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Migraines, Anxiety and Antiphospholipid Syndrome: on the Chronic Headache & Migraine Summit

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The autoimmune condition called Antiphospholipid Syndrome (APS) is one of many possible contributing factors for both migraines and anxiety. I came across this condition when researching the links between migraine and anxiety in preparation for my interview with Erin Knight, one of the hosts of The Chronic Headache & Migraine Summit, starting July 10. This is one of the reasons I love presenting because I get to learn so much too!

Antiphospholipid syndrome occurs when your immune system attacks some of the normal proteins in your blood. It can cause blood clots in your arteries or veins. And it can cause pregnancy complications, such as miscarriage and stillbirth. (Source: Mayo Clinic)

I share some highlights from a 2015 paper: Antiphospholipid antibodies as biomarkers in psychiatry)

  • Antiphospholipid syndrome (APS) has been implicated in a range of neuropsychiatric presentations
  • The link between depression, stroke, and cardiovascular disease could be explained in at least some patients by the presence of aPL antibodies
  • Approximately one in five (20%) strokes in individuals under the age of 45 years are associated with APS
  • Migraine is one of the most commonly observed symptoms in patients with APS
  • aPL antibodies are often found to show low or moderately positive levels which makes this syndrome a diagnostic dilemma in psychiatry. The St. Thomas ‘alternative criteria’ for APS may be a useful clinical tool for psychiatrists. These criteria include cognitive impairment, affective disorders [like depression and anxiety], headaches [or migraines], and livedo reticularis, with improvement after aspirin treatment

In case you are not familiar with livedo reticularis, it is a mottled purplish discoloration of the skin. Having this skin condition does not mean you have APS because livedo reticularis can be a normal condition that is simply more obvious when you are exposed to the cold. It can also be an indicator of impaired circulation.

Phospholipids are a class of lipids that are a major component of all cell membranes and also facilitate neurotransmitters communication so this condition affects serotonin, dopamine, glutamate and GABA levels.

Working with my client’s doctor, I would recommend an autoimmune dietary approach and trials of the respective amino acids to support low serotonin, low GABA and low dopamine.

My interview also addresses the prevalence of anxiety with migraine sufferers.

We also cover how effective gluten removal can be for certain individuals. We always start with gluten removal for my clients with anxiety and migraines and find it to be a common underlying factor (whether it’s celiac disease or gluten sensitivity). Since gluten is always an important factor for autoimmunity it should always be explored if APS has been diagnosed or is suspected.  

We also cover low serotonin as one possible cause of migraines and the how to do a trail of tryptophan (instead of SSRIs). Erin shares her frightening SSRI experience too.  Using tryptophan also addresses the low serotonin that often occurs with APS and is one possible contributing cause of the anxiety, depression, insomnia and migraines.

The Chronic Headache & Migraine Summit will be online from July 10-17, 2017

Hosts of The Chronic Headache & Migraine Summit, Erin Knight, Corey Schuler and Marta Taylor, are familiar with headache pain and migraines; they’ve all experienced severe headache problems. They found functional medicine solutions, which they now share in their health practices each day. Discover in one week what they’ve spent years learning!

You can register for the summit here

Depression as a black dog that comes in and lays down beside you at night

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Trevor King’s interview about his journey with depression – on That Vitamin Summit – is not to be missed if you are depressed, have ever suffered with depression or if you have a loved one or friend with depression. He shares how he feels a sense of complete hopelessness at times:

It descends like a black cloud that makes me almost sort of retreat into myself. And my eyes will know and I don’t want to take the world in. I don’t want to get out of bed at times. Actually, that’s one of the things that … one of the only things that actually helps me, is going to bed and lying down.

Winston Churchill famously described it as this black dog who’d come in and lay beside him at night.

“From the moment my eyes opened in the morning, I am engaged in a battle. I must protect myself with armor against ongoing, negative, intrusive thoughts that flood into my brain, while sending my prefrontal cortex, which is the home of logical thought, the green light to make decisions and take charge of my brain’s limbic system. That is, before the fear center completely spazzes out. I spend more time and energy chasing and maintaining good health than I do in any other aspect of my life. My marriage, family or work. Because I know that everything meaningful and good around me depends on a stable base. And I hope and pray that one day, I don’t have to fight so hard for my sanity.”

