Business Innovators Radio - Flu Season Fallacy

Episode Date: December 3, 2023

“Flu Season” has been quite an effective marketing strategy for years; so much so that it almost feels like the virus knows when we’re about to flip the calendar. But logic tells us that just isn’t the case. The flu is always around (and not on vacation during the summer months), so why does it seem that winter weather ushers in the flu with the snow flurries?In this episode, Dr. Dan and Angela take on the Flu Season Fallacy. They’ll answer the big question: what creates the perfect storm that allows you to become vulnerable to the virus AND what can you do to protect yourself. Tune in to learn the best ways to build your immune system and make your body a no flu zone.To learn more about this and other hot health topics, follow us on social media and subscribe to our WTH podcast. If you have a specific health question or would like to find out if we can help you with a personal health challenge, check out our office page or contact us at 412-369-0400/ [e-mail] always, our mission is to help you Get Healthy and Stay Healthy for a Lifetime!What the Health?!https://businessinnovatorsradio.com/what-the-health/Source: https://businessinnovatorsradio.com/flu-season-fallacy

Welcome to What the Health, where anything health is fair game as we tackle the trends and bust the myths about health and wellness. Here are your hosts, Dr. Dan and Angela Toro. And welcome to another episode of What the Health. I am, Dr. Dan, here with my co-host. Angela, welcome back, everyone. We'll get that disclaimer out of the way real quick. As you know, we are here for informational purposes only in no way offering individualized medical advice. Always talk to your trusted health care provider before making change.

to your life or lifestyle. So with that being said, we got, with this time of year, we got to talk about it. I'm not to talk about it. Flu season fallacy. So we are headed into the oh so dreaded flu season. She had a quotes off by air quotes out. Air quotes, flu season. Yes, the also dreaded flu season, cold and flu season.

Which, again, there's no doubt that people get more sick this time of year. Yes, we have to understand why. Yes. So we're not saying that there aren't. increased instances. In cases of cold and flu this time of year. But the idea that it's just an inevitability that, oh, I'm just doomed to get, you know, to be sick through these colder months, that is the fallacy because we need to understand

why this is happening. Yeah. Well, you just mentioned colder months, and that's the first point. So we're going to go through five points as to why this idea that we're just doomed to get sick, you know, over the next six months. with, you know, colds, flus, you know, digestive issues, you know, whatever the case may be, that we're just doomed. You know, it's not the case.

And so we're going to go over five points as to why this, you know, quote, unquote, flu season is actually a thing. And you mentioned so the first thing is the colder weather, right? So what happens? Rhinoviruses are actually more active. Those are the, you know, your head cold, you know, your congestion, your sinus congestion. A lot of times are rhinoviruses. and they are more active in colder weather. And again, there's probably different types.

I am not a virologist. I am not getting into the disease. I always am focused on the how does your body respond to these things. So I don't care what the type of viruses because your body basically has a mechanism to fight it. So rhinoviruses are more active when it's cold outside. So a lot of times when you're, you know, especially if you're outside for like a soccer game. If you're, you know, outside doing an activity, all these fall festivals, which again, get out. get the pumpkins, get the apples. Like, you know, it's a, it's a beautiful time to be outside.

I love it. But it is colder. And so, you know, you get that, you know, nice little, you know, red nose and red cheeks, you know, rosy nose and cheeks, because you've been outside for a couple hours and, you know, a nice cool temperature. Well, you know, that activity, you know, in the nose and in the sinuses with the rhinoviruses that are present, you know, it becomes a little bit more challenging, not impossible. but maybe more challenging because of the number and because of like the replication. So it's something called your viral load, right? So if they're more active during, during cooler weather, you know, maybe they're replicating faster. Well, if there's a higher viral load, just think of it in terms of, you know, an army, you know, an army that has 10,000, you know, people versus, you know, 300, you know, typically, you know, you would want to be on the side of the 10,000.

