It is not only practitioners of so-called alternative medicine (SCAM) who can be fraudulent charlatans. The study of medicine does not protect you from joining in. Here is an impressive case in point:
It has been reported that a former doctor convicted of fraudulently submitting nearly $120 million in claims related to the 1-800-GET-THIN Lap-Band surgery business has been sentenced to seven years in federal prison.
Julian Omidi, 58, of West Hollywood was sentenced Monday by U.S. District Court Judge Dolly M. Gee. The judge also imposed a five-year probation period on Surgery Center Management LLC, an Omidi-controlled Beverly Hills-based company. In the coming weeks, Gee is expected to hold a separate hearing to decide on restitution and forfeiture in the case, along with setting a fine for the Beverly Hills company.
“Mr. Omidi made millions at the expense of the multiple victim companies he defrauded, and he violated his oath to ‘do no harm’ by callously misleading patients about the need for a sleep study and subsequent weight loss surgery,” said Donald Alway, the assistant director in charge of the FBI’s Los Angeles field office.
Omidi controlled several entities in the GET-THIN network. Prosecutors say Omidi incentivized employees to ensure patients underwent sleep studies and then falsified the results to show that patients had obstructive sleep apnea to help them qualify for insurance coverage for the weight loss surgery. Those results were then filed with insurance companies to pre-approve the Lap-Band weight-loss surgeries. The 1-800-GET-THIN business received approximately $41 million for those procedures, according to prosecutors. While not all patients were approved to receive the surgery, prosecutors say GET-THIN would bill the patient roughly $15,000 for each sleep study, totaling $27 million in payments from insurance providers.
Omidi and his Beverly Hills-based company, Surgery Center Management, were found guilty of 28 counts of wire fraud, three counts of mail fraud, and one count of conspiracy to commit money laundering. Omidi was also found guilty of two counts of making false statements relating to healthcare matters, one count of aggravated identity theft, and two counts of money laundering after a 48-day trial in downtown Los Angeles.
“As found by the jury, the defendant Julian Omidi deliberately and repeatedly acted with an eye towards business and profits, rather than in the interest of GET-THIN’s medical patients, by inducing patients to undergo medical treatment premised on fraud rather than medical necessity, including surgeries that carry significant risks and life-long health impacts,” said U.S. Atty. Martin Estrada. A series of Los Angeles Times columns from 2010 to 2014 detailed how five patients died after they received Lap-Band surgeries at clinics affiliated with 1-800-GET-THIN. During a 2009 inspection, the Department of Health and Human Services found unsanitary conditions, inoperative scrub sinks, one-time-only equipment being reused, and several other deficiencies. The inspector shut down the clinic for a day, but further action was not taken at the time.
Omidi’s medical license was revoked in 2009, and he was arrested. In 2014, federal agencies seized more than $110 million from the 1-800-GET-THIN network in securities and funds.
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This is a spectacular case, of course. Yet, I fail to see how it differs in principle from the many instances we see on a daily basis in the realm of SCAM. Let me give you just a few examples:
- A chiropractor diagnoses subluxation and subsequently treats his patient with a series of spinal manipulations.
- A naturopath uses iridology to diagnose a weakness of the liver and subsequently treats it with herbal remedies.
- An acupuncturist diagnoses a blockage of chi and follows it up with a series of acupuncture sessions.
- A Heilpraktiker employs bioresonance to diagnose an intoxication which he then treats with a detox program.
The strategy is always the same:
- Charlatans use bogus diagnostic methods.
- They make bogus diagnoses with them.
- They then start expensive and often dangerous treatments.
- They make good money by defrauding the system.
Could someone please explain what the difference in principle is between the case of the fraudulent surgeon and the average SCAM practitioner?
44 Responses to Doctor gets 7-year sentence for multimillion-dollar fraud scheme
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I can see no significant difference. Fraud is fraud.
EE: A chiropractor diagnoses subluxation and subsequently treats his patient with a series of spinal manipulations.
