The longer the better: Sleep–wake patterns during preparation of the World Rowing Junior Championships

2016

Recovery is essential for high athletic performance, and therefore especially sleep has been identified as a crucial source for physical and psychological well-being. However, due to early-morning trainings, which are general practice in many sports, athletes are likely to experience sleep restrictions. Therefore, this study investigated the sleep-wake patterns of 55 junior national rowers (17.7 ± 0.6 years) via sleep logs and actigraphy during a four-week training camp. Recovery and stress ratings were obtained every morning with the Short Recovery and Stress Scale on a 7-point Likert-type scale ranging from 0 (does not apply at all) to 6 (fully applies). The first training session was sch…

The Vegf Pathway in Patients with Pancreatic Neuroendocrine Tumors: Efficacy of Everolimus by Baseline Marker Level, and Prognostic and Predictive Ef…

2012

ABSTRACT Background RADIANT-3 was a phase III study investigating the effect of the mammalian target of rapamycin inhibitor everolimus on progression-free survival (PFS) in patients with advanced pancreatic neuroendocrine tumors (pNET; Yao et al, NEJM, 2011). Everolimus significantly improved PFS compared with placebo (11 vs 4.6 months, P  Methods Baseline plasma levels of VEGF-A, PlGF, sVEGFR1, and sVEGFR2 were determined by ELISA using multiplexed MSD platform. The optimal cutoffs for these markers were explored using the “survival tree analysis” method. Interaction of treatment and baseline marker status ( Results PFS was significantly improved to a similar extent in patients receiving e…

Development of two short measures for recovery and stress in sport.

2017

The Acute Recovery and Stress Scale (ARSS) and the Short Recovery and Stress Scale were first established in German for the purposes of monitoring athletes’ current recovery-stress states in an economical and multidimensional manner. The aim of this paper is to document the development and initial validation of the English versions of these two psychometric monitoring tools. A total of 267 English-speaking athletes from a variety of team and individual sports participated in the study. The English versions demonstrated satisfactory internal consistency for both instruments (Cronbach \(\alpha\) of .74–.89). Furthermore, good model fit was found for the eight scales of the ARSS, matching the …

Portable PSG for sleep stage monitoring in sports: Assessment of SOMNOwatch plus EEG.

2019

Current sport-scientific studies mostly neglect the assessment of sleep architecture, although the distribution of different sleep stages is considered an essential component influencing an athlete's recovery and performance capabilities. A mobile, self-applied tool like the SOMNOwatch plus EEG might serve as an economical and time-friendly alternative to activity-based devices. However, self-application of SOMNOwatch plus EEG has not been validated against conventional polysomnography (PSG) yet. For evaluation purposes, 25 participants (15 female, 10 male;

Heart Rate Variability Monitoring During Strength and High-Intensity Interval Training Overload Microcycles

2019

Objective: In two independent study arms, we determine the effects of strength training (ST) and high-intensity interval training (HIIT) overload on cardiac autonomic modulation by measuring heart rate (HR) and vagal heart rate variability (HRV).Methods: In the study, 37 well-trained athletes (ST: 7 female, 12 male; HIIT: 9 female, 9 male) were subjected to orthostatic tests (HR and HRV recordings) each day during a 4-day baseline period, a 6-day overload microcycle, and a 4-day recovery period. Discipline-specific performance was assessed before and 1 and 4 days after training.Results: Following ST overload, supine HR, and vagal HRV (Ln RMSSD) were clearly increased and decreased (small ef…

Relaxation techniques in sports: A systematic review on acute effects on performance

2016

Abstract Objectives The aim was to provide an overview on the current state of research on acute effects of relaxation techniques in sports. Design A systematic review of randomized controlled trials was conducted. Methods PubMed, MEDLINE, PsycINFO, and SPORTDiscus were searched until August 2014. Additionally, reference lists of retrieved articles and relevant reviews were hand searched. To be included articles had to examine the effects of relaxation techniques on performance in sports. Furthermore, they had to be published in English, in a peer-reviewed journal, available full text online, and designed as either treatment outcome, clinical trial, and/or randomized controlled trial. The d…

Muscle mechanical properties of strength and endurance athletes and changes after one week of intensive training

2015

The study investigates whether tensiomyography (TMG) is sensitive to differentiate between strength and endurance athletes, and to monitor fatigue after either one week of intensive strength (ST) or endurance (END) training. Fourteen strength (24.1±2.0years) and eleven endurance athletes (25.5±4.8years) performed an intensive training period of 6days of ST or END, respectively. ST and END groups completed specific performance tests as well as TMG measurements of maximal radial deformation of the muscle belly (Dm), deformation time between 10% and 90% Dm (Tc), rate of deformation development until 10% Dm (V10) and 90% Dm (V90) before (baseline), after training period (post1), and after 72h o…

Assessment of Fatigue and Recovery in Male and Female Athletes After 6 Days of Intensified Strength Training.

