A story published this morning on Reuters reports that a new study in the Proceedings of the National Academy of Sciences (PNAS) shows that Atrazine, the most commonly used weedkiller in the United States can turn male frogs into females.
The study describes experiments performed in the U.C. Berkeley laboratory of Tyrone Hayes, who has published a number of earlier studies related to Atrazine and amphibians here, here, and here, showing that exposure to Atrazine could create males with both male and female features, but the recent study is the first to document complete sex-reversal under laboratory conditions.
And most importantly, the study shows that this sex-reversal is hormonally-caused, and demonstrates that regardless of the “blueprint” of the genes, hormones can override genes.
As with practically every article regarding sexual changes in animals due to exposure to hormonal chemicals, the Reuters author makes the usual caveat, saying: “Whether the effects translate to humans is far from clear. Frogs have thin skin that can absorb chemicals easily and they literally bathe in the polluted water.”
While it is true that amphibians do have more porous skin, this merely affects the pathway of exposure that determines the dose. There is no evidence suggesting that the pathway of exposure per se plays any role in developmental outcomes, what matters is the ultimate chemical dose, and the developmental time frame when exposure occurs. So this comment is actually a non-sequitur.
Furthermore, as stated in the last blog entry, nobody is even looking for these types of effects in humans. The closest that any researcher has come is Shanna Swan, who studied male children born to mothers that had varying degrees of exposure to Phthalates, chemicals often added to plastics to make them more flexible. The methodology of the study was widely attacked by industry, with several industry representatives actually disputing the validity of the study in a subsequent issue of the same journal where it was printed, Environmental Health Perspectives. This is a peer-reviewed journal published by the National Institutes of Environmental Health Sciences, a division of the National Institutes of Health, yet industry representatives brazenly attacked it immediately here.
As was mentioned in my last post, the EPA has not yet performed any studies regarding the outcomes of endocrine disruption, and the protocol suggested by the Endocrine Disruptor Screening and Testing Advisory Committee (EDSTAC) does not plan to examine outcomes such as sex-reversal or any other changes to sexuality. So the EPA will not be reporting these kinds of outcomes in humans because – they are not looking.
And so it goes. There is a circular argument that has been going on in this area for a long time. First it is admitted – often by psychologists - that, yes, it is theoretically possible to alter sexuality and gender identity due to chemical exposure, but there is no evidence of such outcomes. And at the same time, the researchers who could potentially study these sorts of outcomes claim that the outcomes are so rare that they would not have the statistical power to detect them, so why bother even looking? This is followed by more claims that no evidence exists, ad infinitum.
The fact is that practically nobody wants to really study this linkage properly. There was a wonderful opportunity to do so in the case of diethylstilbestrol (DES), the “anti-miscarriage” drug given from anywhere between 4 and 8 million pregnant women from 1940 to 1971. Over the next few weeks, I’ll be discussing the research on children born to mothers who were given this drug, which was marketed as a wonder-drug and in many cases as a “vitamin.” As an incredibly potent estrogen mimic, this research holds the key to exposing the human effects of exposure to endocrine disruptors.
Tuesday, March 2, 2010
Sunday, February 28, 2010
Congressional Obsfucation
Today I came across an interesting article that suggests that members of the United States Congress are aware of the obvious relationship between endocrine disrupting chemicals and changes in gender and sexuality, but that they refuse to actually study the problem appropriately.
According to the Belmont Citizen-Herald, Edward J. Markey, the Massachusetts Democratic Chairman of the House Energy and Commerce Energy and Environment Subcommittee, made several comments at a hearing last Thursday, entitled “Endocrine Disrupting Chemicals in Drinking Water: Risks to Human Health and the Environment:”
In his statement, he said: “Just last week a local newspaper warned that the Potomac River and other mid-Atlantic rivers are laced with toxins that may be responsible for bizarre deformities in fish, frogs and other wildlife that come in contact with the contaminated water. This includes male fish that have begun growing female sexual organs, and female fish that can no longer reproduce."
The Congressman then went on to say “There are serious concerns that the same chemicals that are responsible for these deformities in wildlife may also have similar effects in humans and may be the culprit for the widespread increase in human disorders such as infertility, obesity, diabetes and cardiovascular disease. These contaminants, which fall under a class of chemicals called Endocrine Disruptors, are pervasively showing up in our nation’s waterways, including in water that millions of people rely on for drinking.” [emphasis mine]
So here we have a United States Congressman acknowledging that the effects observed in wild animals, including “male fish that have begun growing female sexual organs,” are possibly also happening to humans.