WHO definition of subluxation: “dysfunction in a joint or motion segment in which alignment, movement integrity and/or physiological function are altered, although contact between joint surfaces remains intact”
“chiropractic subluxation” is a physical entity. Other professions use other labels. Joint restriction (PT). Somatic lesion (DO). Paraspinal muscle spasm (MD).
https://edzardernst.com/2015/02/subluxation-a-myth-that-is-deeply-ingrained-in-the-chiropractic-mind-set/
https://edzardernst.com/2023/03/chiropractic-subluxation-the-myth-must-be-kept-alive/
https://edzardernst.com/2018/08/chiropractors-dammed-if-they-do-and-dammed-if-they-dont-abandon-the-subluxation-myth/
Paper 1. Students strongly agreed (17.4%)…. that it is important for chiropractors to hold strongly to traditional chiropractic theories and practices.
That’s a minority.
Paper 2. Editorial.
Paper 3. Just covers the use of the word subluxation in chiropractic courses.
If that’s the best you’ve got…
Another example:
A doctor gives a patient a cholesterol test and puts them on an expensive Statin known to cause numerous serious even deadly side effects for the rest of their life (shortened by the statins). This despite it being well known in the last decade that arteriosclerosis is not caused by “cholesterol”.
Oh, but that one is repeated hundreds/thousands of times daily and no one seems to object.
No, but lets take all those alt “scammers” out and shoot them.
oh dear!
Oh dear Stan
“A doctor gives a patient a cholesterol test and puts them on an expensive Statin”
Generic statins are some of the cheapes drugs out there. Generic atorvastatin cost the NHS 81p for a 28 tab pack.
” known to cause numerous serious even deadly side effects for the rest of their life”
Side effects from statins are mild and occur in around 5% of people. The most common – muscle pain – has been shown to be due to the nocebo effect in most cases. Please us show any deaths confirmed to have been caused by statin use.
“life shortened by the statins”
Statins give a 30% reduction in cardiovascular events, Stan. They have been shown to be one of the most effective preventative medications there is.
“This despite it being well known in the last decade that arteriosclerosis is not caused by “cholesterol””
Do we need to explain to you the difference between HDL and LDL, Stan?
So that’s you being wrong on every point. Again. Good work.
I fear one would need to explain the difference between BS and evidence to Stan.
@Lenny
Most MD’s attempting to treat high cholesterol are just mimicking what the authorities have instructed them to do. High cholesterol ?… then prescribe some statins. It’s really more complicated than that. MD’s in the USA blindly follow along so they don’t get taken to court.
The underlying reason for much of the high cholesterol is due to high blood sugar…. not high fats or high cholesterol foods. Sugars are what causes damage the cholesterol. Statins can lower LDL cholesterol, but at a cost to wallet and health. Again, right back to our modern-day diet.
Dr. Sten Ekberg gives some good instruction on cholesterol in the video link.
https://www.youtube.com/watch?v=sY48qLl9ZzE&t=1469s
https://drbeckycampbell.com/the-real-cause-of-high-cholesterol/
@RG
… is not a real doctor at all, but a quack without any education in medicine whatsoever. This man should be banned from telling people what medicines they should or should not take. And oh, look, this man has his own shop(*), selling all sorts of extremely expensive quackery products. Now I wonder what he would recommend instead of statins …
Anyway, here is what a REAL doctor thinks of Mr (not Dr) Ekberg’s ‘information’:
https://www.youtube.com/watch?v=IFGvs1Qe7cA
Summary: Mr Ekberg is a lying quack, not someone to listen to.
… is also not a real doctor at all, but a quack (naturopath), mostly educated in tooth fairy science, not real medicine. And oh, look, she too has her own shop selling all sorts of completely useless yet extremely expensive quackery products.
Now I wonder why these quacks insist on using the ‘Dr’ prefix when they are not real doctors at all … The only reason I can come up with is that they want to mislead their
victimshapless customers into believing that they are actually knowledgeable on the subject of medicine.*: On a mildly amusing note, his Web site name drekberg.com has a rather appropriate meaning in Dutch.
Oh dear. Another one of those “he’s not a real doctor” BS arguments.
This is typical of people that don’t have a brain of their own to use. Someone who can think, has no problem in distinguishing between the “patch it up quickly”-mindset of most mindless ‘real’ doctors and the complex thinking of someone who has done the work of really finding out how the human body works.
Your cholesterol is too high, so let’s bring it down with some drug. Don’t bother asking what is or why it is “too high”, shall we ? Do not bother about the side effects either. No, just bring it down. Next patient, please…
If you cannot recognize the idiotic simplistic thinking pattern behind this, then there is no hope for you.
