Healthy Spirits: New at Castro

1. Crooked Stave Hop Savant-$8.99/12oz

2. Crooked Stave St. Bretta-$8.99/12oz

3. Crooked Stave Vielle Saison-$8.99/12oz

4. Crooked Stave Surette-$8.99/12oz

Friday Q&A: Collapsed Lung

Front View of Heart and Lungs

Q: Got a friend (a smoker) who ended a camping trip in the mountains (probably around 6K feet) by getting a collapsed lung. His wife got him to the hospital and all is well--he is even back to enjoying his electronic cigarettes (says it is not really smoking!) Anyway, I was thinking of using this as an opportunity to (finally) get him to try breathing meditation, Yoga/Tai Chi—but the lung thing has me worried. This was spontaneous with no obvious indications of why it happened or if it will happen again. He does nothing half-way, this guy, so if I get him doing deep-breathing exercises he will be going for the max. Is there a danger of the collapse happening again or can we use deep breathing to strengthen his lungs?

A: Thanks for writing to us about your friend’s condition. As always, the information I will share is of a general nature and in no way a prescription for how you will want to work with your friend. But I hope the following discussion will give you more information to work with as you try to help your buddy. 

Let’s start with the condition that your friend developed. He has what is called a spontaneous pneumothorax (SP), when air gets in between the lungs and the space around the lungs—not a natural state of affairs—resulting in a change in air pressure inside the chest cavity, with the air pushing on the lung.  The lung subsequently collapses a little or a lot and leads to chest pain and shortness of breath of varying degrees, depending on the size of the collapse. With a small, uncomplicated collapse, the person's lung may quickly heal on its own.

Although pneumothorax can occur for no obvious reason, as a cigarette smoker, your friend would be at higher risk for this right away. Known causes of SP include a chest injury, underlying lung disease or ruptured air blisters (blebs). According to the Mayo Clinic website, the following are risk factors for the development of SP:

• Gender. In general, men are far more likely to have a pneumothorax than are women.
• Smoking. The risk increases with the length of time and the number of cigarettes smoked, even without emphysema.
• Age. The type of pneumothorax caused by ruptured air blisters is most likely to occur in people between 20 and 40 years old, especially if the person is a very tall and underweight man.
• Genetics. Certain types of pneumothorax appear to run in families.
• Lung Disease. Having an underlying lung disease, especially emphysema, pulmonary fibrosis, sarcoidosis and cystic fibrosis, makes having a collapsed lung more likely.
• Mechanical Ventilation. People who need mechanical ventilation to breathe effectively are at higher risk of pneumothorax.
• History of Pneumothorax. Anyone who has had one pneumothorax is at increased risk of another, usually within one to two years of the first episode. This may occur in the same lung or the opposite lung.

Before I address the value of yogic breathing techniques for SP, I do want to mention a potential downside to yoga and SP. There is one report in the medical journal Chest about a pneumothorax arising in a yoga practitioner who had been doing the pranayama technique called the Bellow’s Breath, which is a fast breathing technique of inhaling and exhaling. Fortunately, this is a very rare occurrence; but you would likely want to avoid that and similar breathing techniques for quite some time after the person’s lungs re-inflate and they get the go-ahead from their doctor to return to normal activity. And in the case of our above SP person, they are at an increased risk of a recurrence of a pneumothorax, so you will need take care.

So what do I think would be a reasonable approach of yoga breath techniques for SP? We do know from a few studies done in India that yoga practices, including pranayama, can be helpful for other lung conditions like asthma and emphysema. That means yoga has been used safely in other people whose lungs that don’t work quite right. To me, this is very encouraging about the overall safety of yoga for lung diseases. One possible unwanted result of someone having a SP might be a reluctance to take even a normal inhalation due to fear of a recurrent collapse. However, practicing a gradual increase in the length of the inhalation and exhalation while monitoring for pain or shortness of breath could effectively re-establish a person’s pre-SP breathing ability. And if you encouraged the breathing to have a gentle quality on both the inhale and exhale portions of the breath cycle, you could also eventually improve the overall deep breathing capacity of your student.

It would likely be important if your student has a type-A personality to observe his breathing while you teach him the technique to verify that the breath is not aggressive in any way.  If you yourself do not do a lot of pranayama in your own practice, I’d really recommend that you find an experienced teacher to work with your student.