The Congressman also stated:
“W.C. Fields once said, ‘I never drink water because of the disgusting things fish do in it.’"
“Today, people wonder whether they should be drinking the water that comes out of their taps because of the disgusting things it is doing to the fish, and possibly to them."
Isn’t this an interesting pair of statements? I think the Representative from Massachusetts made an incredibly poor word choice in using the term “disgusting.” Personally, I don’t find male animals growing female sexual organs to qualify as “disgusting.” It just happens. What I do find disgusting is the lack of chemical regulation and enforcement of the existing regulations by Congress and the EPA.
Notwithstanding Mr. Markey’s value-laden judgment about “disgusting” outcomes such as male fish growing female sex organs, there is in fact already a term for humans that do not sexually differentiate along “normal” lines. Known as intersexuals, these are typically people whose genitalia do not develop in concordance with their genotype. To the best of my knowledge, there have been no government studies examining the prevalence or incidence of intersexualism in the U.S. population.
One academic study from 2000, by Blackless, et. al., did try to quantify the prevalence, and determined that approximately 0.1-0.2% of live births received “corrective” genital surgery, based entirely on reports in the academic literature. They estimated that up to 2% of the population could be characterized as intersexual, based upon a lack of concordance between genes, hormones, or physical characteristics such as the size and configuration of the genitalia. Given that most of the source material for these estimates was quite old, was from around the world rather than just from the U.S., and that made a number of assumptions, this number probably represents a gross underestimate of the actual numbers.
The Intersex Society of North America, (ISNA) an education, outreach, and advocacy organization oriented around issues of importance to intersex people reports a similar incidence, however, in a posted discussion among ISNA staff members, they note the same lack of evidentiary information in determining any hard numbers, and in fact, they rely on two sources, the previously mentioned Blackless paper, and a book by one of the authors of that same paper, which utilized most of the same source material referenced in the Blackless paper. So in summary, as of this date, there is really only a single study has actually made an attempt to count the number of intersex people in the world, and the methodological limitations indicate that this is most likely an underestimate.
Further, one of the unarticulated assumptions in this paper is that the rate of intersexualism in the world is a constant. Yet if one looks at the environmental health literature, and specifically at effects observed in animals, the evidence is unequivocal that the frequency of effects relating to sexual development is increasing. So if there is a connection between effects seen in animals to those expected in humans, then it suggests that the number of intersex people is similarly increasing. Consequently, the intersex prevalence figure is probably a gross underestimate, as any estimate is trying to pin down a moving target.
Another area where this same pattern exists is in studies examining the incidence and prevalence of transsexualism. The pattern is two-fold: consistent under-reporting, coupled with the assumption that the prevalence rate is a constant. For example, the World Professional Association for Transgender Health (WPATH) publishes what is known as the Standards of Care for Gender Identity Disorders, now in its sixth edition. In the earlier editions, the prevalence was reported as 1 in 37,000 for male to female transsexuals, and 1 in 107,000 for female to male transsexuals. More recent versions have utilized epidemiological evidence from the Netherlands, reporting the figures 1 in 11,900 for male to females and 1 in 30,400 for female to males. This increase in prevalence is typically attributed to: 1) better reporting and data collecting, 2) increased benevolence of society, permitting more people to “come out” as transsexuals, and 3) improved diagnosis and availability of treatment.
However, in 2007, Femke Olyslager and Lynn Conway published a paper at the WPATH 20th International Symposium in Chicago that took a different approach. They simply surveyed surgeons to count the number of actual sex reassignment surgeries and made an estimate of the prevalence based on these figures. They estimated that the prevalence for male to female transsexualism at between 1 in 1,000 and 1 in 2,000 based on these data.
But as with all estimates of the prevalence of people who are intersexual or transsexual, the authors implicitly assume that the rate is actually a constant, regardless of whether the authorities are under-reporting the “true” prevalence.
Yet if Mr. Markey’s concerns are legitimate, and there is in fact a relationship between effects observed in animals and those expected in humans, then it should be clear that the prevalence is not a constant, but is instead steadily increasing.