2016

Raeder, C, Wiewelhove, T, Simola, RADP, Kellmann, M, Meyer, T, Pfeiffer, M, and Ferrauti, A. Assessment of fatigue and recovery in male and female athletes after 6 days of intensified strength training. J Strength Cond Res 30(12): 3412-3427, 2016-This study aimed to analyze changes of neuromuscular, physiological, and perceptual markers for routine assessment of fatigue and recovery in high-resistance strength training. Fourteen male and 9 female athletes participated in a 6-day intensified strength training microcycle (STM) designed to purposefully overreach. Maximal dynamic strength (estimated 1 repetition maximum [1RMest]; criterion measure of fatigue and recovery); maximal voluntary iso…

Assessment of Neuromuscular Function After Different Strength Training Protocols Using Tensiomyography

2015

The purpose of the study was to analyze tensiomyography (TMG) sensitivity to changes in muscle force and neuromuscular function of the muscle rectus femoris (RF) using TMG muscle properties after 5 different lower-limb strength training protocols (multiple sets; DS = drop sets; eccentric overload; FW = flywheel; PL = plyometrics). After baseline measurements, 14 male strength trained athletes completed 1 squat training protocol per week over a 5-week period in a randomized controlled order. Maximal voluntary isometric contraction (MVIC), TMG measurements of maximal radial displacement of the muscle belly (Dm), contraction time between 10 and 90% of Dm (Tc), and mean muscle contraction veloc…

Sleep monitoring of a six-day microcycle in strength and high-intensity training

2015

This study examined the effect of microcycles in eccentric strength and high-intensity interval training (HIT) on sleep parameters and subjective ratings. Forty-two well-trained athletes (mean age 23.2 ± 2.4 years) were either assigned to the strength (n = 21; mean age 23.6 ± 2.1 years) or HIT (n = 21; mean age 22.8 ± 2.6 years) protocol. Sleep monitoring was conducted with multi-sensor actigraphy (SenseWear Armband™, Bodymedia, Pittsburg, PA, USA) and sleep log for 14 days. After a five-day baseline phase, participants completed either eccentric accented strength or high-intensity interval training for six days, with two training sessions per day. This training phase was divided into two h…

Lenvatinib (len) plus pembrolizumab (pembro) for the first-line treatment of patients (pts) with advanced hepatocellular carcinoma (HCC): Phase 3 LEA…

2019

TPS4152 Background: Len, an inhibitor of VEGF receptors 1-3, FGF receptors 1-4, PDGF receptor α, RET, and KIT, is approved for first-line treatment of unresectable HCC (uHCC) based on the open-label phase 3 REFLECT study in which len showed noninferior overall survival (OS) and significantly improved objective response rate (ORR), progression-free survival (PFS), and time-to-progression (TTP) vs sorafenib. In the phase 2 KEYNOTE-224 study of pembro (a PD-1 inhibitor) as second-line treatment of advanced HCC, pembro showed meaningful clinical efficacy in pts previously treated with sorafenib, with median PFS 4.9 mo, median OS 12.9 mo, and a manageable safety profile. In results from the pha…

Erratum to: miRNAs and sports: tracking training status and potentially confounding diagnoses

2016

Erratum to: J Transl Med (2016) 14:219 DOI 10.1186/s12967-016-0974-x Unfortunately, the original version of this article [1] contained an error. The name of the author [Farbod Sedaghat] was incorrect, the author's surname should be Sedaghat-Hamedani. The author's name is Farbod Sedaghat-Hamedani.