As things progress, your friend may be able to do the modern three-part breath that is very commonly taught in all levels of yoga classes in the US (you start by imagining you are filling the belly first, then the lower chest second, and finally the upper chest last, but in one continuous breath without a pause). It is also possible that once a good three-part breath is established, teaching a very mild form of ujjayi breathing could be helpful. Ujjayi mimics the effect of using a device called a spirometer that is used in a different lung condition called atelectasis, which is more a problem inside the lung’s tiny air sacs the alveoli, not a result of a collapsed lung specifically. Again, I’d have the student create a very quite ujjayi sound as you monitor  his work for a while to ensure he is keeping it on a more gentle level.

So, to recap, you could gradually reintroduce the three-part breath. Once that is safely accomplished, you might add in some gentle ujjayi to the three-part breath. And with all beginning breath teaching, I’d recommend starting off with the student lying supine to learn these techniques. To be on the safe side, avoid holding the breath at the top of the inhale, and also the bastrika and kapalabhati forms of pranayama.


 —Baxter

Book Release: "Yoga Sparks" by Carol Krucoff

by Nina

Just a brief announcement today that one of our guest bloggers, Carol Krucoff (see Yoga May Be the Best Activity for the Elderly), has released a new book! It is called Yoga Sparks: 108 Easy Practices for Stress Relief in a Minute or Less.

Baxter reviews the book in the September 2103 of Yoga Journal Magazine, which is currently available.

Healthy Spirits: New at Both Shops!

Now available at Castro and Clement.

Healthy Spirits: Prairie Bomb

Both shops just got a little bit more Prairie Bomb. Limit 2 bottles per customer.

Healthy Spirits: New Arrivals at 12th and Clement

New! At Clement and 12th Ave...

-Heidrun Meadery: California Orange Blossom Sparkling Mead + Madras Carrot Blossom Sparkling Mead -$21.99/ea

-Thistly Cross Cider  $6.99/ea

-De Proef Tropical Tripel - collaboration with Cigar City Brewing (tripel aged on oak chips, coconut, and peaches) -$17.99/ea

-Bocker Vander Ghinste Oud Bruin (new package for Bellegems Bruin) -$4.99/ea

-Affligem Cuvee 950 Blond (quadruple-hopped) -$12.99/ea

-Lost Abbey Saint's Devotion (golden ale with brett)  -$6.99/ea

-Allagash Fluxus (with blood oranges) -$23.99/ea

The Epidemic that is Taking over children

*disclaimer: I was provided an advance digital copy of the book in exchange for a review, comments, and/or blog post.  

(and yes, I know I have been gone for a while- I'm trying to desperately to find a routine- it's not going so well!) 

This post is a little different in that I am going to be doing a review plus talk about something that is very close to my heart.  There is an epidemic that is taking over our children and taking away their childhood.  Obesity in children is growing at disturbing rate- I am including links that tell the tale:
The CDC does state that obesity has declined a small bit in preschool children in low income areas
(and if you scroll down there are a couple other links there with info)
This PDF has some disturbing facts- 1 in 3 preschool children are obese or overweight by their 5th birthday!
Why Children need an hour of exercise a day
What can we do about obesity?
Kids health tackles overweight and obesity
and finally- Childhood Obesity Facts

As you can see- a lot has changed in the last few years and quite honestly, it's time to get off our hands and DO something about it.  I will be honest- I was never overweight as a child- as I hit puberty though things started to change and by high school I would have been considered overweight- I have been fighting that ever since.  I am still working my way through this journey and I just wonder if it would have been any different if I had not been overweight?  I also know that as long as I was playing basketball I didn't have a weight problem, as soon as that stopped, pretty much all physical activity stopped and the weight gain started.  I have no clue what I weighed in high school or college.  I know that I can look at my senior picture and see the weight there (of course the big hair probably helped with that- LOL).  What I do know is that part of my job is to teach the children that I come in contact with about healthy habits.  And I can't teach them what I don't do.  So, I am going to make even more of an effort to lead by example.

This book by an IIN graduate will help in that.  This book is an interactive workbook that breaks up the teachings into 8 Life Lessons: Love Yourself, Love Your Life, Dream Big, Think Positive, Learn to Relax, Eat Healthy, Be Active and Love Others

Lindsey and Janelle have collaborated on this book and a "movement" they are calling- Nourishment for Kids.  You can see their website HERE; facebook page HERE; and their twitter page HERE!  They are just getting this launched and I would love for you to go take a look!   

