This type of nerve conduction testing measures the healthiness of the lining of your nerve. ₹60 lakh+ saved for our customers. David Valentine, MD is a neurology specialist in Pasadena, CA and has over 7 years of experience in the medical field. 5/5 Based on 11 reviews. The aim of this study was to test the sensitivity of specific motor nerve conduction tests in comparison with, as well as in addition to, sensory nerve. The NCV testing is the nerve conduction velocity test. To find out more about EMG/NCV testing and how it can help you, call Neurology Center of Las Vegas or book an appointment online today. The pinkie finger was tested to see if it's a carpal tunnel thing (thumb and first two fingers) or a cubital tunnel thing (pinke and next to last finger). Electromyography (EMG) and nerve conduction velocity (NCV) are electrodiagnostic tests that measure the electrical activity of muscles and nerves. In March 2017, the American Academy of Neurology affirmed AANEM's. Apollomedics Super Speciality Hospitals is a 330-bedded quaternary care hospital with state-of-the-art modern healthcare facilities located in the heart of Uttar Pradesh, in the. 80% passing score. 1500 to Rs. Electromyography (EMG) is a diagnostic test that assesses muscle and nerve activity in response to stimuli. Two electrodes are placed on the skin over your nerve. Sparman, M. An EMG is a nerve conduction study that evaluates a muscle’s response to the nerve that controls it. [1] Entrapment neuropathies occur within peripheral nerves and is typically characterized by pain and/or loss of function (motor and/or sensory) of the nerves as a. The referral contains the detailed report with the other specialists findings (a. Pasadena, Tx 77505 713-948-7023. Working hours: 8 AM to 2 PM. Donate. Many people suffer from muscle pain, numbness, or tingling that can be a result of multiple factors, including damage to the muscle tissue, nerve, or joints. 1 Answer. Phone: 530-265-1627. This test may. This procedure is different and distinct from assessment of nerve conduction velocity, amplitude and latency. Explanation: ncvTest () is not in base R, so we need to load the appropriate package in. They are situated along your spinal cord, outside your brain. Office Hours: Main Office Mondays to Fridays: 8:00 am - 5:00 pm Lunch: 12:30 pm - 1:30 pm Sleep Lab Mondays to Sunday: 8:00 pm - 6:00 am. constant voltage electric stimulator evokes a response from muscle (motor nerve study) or along the nerve (sensory nerve study) standard stimulus is 0. Electromyography (EMG) Testing & Nerve Conduction Studies (NCS) in Pasadena, CA. A nerve conduction velocity (NCV) test measures how fast an electrical impulse moves through your nerve. NCV measures the conduction of electrical impulses along a nerve, with healthy nerves showing higher speed and strength than. Better known as NCV testing, Nerve Conduction Velocity testing helps determine the speed at which an electrical impulse moves through your nerve. The GP may also arrange blood tests, especially to check for causes such as diabetes or vitamin B12. Your doctor will order an electromyography test if you are showing signs of muscle or nerve disorder. 2 (19 ratings) Pasadena, TX. 5% of them said that the NCV test was more uncomfortable. A nerve conduction velocity test (NCV) is used to determine damage to the nerve and neuromuscular unit. He then completed medical school in 2001. What is nerve conduction velocity test? In this video, get to know more what is nerve conduction velocity test. Consult Your Healthcare Provider: The first and most crucial step is to discuss your NCV test results with your healthcare provider or neurologist. If I am really 100 percent sure that the problem is specifically in the muscle, I’ll skip ahead to the EMG or what I call the needle portion of the exam. They often use this test alongside a nerve conduction study. The NCV/EMG tests the speed of the nerve impulse as it travels down the nerve. He accepts multiple insurance plans. The NCS is usually done with an electromyogram (e-LEK-tro-MY-oh-GRAM), or EMG, which measures the electrical activity of your muscles. Mamta Kumari from Delhi. In this case, the NCV test may reveal a slower nerve conduction velocity and reduced amplitude across the affected nerve. EMG/NCV Test costs. The Nerve Conduction Velocity (NCV) study is a component of an Electromyography (EMG) test. J. With standard NCV testing, a trained clinician scores peaks, latencies, determines if tests are normal, adjusted to clinically. An electromyography needle exam, also known as EMG testing. Nearly all these test include a test of how fast the motor nerve conducts electrical impulses, called