intertrigo african american. Bright red, well-defined weeping patches and plaques are seen in the folds of the neck, armpits, elbow pits, groin, finger and toe webs, or backs of the knees. intertrigo african american

 
 Bright red, well-defined weeping patches and plaques are seen in the folds of the neck, armpits, elbow pits, groin, finger and toe webs, or backs of the kneesintertrigo african american  Clinical Pathologic Challenge Answer

Please read their thoughts. Symptoms include a bright red rash under your breasts and on your upper torso. image source: healthooze. It is a common skin condition affecting opposing cutaneous or mucocutaneous surfaces. Minimizes friction with polyurethane coating. These stereotypes, including assumptions about criminality, can influence how Black Americans are treated by the legal system. It is a common skin condition affecting opposing cutaneous or mucocutaneous surfaces. “Postinflammatory hypopigmentation and hyperpigmentation”. Black History Timeline: 1960–1964. Symptoms Of Intertrigo With Infection. Intertrigo is a common inflammatory skin disorder that occurs because of skin-on-skin friction in the skin folds (called intertriginous regions), as a result of moisture becoming trapped owing to poor air circulation (Janniger et al, 2005; Mistiaen and van Halm-Walters, 2010; Black et al, 2011). Coconut oil has anti-inflammatory and skin protective properties. Treatment. pain. Excessive sweating on the parts of the skin folds. La patiente est admise un mois par la suite aux urgences pour la prise en charge d'un état de choc septique avec une décompensation acéto-cétosique. Intertrigo. 2. Intertrigo is common for all ages. Local risk factors of cellulitis reported were: disruption of the skin barrier, neglected wounds, toe-web intertrigo, leg ulcers, use of depigmentation drugs and leg oedema. Low dose corticosteroids, such as hydrocortisone cream, may help reduce inflammation. It may itch, ooze or be a little sore. INTRODUCTION. African-American society has begun to reflect this change. Allergy. In 2021, there were 4. Explore our records documenting African American History through the African American Research page and within the National Archives. Also, macromastia may be associated with psychosocial or. 2 million in 1976. 1 Despite increasing awareness of TEC, such eruptions may remain unrecognized and subsequently result in unnecessary hospitalizations. S. Then, a single, large spot may appear on your chest, stomach, or back. 7548 Christopher Ha, MD American Board of DermatologyThe most common symptoms of erythrasma include pink, red, or brown skin patches with scales, and mildly itchy skin. Chronic intertrigo. It appears as moist, erythematous and scaly areas in the flexures. 5% of Latinos, and 34. Black students were establishing fraternities and sororities on college. Patients may complain of pruritus or soreness. It is a common skin condition affecting opposing cutaneous or muco-cutaneous surfaces. 5 times more likely to suffer a limb amputation and up to 5. 6M 9 posts / week Get Email Contact. Tinea Cruris (Jock Itch) Tinea cruris is a dermatophyte infection of the groin. According to the Pew Research Center, the number of African immigrants in the USA has risen about 2,500% since 1970 — from 80,000 in 1970 to about 2. Influenced by the Harlem Renaissance movement, Jones broadened the idea of Black. Intertrigo is skin maceration in intertriginous areas caused by moisture and/or infection. She has a 10-year history of psoriasis on the scalp and lateral face and notable disease relapses in this area. decennial censuses. The diagnosis and treatment of inverse psoriasis is reviewed, and other conditions that may be confused with Candida and inverse psoriasis, including bacterial intertrigo, tinea, and seborrheic dermatitis. delivers his "I Have a Dream" speech, takes place; and the Civil. For the first time in its history, the Eighth Joint National Committee (JNC-8) published hypertension guidelines that varied depending on patient race, with different treatment recommendation for Black and non-Black patients. Intertrigo frequently is worsened or colonized by infection, which most commonly is candidal but also may be bacterial or viral or due to other fungal infection. It is associated with a variety of dermatological conditions caused by fungal infections, notably seborrhoeic dermatitis and tinea versicolor. This is usually located in the inner thighs, armpits, and underside of the breasts or belly. Intertrigo results from constant moisture within the skin folds and skin-on-skin friction. Diagnosis is typically by clinical appearance. Intertrigo in the large skin folds is a common problem. Aug. American English: Pages (from-to) 833-838+840: Journal: American Family Physician: Volume: 72: Issue number: 5: State: Published - Sep 1 2005: ASJC Scopus subject areas. A piece from. Thirteen databases were sensitively searched, supplemented by reference tracking and forward. 