I had the opportunity to preview this and I loved it!  I can see myself using this on a weekly basis with an after school club or in my health coaching with children.  You can read other reviews HERE

Healthy Spirits: New at Castro

 

1. Lost Abbey Saint's Devotion (golden ale with brett)-$6.99

2. Bockor Vander Ghinste Oud Bruin (new packaging for Bellegems Bruin)-$4.99

3. Oud Beersel Framboise-$11.99

4. De Proef Collaboration Series: Tropical Tripel (with Cigar City)-$17.99

5. Heidrun Meadery California Orange Blossom Sparkling Mead-$21.99

6. Heidrun Meadery California Avocado Blossom Sparkling Mead-$21.99

7. Allagash Fluxus 2013(blood-orange porter)-$24.99

Take Your Time: Results from Yoga Practice

by Nina

Horses Grazing by Brad Gibson

It's a running joke in our family that when Brad gets impatient with me—because I often do various household tasks a bit slower than he does—he says to me, "Take your time!" He swears that Bill Murray said this repeatedly in the movie Caddy Shack, but when we watched it again recently, no one actually ever uttered that line. Regardless, I always reply, "You take your time."

But many worthwhile things really do take time. For example, if you want to cook a really good meal instead of eating fast food, you need to shop for fresh ingredients and prepare everything from scratch. And if you want to turn a new acquaintance into a close friend, you need to spend a lot of time together, getting to know and trust each other. The same is true for seeing results from yoga practice. Obviously, one Downward-Facing Dog pose doesn't instantly make your arms stronger, though with regular practice, it definitely will increase your strength. And it also seems obvious that if you want to reduce your stress levels, you'll need to practice stress management regularly over a period of time.

So it was very interesting for me to hear about a recent study at the Feinberg School of Medicine, Northwestern University, that looked at the effect of exercise on insomnia. One of the findings as reported by Gretchen Reynolds in the New York Times post How Exercise Can Help Us Sleep Better was:

"After the first two months of their exercise program, the exercising volunteers (all of them women) were sleeping no better than at the start of the study. Only after four months of the program had their insomnia improved."

Yes, it took four whole months of regular exercising to bring improvements. That's quite a bit of time, don't you think? The women in this study were not practicing yoga for exercise, but it's likely that using yoga as a form of exercise to help with insomnia (something I definitely recommend) might take a similar amount of time. And it also makes sense to me that if you are practicing yoga for insomnia (see Yoga for Insomnia, Part 1) by using stress management techniques, you should also give that some time (though some people report that doing breath practices in the middle of the night produces immediate results). So be patient.

In general, the time you invest in your yoga practice—whether you are practicing for your physical health, your emotional health or both—is what brings the payoffs. After all, yoga sutra 1.14 tells us that equanimity is attained only through steady, dedicated, attentive practice:

Long, uninterrupted, alert practice is the firm foundation for restraining the fluctuations of the mind. —trans. by B.K.S. Iyengar

Ultimate Workout Playlist (60 Songs)

I'm a huge proponent of using music in your workouts to help get you going.  Even on my most low energy, depressed days, when I'm literally dragging myself to the gym or park with a head full of self-talk like, "Just WALK for 15 minutes- you don't have to run or lift weights." If, when I get there, I put my ipod on, after a few minutes, I can't help but start running or working out harder.  Like music magic.

Lyrics, tempo, beat, and rhythm get me in the mood to work out.  I like booty-shakin' music, R&B, Christian Pop, and a little rock-n-roll.  Below are the top 60 songs currently on my "Work Out" Playlist.

To get me moving or start the workout I love to hear "Good Morning" by Mandisa & Toby Mac.

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When it's time to lift heavy weights on squats, "Sober" by Pink is great because it's a little slower (which is how I like to do squats, and I feel like it makes me dig deep).

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In the groove and feeling good?

"Starships" by Nicki Minaj

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"Only Girl in the World" by Rihanna

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"Raise Your Glass" by Pink

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"S&M" by Rihanna

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"Life in the Fast Lane" by The Eagles

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"Lose Yourself" by Eminem

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"I Gotta Feeling" by The Black Eyed Peas

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If you're working out some emotional stuff, going through a heartbreak, or life is just generally shitty, here are a few songs to give you some encouragement.