He talks about how he is affected by sugar and low blood sugar, and how he’s found some benefits with niacin, chromium, magnesium and tryptophan (when he’s consistent with taking them!).

Trevor actually talks about the GABA interview I did with him a few days earlier and how he’s very interested in what he learned. He is planning to do a trial of GABA to see if it can help him further.

Here is a snippet from my interview on GABA (so do tune in to this interview if you’re new to my work and the targeted amino acids):

GABA is really quite profound. When I had my anxiety, GABA was my lifesaver. It completely turned my life around. Within three days of using GABA, the panic attacks stopped and the anxiety started to go down, and then I had to look for all the other root causes. It worked immediately so I’m a complete believer, just because I’ve experienced it myself. You’ll hear a lot of people say GABA won’t work. It doesn’t cross the blood/brain barrier so it’s not going to have an impact.

We’ve now got research showing that there may be ways that it crosses the blood/brain barrier. We’ve also got research showing that we have GABA receptors in various parts of our body. We’ve got a lot in our muscles, and with low GABA symptoms you’ll have physical tension.

The beautiful thing is it works. It works quickly, and if you have these low GABA symptoms, which is the physical anxiety, which could be panic attacks. It could be stress eating, it could be drinking to calm down. If you are the kind of person who needs wine to wind down at the end of the day, that’s a big sign that you may need GABA. You take the GABA and you just feel this physical tension release from you, you know you’re onto something good.

I just wish I’d known about his struggles with depression at the time of our interview – I would have talked more about tyrosine for dopamine support (for curl up in bed depression) and DPA for endorphin boosting (for low endorphins weepy depression). 

I did discuss gluten and would consider this especially since his daughter has issues with it. I talked about low serotonin and mentioned Lidtke tryptophan.  If someone doesn’t do well on another brand I’d have them trial the Lidtke brand.  I’d also look into SIBO – I have SIBO and rice and grains make me feel flat and low and I see this often with clients.  Finally I’d look into lithium orotate for keeping an even mood. 

Trevor shares these wise words at the end of his interview:

You do find that when you actually bite the bullet and share it with people,

people are very, very understanding. And actually, you’re amazed that many people have been there themselves.

I could not agree more which is why I’ve always shared my journey with anxiety. I appreciate him for being willing to share his story with depression!

If you’re not already registered here is the registration link for That Vitamin Summit

Feel free to post questions or feedback below – and share your story with anxiety or depression if you feel drawn to do so

GABA, toxins, hormones, autoimmunity – encore of The Diabetes Summit

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Brain Mowll is host of the 4th season of the Diabetes Summit and here are all the speakers and topics in the encore replay line-up (including yours truly).

TRUDY SCOTT, CN: Understanding Anxiety: The Connection to Diabetes

  • Learn about the link between diabetes, anxiety, and depression
  • Understanding the root imbalances underlying anxiety
  • Natural solutions and supplemental support for anxiety 

We may need to look at low serotonin as well because we’ve got two kinds of anxiety when it comes to neurotransmitters, the low GABA, which is the physical anxiety, and the low serotonin, which is more the ruminating thoughts, the worry in the head, the reprocessing, the negative self-talk. So we often have low GABA, and we often have low serotonin as well. And both of those have a corresponding amino acid that helps to raise it. With low GABA we use GABA. With low serotonin we use tryptophan or 5-HTP. And we’re going talk about that one in a second. But the interesting thing is I was really excited to see that there’s some really new research on how GABA has some pretty promising benefits in terms of diabetes support as well.

Read some additional snippets from my interview: Diabetes, anxiety and GABA

 

RAZI BERRY: Using Naturopathic Principles to Prevent Diabetes

  • Learning from Razi’s health experience and journey
  • How toxins in our environment can disrupt metabolism
  • Natural solutions to improve blood sugar and overall health

Read some snippets from her interview here: Anxiety, phenibut, toxins and cold showers for detoxification

 

ANNA CABECA, DO: Creating Hormone Balance to Optimize Metabolic Health

  • The keys to balancing hormones to burn fat and control sugar
  • Understanding the connection between menopause and metabolism
  • How to optimize hormone levels

Dr Cabeca shares this about the ketogenic diet (for women), going keto-crazy and being like a witch when eating too low-carb:

…if you’re working on a ketogenic diet and lifestyle, check to see your urine. And you’re most likely acidic. But now, get that pH up into an alkaline range, and you’ll see your neurotransmitters will balance. You’ll feel calmer. You’ll sleep better. You’ll start to melt fat away which is huge. And that made all the difference in the world, combing those two.