Assessing the impact of COVID-19 on liver cancer management (CERO-19)

2021

[Background & Aims] The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to healthcare systems and it may have heavily impacted patients with liver cancer (LC). Herein, we evaluated whether the schedule of LC screening or procedures has been interrupted or delayed because of the COVID-19 pandemic.

Individual Patterns in Blood-Borne Indicators of Fatigue-Trait or Chance.

2017

Julian, R, Meyer, T, Fullagar, HHK, Skorski, S, Pfeiffer, M, Kellmann, M, Ferrauti, A, and Hecksteden, A. Individual patterns in blood-borne indicators of fatigue-trait or chance. J Strength Cond Res 31(3): 608-619, 2017-Blood-borne markers of fatigue such as creatine kinase (CK) and urea (U) are widely used to fine-tune training recommendations. However, predictive accuracy is low. A possible explanation for this dissatisfactory characteristic is the propensity of athletes to react to different patterns of fatigue indicators (e.g., predominantly muscular [CK] or metabolic [U]). The aim of the present trial was to explore this hypothesis by using repetitive fatigue-recovery cycles. A total …

Modification and Applicability of Questionnaires to Assess the Recovery-Stress State Among Adolescent and Child Athletes

2019

Despite the general consensus regarding the implementation of self-report measures in the training monitoring, there is a lack of research about their applicability and comprehensibility among developing athletes. However, this target group needs special considerations to manage the increasing training demands while maintaining health and performance. This study deals with challenges of applying recovery-stress questionnaires which were validated with adult populations among developing athletes and presents a possible approach to enhance their applicability. In two phases, the Acute Recovery and Stress Scale (ARSS), a 32-adjective list covering eight scales, and the 8-item derived version, …

TH-302 + Gemcitabine (G + T) vs Gemcitabine (G) in Patients with Previously Untreated advanced Pancreatic Cancer (PAC)

2012

ABSTRACT Background TH-302 is a hypoxia targeted prodrug with a hypoxia-triggered 2-nitroimidazole component designed to release the DNA alkylator, bromo-isophosphoramide mustard (Br-IPM), when reduced in severe hypoxia. A randomized Phase 2B study (NCT01144455) was conducted to assess the benefit of G + T to standard dose G as first-line therapy of PAC. Materials and methods An open-label multi-center study of two dose levels of TH-302 (240 mg/m2 or 340 mg/m2) in combination with G versus G alone (randomized 1:1:1). G (1000 mg/m2) and T were administered IV over 30-60 minutes on Days 1, 8 and 15 of a 28-day cycle. Patients on the G could crossover after progression and be randomized to a G…

Responses of low and high compression during recovery after repeated sprint training in well-trained handball players.

2017

The aim of the study was to investigate the effects of wearing various levels of compression following repeated and exhausting sprint exercise on variables related to recovery. Twelve well-trained handball players performed three sessions of repeated and exhausting sprint exercise (30 × 30m). Directly after each session the participants wore tights extending from below the hip to the foot with either 0, 10, or 25 mm Hg of compression onto the thigh and calf muscles. 48 h after the training session all participants performed 5 × 30m sprints and counter movement jumps. Before, directly after, 24 h, and 48 h after the training session venous blood samples were drawn for the determination of cr…

Individualized Monitoring of Muscle Recovery in Elite Badminton

2019

\(\bf Purpose:\) Individualized reference ranges for serum creatine kinase (CK) and urea are a promising tool for the assessment of recovery status in high-level endurance athletes. In this study, we investigated the application of this approach in racket sports, specifically for the monitoring of elite badminton players during the preparation for their world championships. \(\bf Methods:\) Seventeen elite badminton players were enrolled of which 15 could be included in the final analysis. Repeated measurements of CK and urea at recovered (R) and non-recovered (NR) time points were used for the stepwise individualization of group-based, prior reference ranges as well as for the evaluation o…

Tensiomyography reliability and prediction of changes in muscle force following heavy eccentric strength exercise using muscle mechanical properties

2015

AbstractThe current study involved the completion of two distinct experiments. Experiment 1 analyzed the inter-day reliability of tensiomyography (TMG) muscle mechanical properties based on the amplitude of the muscle belly radial deformation, the time it takes to occur, and its velocity under maximal and submaximal stimuli, in the muscles rectus femoris, biceps femoris, and gastrocnemius lateralis, from 20 male sport students. Experiment 2 investigated whether changes in maximal voluntary isometric contraction (MVIC) could be predicted based on changes in TMG properties following 24 h after different squat training protocols (MS = multiple sets; DS = drop sets; EO = eccentric overload; FW …

Acute effects of psychological relaxation techniques between two physical tasks.