While I applaud the Representative from Massachusetts for proposing legislation to improve water quality, it is far past time to take action. Way back in 1993, a number of prominent researchers in the field of endocrine disruption, including Theo Colborn, Louis Gillette, Jr., and Frederick Vom Saal, testified in front of Congress, describing the observed effects of endocrine disruptors in animals and the likely consequences for human health. As a result of this hearing, Congress mandated the Environmental Protection Agency (EPA) to study these chemicals and their effects, and the EPA subsequently created the Endocrine Disruptor Screening and Testing Advisory Committee (EDSTAC). According to the EPAs website,
“EPA charged EDSTAC to advise the Agency regarding:
1. Methods for chemical selection and priorities for screening,
2. A set of available, validated screening assays for early application,
3. Ways to identify new and existing screening assays and mechanisms for their validation,
4. Processes and criteria for deciding when additional tests beyond screening would be needed and how to validate such tests, and
5. Processes for communicating to the public about EDSTAC's agreements, recommendations, and information developed during priority setting, screening, and testing.”
In 1998, EDSTAC submitted a final report to Congress, which outlined the approach they recommended to the EPA. Yet after twelve years, practically nothing has been done. Just last year, on October 21, 2009, the EPA published a list of chemicals proposed for Tier 1 screening – the first step in the screening process - that included just 67 chemicals. Given that there are approximately 80,000 chemicals in commerce today and that approximately 4000 are imported/used in the United States in quantities exceeding 1 million pounds per year, the EPAs endocrine disruptor program is completely lacking in credibility. The program is a bad joke.
If EDSTAC and the EPAs nonexistent effort over the last twelve years is the best the government can do, then we can surely expect that there will be a vast increase in the number of “disgusting” outcomes. It boils down to the simple fact that if one does not look, one will not find. If Mr. Markey is really concerned about these chemicals and their “disgusting” effects, might I suggest that he propose simply looking for the same outcomes in humans that are observed in animals?
According to the Belmont Citizen-Herald, Edward J. Markey, the Massachusetts Democratic Chairman of the House Energy and Commerce Energy and Environment Subcommittee, made several comments at a hearing last Thursday, entitled “Endocrine Disrupting Chemicals in Drinking Water: Risks to Human Health and the Environment:”
In his statement, he said: “Just last week a local newspaper warned that the Potomac River and other mid-Atlantic rivers are laced with toxins that may be responsible for bizarre deformities in fish, frogs and other wildlife that come in contact with the contaminated water. This includes male fish that have begun growing female sexual organs, and female fish that can no longer reproduce."
The Congressman then went on to say “There are serious concerns that the same chemicals that are responsible for these deformities in wildlife may also have similar effects in humans and may be the culprit for the widespread increase in human disorders such as infertility, obesity, diabetes and cardiovascular disease. These contaminants, which fall under a class of chemicals called Endocrine Disruptors, are pervasively showing up in our nation’s waterways, including in water that millions of people rely on for drinking.” [emphasis mine]
So here we have a United States Congressman acknowledging that the effects observed in wild animals, including “male fish that have begun growing female sexual organs,” are possibly also happening to humans.
The Congressman also stated:
“W.C. Fields once said, ‘I never drink water because of the disgusting things fish do in it.’"
“Today, people wonder whether they should be drinking the water that comes out of their taps because of the disgusting things it is doing to the fish, and possibly to them."
Isn’t this an interesting pair of statements? I think the Representative from Massachusetts made an incredibly poor word choice in using the term “disgusting.” Personally, I don’t find male animals growing female sexual organs to qualify as “disgusting.” It just happens. What I do find disgusting is the lack of chemical regulation and enforcement of the existing regulations by Congress and the EPA.
Notwithstanding Mr. Markey’s value-laden judgment about “disgusting” outcomes such as male fish growing female sex organs, there is in fact already a term for humans that do not sexually differentiate along “normal” lines. Known as intersexuals, these are typically people whose genitalia do not develop in concordance with their genotype. To the best of my knowledge, there have been no government studies examining the prevalence or incidence of intersexualism in the U.S. population.