"Stronger" by Kelly Clarkson

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 "Fighter" by Christina Aguilera

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"Perfect" by Pink

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"Overcomer" by Mandisa (I added the lyrics to the whole song because it's so perfect.)

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Ready to cool down and stretch?  "You & I" by Lada GaGa starts with a great slower tempo.

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"Where is the Love" by Black Eyed Peas

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Let's share.  What are your favorite songs to workout to?  

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If you'd like to enter to win a trip for 4 from Nestlé® Pure Life® Purified Water to Universal Studios Hollywood or Universal Orlando Resort, click HERE or the picture below.  

They are also giving away a YEAR supply of Nestlé® Pure Life® Purified Water!

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Nocturnal Leg Cramps and Yoga

by Baxter

Recently while reading through one of my Family Medicine journals, I came across an article that caught my interest due to the frequent complaints of some of my students.  It was on nocturnal leg cramps.  Yes, quite often my students will ask me what they can do to address these ill-timed leg cramps (as if there is any good time for a leg cramp!).  I’ll get into what we know about the nocturnal leg cramps (NLCs) in a minute, but what caught my eye in reading was the recommendation for treatment:

“Limited evidence supports treating NLCs with exercise and stretching…”

Now, they don’t specify yoga, but as we all know by now, modern yoga would fit the bill. This treatment was recommended before any mention of medications, which is quite unusual for these journal articles.  It is usually the other way around—meds first, non-drug options mentioned last. This gave me a great sense of hope that modern medicine is beginning to grasp the benefit of starting with non-drug treatments for some conditions!

So what are these NLCs and how common are they? Well, according to the American Academy of Family Practice, they are super common, with up to 60% of adults reporting they get these kind of leg cramps.  They are described as recurrent, painful tightening of muscles in the legs, usually the calf muscles. And the NLCs can contribute significantly to insomnia. The exact cause in not known, but they hypothesize that the cramps are probably caused by muscle fatigue or nerve dysfunction, as opposed to low levels of blood electrolytes like sodium, potassium and such, or from other abnormalities.

Just to flesh out the symptoms of NLCs, they are painful and incapacitating, like no walking while they are occurring! They last an average of nine minutes per episode, and the first bout can be followed by hours of recurrent episodes and residual pain. Even though the calf is the most common muscle affected, cramps in the feet and thighs are also fairly common. Sufferers describe them as a spasm, tightening, twinge, strain, or a muscle seizure. And they are usually in one leg, and can cause the limb to move.

Folks with other conditions are sometimes more likely to have NLCs, such as those with vascular diseases, lumbar canal stenosis (narrowing of the spinal cord channel in the lower back), cirrhosis of the liver, patients on hemodialysis, and those who are pregnant, to name a few. Certain medications are also associated with NLCs, such as estrogen, Naprosyn and others. So, definitely check that out with your family MD if you start having them. NLCs are different from other conditions that might seem similar, like restless leg syndrome, claudication (cramps due to vascular narrowing of blood vessels in legs that occur with walking), myositis (muscle inflammation), and peripheral neuropathy (which has many causes).  So you do need to get checked out with your doc to rule out these other conditions, which may not respond to yoga so favorably.

Once you have been diagnosed, you will obviously want to do something to diminish the number of attacks or completely prevent them. A yoga asana approach would include practices and poses that bring movement and stretching to the lower legs, as well as practices that quiet the nervous system, as nerve dysfunction is one of the purported causes of NLCs. I’d start by reclining on the back and doing Thread the Needle pose (Sucirandhrasana), also known as Eye of the Needle or Figure 4 pose. Focus on circling your ankles as well as flexing and extending your foot at the ankle joint.

From there, I’d take one leg up into Reclined Leg Stretch pose. Start with the strap on your heel pad for a few breaths, move it to the arch of your foot for a few breaths, and finally place it on the ball of your foot and more actively pull down with the strap as you push up with the heel of the foot. This last variation will likely give you the most feeling of stretch in the calf muscles, which include the superficial gastrocnemius, the deep soleus, the posterior-lateral peroneus longus, and the posterior-medial tibialis posterior.