10. If the rash is like a boil, then you may also experience bleeding and oozing of pus. 8 million correctional population. 6 times more likely to suffer kidney disease. Until research further clarifies this finding, consider PI a clinical sign rather than a distinct diagnosis. The rash is often caused by yeast, fungi, or bacteria that love being in a damp environment. Using cornstarch to keep the area dry and friction free 6. Jock itch is the popular name given to an itchy rash in the groin that commonly involves the inner thighs and adjacent skin, including the scrotum in males. have a combined net worth of $22. Type. Recalcati, a dermatologist in Italy, collected data on 88 COVID-19 patients — 18 patients (20. Intertrigo affects the top layers of skin. burning. The skin eventually becomes dry and gains a crust-like texture. The Black-only population is 13. 8 million foreign-born Black Americans, up from 2. Clinically, there is erythema and sometimes maceration, erosions, or fissuring. In the United States, Blacks were originally thought to be. It occurs in skin folds, where skin rubs against other skin. com, the largest free online thesaurus, antonyms, definitions and translations resource on the web. Introduction: The etiologies of intertrigo in adults are numerous and different. Introduction. You can prevent yeast infections by using a drying powder under your breasts. The survey shows that two-thirds of Black Americans (66%) are Protestant, 6% are Catholic and 3% identify with other Christian faiths – mostly Jehovah’s Witnesses. , usually raised here, who are of African ancestry, whereas the term Black is more general and can refer to anyone of African ancestry, including recent immigrants. Throughout this report, “Black, non-Hispanic” respondents are those who identify as single-race Black and say. Preventing skin chafing can be as simple as keeping areas of the body. According to the American Academy of Dermatology, people who already have plaque psoriasis and are 20 or more pounds overweight may be at greater risk for having inverse psoriasis, as well. Placing gauze or cotton in between the folds of skin where intertrigo has developed keeps the folds from rubbing together and creating friction that can worsen your rash. U. Sponsored by. It is a common skin condition affecting opposing cutaneous or muco- cutaneous surfaces. Just over half of Black Americans say belief in God is necessary for morality. In honor of Black History Month which starts in February 2023, we rounded up 120 inspiring quotes from African American civil rights icons. Among African-Americans between the ages of 12 and 19, the obesity rates are 24 percent for girls and 21 percent for boys. More than half of the nation’s Black population (56%) lived in Southern states in 2021, up. 3. Kindred, by Octavia E. Pseudofolliculitis barbae affects around 45% of African American Service Members, a much lower percentage of Hispanics and about 3% of Caucasians. It is possible the name you are searching has less than five occurrences per year. ". We also know medical mistrust is correlated with not adhering to medical advice, filling. Infants are especially susceptible to this inflammatory condition because of their flexed posture, relatively high percentage of body fat, and short neck. Causes. Such an environment encourages skin breakdown and can lead to fungal, viral, or bacterial. 1 million Americans were forbidden from voting because of their felony record in 2016, rising from 1. [1] The European colonization of the Americas, and the resulting transatlantic slave trade, led to a large-scale. Bacterial, viral, or other fungal infection may also occur. Heat. blisters or pustules that contain foul-smelling pus. Manifesting as intense, fiery-red erythema and maceration in the. Although initial therapy in non-Black patients is to be carried out with o. 2. (The authors discuss the utility of topical retinoids for treatment of some of the most common dermatologic complaints of African American patients [including acne, eczema, pigmentary disorders, and keloids]. image source: healthooze. , Black Americans) are subjugated to unfair treatment and social and economic oppression (Feagin, 2006). Oozing or crusting may also be present in severe cases. The symptoms of intertrigo include: Roughly symmetrical red or reddish-brown rash with small bumps. Intertrigo (intertriginous dermatitis) is a clinical inflammatory condition that develops in opposing skin surfaces in response to