BTW : you don’t want to know how many patients your “real” doctors are killing every year with medication.
And if you do, look it up…
If you cannot recognize the idiotic simplistic thinking pattern behind your comment, you probably are an idiot.
@James
Oh dear, another one of those “regular doctors are no good” arguments, by someone who really doesn’t know what he is talking about. Please allow me to educate you.
What you are describing here is definitely a real doctor, who has spent at least 15,000 hours of hard study and internships to really find out how the human body works.
Uneducated people such as not-a-doctor-at-all Mr Ekberg probably did not even spend 15 hours of studying medicine before deciding that it was much easier to sell his snake oil to gullible, equally uneducated people such as you.
Well, yes, if that has proven benefits for the patient, and other interventions such as lifestyle and dietary changes do not help sufficiently. Statins absolutely lower the risk of cardiovascular events in people with high blood cholesterol – and the average real doctor has many patients with this problem, who nowadays live significantly longer than even 25 years ago(*).
I really wonder if not-a-doctor-at-all Mr Ekberg ever treated a real patient in his life. And if so, whether these people survived his bad advice and ill-informed ‘treatment’.
*: And don’t even get me started on people with for instance familial hypercholesterolemia, some of whom I know personally. Without statins, these people typically have their first ischemic heart attack before age 40, and most die around the age of 60. So, lowering a very high cholesterol level is absolutely a Good Thing. And no, people don’t die from statins – most don’t even experience any side effects.
Oh, I DO know how many people die as a result of errors with medication prescribed by real doctors, at least here in the Netherlands: about 1100 every year. And yes, that is quite a lot, and great efforts are taken to try and get that number down.
Then again, those real doctors deal with really sick people, quite a lot of whom are old, frail and suffer from multiple ailments – several hundred thousand, again here in the Netherlands. At least half those people would long be dead WITHOUT all those medicines. You are in other words committing the classic fallacy of focusing exclusively on negative outcomes while ignoring the positive ones.
In contrast, people like not-a-doctor-at-all Mr Ekberg don’t even want to deal with customers like that – because they know that these are high-risk patients who bring them more trouble than profit.
In other words: as soon as it tuns out that a customer is suffering from an actual, serious condition, then most practitioners such as not-a-doctor-at-all Mr Ekberg drop them like the proverbial hot potato(**), after which real doctors have to clean up the mess.
Anyway, I hope this clears things up a bit. No, no need to thank me, it’s been my pleasure, really.
**: Which is in fact a good thing. The last thing you want as a patient is to have an uneducated quack continue their useless treatments in cases of serious illness.
OMG James,
I completely agree, brainless people think that they have to visit a doctor when they are ill. In fact, there are non-doctors who can cure most ailments more effectively than a real doctor can.
For example, butchers can do most surgeries, including lobotomies They are not real surgeons but know how to slice and dice. Yet they don’t charge exorbitant prices for their services. When you need surgery, be sure to inquire at your nearest butcher shop. They don’t always have the funds to spend on advertisments.
Perfect, James👏👏👏 People are bothered when somebody brings the answers they cannot reach.
@Richard Rasker
You should learn to read. “Regular doctors are no good” was NOT my argument, and what’s more, I never even said that.
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“What you are describing here is definitely a real doctor, who has spent at least 15,000 hours of hard study and internships to really find out how the human body works.”
——————————–
No, what I am describing here is someone like Dr. Ekberg, who proves time and time again he knows how the human body works, because he can explain the mechanisms of it in detail and does so in several of his videos, unlike most of your precious “real doctors”, who are unable, for example, to diagnose a patient with insulin resistance, pre- or full-blown diabetes until the sugar comes running out of their ears. And even then, all they have to offer is a drug, like Metformin, or in later stages, insulin. What could possibly go wrong, anyway ?
If at all “real doctors” knew at some point how the human body works, there are a hell of a lot of them who seemed to have forgotten.
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“Uneducated people such as not-a-doctor-at-all Mr Ekberg probably did not even spend 15 hours of studying medicine before deciding that it was much easier to sell his snake oil to gullible, equally uneducated people such as you”
————————————
Dr. Ekberg is a doctor of Chiropractic, sunshine, so that makes him educated AND a doctor. He’s just not a medical doctor. And so what ? He could be an engineer for all I care, since what he has to say would still be relevant, interesting and most importantly, it makes a lot of sense.