a nerve conduction study (NCS) or nerve conduction velocity (NCV. Nicolet VikingQuest b 2-9-15 Contact information. Pasadena, CA has 2423 Nerve Conduction Study doctors results with an average of 29 years of experience and a total of 14156 reviews. Often, the nerve conduction test is followed by EMG. We don't bill a separate E&M service with the EMG/NCV. The lowest Nerve Conduction Velocity test cost is ₹1275 only. values ## Chisquare = 46. All ITI Trades CBT Exam Nimi Mock Test. NCV Test Preparation . You may feel some discomfort depending on how strong the impulse is. Four RCTs. For instance, an arteriogram (or angiogram) can. An EMG/NCV test is a two-part diagnostic procedure used to evaluate the health and functionality of nerves and muscles in the body. It can diagnose diseases of the nerves. Use EMG codes 95860-95864 and 95867-95870 when no nerve conduction studies (95907-95913) are performed on that day. You may have muscle soreness or bruising after the test at the site where the needle was inserted. This test is done in two or more places along the nerve’s path. An NCS can help detect the presence and extent of peripheral nerve damage. St. now what? Justin Graff, M. This test helps diagnose various conditions that impact the spinal cord, nerve root, nerve, muscle, or neuromuscular junction. Best answers. This study included 114 T2DM patients (58 men) with mean age 64. G. 60 ±8. EMG/NCS TESTING LOCATIONS. Just call (512) 439-1001 or schedule an appointment online at a location near you. This test screens for damage to the optic nerve and is considered the most common nerve conduction study used in an MS diagnosis. D1 was nearest to the stimulation site while D2 was furthest. Two electrodes are placed on the skin over your nerve or over a muscle. We do the tests on our own patients (we're pain management as well as physical medicine/rehab), and we have specialists refer their patients to us just for EMG/NCV. NET . During the test, your nerve is stimulated, often with electrode patches put on your skin. The electrical impulses generated by the shock are measured, and the speed at which they travel through the nerve is recorded. Are you nervous about your upcoming EMG/Nerve Conduction study? Don't be! By watching our video, our lab tech will walk you through the motions of both of th. an optional data frame containing the variables in the model. Register for urine or hair drug tests in Pasadena, CA quickly and easily online. Book an appointment now by visiting out website medintu. Adding a third stimulation site to the two normally used increased the sensitivity of the test from 80 to 96 percent. - NCV studies are used mainly for evaluation of paresthesias (numbeness, tingling, burning) and/or weakness of arms and legs. In fact, the results show, people without any typical carpal tunnel syndrome symptoms can register abnormal results on nerve conduction tests depending on how the test is performed---and not all. Precision Medical Group, California's leader in patient-centered electrodiagnostic testing. EMG and NCV tests are done to help get to the bottom of why those symptoms are occurring. The Nerve Conduction Velocity (NCV) study is a component of an Electromyography (EMG) test. One is a nerve conduction study. Nerve conduction study (NCS), also known as a nerve conduction velocity (NCV) test, enables the diagnosis of possible nerve damage by measuring the speed with which an electrical impulse travels through a nerve. To book an “ NCV test near me ,” call City X-Ray & Clinic at 011-47252000. To best serve our patients, Precision Medical Group, Inc. How the Test is Performed. 6000, depending on various factors like the area to be studied, the location of the diagnostic center, and the technology used. EMG test results can be expected within 24 to 48 hours, while the NCV test can take up to 7 days. It is used to measure the muscle while at rest and then when the muscle is contracted. Your peripheral nerves begin where the nerve root gets off from the spinal cord. This school is far below the state average in key measures of college and career readiness. Address: 4141 Vista Road, Pasadena, TX 77504. The speed of electrical signals travelling down the median nerve is recorded. 2750. 151835e-12 ncv. An NCV will detect a problem with a nerve, while an EMG would detect a muscle not working properly in response to a nerve’s stimulus, so they will often be performed at the same time. RANCHO CUCAMONGA ; 8520 ARCHIBALD AVE, STE. Phill. This measures how well electricity moves through your nerves. AANEM identified normative criteria for nerve conduction velocity tests based on a review of high-quality published studies (see Table 1). Alambagh, Lucknow, 226012. 