Now, we know there's hundreds of incidents in history that, you know, that was. wasn't the case. If you haven't seen the movie 300, it's definitely recommended. Fantastic movie. But anyway, you know, if you have a lot more of a viral load, then again, it just makes it, you know, more difficult, you know, or, you know, it just makes it more difficult for your body to fight that off. So, so that's point number one is the cooler weather. I feel like I'm about to go out of order, but I feel that naturally leads into the being inside more. So it's getting colder out. outside. So we're having this increased viral load, but now we're also cooped up inside with these

people that have now been exposed and carrying that viral load. Yes. So yeah, whether it's your children or your spouse or, you know, family friends. So you're cooped up inside. So two things with that. Obviously with cold weather, we're not sunbathing anymore. So, you know, you get plenty of sunlight. because, and we've talked about this in another episode, but with the inclination of the sun, you know, we start, you know, the equator, we are moving in the northern hemisphere away from the sun right now. We have moved. We have officially shifted. When it was pitch black when we were leaving at 7 o'clock last night, I'm like,

and it happened. It's really bad when it's five o'clock. I know, I know. We're not there yet. We're not there yet. We are, yes, we've already passed the equinox, so we are headed to the, by every day from here until the, until the solstice, we are getting darker and darker. So not only the cooler weather, we have warm clothes on, so we're not getting skin exposure

to the sun, but also the inclination of the sun. The earth is literally at a less steep of an angle to the sunshine, so we're not getting the direct rays because we're covered up, and even if we weren't covered up, it's not as penetrating because the sun isn't directly above us like it is in the summertime. it's more at a steeper angle. So we're not getting that yet. The vitamin D and the benefits of the sun. And then we're stuck inside and it's, you know, this time of you're, I'm still that

crazy person that has the windows open during the day. But most people, I would say, had windows closed and probably even have the heat on at this point. So now you're getting that, you know, recirculated air where you're just essentially breathing, breathing those viruses around and they're just, you know, circulating back through over and over and over and over and getting blasted out on top of, you know, if you live in, you know, like the lovely city of Pittsburgh where the air quality is not the best. Now you're talking about whatever's in the ducks getting mixed in with. So I always notice when the AC's on or the heat's on,

that's when I feel at my worst. Like when I'm not, when I don't have like the fresh air, I just immediately feel like something's not right. Yeah. Well, and again, in the, you know, in the summertime, even if the AC's on, you know, because it's super hot, you can still go outside Yeah, exactly. You know, if it's 10, you know, 20 degrees outside, you know, and the heat's on, you're not necessarily going to run outside. Just to like. Just to be outside.

Although it is healthy to go out and get your fresh air rather than being cooped up. So in fact, I've actually read stories in certain countries, northern, like, you know, I've heard it in the country of Russia, but it might be true for other like northern European countries. but they let their kids, like preschool kids, go out with very little clothing for a couple minutes in the snow. Oh, yeah. That stimulation. We've talked about that in another episode. Talk to Mike from the gym.

He goes when it's, he'll go out and lay in the snow. Yes. Absolutely. Absolutely. And that stimulation, again, it's so much of it. Again, you need to stop before the point of getting into like cross-glater, right? Right. Phithermia.

But, yes. Those short bursts of cold, absolutely. Yes. It's very good. Yeah, I'll walk out. and I'll take the trash out of my bare feet and, you know, I'll walk out and, you know, take the dog out and, you know, and I'll just have, like, shorts and T-shirt on for my PJs and, you know, you walk out in the cold. And again, the more you can stimulate your body to those extremes, hot and cold, the better you are. So back to the circulating air.

So we're inside. We're getting less sunshine. We have recirculating air. By the way, make sure that you change your filters. Yes. You should, if you have a filtered, you know, central air system, you should. change your filter every six months, you know. So basically before the spring, yeah, basically spring and fall, you know, before each season change there. So make sure that- Especially around here. I mean,

I mean, anywhere. But again, yeah, you really got to like pay attention to the air quality of where you live. Yes. Yes. So it does, it does make a difference. And so I haven't changed mine yet. Yeah, I was like, speaking of which, Dr. Dan needs to run off for a second. I'll be back. But so, so, so we talked about definitely colder. Again, it's not just the recirculating air of viruses, but as you mentioned, the quality of air. So if you have dust particles, your body as its primary defense system, forms mucus, okay? Well, if it's, you know, if all of that mucus has to fight, and there's white blood cells in that mucus, okay? So, you know, that mucus is designed to trap. It's a physical defense barrier. It is, you know, the primary, one of the primary defense systems, uh,