Read some additional snippets from her interview: Menopause: insulin, cortisol, and oxytocin (an interview with Dr. Anna Cabeca)

 

TOM O’BRYAN: Autoimmune Disease and the Connection To Diabetes

  • Understanding what drives autoimmune disease
  • Exploring various toxins that inundate our lives
  • How to balance the immune response to allow proper healing

 

SAYER JI: What the Evidence Reveals About Reversing Diabetes

  • What the peer reviewed, medical literature shows
  • The best natural strategies to reverse diabetes
  • The role of supplements and helpful nutrients

 

BJ HARDICK: Sugar, Detox, and The Brain: Natural Strategies For Healing

  • Understanding damaging foods and how to remove them
  • How to properly structure a detoxification program
  • Type 3 diabetes and how dysglycemia effects the brain

 

SACHIN PATEL: A New Model for Medicine, Diabetes, and Blood Sugar Health

  • Re-evaluating the healthcare model and redefining our roles
  • How to be empowered to control your health as a patient
  • A new model for caring for the body and optimizing health

This aspect of why we eat is seldom addressed and it’s profound:

When you are living a life that is on purpose – that requires you to be eating healthy because you’re going to do whatever it takes to eliminate things that are going to impact that purpose.

I also love the analogy of the right fuel in the car but driving in the wrong direction (like hating your job or not having a purpose):

When you are living a life that is on purpose – that requires you to be eating healthy because you’re going to do whatever it takes to eliminate things that are going to impact that purpose

 

NIKI GRATRIX: The Mind-Body Connection to Metabolic Health

  • How to tap into your internal abundance of energy
  • Understand ACE (adverse childhood events) score and how childhood events impact health
  • Natural techniques and strategies to let go of limits

 

PETER OSBORNE: The Autoimmune Connection to Blood Sugar and Diabetes

  • The connection between autoimmune and blood sugar
  • How to test and treat autoimmune disease effectively
  • Natural solutions to reduce inflammation and heal the body

 

MICHAEL MURRAY, ND: The Four Types of Blood Sugar Problems in Diabetes

  • Understanding a natural medicine approach to diabetes
  • Dr. Murray’s four types of blood sugar problems
  • Natural strategies to address the specific blood sugar issues

 

JOEL KAHN, MD: A Plant-Based Approach to Heart Health and Blood Sugar Health 

  • Sorting through the confusion about dietary strategies
  • Understanding the importance of plant-based foods
  • Key nutrients and supplements for heart health

I’d like to add that while I respect Dr. Kahn’s cardiology diet expertise, I am an advocate of quality animal protein and have found that many people with anxiety and depression typically don’t do very well on a vegan diet. His discussion was professional and very respectful and I do wholeheartedly agree with this:

I think whether grass fed beef, free range, omega 3 rich eggs are healthy or not, and that’s probably not possible to solve that question completely, the data’s here, there, or frankly there’s not enough data, just always add these organic brightly colored fruits and vegetables to whatever you’re eating

He also acknowledged Dr. Hyman’s coining of the term, the Pegan diet, which combines the best of a Paleo and vegan diet saying

It’s a useful term. It’s another way to say eat a very clean, very vegetable rich diet with a little wiggle room [i.e. the addition of quality animal protein]

We really do need a study comparing a real foods diet with feedlot meat and farmed fish – with a real foods diet with grass-fed meat and wild fish!

Here is the link to register for the Diabetes Summit if this is the first you’re hearing about it. You can still sign up to listen!

Enjoy these encore day replays!

SMILES diet depression trial: reduced depression and anxiety

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The SMILES trial, A randomised controlled trial of dietary improvement for adults with major depression was recently published BMC Medicine. It is the first randomized controlled trial to test whether dietary improvement can actually treat depression. Yes, we’re using dietary improvement and treat in the same sentence!