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“-Your cholesterol is too high, so let’s bring it down with some drug- “Well, yes, if that has proven benefits for the patient…”
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Well, well, what do we have here ? If it isn’t the ‘classic fallacy of focusing exclusively on’ POSITIVE outcomes while ignoring the NEGATIVE ones ?
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“… and other interventions such as lifestyle and dietary changes do not help sufficiently”
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No wonder, if the “dietary changes” are prescribed by your average “real doctor”, or sometimes even worse, some dietician who hasn’t the slightest idea that the western diet is filled to the brim with sugar and processed rubbish. But hey, as long they have their diploma’s, all is well, I suppose ?
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“I really wonder if not-a-doctor-at-all Mr Ekberg ever treated a real patient in his life”
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Oh, haha, not only is the doctor not real, now also the patients are not, huh ?
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“Oh, I DO know how many people die as a result of errors with medication…”
————————————-
I was not talking about errors, sunshine, unless you are admitting now that prescribing a statin to lower your cholesterol is an “error with medication”…
————————————-
“Then again, those real doctors deal with really sick people, quite a lot of whom are old, frail and suffer from multiple ailments – several hundred thousand, again here in the Netherlands. At least half those people would long be dead WITHOUT all those medicines.”
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Well, if we’re going to take guesses, mine is that “at least half those people” wouldn’t have been sick in the first place if they wouldn’t have stuffed themselves with carbs and processed garbage their whole lives.
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“You are in other words committing the classic fallacy of focusing exclusively on negative outcomes while ignoring the positive ones.”
————————————-
Well, I kind of permit myself to do so, because we’re talking for the most part about a bunch of medication you probably didn’t need in the first place…
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“In contrast, people like not-a-doctor-at-all Mr Ekberg don’t even want to deal with customers like that…”
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You have a real talent to draw the wrong conclusions, haven’t you ?
Most people ending up with “not real doctors” like dr. Ekberg are exactly that : ‘really sick people, quite a lot of whom are old, frail and suffer from multiple ailments’, ‘suffering from an actual, serious condition’ and tired to have been send from left to right by “real doctors” and given all kinds of not working medication, or worse, medication with side effects that gave rise to new symptoms.
So now you know who has to “clean up the mess”.
You were right about one thing, though : this DOES clear “things up a bit”, especially that you’re someone that values titles a lot more than common sense, and use the former more often than not as an argument.
That’s called “the appeal to authority fallacy”, BTW, but you already knew that. You just hadn’t figured out it applied to you. That’s ok, most people are this way, walking the paths of the ‘sheeple’ because of their insecurity and lack of judgement, common sense and logical thinking. Watch out, at some point, you are likely to become (haha) “gullible” and being sold “snake oil” to…
So I’m afraid the part where you “educate” me, will never happen.
Don’t be miserable…
“Dr. Ekberg is a doctor of Chiropractic, sunshine, so that makes him educated AND a doctor.”
No, it makes him a charlatan who pretends to be a doctor. I know some chiros and they are unbelievably stupid.
Dr. Ekberg makes money (likely millions) by telling people good news about their bad habits. His “research” includes eating foods high in fat / cholesterol for short periods of time (10 or 30 days) then declaring that these foods are safe / harmless because he didn’t get sick. It wouldn’t surprise me if he’s getting kickbacks from the meat / dairy industries.
He’s likely convincing thousands of people that’s it’s fine to eat huge amounts of these foods over many years, which will kill most of them. He’s either a moron or a fraud, perhaps both.
I don’t know Sten Ekberg.
I do know that many many thousands of MDs are eating Keto, Ekberg is one. Many MD’s are also eating carnivore diet (lion diet).
Most all will testify that they are healthier and feel better now than previous to changing their eating menu. A smaller number have been eating carnivore diet for more than 20 years. They appear to still be doing well, and staying with it. They will also tell that their LDL cholesterol went a tad higher, and total cholesterol may or may not have increased. These markers alone do not depict worse/better health.
So, I have my doubts about the worry of high cholesterol from eating too much dairy foods. Are there other hazard factors to consider from eating a carnivore diet… I think probably. However, I seriously doubt that it’s any more harmful than earing the SAD (standard American diet).