You know, of the immune system. You know, your skin is a physical defense barrier. You know, your mucus membranes or physical defense barriers. But if it's so concentrated on like dust particles that are in the air, well, then there's less attention to the virus particles. The virus particles are obviously smaller than dust. And so, you know, then, you know, if all your mucus is dedicated to that dust with recirculating air, then, you know, the possibility of virus particles penetrating deeper and actually causing. an active infection. And that's, you know, I think we have to understand the difference, you know, between healthy response to, you know, to viruses, you know, versus like an actual

infection, you know, because so many of us, like, I get congested this time of year, you know. You know, it happens. You're blowing. No one to say never. It very, I don't want to say never. Yeah. It very rarely reaches the point to where it's like an actual systemic infection where I actually spike a fever. And again, all that is. is the virus penetrating a little deeper into your system. You know, a, you know, that's a fever. Sorry, where was it getting at? A temperature increasing your body, a fever is another line of immune defense.

So if it's gotten past, if the virus has gotten past the physical defense of your, you know, skin and your mucus membranes, well now, you know, that immune system, it's called your non-specific cell mediated immune system starts to recognize it just recognizes a foreign invader it doesn't we haven't gotten down to the you know the immune you know response where it's like or the antibody response system where you actually have like oh this specific virus and the body recognizes that specific virus and matches it with the antibodies no it's actually your cell mediated is non-specific so those are all the macrophages you know which are a type of white blood cell just like your you know antibiotics are produced by different types of white blood cells.

So your macrophages are just going around. They're recognizing that this is not part of our body. This is not part of our system. So we're just going to go eat it up. Well, that is part of your immune response system. So if it gets past that mucous memory, now you're going to start having macrophages engaged. But very rarely, you know, in my case,

because I have a strong, you know, cell mediated, cell-mediated immune system because it's been, you know, it's been activated throughout the years. Those viruses don't get to that next layer and it doesn't become a systemic infection where it's like, okay, now you actually have like the painful sinuses, you know, you're inflamed, you know, maybe you get some of that drip down into the chest and you actually, you know, develop like a bronchitis and, you know, and actually, again, have an active infection from those viruses. That rarely happens. I think it's your case too, right? You know, because, you know, again, the sniffles, that doesn't mean you're sick.

That's your body's natural normal response to cold, to a lot of water. Yeah, you walk outside in a cold morning, your nose is going to start running. Exactly. You're not sick. You're just, it's just. So that's a, you know, that's a very, very, you know, strong point that we have to make is like, you know, sometimes this time of year, you know, I've been sneezing a lot over the last couple days. Again, it's just, you know, leaves are starting to change. We have big sycamore trees outside of our office.

And I know I'm sensitive to those branches and, you know, to those leaves that are falling off. And so it's like, you know, all of that stuff are, you know, are environmental irritants. But my body is recognizing it is foreign. It's creating the mucus and it's trying to get it out. And so through blowing my nose and through sneezing, it's trying to get it out. It doesn't mean I'm sick. It's the body's natural immune response to those environmental stimulants. So it's important that we recognize that, you know, if you have a strong immune,

system, your body is able to fight that stuff off to the point where you never get an active infection. I mean, that was the same argument in COVID, right? You know, having a, you know, having the COVID virus versus actually a COVID-19 infection or having a coronavirus, you know, stimulation versus actually, you know, progressing far enough to a COVID-19 infection that landed you in the hospital, massive difference. You know, the majority, the world population all got, exposed to COVID, right, at this point. The percentage of people had actually developed a COVID-19 infection that landed them, you know, so severely, you know, that they ended up in the hospital, I mean, you know, a fraction of a percentage. So, you know, that's the difference of how far those

viruses penetrate in, and that depends on your immune system. Well, what decreases your immune system as we go into the holidays? Oh, man, sugar season. Here we go. I mean, Philly's been a while since I talked about sugar, but... Right. But yes, we are definitely what we said. We're headed right to the first holiday. Halloween, we got Halloween through... I forget what you said, the Easter or something.

Yes, well, you got Halloween, and then you've got, you know, you got all your pies and your sweet, you know, your... Yeah, we're headed into the fall, baked goods, your... You just asked the question yesterday, apple or pumpkin. What's your... What's your preference? I literally meant flavor. Some people took at his pie.

I'm like, yeah, I went to... I went to that, you know, that big coffee chain. the other day and they had a new flavor out. It was like apple, oatmeal, something. I had to get it. Of course. But actually, it was, I was literally looking at the grams of, or the calories on it. It had the lowest calories of all the other drinks.