The objective was to determine if “structured dietary support, focusing on improving diet quality using a modified Mediterranean diet model” would have an impact on mood. The outcome is very exciting:

‘SMILES’ was a 12-week, parallel-group, single blind, randomised controlled trial of an adjunctive dietary intervention in the treatment of moderate to severe depression. The intervention consisted of seven individual nutritional consulting sessions delivered by a clinical dietician. The control condition comprised a social support protocol to the same visit schedule and length.

The results indicate that dietary improvement may provide an efficacious and accessible treatment strategy for the management of this highly prevalent mental disorder, the benefits of which could extend to the management of common co-morbidities.

These encouraging results were seen in participants who switched from a junk food diet to a real foods diet. Of the 67 who were enrolled in the study, the majority were using some form of therapy: psychotherapy and medications combined or psychotherapy only or medication only. There were 31 in the diet support group and 25 in the social support control group. Participants had to have been eating this diet in order to be accepted into the study:

a poor (low) intake of dietary fibre, lean proteins and fruit and vegetables, and a high intake of sweets, processed meats and salty snacks.

The dietary approach followed by participants in the study intervention group was the ‘ModiMedDiet’ which is based on the Australian Dietary guidelines and the Dietary Guidelines for Adults in Greece.

The primary focus was on increasing diet quality by supporting the consumption of the following 12 key food groups (recommended servings in brackets): whole grains (5–8 servings per day); vegetables (6 per day); fruit (3 per day), legumes (3–4 per week); low-fat and unsweetened dairy foods (2–3 per day); raw and unsalted nuts (1 per day); fish (at least 2 per week); lean red meats (3–4 per week), chicken (2–3 per week); eggs (up to 6 per week); and olive oil (3 tablespoons per day), whilst reducing intake of ‘extras’ foods, such as sweets, refined cereals, fried food, fast-food, processed meats and sugary drinks (no more than 3 per week). Red or white wine consumption beyond 2 standard drinks per day and all other alcohol (e.g. spirits, beer) were included within the ‘extras’ food group. Individuals were advised to select red wine preferably and only drink with meals.

The dietary composition of the ModiMedDiet was as follows: protein 18% of total energy; fat 40%; carbohydrates 37%; alcohol 2%; fibre/other 3%.

Here are the reasons I’m excited about this research:

  • It’s the first randomized controlled diet depression study and ONE THIRD of the dietary intervention group saw improvements in their depression symptoms.  This was just diet alone and switching from processed/junk food to real food with no specific dietary restrictions!
  • Participants also reported improvements in anxiety symptoms.
  • The authors even addressed the cost factor, stating it was more affordable to eat this way ($112 per week vs $138 per week).
  • The authors address the fact that the dietary intervention group was able to make these dietary changes “despite the fatigue and lack of motivation” that we so commonly see with depression.
  • I’m optimistic about it paving the way for making dietary approaches part of the standard of treatment for mental health conditions. The paper suggests the addition of “clinical dieticians to multidisciplinary mental health teams.”  I’d like to add that these dieticians, together with nutritionists and health coaches would need to be well versed in functional medicine approaches.
  • According to an article on ABC, one participant continued the Mediterranean diet after finishing the study and is now doing a diploma in health science. How inspiring is this? When we get results like this we want to share them with everyone!  

These are very encouraging results and we applaud the positive results of this SMILES study which are truly groundbreaking.

Let’s also be aware of where we are headed with future research and how we can improve on the trial diet.  The researchers conclude with this comment about future research:

The scaling up of interventions and identification of the pathways that mediate the impact of dietary improvement on depressive illness are also key imperatives

Professor Jacka recently shared this paper on how personalized dietary interventions successfully lower post-meal glucose i.e. how certain foods can affect two people quite differently because of our unique gut bacteria. She said that she wants to do a similar personalized nutrition study for depression if they are successful in obtaining NHMRC funding.

Here are some questions I’ve been asked about this SMILES trial (and I’m sharing here in case you have similar questions):

  • why did only one-third of the study intervention group see improvements?
  • why was wheat and other grains included?
  • why was low fat dairy and lean meats emphasized?
  • why was there no mention of grass-fed meat, wild fish, healthy fats like butter and coconut oil, pastured eggs or chickens or quality organic fruits and vegetables?