Ekberg may not be and MD, but you need not be an MD to understand good nutrition, in fact MD’s have very little education in nutrition from their medical school.
“Many MD’s are also eating carnivore diet (lion diet).”
Are you sure?
Slip another wildebeest on the barbie, Sheila.
Pete Atkins
Perhaps you should climb out of your cave, skip the zoo, and learn a bit more.
https://www.healthline.com/nutrition/lion-diet
https://www.everydayhealth.com/diet-nutrition/lion-diet/guide/
Loved your deployment of the grocer’s apostrophe, ‘John’.
RG,
Thank you for posting examples of quacks that we should stay away from.
Most of the time you come here screaming about one or more of the following – vaccines, insulin resistance, statins, big pharma. All that stress is not good for you. Why don’t you go on a shopping spree on Ekberg’s website: https://www.drekberg.shop/collections/health-devices? You could put on a BrainTap headset ($500 plus a monthly subscription costing $29), lay on a PEMF mat ($2450) and wrap yourself with EMF shield ($20). Apparently, all these products will help you de-stress.
Campbell sells a wide array of supplements in her store to treat various metabolic conditions. My favorite is “Optimal Reset Liver Love” https://shop-dr-becky-campbell.myshopify.com/collections/products-for-everyone/products/dr-becky-campbell-liver-love, it is all natural dietary supplement designed to show some love to your liver. I think you should try that. If you want to support your immune system to fight off COVID you should try “Ultimate Immune Support” https://shop-dr-becky-campbell.myshopify.com/collections/products-for-everyone/products/optimal-ultimate-immune-support.
Rest assured, money you spend on above products is not going into big pharma pockets.
PS: how much are you getting paid to promote Ekberg and Campbell websites on here?
RG
Proof by YouTube! That’s me convinced!
Now. How about some decent studies to back up your assertions?
We’ll wait.
You will notice in the show notes, Dr. Ekberg provides no studies to support his dubious claims. Here is an example:
https://www.youtube.com/watch?v=BhNGRB14TTE
Here is a response to the above video by a guy who backs up his video with actual studies:
https://www.youtube.com/watch?v=OfbTdivzDXg
@Lenny
When I post pertinent information, the moderator blocks me.
when you promote stupid conspiracy theories, I block you.
RG,
You can barely read and argue your point without melting down, let alone differentiate conspiracy theories from facts. Perhaps you should pull your head out once in a while, all that methane you end up breathing in can’t be good for your brain.
@Talker
Ha, big words coming from a moniker that post nothing valuable to add here….just attacks on others. When have you offered any evidence? … nada
Go away you nutjob.
nutjob?
seems a bit rich from you, RG
@RG
You have a very consistent history of quoting people who say things that aren’t true, to put it mildly.
The latest example is this chiropractor and not-a-real-doctor-at-all by the name of Sten Ekberg, who tells a couple of major untruths about cholesterol and statins. And yes, the (real) doctor who debunks those untruths – in a very respectful manner, I might add – does this not just by saying where not-a-real-doctor-at-all Mr Ekberg is wrong, but also by pointing at lots of high-quality scientific evidence explaining why what not-a-real-doctor-at-all Mr Ekberg says is wrong.
Not-a-real-doctor-at-all Mr Ekberg on the other hand does NOT point to proper evidence when he says for instance that statins do more harm than good, or that high blood cholesterol levels are no problem at all.
And yes, you also have propensity to not only believe in all sorts of conspiracies, but to also promulgate those beliefs here, without producing good evidence (and no, links to other believers who basically say the same thing you repeat here are not evidence). Which is probably why Edzard sometimes pinches off your firehose, so to speak.
precisely!
RG,
You want evidence? Evidence for what? Little green men? Big foot? Chemtrails? Unlike you I don’t believe in and/or propagate conspiracy theories, disinformation, and misinformation.
You have lowered the bar for rest of us by constantly posting conspiracy theories and all I have to do is point out how stupid you are for believing in that nonsense.
@EE
Just an excuse to block… no conspiracy theory was stated.
What conspiracy theory, that a certain anti-SCAM website moderator was peddling books on his website ?
Ohhhh that theory.
@Edzard
“If you cannot recognize the idiotic simplistic thinking pattern behind your comment, you probably are an idiot”
You don’t seem to understand, so let me spell it out for you :
– “He’s not a real doctor” is NOT a valid argument. Thinking it is, is a “simplistic thinking pattern”.