2016

The concept of recovery strategies includes various ways to achieve a state of well-being, prevent underrecovery syndromes from occurring and re-establish pre-performance states. A systematic application of individualised relaxation techniques is one of those. Following a counterbalanced cross-over design, 27 sport science students (age 25.22 ± 1.08 years; sports participation 8.08 ± 3.92 h/week) were randomly assigned to series of progressive muscle relaxation, systematic breathing, power nap, yoga, and a control condition. Once a week, over the course of five weeks, their repeated sprint ability was tested. Tests (6 sprints of 4 s each with 20 s breaks between them) were executed on a non…

Trial Design and Endpoints in Hepatocellular Carcinoma: AASLD Consensus Conference

2020

Proper trial design is critical for the success of clinical investigations. Hepatocellular carcinoma (HCC) is a complex disease that has several unique properties. In 2008, after the approval of sorafenib, a panel of experts proposed guidelines for trial design and endpoints in HCC that have been instrumental during the last decade and provided a framework to allow an homogeneous analysis of reported investigations. Since then, several phase III studies have been reported and novel challenges have emerged. A panel of experts conveyed by AASLD organized a Special Topic Conference on trial design and endpoints to address those emerging challenges. This review summarizes the analysis and concl…

Recovery during and after a simulated multi-day tennis tournament: Combining active recovery, stretching, cold-water immersion, and massage intervent…

2021

The aim of this study was to investigate the effects of a mixed-method recovery intervention (MMR) consisting of active recovery, stretching, cold-water immersion, and massage on physical, technical, physiological, and perceptual recovery during and after a five-day simulated tennis tournament. Nine competitive male tennis players (age, 24.6±4.2 years) with national ranking positions (German Tennis Federation) and Universal Tennis Ratings between approximately 11 to 13 participated in two singles tennis tournaments, which were separated by a three-month washout period. During the tournaments, participants played five two-and-a-half-hour competitive singles tennis match on five consecutive d…

Neuromuscular Fatigue and Physiological Responses After Five Dynamic Squat Exercise Protocols

2015

This aimed to analyze neuromuscular, physiological and perceptual responses to a single bout of 5 different dynamic squat exercise protocols. In a randomized and counterbalanced order, 15 male resistance-trained athletes (mean ± SD; age: 23.1 ± 1.9 years, body mass: 77.4 ± 8.0 kg) completed traditional multiple sets (MS: 4 × 6, 85% 1 repetition maximum [RM]), drop sets (DS: 1 × 6, 85% 1RM + 3 drop sets), eccentric overload (EO: 4 × 6, 70% 1RM concentric, 100% 1RM eccentric), flywheel YoYo squat (FW: 4 × 6, all-out), and a plyometric jump protocol (PJ: 4 × 15, all-out). Blood lactate (La), ratings of perceived exertion (RPE), counter movement jump height (CMJ), multiple rebound jump (MRJ) pe…

Heart Rate Variability Monitoring During Strength and High-Intensity Interval Training Overload Microcycles

2019

Objective: In two independent study arms, we determine the effects of strength training (ST) and high-intensity interval training (HIIT) overload on cardiac autonomic modulation by measuring heart rate (HR) and vagal heart rate variability (HRV). Methods: In the study, 37 well-trained athletes (ST: 7 female, 12 male; HIIT: 9 female, 9 male) were subjected to orthostatic tests (HR and HRV recordings) each day during a 4-day baseline period, a 6-day overload microcycle, and a 4-day recovery period. Discipline-specific performance was assessed before and 1 and 4 days after training. Results: Following ST overload, supine HR, and vagal HRV (Ln RMSSD) were clearly increased and decreased (small …

Effects of in-play cooling during simulated tennis match play in the heat on performance, physiological and perceptual measures