8. 5 (83 reviews) Claimed Neurologist, Sleep Specialists,. Once an EMG doctor knows how quickly your nerve reacts to the test, they can. We want your feedback! Note that we can't provide technical support on individual packages. NCV can identify nerve damage. Two electrodes are placed on the skin over your nerve. 6/10. Electromyography: This is more involved than NCS. We evaluated the utility of automated nerve conduction study (NCS) of the sural nerve with a new portable device for the diagnosis of DPN in patients with type 2 diabetes mellitus (T2DM). Technique. This test is done along with electromyography (EMG) to assess the muscles for abnormalities. . NCV tests are able to gauge the velocity and power of nerve signals. 2. Low-income and underserved students. Help diagnose nerve disorders, such as carpal tunnel syndrome or Guillain-Barré syndrome. 1. m. NCSs assess action potentials following peripheral nerve stimulation which include the speed (conduction velocity and/or latency), size (amplitude), and shape of the. In a variation of electromyography, two electrodes are taped to the skin. The Nerve conduction. Current perception threshold/sensory nerve conduction test (SNCT), per limb, any nerve [when specified as other portable automated nerve. Electromyography (EMG) and Nerve Conduction Velocity (NCV) studies are ordered to evaluate for injury or disease of muscle, nerve roots, and peripheral nerves. This test, often performed in conjunction with electromyography (EMG), allows the doctor to differentiate nervous system issues from. Chest X-Ray. Call 1800-572-0003 to Book your Scan OR 1) Leave your contact details, 2) We will reach out to you, 3) Lab details & charges will be shared with you, 4) We’ll book your test. Nerve conduction velocity tests help to distinguish muscular weakness in the affected upper extremity from cervical intervertebral disk protrusion, anterior horn cell disease, or a brachial plexus lesion. A number of tests may be used to diagnose peripheral neuropathy and its underlying cause. This test is also called a nerve conduction study. Dr. CPT Code Ncv 2023 is a diagnostic test used to evaluate the health of nerve cells and their ability to transmit signals to the muscles. A nerve conduction velocity (NCV) test measures how fast an electrical impulse moves through your nerve. The test is painless and doesn’t cause any discomfort or shock. Axonal Neuropathy: drop in amplitude . car::ncvTest(lmMod) # Breusch-Pagan test Non-constant Variance Score Test Variance formula: ~ fitted. An EMG and NCV are often done together to determine if a child has a muscle disorder or a nerve disorder. A nerve conduction study measures how electrical impulses move along a nerve; the two main parameters your physician will look at are velocity and amplitude of nerve signals: these will better characterize your disease and give clues to the causes. Where NCV is Used. RANCHO CUCAMONGA ;. 74 %. , DCA. A damaged nerve may send a slower and weaker signal than a healthy one. Electromyography (EMG) This is a test of your muscles and nerves. You can avail NCV upper. Nerve conduction studies (NCS) are commonly performed procedures during the diagnostic workup for peripheral nervous system disorders. A nerve conduction velocity (NCV) test is a commonly used diagnostic test to check for nerve damage and dysfunction. If a nerve conduction study was not performed, do not report these codes (instead go back to codes 95870 or 95860-95864 to report your EMG test). For the nerve conduction study, the doctor stimulates a nerve with small electric shock by placing an electrode on the skin above the nerve. Houston Neurological Institute in Pasadena and Pearland, Texas,. A nerve conduction velocity (NCV) test measures how fast an electrical impulse moves through your nerve. It is possible to have normal results even if a person has nerve. The reports are provided by a board-certified radiologist within 24 hours and. - 5 p. 4 in the total cohort, 47. As a HODS approved PT and Diagnostic Center we did an EMG and found out that the real issue was an L5 radiculopathy. Your doctor may order additional tests, such as: A nerve conduction study, to measure how well a nerve works and to locate the site of injury; An electromyography (EMG). The NCV and EMG tests can detect an injured nerve. To book an appointment at Garden State Pain & Orthopedics, call us at 732-256-1753. Mild electrical stimulation is administered to the skin directly overlaying the nerve. , M. A malfunctioning median nerve produces slower signals. The nerve conduction velocity (NCV) test (also known as nerve conduction study or NCS), studies the speed at which electrical impulses move through the peripheral nerves. Luke's Health - Patients Medical Center - Pasadena, TX. He currently practices at Practice and is affiliated with Huntington Hospital. 