Many of the standing poses will bring some stretch to your calves and feet, especially the back foot in poses like Warrior 1 and Pyramid pose (Parsvottanasana). But even Warrior 2, Triangle pose and Extended Side Angle pose (Parsvokanasana) will provide a little stretch to the area, and might be better starting poses for newer students with lots of tightness in that calves. Wall Calf Stretch (a modified version of Warrior 1 with the toes of your front foot touching the wall and either hands or forearms on the wall) really isolates the calf muscles nicely, too. There are other poses that will have some nice benefits for the calves as well, like versions of Childs pose that will bring some stretching pressure and compression from the thigh bones and body down onto the calves and lend to some widening of the muscles. So throw a few Childs poses in the mix. And you can fulfill the “exercise” part of the recommendation by doing more active flowing practices, which will encourage warming and improved circulation to the lower extremities. And finishing off with some supported inversions like Legs Up the Wall or Chair Shoulderstand will release increased blood pressure from the legs for a bit, which could have a lovely calming effect on your legs, as well as your nervous system.

Pranayama practices that quiet the nervous system, like extending the exhalation (perhaps a 1:2 ratio of inhale to exhale) and others would be of great benefit, as would a body scan meditation, where you encourage all of the muscles of your body to release deeply.  Such a meditation could be done just prior to bed to prepare you for a good night’s sleep. There are, of course, other options you could include, but this will get you or your students started if nocturnal leg cramps are disturbing your rest. Let us know if you have a favorite calf release that I did not mention. We love your feedback!

Could we have evolved traits that are detrimental to our survival?

Let us assume that we collected data on the presence or absence of a trait (e.g., propensity toward risky behavior) in a population of individuals, as well as on intermediate effects of the trait, downstream effects on mating and survival success, and ultimately on reproductive success (a.k.a. “fitness”, in evolutionary biology).

The data would have been collected over several generations. Let us also assume that we conducted a multivariate analysis on this data, of the same type as the analyses employing WarpPLS that were discussed here in previous posts (). The results are summarized through the graph below.



Each of the numbers next to the arrows in the graph below represents the strength of a cause-effect relationship. The number .244 linking “a” and “y” means that a one standard deviation variation in “a” causes a .244 standard deviation increase in “y”. It also means that a one standard deviation variation in “a” causes a 24.4 percent increase in “y” considering the average “y” as the baseline.

This type of mathematical view of evolution may look simplistic. This is an illusion. It is very general, and encompasses evolution in all living organisms, including humans. It also applies to theoretical organisms where multiple (e.g., 5, 6 etc.) sexes could exist. It even applies to non-biological organisms, as long as these organisms replicate - e.g., replicating robots.

So the trait measured by “a” has a positive effect on the intermediate effect “y”. This variable, “y” in turn has a negative effect on survival success (“s”), and a strong one at that: -.518. Examples: “a” = propensity toward risky behavior, measured as 0 (low) and 1 (high); and “y” = hunting success, measured in the same way. (That is, “a” and “y” are correlated, but “a”=1 does not always mean “y”=1.) Here the trait “a” has a negative effect on survival via its intermediate effect on “y”. If I calculate the total effect of “a” on “w” via the 9 paths that connect these two variables, I will find that it is .161.

The total effect on reproductive success is positive, which means that the trait will tend to spread in the population. In other words, the trait will evolve in the population, even though it has a negative effect on survival. This type of trait is what has been referred to as a “costly” trait ().

Say what? Do you mean to say that we have evolved traits that are unhealthy for us? Yes, I mean exactly that. Is this a “death to paleo” post? No, it is not. I discussed this topic here before, several years ago (). But the existence of costly traits is one of the main reasons why I don’t think that mimicking our evolutionary past is necessarily healthy. For example, many of our male ancestors were warriors, and they died early because of that.

What type of trait will present this evolutionary pattern – i.e., be a costly trait? One answer is: a trait that is found to be attractive by members of the other sex, and that is not very healthy. For example, a behavior that is perceived as “sexy”, but that is also associated with increased mortality. This would likely be a behavior prominently displayed by males, since in most species, including humans, sexual selection pressure is much more strongly applied by females than by males.

Examples would be aggressiveness and propensity toward risky behavior, especially in high-stress situations such as hunting and intergroup conflict (e.g., a war between two tribes) where being aggressive is likely to benefit an individual’s group. In warrior societies, both aggressiveness and propensity toward risky behavior are associated with higher social status and a greater ability to procure mates. These traits are usually seen as male traits in these societies.