One academic study from 2000, by Blackless, et. al., did try to quantify the prevalence, and determined that approximately 0.1-0.2% of live births received “corrective” genital surgery, based entirely on reports in the academic literature. They estimated that up to 2% of the population could be characterized as intersexual, based upon a lack of concordance between genes, hormones, or physical characteristics such as the size and configuration of the genitalia. Given that most of the source material for these estimates was quite old, was from around the world rather than just from the U.S., and that made a number of assumptions, this number probably represents a gross underestimate of the actual numbers.
The Intersex Society of North America, (ISNA) an education, outreach, and advocacy organization oriented around issues of importance to intersex people reports a similar incidence, however, in a posted discussion among ISNA staff members, they note the same lack of evidentiary information in determining any hard numbers, and in fact, they rely on two sources, the previously mentioned Blackless paper, and a book by one of the authors of that same paper, which utilized most of the same source material referenced in the Blackless paper. So in summary, as of this date, there is really only a single study has actually made an attempt to count the number of intersex people in the world, and the methodological limitations indicate that this is most likely an underestimate.
Further, one of the unarticulated assumptions in this paper is that the rate of intersexualism in the world is a constant. Yet if one looks at the environmental health literature, and specifically at effects observed in animals, the evidence is unequivocal that the frequency of effects relating to sexual development is increasing. So if there is a connection between effects seen in animals to those expected in humans, then it suggests that the number of intersex people is similarly increasing. Consequently, the intersex prevalence figure is probably a gross underestimate, as any estimate is trying to pin down a moving target.
Another area where this same pattern exists is in studies examining the incidence and prevalence of transsexualism. The pattern is two-fold: consistent under-reporting, coupled with the assumption that the prevalence rate is a constant. For example, the World Professional Association for Transgender Health (WPATH) publishes what is known as the Standards of Care for Gender Identity Disorders, now in its sixth edition. In the earlier editions, the prevalence was reported as 1 in 37,000 for male to female transsexuals, and 1 in 107,000 for female to male transsexuals. More recent versions have utilized epidemiological evidence from the Netherlands, reporting the figures 1 in 11,900 for male to females and 1 in 30,400 for female to males. This increase in prevalence is typically attributed to: 1) better reporting and data collecting, 2) increased benevolence of society, permitting more people to “come out” as transsexuals, and 3) improved diagnosis and availability of treatment.
However, in 2007, Femke Olyslager and Lynn Conway published a paper at the WPATH 20th International Symposium in Chicago that took a different approach. They simply surveyed surgeons to count the number of actual sex reassignment surgeries and made an estimate of the prevalence based on these figures. They estimated that the prevalence for male to female transsexualism at between 1 in 1,000 and 1 in 2,000 based on these data.
But as with all estimates of the prevalence of people who are intersexual or transsexual, the authors implicitly assume that the rate is actually a constant, regardless of whether the authorities are under-reporting the “true” prevalence.
Yet if Mr. Markey’s concerns are legitimate, and there is in fact a relationship between effects observed in animals and those expected in humans, then it should be clear that the prevalence is not a constant, but is instead steadily increasing.
While I applaud the Representative from Massachusetts for proposing legislation to improve water quality, it is far past time to take action. Way back in 1993, a number of prominent researchers in the field of endocrine disruption, including Theo Colborn, Louis Gillette, Jr., and Frederick Vom Saal, testified in front of Congress, describing the observed effects of endocrine disruptors in animals and the likely consequences for human health. As a result of this hearing, Congress mandated the Environmental Protection Agency (EPA) to study these chemicals and their effects, and the EPA subsequently created the Endocrine Disruptor Screening and Testing Advisory Committee (EDSTAC). According to the EPAs website,
“EPA charged EDSTAC to advise the Agency regarding:
1. Methods for chemical selection and priorities for screening,
2. A set of available, validated screening assays for early application,
3. Ways to identify new and existing screening assays and mechanisms for their validation,
4. Processes and criteria for deciding when additional tests beyond screening would be needed and how to validate such tests, and
5. Processes for communicating to the public about EDSTAC's agreements, recommendations, and information developed during priority setting, screening, and testing.”
In 1998, EDSTAC submitted a final report to Congress, which outlined the approach they recommended to the EPA. Yet after twelve years, practically nothing has been done. Just last year, on October 21, 2009, the EPA published a list of chemicals proposed for Tier 1 screening – the first step in the screening process - that included just 67 chemicals. Given that there are approximately 80,000 chemicals in commerce today and that approximately 4000 are imported/used in the United States in quantities exceeding 1 million pounds per year, the EPAs endocrine disruptor program is completely lacking in credibility. The program is a bad joke.