2021

BACKGROUND: The aim of this crossover study was to investigate whether a cooling intervention during simulated tennis match play in the heat could affect players' performance, physiology, perception of effort, and well-being. METHODS: Eight competitive male tennis players performed two testing sessions of 45-minute simulated tennis match play on a hard court at 31.8±2.1°Cand 48.5±9.6% relative humidity. During change-of-end breaks, the cooling interventions (COL) consisted of cold-water ingestion (ad libitum) and an electric fan facing the players at a distance of 1 m combined with an ice-filled damp towel around the neck and on the thighs or no cooling (CON) were applied. Measures of perfo…

Resting the mind – A novel topic with scarce insights. Considering potential mental recovery strategies for short rest periods in sports

2019

Abstract Both meticulously structured trainig routine as well as specific characteristics of various sports (e.g., swimming, shooting, modern pentathlon) with multiple competition bouts in a single day appear to be mentally demanding and may result in a state of mental fatigue. Due to these multidimensional demands, adequate training and competition recovery is essential. Consequently, the idea of mental recovery embraces the spotlight of research. On training and competition days, short rest periods implemented as a vital part, can be used for mental recovery and can help in assisting athletes to return to baseline levels of mental abilites (e.g., concentration, attention). Sport-specific …

Can Cold Water Immersion Enhance Recovery in Elite Olympic Weightlifters? An Individualized Perspective.

2017

We investigated whether cold water immersion (CWI) after intensive training sessions can enhance recovery in elite Olympic weightlifters, taking into account each athlete's individual response pattern. The entire German male Olympic weightlifting national team participated in the study (n = 7), ensuring collection of data from elite athletes only. Using a randomized cross-over design, the athletes went through 2 high-intensity training microcycles consisting of 5 training sessions that were either followed by a CWI or passive recovery. Barbell speed in a snatch pull movement, blood parameters, and subjective ratings of general fatigue and recovery were assessed throughout the study. Physica…

Effects of Training-Induced Fatigue on Pacing Patterns in 40-km Cycling Time Trials

2014

In some endurance sports, athletes complete several competitions within a short period, resulting in accumulated fatigue. It is unclear whether fatigued athletes choose the same pacing pattern (PP) as when they have recovered.This study aimed to analyze effects of fatigue on PP of cyclists during a 40-km time trial (TT).Twenty-three male cyclists (28.8 ± 7.6 yr) completed three 40-km TT on a cycle ergometer. TT were conducted before (TT1) and after (TT2) a 6-d training period. A third TT was carried out after 72 h of recovery (TT3). Training days consisted of two cycling sessions: mornings, 1 h at 95% of lactate threshold or 3 × 5 × 30 s all-out sprint; afternoons, 3 h at 80% individual ana…

The effect of westward travel across five time zones on sleep and subjective jet-lag ratings in athletes before and during the 2015's World Rowing Ju…

2016

ABSTRACTThis study examined sleep-wake habits and subjective jet-lag ratings of 55 German junior rowers (n = 30 male, 17.8 ± 0.5 years) before and during the World Rowing Junior Championships 2015 in Rio de Janeiro, Brazil. Athletes answered sleep logs every morning, and Liverpool John Moore’s University Jet-Lag Questionnaires each evening and morning. Following an 11-h westward flight with 5-h time shift, advanced bedtimes (−1 h, P < .001, ηp2 = 0.68), reduced sleep onset latency (P = .002, ηp2 = 0.53) and increased sleep duration (P < .001, ηp2 = 0.60) were reported for the first two nights. Jet-lag symptoms peaked upon arrival but were still present after 6 days. Sleep quality improved (…

Portable polysomnography for sleep monitoring in elite youth rowing: An athlete's gain or the sleep's thief?

2020

Validity of the Acute Recovery and Stress Scale: Training Monitoring of the German Junior National Field Hockey Team

2015

The aim of the present study was to examine the sensitivity of the Acute Recovery and Stress Scale (ARSS). This new psychometric questionnaire was developed to assess the physical, mental, emotional, and overall recovery and stress states of athletes. During a five-day field hockey training camp of the German Junior National Field Hockey Team ( n = 25) the ARSS was administered every morning and evening. The study indicated swift reactions of the scores of the physical and general factors as well as stability of scores for the emotional factors in accordance with the training schedule. The straining effect of the camp was best reflected by the adaptations of the scales Physical Performance…

Blood-Borne Markers of Fatigue in Competitive Athletes – Results from Simulated Training Camps