It was still a sweet drink. Yeah. It wasn't like the 500 calories sugar drinks. It was tasty. But anyway, yeah, you have all of these, you know, sweet desserts and drinks and everything, you know, coming up. So it's increased sugar. So you got Halloween a couple weeks later. you go right into your um your november your uh thanksgiving yeah again how often do we have

leftover so it's not like you're just having pie on one day it's like oh no we have leftovers so now we have pie like three days four days a week in a row and it's like oh no wonder i feel like crap um then we go right into christmas yeah christmas hana cook ones all that all the winter holidays all the winter yep all the winter holidays and then you know new year new year we got to celebrate so we got to drink let's make some sugary cocktails Sugar and cocktails. Absolutely. It's funny. I mentioned that the other night. We were out with some friends and it's like, I, you know, not that I recommend this, but like, I could sit,

we've had this conversation before. I could sit and drink, you know, several drinks of straight bourbon and feel absolutely fine the next morning. You start mixing like sugar into, you know, make sugary mixed drinks and I will feel like absolute crap. Like even wine anymore. Like wine and beer, I don't have a great reaction to just because of, you know, the extra sugars in those. Yeah. You know, and I just, you know, straight bourbon starts on a reason.

It's like, no problem. But anyway, yeah, so you got New Year's. And then you go Valentine's Day, a couple weeks after that. So you got your, you know, your sweethearts and chocolates and, you know, all the candy that's around Valentine's Day. And then you go right into the drinking holiday of St. Patrick's Day. And then finally, we like head into spring. And it's like, okay, we can chill for a minute.

And we can go back outside. So can you see it's like literally over the. the next six months, there's a holiday once a month. And again, we all know, and we're all guilty of this. We all know that, you know, all those candies, like, okay, you know, my, you know, my lovely wife just bought some Halloween candy for, you know, for the neighborhood, for trick-or-treating. Well, you know, how many households, you know, oh, I'm going to sneak one of those or, or I'm just going to get an extra bag and that's going to be my bag. So it's like, it's not that it's a one-day thing. It's like it stretched over the week before and the week after.

Plus, never mind all the candy your children are going to come home. The pillowcase is full. Throwing it out this year. But yeah, so that's so sugar is, it just directly impacts the immune system. Everything that you just talked about. So with the white blood cells. It slows down the activity of white blood cells. Exactly.

So it's not just, you know, we're not just saying sugar. It's not just a calorie thing. It directly impacts that immune system, especially that first response of the immune system. So that's, that's the. correlation. We see this increase in sugar and your immune system response is going to drop. So then coupled with everything we were just talking about, now you're around more people inside, more exposure. It's just like we said, perfect storm. Higher activity of viral load. Yep. So now you cut all that sugar on top of it. Yeah. I guarantee you, first week of January,

I can like clock and I'm like, I'm going to be sick. I just, it's like because no matter, no matter how good intentions I have, it's still, I mean, I pretty much. no sugar on a, like, regular basis. So then even the, like, even the little bit of extra, it just, it wrecks me. It really wrecks me. So it's like every year I go to it with the best intentions and then your darn wife, such a good baker. She did me in.

It started with Friday the 13th this year. She made that dirt dessert, which was absolutely my weakness in life. Cool whip and Oreos. Come on. That was probably one of the lighter desserts. It was. It was delicious. But again, it's, you know, heading into that.

And then I'd say the other thing that directly impacts the immune system, which is activity, we see a huge, we see this huge increase of sugar. And then we're seeing a huge decrease in physical activities. So you're outside less. Yeah, that's, yeah, less, you know, less, you know, less, you know, running around the kids at the park. And, you know, just kind of the sort of the natural activities that come. And then people just seem to get less motivated for. you know, going to the, you know, do I really want to drive the gym? I have to, you know, I have to clean my car off.

It's dark. Yeah, oh my gosh, that does it. That does it. That does it. That does it. The temperature is not an issue. Yeah, I can do, getting up earlier is easier. Like, by the end of the day, like, when we think in the office at 7 o'clock, I went home, I was in bed at 8. I'm like, this time of year kills me with the dark, the dark evenings. It's just, I have, I do. I have no motivation. Like, once it's dark, I'm like, I don't want to go out. I don't want to do it. I don't want to see people.