8 40 Sensory nerve studies Nerve Amplitudes (µV) Peak Latency (ms)Peripheral neuropathy has a variety of systemic, metabolic, and toxic causes. What is normal nerve conduction velocity? Normal NCV values can vary depending on the nerve being tested and the individual being tested. PASADENA, CA 9 1107 ; POMONA ; 675 N PARK AVE. Under Current Perception Threshold/Sensory Nerve Conduction Threshold Test (sNCT) removed italicized verbiage taken from CMS Publication 100-3, Medicare National Coverage Determinations Manual,. (NCV) Testing • Saturday appointments available! COMPETITIVE ADVANTAGE • Significant Cost Saving Strategies • Multiple. EMG and nerve conduction studies are used to help diagnose a variety of muscle and nerve disorders. Nerve Conduction Studies. Understanding the results of your NCV test is essential for getting the right treatment and managing your health effectively. Nerves conduct just like an electrical wire, so the test is performed in a manner similar to one used by an electrician in testing a wire. Natus Neurology Incorporated. The lowest EMG test cost is ₹1800 only. Neurology Training. Priti Palvadi, MD is a neurology specialist in Pasadena, TX. Medical Clinics of NYC is a leading provider of EMG/NCV testing in New York City. 325 0. This testing involves measuring the electrical activity of muscles and nerves to determine if there is. Her office accepts new patients and telehealth appointments. Pasadena Medical Office 3280 Foothill Blvd. This test is used to detect signs of nerve injury. 77 Automated Point-of-Care Nerve Conduction Tests Effective Policy Date: January 1, 2021 Original Policy Date: December 2011 Related Policies: 2. The test is used to evaluate the function of the peripheral nervous system, which includes the nerves that connect the brain and spinal cord to the rest of the body. A nerve conduction test is performed in a medical office with an EMG/NCS machine. PHONE: 855-364-6281- FAX: 949-955-0220 – EMAIL: EMGNCV@POMG. 15 ½ Minimum age to apply. The doctor will do nerve conduction tests first. Two electrodes are placed on the skin over your nerve or over a. Results The NCV function allows you to measure voltage without connecting one of the multimeter’s probes to the live wire. Your doctor. Conditions that can be detected or ruled out are muscular dystrophy, carpal. Employing the test allows a doctor to distinguish between a nerve and muscle disorder, thereby allowing for a more precise diagnosis. A physician’s prescription is required before scheduling an EMG. Petersburg, FL and 4 other locations and specializes in Neurology, Psychiatry and Child Neurology. Dr. Book an appointment now by visiting out website medintu. NCV TEST 5 Results D1 in meters D2 in meter T1 in sec T2 in sec Velocity in m/s 0. 8700 Beverly Blvd. NCV can determine nerve damage and destruction. FEP 2. Her office is not accepting new patients. Nerve conduction velocity (NCV) is a diagnostic test that measures the speed at which electrical impulses travel through nerves in the body. Register. Nerve Conduction Velocity (NCV) is a test which measures how fast electrical signals move through the peripheral nerve. I do not own the rights to the images used in this video. What are normal nerve conduction test results? NCV tests can measure the speed and strength of nerve signals. Small stickers, called electrodes, are placed on your child's legs and arms. A nerve conduction velocity (NCV) test measures how fast an electrical impulse moves through your nerve. 03104933 . It is used to learn more about the functioning of nerves running from the spinal cord to the muscles. EMG translates the electrical signals transmitted by motor neurons into graphs or numerical values, which can help diagnose muscle or nerve dysfunction or evaluate the degree of muscle injury. 2 Working hours: 9 AM to 1 PM. 25 questions. , He finished his Bachelor degree in Prince Sri Venkateshwara College of. To make an appointment at any of our locations, please contact the scheduling desk Monday-Friday, 8:00 AM – 4:30 PM at 855-EMG-NCV1 (855-364-6281). At AccuHealth Diagnostics, the price of NCV tests is pretty reasonable. The sensitivity of the TLI-APB is 80. Selama tes, saraf Anda akan dirangsang, sering kali dengan cara. Rs. . Working hours: 7 AM to 10 PM. Both these test have a p-value less that a significance level of 0. We use cookies to give you the best possible experience. We offer nerve conduction studies (NCS) & electromyography (EMG). It is a test for heteroscedasticity. Trusted EMG Specialist serving Las Vegas, NV. PASADENA, CA 91107 . 