If EDSTAC and the EPAs nonexistent effort over the last twelve years is the best the government can do, then we can surely expect that there will be a vast increase in the number of “disgusting” outcomes. It boils down to the simple fact that if one does not look, one will not find. If Mr. Markey is really concerned about these chemicals and their “disgusting” effects, might I suggest that he propose simply looking for the same outcomes in humans that are observed in animals?
Welcome. An Introduction.
Welcome to my new blog, Fear of a Pink Planet.
As background, this blog title is taken from a chapter in Deborah Rudacille’s book The Riddle of Gender: Science, Activism, and Transgender Rights which discussed my work along with those of others attempting to connect the dots between environmental change, medicine, and the increase in the number of transgender people seeking treatment, many of whom are searching for a rational explanation of how gender identity forms and how the developmental process can be altered.
Like many trans people, I felt a discordance between my sense of gender identity and my physical body from my earliest memories, around age three. After many years of struggle and many deliberate attempts at avoiding and denying my own deeply-held sense of self, I decided to transition in 1995 rather than commit suicide, which I felt was my only other realistic option. Although the transition process was arduous at times, I no longer feel that same sense of dissonance regarding my gender. In many respects, things have turned out far better than I ever could have imagined. It turns out that the fear was much worse than the reality.
Nonetheless, being the curious type, I began to research possible causes of transsexualism around the time of my transition, and have read everything I could find on the topic. I was particularly dubious of psychological explanations that claimed gender identity is determined solely by sex of rearing, a theory that has been prominent since John Money first introduced it in 1955. His theory didn’t fit my circumstances or upbringing at all, so I kept searching for some explanation that might prove to be more consistent with my own experience.
In early 2001, while doing research on another topic, I stumbled across the term “endocrine disrupting chemical” and for the first time, I had a strong feeling that I had inadvertently found a key piece of the puzzle. I began to research the environmental health scientific literature, and much to my amazement, a completely new picture emerged, and all those disparate pieces of information I had collected along the years finally fit into a coherent framework. In addition, it also suggested a course of action and areas to study that would likely be fruitful along these lines.
Along with my friend Angie Kimble, we created the website www.transadvocate.org, where I published my papers and tried to gain a wider audience for my work. Angie did much of the advocacy and outreach work, and shared my passion regarding the immense importance of the uncovered evidence. The goal was to change the terms of the debate, and to reframe transsexualism as the predictable outcome of exposure to endocrine disrupting chemicals during crucial periods of development. That is, I wanted to widen the scope of the problem to an ecological perspective.
In 2002, I was interviewed by Deborah Rudacille for her book after she had come across my website, and was somewhat surprised to see my claims given such a prominent role, even though the publishers and reviewers routinely avoided mentioning that section of the book. In retrospect, she was very kind; at that time I had a limited understanding of the consequences of my work, and she could have easily painted a far different picture.
Later that same year, I returned to college, entering the Environmental Studies program at The Evergreen State College in Olympia Washington. During my time there, I had access to a much larger body of research data and many journals that are unavailable to the public. In fact, this was a large part of my interest in returning to academia, simply to get access to this literature. As part of my coursework, I wrote a master’s thesis examining the relationship between endocrine disrupting chemicals and transsexualism.
For the last six years, I have been much less active in my research. While the reasons for this are partially due to circumstance, to a large degree it was simply to get some distance from the problem, since by that time I had been researching for almost a decade, and full-time for almost four years. I needed to take some time off to regain some perspective and to resolve some long-standing personal issues. During that time, I also ran into some financial problems, and lost the www.transadvocate.org web domain, which was subsequently bought by a pay-per-click cyber-squatter who has been capitalizing from links to the site for the last four years. Despite my best attempts at recovering the domain, they have all failed. So reader, please be advised that I have not had any relationship to www.transadvocate.org for the last four years, and you are wasting your time going there.
Nonetheless, I have watched the news over the last few years and see evidence mounting that the number and quantities of endocrine disruptors in the environment are steadily increasing, animals are increasingly at peril, government regulation and enforcement is completely broken, and an increasing number of children are being pathologized by over-zealous “treatment providers,” and the psychological establishment at large.