Angela is actually a band. I think I. guy, no, the opposite of an vampire, they like the dark. That's true. I said, I'm a bear. I just want to hibernate this time. There you. But it's funny because you mentioned about how I don't tend to go into full-blown sickness either.

And it's interesting because, you know, I noticed the one thing that really helps is the activity. So when I feel myself kind of in that like, oh, I'm like, I'm kind of, you know, kind of sniffly, kind of, you know, maybe trying to clear some stuff out of my lungs. But I'm like, I don't really feel sick. I'm like, go workout. Even if it's not a great workout, go. And I always feel better after. Sweat out. It's like, unless I'm actually full-blown sick, those are the workouts where I'm like, nope, I need to be in bed.

And that's where I can really tell the difference between what my body needs. Yeah. And that's where, again, you've become very in tune with it. And that, you know, it helps when you, the more you, you know, stress your body in a healthy way that, you know, the more in tune you get with it. So, yes, there's a difference between pushing through. I remember out listening to a doctor. at one point in time they talked about, you know, if it's just stuck up, you know, if it's just like the sign is the congestion, it's like it's staying in the head, you know, you've got some of the runny nose.

It's like, yeah, push through it. You know, go work. But like, like, if it's actually down in the chest and you're like, you know, you've got that heavy, you know, productive cough, like that's probably where you might not want to push it too much. But again, also the types of works out. We've talked about activity versus exercise. Like, you know, just going for a nice walk. You know, again, it could be very stimulating to your parasympathetic system, you know, versus, you know, versus actually going and training super hard.

So, again, you know, you might need to, you know, dial in your, dial in your activity and exercise over this time of year. And then, yeah, and if you're like our family where it's like, okay, we had, even though we all live fairly close and see each other all the time, it's like, oh, it's the holidays. We now have to see each other old. So if your social calendar gets much busier this time a year, then again, just, you know, you have to sort of plan ahead and take that, you know, if you're going to be traveling, figure out, is there a gym where you're going or are there things you can do at home? You know, get out and go for a walk when you're, you know, after your big holiday meal. I remember going to our uncle's house and, you know, growing up. And so, like, you know, a lot of us would go out and we would chop firewood. Yeah.

You know, and we would have this family gathering. That's a massive activity. And again, it was fun. we were a teenager. And in a dorm pool. So we would, yeah. So it's like,

there's lots of ways that you can be active, um, even through the holiday. I know, yeah, I know, Aaron mentioned like she like, you guys like to find hotels

that have a pool so that the kids can, again, burn. Yes. Burn off the energy. So yeah, just finding it might look different than your summer, you know, warmer month activities,

but find something that's going to keep you active because that's one of the other, you know, huge benefits, physical activity has a, a positive benefit on the, immune system. So, you know, with with that coupled increased sugar, decreased physical activity, it's a, it's a, you know, really bad, really bad effect on that immune response. Absolutely.

So did we hit all our points? Our last one was stress. Oh, yeah, good old stress. Because no one gets stressed this time here. Yeah, the holidays, we understand. I mean, it can be a tough time on a lot of people, especially if you've lost someone close to you, you know, over the holidays, you know, your family's all over the place. Yeah, families far away. Like, it's, we understand it's definitely a tough time. So, you know, in a previous podcast that we just recorded, actually, we talked about the deep breathing, right? And, you know, using that to, you know, to help mitigate the stress response. But you just talked about activity and, you know, activity helps to keep the stress down. But yes, this can be a very, you know, high anxiety time of year. So, you know, again, it's,

it's about the mindfulness, you know. Do you need to go get that last gift? Do you need to get that rapping? Does your house be absolutely clean? Is anyone going to notice if the, you're The one side dishes is seen is the little things that we stress over. I have to remind my life about that constantly. Really? You think we need that side dish? Yeah. No one will starve.

And yes, we can feed a small country looking about the food that she makes. Yeah, and I would even couple the increased stress with sleep quality as well. Because again, this time, especially if you're less active, then that's going to impact sleep. Now, some people like me, I want to hibernate. But sometimes that doesn't necessarily, just because you're in bed longer, it still might not be good quality sleep. So I've noticed I talked to some people this week, but they're like, yeah, I just don't, I'm tired, but I don't feel like I'm sleeping well.