4 4. But other times, the doctor may have to directly. Her secondary back pain and primary knee pain/numbness resolved within a few visits. Use 95885, 95886, and 95887 for EMG services when nerve conduction studies (95907-95913) are performed on the same day. 4. The test translates the electrical signals into numbers or graphs, which, in turn, helps your physician diagnose your condition. A nerve conduction velocity (NCV) test, also called a nerve conduction study, detects nerve damage. EMG uses an electrode. We observed a marked reduction in NCV in the distal portion of the left RLn compared to the right (p < 0. The distance was determined by subtracting D2 and D1 (D2-D1). 950 Maidu Avenue, Suite 120. This includes diseases that damage muscle tissue or cause nerve. , the NC-stat ® System, the Brevio ® NCS-Monitor, and the Advance ™ System) that test only distal motor latencies and conduction velocitiesDisease and neural transmission. CPT Code 95903 - F-wave study . An EMG test is used to measure the electrical impulses inside of the muscle or to determine how the muscle responds to electrical activity and stimulation of the nerves. Along with radiologic studies, it plays a critical role in. Girard is board certified in Neurology. Book a Angiogram at Medicover Hospitals. This measures how well electricity moves through your. What is normal nerve conduction velocity? Normal NCV values can vary depending on the nerve being tested and the individual being tested. An EMG test measures the response a muscle has to stimulation from a nerve. Students at this school are making less academic progress given where they were last year, compared to similar students in the state. nerve conduction velocity test. This test is also called a nerve conduction study (NCS). Following distance should be a minimum of 3 to 4 seconds. Healthy nerves send electrical signals at a faster and stronger rate as compared to. There is contrasting evidence concerning the use of NCS in the assessment of patients with lumbosacral radiculopathy. NCV is an abbreviation for Nerve Conduction Velocity, also known as a nerve conduction study. Diagnosis is made by combining the patient’s symptoms, sensory and motor physical exam findings, and electrodiagnostic results. They basically measure the health of your median nerve and your thumb muscles. 1. Veritaas Healthcare. 2 NCV test. If your test, item or service isn’t listed, talk to your doctor or other health care provider. Summary of nerve conduction study and EMG findings A The first study: Motor nerve studies Nerve Amplitudes (mV) Distal latency (ms) Conduction velocity (m/s) Peroneal Right 1. The peripheral nerve connects the brain and spinal cord to the entire body as well as controls sensations and muscle coordination. This helps your doctor know whether the problem is in the muscle itself or in the nerves that control the. com PASADENA, CA 91107 PLACENTIA; 1041 EYORBA LINDA BLVD, STE 209 PLACENTIA, CA 92870;. Adhesive patches called surface electrodes are placed on the skin over nerves or muscles at different spots. Luke's Memorial - Lufkin Health Information Management 1201 W Frank St Lufkin, Tx 75904 936-639-7265. This current is harmless and lasts 0. action setting of options. Find Top Electromyography (EMG) Doctors by State. A nerve conduction study (NCS) is a test commonly used to evaluate the function, especially the ability of electrical conduction, of the motor and sensory nerves of the human body. This test can be used to identify the type and location of nerve damage. PLACENTIA ; 1041 E YORBA LINDA BLVD, STE 209 ; PLACENTIA, CA 92870 . Your doctor has ordered an EMG/nerve conduction study. Yours Care Path Lab. NCV can identify nerve damage. - NCV is a test commonly used to evaluate the function of the motor and sensory nerves of human body. 1000 to Rs. Pain Medicine Physicians & Orthopedics providing Electrodiagnostic Testing services to Edison, Clifton, Hazlet, Jersey City and West Orange, NJ. A nerve conduction velocity (NCV) test is used to assess nerve damage and dysfunction. • nerve conduction velocity (NCV) testing performed without needle electromyography, other than when performed for follow -up testing, with current use of anticoagulants, the presence of lymphedema, or for. 0 Medicine Page: Page 1 of 16 . When a normal muscle is at rest, it is electrically silent. The NCV and EMG tests can detect an injured nerve. EMG uses an electrode. At AccuHealth Diagnostics, we are committed to providing you with quality testing services at a cost that suits every pocket. Dr. Given below are the NCV costs at our centers. David Girard, MD is a neurology specialist in Pasadena, CA and has over 9 years of experience in the medical field. 