My aim with this blog is to provide information in a weekly posting that will help readers to “connect the dots” so that interested people will be able to understand and act intelligently when it comes to endocrine disruptors and their effects on gender and sexuality. For those of you who have an interest, all my original papers from the transadvocate website have been archived by my friend Jenny, and can be found here.
As background, this blog title is taken from a chapter in Deborah Rudacille’s book The Riddle of Gender: Science, Activism, and Transgender Rights which discussed my work along with those of others attempting to connect the dots between environmental change, medicine, and the increase in the number of transgender people seeking treatment, many of whom are searching for a rational explanation of how gender identity forms and how the developmental process can be altered.
Like many trans people, I felt a discordance between my sense of gender identity and my physical body from my earliest memories, around age three. After many years of struggle and many deliberate attempts at avoiding and denying my own deeply-held sense of self, I decided to transition in 1995 rather than commit suicide, which I felt was my only other realistic option. Although the transition process was arduous at times, I no longer feel that same sense of dissonance regarding my gender. In many respects, things have turned out far better than I ever could have imagined. It turns out that the fear was much worse than the reality.
Nonetheless, being the curious type, I began to research possible causes of transsexualism around the time of my transition, and have read everything I could find on the topic. I was particularly dubious of psychological explanations that claimed gender identity is determined solely by sex of rearing, a theory that has been prominent since John Money first introduced it in 1955. His theory didn’t fit my circumstances or upbringing at all, so I kept searching for some explanation that might prove to be more consistent with my own experience.
In early 2001, while doing research on another topic, I stumbled across the term “endocrine disrupting chemical” and for the first time, I had a strong feeling that I had inadvertently found a key piece of the puzzle. I began to research the environmental health scientific literature, and much to my amazement, a completely new picture emerged, and all those disparate pieces of information I had collected along the years finally fit into a coherent framework. In addition, it also suggested a course of action and areas to study that would likely be fruitful along these lines.
Along with my friend Angie Kimble, we created the website www.transadvocate.org, where I published my papers and tried to gain a wider audience for my work. Angie did much of the advocacy and outreach work, and shared my passion regarding the immense importance of the uncovered evidence. The goal was to change the terms of the debate, and to reframe transsexualism as the predictable outcome of exposure to endocrine disrupting chemicals during crucial periods of development. That is, I wanted to widen the scope of the problem to an ecological perspective.
In 2002, I was interviewed by Deborah Rudacille for her book after she had come across my website, and was somewhat surprised to see my claims given such a prominent role, even though the publishers and reviewers routinely avoided mentioning that section of the book. In retrospect, she was very kind; at that time I had a limited understanding of the consequences of my work, and she could have easily painted a far different picture.
Later that same year, I returned to college, entering the Environmental Studies program at The Evergreen State College in Olympia Washington. During my time there, I had access to a much larger body of research data and many journals that are unavailable to the public. In fact, this was a large part of my interest in returning to academia, simply to get access to this literature. As part of my coursework, I wrote a master’s thesis examining the relationship between endocrine disrupting chemicals and transsexualism.
For the last six years, I have been much less active in my research. While the reasons for this are partially due to circumstance, to a large degree it was simply to get some distance from the problem, since by that time I had been researching for almost a decade, and full-time for almost four years. I needed to take some time off to regain some perspective and to resolve some long-standing personal issues. During that time, I also ran into some financial problems, and lost the www.transadvocate.org web domain, which was subsequently bought by a pay-per-click cyber-squatter who has been capitalizing from links to the site for the last four years. Despite my best attempts at recovering the domain, they have all failed. So reader, please be advised that I have not had any relationship to www.transadvocate.org for the last four years, and you are wasting your time going there.
Nonetheless, I have watched the news over the last few years and see evidence mounting that the number and quantities of endocrine disruptors in the environment are steadily increasing, animals are increasingly at peril, government regulation and enforcement is completely broken, and an increasing number of children are being pathologized by over-zealous “treatment providers,” and the psychological establishment at large.
My aim with this blog is to provide information in a weekly posting that will help readers to “connect the dots” so that interested people will be able to understand and act intelligently when it comes to endocrine disruptors and their effects on gender and sexuality. For those of you who have an interest, all my original papers from the transadvocate website have been archived by my friend Jenny, and can be found here.
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