested and produced via tobacco plants and CHICKEN EMBRYOS.
Little hope of a vaccine inside 2 years, The drugs that worked were actually blood plasma from a nun and now thats all gone
[Edited on 19-10-2014 by Little_Ghost_again]
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Rosco Bodine
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| Quote: Originally posted by macckone | R0 is below 1 in the US. At least based on the
information we have. Since it is below 1 there is unlikely
to be sustained transmission. If it becomes airborne that
could change but until it does there is no need to
stop all of the direct flights from west Africa.
Especially since there are no such flights.
The below 1 figure is based on 4 patients infected in africa
And 2 US transmissions to date. |
Just for the sake of argument let's examine a worst case scenario for an R naught of 0.9 for an infection having a Mortality also of 0.9 affecting a
population of 320 million people like in the U.S. ........that means that if there was no intervention and the epidemic simply ran its course 260
million people will die and 60 million will survive.
Does anyone feel reassured about that arithemetic?
That doesn't take into account the collateral death and destruction from such a catastrophe, nor does it account for the real possibility that the R
naught could be much higher as infrastructure collapses.
The point is that an epidemic with an R naught even well below 1 is still capable of being a world ender for life as we know it.
[Edited on 19-10-2014 by Rosco Bodine]
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Amos
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Are the people quoting the mortality rate as 90%(especially as a potential mortality rate in the developed world) just trying to be as biased as
possible in their research? The total number of cases tends to level out at 50-70% mortality, and virtually every single one of those happened in
rural parts of Africa with little or no treatment. In a week or two, the mortality rate within the United States is likely going to be 33.3% or
less(if others get it and survive with treatment) once those two nurses have recovered. I'm not saying that Ebola isn't threatening and scary, but
come on, 90%? That's BS and you know it.
[Edited on 10-19-2014 by No Tears Only Dreams Now]
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Rosco Bodine
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You have no way of knowing the actual numbers and neither do I, and I prefaced my use of 0.9 by saying it was just for the sake of argument to try to
make a valid point that would not surprisingly be lost on you.
It isn't me that is counting their chickens before they are hatched, it is idiots in administrative positions who lack depth and who are simply lying
about the potential dangers of their incompetent management decisions which have potentially fatal consequences for others who do not consent to such
reckless decisions being made for them.
The CDC puts out propaganda on television that doesn't even square with their own data published on their own website for years before this medical
issue and public health issue became politicized. All the current administration has done is lie about one scandalous thing after another and people
are sick and tired of hearing the damn lies. The political hack now appointed as the ebola czar has no medical credentials and was formerly
associated with another scandal that was Solyndra. The great vision of Obama care now seems to be an agenda of retasking the health care facilities of
the U.S. into becoming the world's ebola treatment clinic.
If liberal progressives want people from abroad to be allowed entry into "their realm" who are potential disease carriers, then quarantine the
diseased all together on their own isolated private estates where they can wallow in their altrusitic diversity and cultural sensitivity while hoping
everything goes okay. But keep it out of community hospitals and schools where my own family may be exposed to danger when that is simply not
necessary or prudent and defies common sense.
[Edited on 19-10-2014 by Rosco Bodine]
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Little_Ghost_again
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90% death rate is pretty close to the truth, not all deaths have been tested. But ALL official studies in lab settings confirm this is a sub strain
Zaire and 90% is about right plus or minus 2%.
Its one reason tabbaco is now being used for vaccine production, normal fast route is egg embryo done under ethical scrutiny, the problem with Ebola
is its so deadly that most embryo techniques are failing, hence why the much much slower tabbaco route has had to be taken.
I would love to prove all this but I would of thought it obvious why I cant post pics of the letters or emails.
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Amos
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| Quote: Originally posted by Little_Ghost_again | 90% death rate is pretty close to the truth, not all deaths have been tested. But ALL official studies in lab settings confirm this is a sub strain
Zaire and 90% is about right plus or minus 2%.
Its one reason tabbaco is now being used for vaccine production, normal fast route is egg embryo done under ethical scrutiny, the problem with Ebola
is its so deadly that most embryo techniques are failing, hence why the much much slower tabbaco route has had to be taken.
I would love to prove all this but I would of thought it obvious why I cant post pics of the letters or emails. |
Where'd your numbers come from?
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Little_Ghost_again
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| Quote: Originally posted by No Tears Only Dreams Now | | Quote: Originally posted by Little_Ghost_again | 90% death rate is pretty close to the truth, not all deaths have been tested. But ALL official studies in lab settings confirm this is a sub strain
Zaire and 90% is about right plus or minus 2%.
Its one reason tabbaco is now being used for vaccine production, normal fast route is egg embryo done under ethical scrutiny, the problem with Ebola
is its so deadly that most embryo techniques are failing, hence why the much much slower tabbaco route has had to be taken.
I would love to prove all this but I would of thought it obvious why I cant post pics of the letters or emails. |
Where'd your numbers come from? |
I wrote loads but edited it all out, really sorry but I felt I had too
[Edited on 19-10-2014 by Little_Ghost_again]
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Chemosynthesis
International Hazard
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Registered: 26-9-2013
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It will hopefully stay that
way, but the CDC is still tracking down exposed individuals, and Ebola is demonstrably mutating. Also, one could distinguish between people brought to
the U.S. in secure transit against the cases diagnosed here. Some sketchy news reports of Nina Pham's boyfriend and possibly an employee of his being
quarantined are coming in. I think the biggest deal is the mutation factor. There are more than one current strain out mutating at random, and even if
the current one on U.S. soil is contained very well, the threat is still out there. Even if with no change, if by some change our BSL-4 ward capacity
were overwhelmed, which is a very real threat, we can expect transmission to increase. This is a valid assessment, and is why the CDC is interested in
designating a state Ebola hospital that will be mandated to figure out a way to handle more patients.
Lab work would be a little easier since technically you can handle unconfirmed Ebola samples in BSL-3 protocol, but that is only because it is a
logistical necessity.
I doubt this is going to be a big deal, but it turns out Dr. Sacra doesn't know how or when he was infected as he didn't handle Ebola patients or
suspected cases. He knew he was working in a hot zone area, so he would probably have been on the lookout. Just goes to show it may not always be so
easy to spot Ebola cases and avoid them.
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