– Trying to lower an isolated blood marker like “cholesterol” with a drug when a “real doctor” :
– doesn’t know what “too high” means in the case of cholesterol ( and he doesn’t )
– doesn’t know that cholesterol is a causal factor or not in the disease or the symptoms ( and he doesn’t )
– doesn’t even know or consider side effects ( and most of the time he doesn’t)
… is also a pretty “simplistic thinking pattern”
– Calling LDL “bad cholesterol”, again is a sign of “simplistic thinking”
All the nuance in this cholesterol-story is explained in Ekberg’s Youtube-video which RG already posted here :
https://www.youtube.com/watch?v=sY48qLl9ZzE&t=1469s
Of course, you would need a brain to follow Ekberg’s discourse. The easier path by far is to just accept what
the standard care system prescribes that’s followed by “real doctors”.
But please feel free where the “idiotic simplistic thinking pattern” in my comment was hiding. I’ll wait.
But I think we both know which one of us is the idiot.
@Frank Collins on Wednesday 14 June 2023 at 00:46
“
‘Dr. Ekberg is a doctor of Chiropractic, sunshine, so that makes him educated AND a doctor.’
No, it makes him a charlatan who pretends to be a doctor. I know some chiros and they are unbelievably stupid.
”
What do YOU think “Dr.” stands for, genius ? Like I said, he’s just not a medical doctor.
And the fact you know “some chiros” who are “unbelievably stupid” makes you conclude what, exactly ?
And BTW : who’s brain did you borrow to decide these chiros were stupid ?
And what, then, shall we deduce from the fact I know a ton of “real doctors” who are “unbelievably stupid ?
What was it again ? Oh yes : “Better to remain silent and be thought a fool than to speak and to remove all doubt”
@Talker on Friday 09 June 2023 at 13:18
“OMG James,
I completely agree, brainless people think that they have to visit a doctor when they are ill. In fact, there are non-doctors who can cure most ailments more effectively than a real doctor can.
For example, butchers can do most surgeries, including lobotomies They are not real surgeons but know how to slice and dice. Yet they don’t charge exorbitant prices for their services. When you need surgery, be sure to inquire at your nearest butcher shop. They don’t always have the funds to spend on advertisments.”
Completely besides the point, Einstein.
I was talking about what RG very accurately described as “Most MD’s attempting to treat high cholesterol are just mimicking what the authorities have instructed them to do. High cholesterol ?… then prescribe some statins”.
And when it comes to cholesterol, as the blood test would just be a ‘check-up’, the illness more often than not, comes AFTER the visit to the doctor. That’s what side effects will do for you.
But hey, you seem to be the brainless kind that would jump if your doctor told you so. No questions asked. Be my guest, but just know that your sarcasm isn’t cutting it.
Don’t be miserable.
Hi RG
have you appologized yet?
No
In that case, this was your last comment under your new pseudonym.
@James
Instead of listening to what authorities and MDs have to say, I have to listen to some random internet troll who goes by the name RG and who has a reputation of being the dumbest of the dumbest trolls. Point taken, James. I will certainly heed your advise and trust a dumb internet troll over MDs. I bet you reach out to internet trolls all the time when you need medical advise.
@Talker on Wednesday 19 July 2023 at 18:57
Wrong again. You don’t “have to” do anything. I was advising you to use your own brain and listen to what is being said instead of focusing on who’s saying it.
But you know what ? I think you were right all the time : it WOULD be best for you to listen to “MD’s” in your case.
Since you’ve clearly proven you are not capable of thinking for yourself, let alone arguing the contents of someone’s train of thought. Instead, you keep coming back time and time again with a version of “the appeal to authority fallacy”, here and there spiced up with a little “reputation” non-argument. But I get it, thinking is hard for most people.
On the other hand, I DO think it’s about time to start feeling miserable now…
Oh, BTW : it’s “medical adviCe”…
@James
Good luck with your version of “thinking for yourself” which includes subscribing to conspiracy theories, listening to quack and internet trolls. You are in great company of false authority.
It is comical how you think you can tell others what to feel.
Oh, BTW: it’s not “MD’s” (possessive form); it’s “MDs” (plural form).
Commentators ‘RG’ and ‘John’ each made this error above. Now ‘James’.