1 to 0. 4/10. Close. A nerve conduction velocity (NCV) test, another part of an EMG, uses electrode stickers applied to the skin to measure the speed and strength of signals traveling between two or more points. Your peripheral nerves are the nerves that lie outside of your brain and spinal cord (central nervous system). The purpose of an NCV test is to look for nerve damage. This test is also called a nerve conduction study. more videos: Donate for more diagrams: test is conducted to identify whether the problem lies in the muscle or the nerve. has more than 35 office locations conveniently located throughout California. An EMG/NCV test is a two-part diagnostic procedure used to evaluate the health and functionality of nerves and muscles in the body. It is often followed by an electromyography (EMG) test, to exclude or detect muscle disorders. . An EEG is used in the evaluation of various suspected brain disorders; seizures, stroke, transient. Blog; Booking Confirmation form; Booking form – Dgchem Labs Pvt Ltd;. We offer the best diagnostic and medical care at a affordable price in Bangalore. data (Ornstein) mod<-lm (interlocks~assets+sector+nation, data=Ornstein) ncv. St. An NCV Test or the Nerve Conduction Velocity Test is an electrical test which is prescribed to determine how fast signals move through peripheral nerves (nerves outside the brain and spinal cord which help control our muscles and experience vital senses). EMG test and Nerve Conduction Studies are often done together to provide us with more complete data. +1 more. EMG (Electromyography) Neurologists use electromyography (EMG) to help diagnose injuries and conditions that affect your muscles and the nerves that control them, such as carpal tunnel syndrome and muscular dystrophy. POMONA ; 675 N PARK AVE. The significance of a test result will also vary depending on how likely it is that a patient has the condition being tested for. An EMG/NCV test can provide essential insights that help your Orlin & Cohen specialist make more accurate. For diagnosing probable CIPNM, the peroneal motor NCS had a sensitivity of 94% (95% confidence interval (CI) 71–100%) and specificity of 91% (95% CI 82–96%), the sural sensory NCS had a. Your peripheral nerves begin where the nerve root gets off from the spinal cord. Medicare coverage for many tests, items and services depends on where you live. Ahn, MDNCSs: NCSs, also referred to as nerve conduction velocity (NCV) studies, are performed to assess the integrity and diagnose diseases of the peripheral nervous system. Different methods of measuring the conduction in the same nerve will not be reimbursed as separate services. Nerve conduction studies (NCSs) are electrophysiological procedures that assess the peripheral nervous system. EMG NCV test cost in Kolkata, NCV test cost in Kolkata and an independent EMG test cost in Kolkata depends on which type of test you are going for. Call (855) 364-6281 to set up your appointment today. He graduated from Medical College of Wisconsin in 1975. An EMG often is used with a nerve conduction study. The second part is a needle electromyogram. He graduated from MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH in 1973. 4. Disorders that affect the motor neurons in the brain or spinal cord, such as amyotrophic lateral sclerosis or a herniated disk in the spine. 4 Q&As Reveal How to Handle 95905 for Nerve Conduction Studies Attention: New NCS code changes how units are reported. 00 ₹3,750. 4. Conditions that can be detected or ruled out are muscular dystrophy, carpal. Average progress with low test scores means that students are starting at a low point but keeping up with their peers. Using electrode patches, your nerve is stimulated, allowing the electrical impulse to be measured as the stimulus occurs. David Girard, MD is a neurology specialist in Pasadena, CA. , DMLT. The nerve conduction testing involves giving small electrical stimulations to nerves in the arms and/or legs. (company number 4709172), 9202 PICO BLVD LOS ANGELES CA 90035. EMG test can cost up to Rs. independent) over the values of the response (fitted values). In this test, a needle is placed into a muscle and you are told to contract that muscle. 0/5 Based on 1 reviews. A nerve conduction velocity test can take between 15 minutes and an hour. This test can tell if your median nerve is not functioning properly. Patel is board certified in adult neurology, clinical neurophysiology, and sleep medicine. Special Instructions. The NCV test charges range between INR 1500 to INR 3500 in Kolkata.