And I think it's that transition of the difference in the daylight, the difference in temperatures, the difference in activity levels, all of that really starts to impact that sleep quality, which we know, again, is super, you know, crucial for your immune system working properly as well. That's why when we do start to feel sick, we want to sleep. because that's what our body needs. So I always tell people this time of me. Again, I'm like, if you're tired at 8 o'clock, go to bed. I'm like, I'm sitting there.

I was like, I'm like, there's no reason. There's no reason for me to be up. I can. So I was like, did I wake up at 5? Yeah, but who cares? I mean, if I had pushed myself to stay up until 10, just because I could have, you know, it could have been a poor night's sleep. So it's, you know, listening to your body.

It's, you know, if there's nothing you have, there's no reason you have to be up, it's natural to feel more tired this time of year. That's, that's just the circadian rhythm, you know, responding to the shift in daylight. So that's, yeah. So instead of fighting it and feeling like you have to get every cram everything into into the day, it's like if you're feeling tired, go to bed and get a good night's sleep. And it can really, even just one good restorative night's sleep can really help do, do wonders. Yeah, that's what you know, Aaron, we try and get, uh, my lovely wife a one good night sleep a week with the kiddos it's like and she she she she always gives me the look too because she'll like she'll hit that capacity of like you know three or four nights in a row

just like terrible sleep you know the kids come in the bed and i and again i i am made i sleep like a freaking rock so it's like i don't wake up or even if i do stir it's like i'm up i'm like huh and then i'm like back to snoring again so it's like you know but there there are you know she hits a point of no return where it's like If she doesn't get a good night's sleep. We all suffer. Yes, we all suffer, especially me. I'm going to die.

So she, yeah, so it's a matter of like, you know, hopefully if you are in a relationship, listen to your spouse and be able to, you know, help them out, recognize the signs that they might need. So it's like, I took the kids and she got like a two hour nap the other day. And it was like, and then she's still got a really good night's sleep that night. So because sometimes when you're over exhausted and you can't pull us sleep, it's like. You're like, you're like, I'm. I need to sleep. Yeah, you're in this vicious cycle and you can't do it.

So she actually, yeah, she slept like two hours, you know, Sunday afternoon. And, you know, then we had our massages scheduled. Oh, yeah, that would be. And then, yeah, she was out. So, yeah, that all goes with, yeah, the stress and sleep, I think, tend to really go hand in hand. But so, yeah, so I would say that would be our, that was our five factors for the perfect storm of flu. Yeah, so the cold weather, obviously. But again, get out and enjoy the cold weather.

There's nothing wrong with it, but understand that, you know, having the sniffles is part of just an increased viral load and your body responding to that environmental stimuli. So it's okay, but just recognize that they are more active this time of year. Being inside, less light, recirculating air, you know, all combine, you know, sugar. You got to watch the sugar intake and try and look at different alternatives. Don't put the mixed drinks in. Try and find something that you enjoy. Every other drink in an adult beverage versus water. You know, keep yourself cleaned out that way.

We got exercise, lack. Exercise and activity. And then mine. Stress and sleep. Yeah, stress and sleep. You're mindful of that. And again, just, you know, find those little moments that you can take proactive steps and celebrate that, you know, throughout this time of year. You know, I'll always hit a point where it's just like, no, I'm tired of, you know, I don't need to eat that.

I, you know. Oh, yeah. You know, no, I'm done. And I will say, Arkansas. Family's gotten much better over the years of realizing like, okay, we don't need all of this. But again, it's, you know, it's going to happen. Again, it's just listening to your body, being mindful and recognizing that if, again, if you do start to feel a little off, you know, do the thing. Get the sleep, get the activity.

Do the things you can because you can very well stop it from progressing to that full-blown, you know, laid out illness. Awesome. Hopefully you found this helpful. If any of this resonates with you or you need more information, do not hesitate to reach out. A lot of information on our website, ToroTU-R-O-Family Chiropractic.com. I am Dr. Dan.

Here with Angela. Thank you guys so much. And we'll see you next time. See at the next one. You've been listening to What the Health with Dr. Dan and Angela Toro. Brought to you by Toro Family Chiropractic. To learn more about the resources mentioned on today's show or listen to past episodes,

visit www. www. www. www. what the health.