The ideal dietary approach for anxiety, depression and any health condition is always one that high quality, is personalized and takes into account biochemical individuality. With the removal of gluten, grains and the inclusion of the other dietary changes mentioned above, plus addressing all nutritional imbalances I expect we will see more than one-third of the dietary group experiencing improvements in depression in future trials.  

I truly appreciate the work of Professor Felice Jacka and her team and look forward to seeing more studies like the SMILES trial, using a personalized approach and quality foods that include grass-fed red meat and wild fish, plus pastured eggs or chickens, and healthy fats; and organic produce as a baseline. 

And then future trials that also look at the impacts of these dietary changes on anxiety and depression: gluten and/or grain removal;  removal of high histamine foods and high oxalate foods;  a low FODMAPs diet; the specific carbohydrate diet/SCD; a Paleo diet and so on – all based on biochemical individuality. We know these diets works in clinical practice and now we just need the research to back this up.  In part 2 of the blog, I share some incredibly inspiring diet-depression and diet-anxiety Paleo success stories.

In summary:

  • a simple change like switching from junk to real food can have a major impact on your depression and anxiety – ONE THIRD of the dietary intervention group saw improvements in their depression symptoms and many also saw reduced anxiety. This is profound! 
  • you may need to make additional dietary changes (gluten-free, grain-free, low FODMAPs i.e. avoiding or adding certain foods based on your biochemical individuality) and always add healthy fats and focus on quality
  • you may also need to address brain chemical imbalances with amino acids supplements, address gut health, adrenal issues, low zinc, low vitamin B6, low vitamin D etc. too

Are you encouraged by this research?

And have you made similar dietary changes to those done in the SMILES trial and seen a reduction in your anxiety and depression?

Have you removed gluten or grains and made additional dietary changes, and added supplements and seen even more benefits?

Note: to avoid confusion I’ve used the Australia spelling of “randomised” and “fibre” in the quoted sections and the US spelling “randomized” elsewhere in the blog.

The Evolution of Psychiatry: integrative psychiatry, anxiety and the thyroid

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James Maskell is the founder of The Functional Forum and this month the theme was The Evolution of Psychiatry. It was such a great episode so I’m sharing it with you here today.

The first presentation was by Janet Settle, MD and Will Van Derveer, MD. They took the stage and presented on the fundamentals of integrative psychiatry, covering root cause-based psychiatry. Together with Scott Shannon, MD, they are also now offering their “Psychiatry Masterclass” training program to other doctors.

This presentation included:

  • The foundations of truly effective, root-cause focused mental health system
  • Typical unresolved physiological dysfunctions that manifest as mental illness
  • Concrete steps for creating the mental health centers of the future

Here is a sampling of what they covered. Isn’t it wonderful to see a slide titled “Integrative Psychiatry Model” and with physiologic root causes listed?

The section on child abuse, trauma and psychospiritual root causes was enlightening:

They cover MDMA- and ketamine-assisted psychotherapy and I look forward to learning more from them about these approaches. However, until I learn more I’m wary of these approaches because of the side-effects. Based on the work I do with targeted individual amino acids I would use them before even considering MDMA or ketamine.

You can watch the entire video presentation here:

 

Next up was Thyroid Pharmacist, Dr. Izabella Wentz, returning to the Functional Forum stage for her first keynote. Dr. Izabella is a dear friend and one of my favorite thyroid experts and she covered the connections between thyroid health and depression and anxiety, looking at proven protocols to address the underlying causes.   Her presentation is titled “The Misdiagnosis Machine: How Thyroid Problems Mimic the Symptoms of Mental Illness.”

Dr. Izabella shares the symptoms of the autoimmune attack on the thyroid gland. As well as fatigue, weight gain, gut issues and apathy, you can experience mood symptoms such as anxiety, OCD-like symptoms and mood swings.