2016

Assessing current fatigue of athletes to fine-tune training prescriptions is a critical task in competitive sports. Blood-borne surrogate markers are widely used despite the scarcity of validation trials with representative subjects and interventions. Moreover, differences between training modes and disciplines (e.g. due to differences in eccentric force production or calorie turnover) have rarely been studied within a consistent design. Therefore, we investigated blood-borne fatigue markers during and after discipline-specific simulated training camps. A comprehensive panel of blood-born indicators was measured in 73 competitive athletes (28 cyclists, 22 team sports, 23 strength) at 3 time…

Entwicklung der Kurzskala zur Erfassung von Erholung und Beanspruchung im Sport (KEB)

2015

Zusammenfassung. Mit der Entwicklung einer Kurzform (Kurzskala zur Erfassung von Erholung und Beanspruchung im Sport; KEB) des Akutmaßes zur Erfassung von Erholung und Beanspruchung im Sport (AEB) wird dem Bedarf der Sportpraxis nach einem ökonomischen, validen und veränderungssensitiven Messinstrument zur Erfassung von Erholung und Beanspruchung nachgegangen. Nach einem vierstufigen Entwicklungs- und Validierungsprozess des AEB wurde aus den exploratorisch errechneten und konfirmatorisch geprüften Faktoren des AEB die KEB mit acht Items abgeleitet. Es konnten sehr gute Bereichshomogenitäten, moderate Interkorrelationen und hypothesenkonforme Korrelationen mit dem AEB berechnet werden. Der…

Psychological tools used for monitoring training responses of athletes

2017

Monitoring athletes’ responses to training and other life stressors is crucial for implementing favourable training routines and achieving optimal performances. The purpose of this review is to provide an overview and evaluation of current psychological tools used in training contexts among athletes. The instruments discussed include the Profile of Mood States (POMS), the Emotional Recovery Questionnaire (EmRecQ), the Total Quality Recovery (TQR) scale, the Daily Analyses of Life Demands for Athletes (DALDA), the Recovery-Stress Questionnaire for Athletes (RESTQ-Sport), the Acute Recovery and Stress Scale (ARSS), the Short Recovery and Stress Scale (SRSS), and the Multi-Component Training D…

miRNAs and sports: tracking training status and potentially confounding diagnoses.

2016

Background The dependency of miRNA abundance from physiological processes such as exercises remains partially understood. We set out to analyze the effect of physical exercises on miRNA profiles in blood and plasma of endurance and strength athletes in a systematic manner and correlated differentially abundant miRNAs in athletes to disease miRNAs biomarkers towards a better understanding of how physical exercise may confound disease diagnosis by miRNAs. Methods We profiled blood and plasma of 29 athletes before and after exercise. With four samples analyzed for each individual we analyzed 116 full miRNomes. The study set-up enabled paired analyses of individuals. Affected miRNAs were invest…

Comparing Subjective With Objective Sleep Parameters Via Multisensory Actigraphy in German Physical Education Students.

2015

This study compared subjective with objective sleep parameters among 72 physical education students. Furthermore, the study determined whether 24-hr recording differs from nighttime recording only. Participants wore the SenseWear Armband™ for three consecutive nights and kept a sleep log. Agreement rates ranged from moderate to low for sleep onset latency (ICC = 0.39 to 0.70) and wake after sleep onset (ICC = 0.22 to 0.59), while time in bed (ICC = 0.93 to 0.95) and total sleep time (ICC = 0.90 to 0.92) revealed strong agreement during this period. Comparing deviations between 24-hr wearing time (n = 24) and night-only application (n = 20) revealed no statistical difference (p > 0.05). As a…

Evaluation of psychological measures for the assessment of recovery and stress during a shock-microcycle in strength and high-intensity interval trai…

2017

Abstract The aim of this paper was a) to analyse the intraindividual change and criterion sensitivity of the Acute Recovery and Stress Scale (ARSS) and its abridged version the Short Recovery and Stress Scale (SRSS) in response to a 6-day microcycle of intensified strength training (STM) and high-intensity interval training (HIIT) in comparison with the change in the criterion measures maximal dynamic strength (estimated 1 repetition maximum [1RMest]; STM) or repeated sprint ability (RSA; HIIT), and b) to compare descriptively the results of the subjective measures with earlier reported physiological and performance markers of the same study. Participants were 23 (STM; 23.7 ± 2.0 years) and…