Here is something interesting. Judging from our knowledge of various warrior societies, including American plains Indians societies, the main currency of warrior societies were counts of risky acts, not battle effectiveness. Slapping a fierce enemy warrior on the face and living to tell the story would be more valuable, in terms of “counting coup”, than killing a few inexperienced enemy warriors in an ambush.

Greater propensity toward risky behavior among men is widespread and well documented, and is very likely the result of evolutionary forces, operating on costly traits. Genetic traits evolved primarily by pressure on one sex are often present in the other (e.g., men have nipples). There are different grades of risky behavior today. At the high end of the scale would be things that can kill suddenly like race car driving and free solo climbing (, ). (If you'd like to know the source of the awesome background song of the second video linked, here it is: Radical Face's "Welcome Home".)

One interesting link between risky behavior and diet refers to the consumption of omega-6 and omega-3 fats. Risky behavior may be connected with aggressive behavior, which may in turn be encouraged by greater consumption of foods rich in omega-6 fats and avoidance of foods rich in omega-3 fats (, ). This may be behind our apparent preference for foods rich in omega-6 fats, even though tipping the balance toward more foods rich in omega-3 fats would be beneficial for survival. We would be "calmer" though - not a high priority among most men, particularly young men.

This evolved preference may also be behind the appeal of industrial foods that are very rich in omega-6 fats. These foods seem to be particularly bad for us in the long term. But when the sources of omega-6 fats are unprocessed foods, the negative effects seem to become "invisible" to statistical tests.

Tasty Fruit & Veggie Protein Smoothies

When I did the Jamie Eason 12-week trainer, one thing she recommended was drinking a protein shake within 30 minutes of working out to aid in muscle growth and recovery.  I do this pretty religiously, making my shake as soon as I get home or ordering one at the gym if I'm not coming straight home after my workout.  Protein is essential for muscle development and recovery, but you can get the adequate amount from whole foods, like meat, fish, beans, egg whites, nuts, and milk too.

I'm usually a protein powder plus water and a few ice cubes kind of girl, but lately I've been trying more fresh fruit and veggie smoothies (with protein powder).  The other day, I added about 6 ounces of Odwalla Superfood drink to my protein powder and it tasted so good.  Although Odwalla is made with all natural ingredients, the calorie content and sugar is high, so I'd use it sparingly.  Mixed frozen bagged fruit is usually what I use.

Since I don't like a huge shake (it feels so daunting- like a chore to chug down), I make just a regular sized glass or mason jar size.  

I add about a scoop and a half of my protein powder (30 grams of protein) as opposed to the recommended 3 scoops (60 grams) because I don't think I can process that much protein at once, nor do I need it.  I'm currently using Amplified Wheybolic Extreme 60 and I like it because it has amino acids (great for muscle growth and energy).  I have the chocolate powder too and just blend it with water and a few ice cubes and it's pretty good.

The best results I've seen working out were when I was adding BCAA (branched chain amino acids- Amino Fuel) to my diet.  The BCAAs are among the nine essential amino acids for humans, accounting for 35% of the essential amino acids in muscle proteins and 40% of the preformed amino acids.  It's easy to do- I add 3 tablespoons of the liquid right into my water bottle when I work out.  It tastes like orange juice, so it's like drinking citrus water.  But, if I don't put the Amino Fuel into my water, I just add it to my shake.  

Chia Seeds are another ingredient in my diet (they are full of omega-3 and fiber) and go in my protein pancakes or oatmeal, but I'll also add a teaspoon to my shake.  I've gotten hooked on mango lately and this Bolthouse Farms mango drink is good (but again, sugary- sweetened with fruit- so use sparingly).  

I'll also add about two big hand-fulls of spinach (the pre-washed bagged kind) to the mix.  I feel good knowing I'm getting my greens in. 

I tried adding two small carrots to a smoothie and have to admit, I didn't love it.  It wasn't terrible, but I don't think I'll do that again.  

I think the point is to just experiment to see what you like, what combinations taste best to you and what other nutritious things you can add to your shake.  After looking at the nutrition on the prepared drinks, I'll probably just stick to my bagged frozen fruit.  

Are you a smoothie person? 

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