You can watch the entire video presentation here (and listen for a mention of my name and how commonly I see anxiety with clients with thyroid symptoms):

 

If you enjoyed Dr. Izabella’s presentation you don’t want to miss her upcoming documentary called The Thyroid Secret. I’m thrilled to have been invited to contribute on my expertise on anxiety and how this ties back to thyroid health. You can read more about it and find a few snippets from my interview here.

 

Dr. Izabella also has a new book that will be released next month: Hashimoto’s Protocol: A 90-Day Plan for Reversing Thyroid Symptoms and Getting Your Life Back. I have a review copy and it’s brilliant! I’ll be sharing more via a book review and interview with Dr. Izabella, taking a deep dive into infections and Hashimoto’s, so stay tuned for that.

I hope you’ve enjoyed these two presentations! For me, hearing presentations like these gives me so much optimism for the future of mental health!

I’d love to hear what has inspired you?

If you’re a practitioner and would like to attend a live Functional Forum meeting in the future or tune in online, you can register here to be notified. James and his team also offer excellent practice resources for functional medicine practitioners. We appreciate him for what he is doing for functional medicine via the Functional Forum!

 

 

Share your diet-depression success story: SMILES study looking for your input

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Professor Felice Jacka, nutritional psychiatry researcher and founder of ISNPR/International Society for Nutritional Psychiatry Research posted this exciting news and important request on the ISNPR facebook page:

The SMILES RCT, which is the first randomised controlled trial to test whether dietary improvement can actually treat depression, has now been accepted for publication in BMC Medicine (publication date 31st January).

As part of the media campaign, we will be needing to identify people who are willing to be interviewed. If there is anyone who has personally experienced a benefit from improving their diet, would you please volunteer for this purpose?

It’s a very important role, as the media coverage for SMILES will be limited if we can’t provide personal, first-person experiences to journalists. Clearly – for the sake of the field – it will be important to generate extensive media in order for clinicians and the general public to understand the implications and possibilities that arise from the RCT. Your help is enormously appreciated!

You can read more about this SMILES RCT here and the Anxiety Summit interview with Felice Jacka here: The Research – Food to prevent and treat anxiety and depression?.

Although anxiety was looked at in the study, Felice shared this regarding the type of interviewees they are looking for:

  • We really need to keep a focus on the topic of the RCT, which is depression
  • And to also keep it to those who improved the quality of their diet i.e. moving from a processed food diet, to one high in plant foods and healthy fats and healthy proteins
  • Not a particular type of diet (e.g. not paleo, not gluten free).

If you’ve personally benefited from changing your diet in this way and you’d like to help by sharing your story with the media please comment on the blog (or send an email to support [at] everywomanover29.com) with details of your story and willingness to be interviewed, plus your location. Be sure to let us know how best to contact you.

Right now we’ll just be calling on those who meet the above criteria for the media interviews.

BUT if you’ve benefited from any other changes to your diet – for either anxiety or depression – feel free to share anyway, so we can inspire others to do the same.

Here is my story:

For me it was anxiety and panic attacks that resolved when I made dietary and other nutritional and lifestyle changes.   I had been eating a vegetarian diet for a few years and I suspect the non-organic/GMO processed soy products (soy milk, soy yogurt, soy “butter” etc) were a big issue for me and damaged my gut.  When I added back quality animal protein (grass-fed red meat, wild fish, pastured eggs and chicken), switched to organic produce, added healthy fats and removed gluten my mood improved dramatically.  Now I eat a combination of a Paleo/SCD /low FODMAPS/low oxalate diet. 

During the severe anxiety and panic attacks I also needed additional support in the way of the targeted amino acids GABA (this was a life-saver and stopped the panic attacks in a few days) and tryptophan, plus zinc, vitamin B6, evening primrose oil, a good multi and B complex and adrenal support.  I still continue with some of these basic nutrients today.

My health issues have been complex as I’ve also had to deal with heavy metals, poor gut health and much more so I had what I call “a perfect storm” and yet diet has had such a huge impact for me!

Thanks for sharing your story! I’ll be sharing more as soon as the paper is actually published. Stay tuned for an interview with Felice too! 

And  big congrats to Felice and her team on this ground-breaking research!

UPDATE January 30, 2017: Here is the link to the research – A randomised controlled trial of dietary improvement for adults with major depression (the ‘SMILES’ trial)