friction, humidity, maceration, or reduced air circulation. Sjogren's syndrome is also called Sjogren's disease. Intertrigo under the breasts is common among people who are overweight or obese. ) Ruiz-Maldonado, R, Orozco-Covarrubias, ML. Try to expose affected skin to air twice a day for about 30 minutes each time. There is a plethora of treatments, but a lack of evidence about their efficacy. Richmond boasts some of the best. U. Pyoderma and Intertrigo (Skin Fold Dermatitis) Yeast Infections and other Fungal Infections. Moisture. Many. As Matthew Frye Jacobson notes in his book Roots Too: White Ethnic Revival in Post–Civil Rights America, the rise of black nationalism in the ’60s and ‘70s coincided with a growing emphasis. The Eugenic Marriage, Vol 2 (of 4) A Personal Guide to the New Science of. Intertrigo's Latin translation, inter (between), and terere (to rub) helps explain the physiology of the condition. It exposed a stripe of her zebra hide, which is the cute nickname we have for the brown and pink intertrigo fungus that lines her torso. It is characterised by asymptomatic, hyperpigmented papules and plaques that have a peripheral, net-like. Intertrigo (intertriginous dermatitis) is an inflammatory condition of skin folds, induced or aggravated by heat, moisture, maceration, friction, and lack of air circulation. It is an autoimmune condition in which you have symptoms affecting your entire body. Aetiological factors include: past history of seborrhoeic dermatitis ; infection with Candida albicans ;. Es causado por humedad, bacterias u hongos en los pliegues de la piel. Bodily secretions, including perspiration, urine, and feces, often exacerbate skin inflammation. Yeast infections under your breasts are a common fungal infection caused by a yeast called Candida. The incidence peaks in those aged 7-12 months, then decreases with age. A longtime push by African-American scholars and writers to capitalize the word black in the context of race has gained widespread acceptance in recent weeks and unleashed a deep debate over. But this month we are focusing instead on 28 seminal Black figures – one for each day of February – who don’t often make the history books. It can affect all skin folds: 2 large. It can occur in any area of the body where two skin surfaces are in close contact with each other, such as the axillary, inframammary, umbilical and inguinal areas, and is. Group A β-hemolytic streptococci have been implicated in a variety of common childhood cutaneous infections. IE 11 is not supported. The term "intertrigo" commonly refers to a secondary infection with bacteria (such as Corynebacterium minutissimum ), fungi (such as Candida albicans ), or viruses. African Americans are mainly of African ancestry, but many have non-Black ancestors as well. The causes and management of these disorders vary, but one constant in the care of obese patients is the need for regular skin inspection. This mechanical marvel, which ran accurately for decades, showcased Banneker's exceptional engineering and craftsmanship skills. Treatment includes drying agents and sometimes topical antibacterial or antifungal medications. Carville et al. Intertrigo and inverse psoriasis are skin conditions that cause discomfort in areas of the body where the skin folds, such as the groin, armpits, and the abdomen. These germs trigger your immune system to react, which leads to skin inflammation and rash. 1 Although intertrigo may occur in both gender and all races, it is more. It is red and raw looking. But when Rodney King is beaten by. Lesions mostly develop in the neck, axilla, sub. It happens when areas of moist skin. There may be maceration or erosion, which would raise the suspicion for an infectious component. In the United States, the estimated prevalence is 13. When intertrigo gets infected, a foul smell arises. avoiding. It most often affects oily parts of. 1. The intertrigo appears on both sides of the skin fold, almost as a mirror image of the opposing side. Intertrigo develops when friction and trapped moisture in intertriginous areas cause skin maceration and. In 1619, a ship with 20 captives landed at Point Comfort in Virginia, ushering in the era of American slavery. How to say intertrigo in English? Pronunciation of intertrigo with 5 audio pronunciations, 2 synonyms, 1 meaning, 3 translations and more for intertrigo. patches of small round bumps. She has been educated in both psychology and journalism, and her dual education has given her the research and writing skills needed to deliver sound and. Oldways’ African heritage diet pyramid, which was. While large majorities of White, Hispanic and Asian American adults all say that Black people face at least some discrimination, Black Americans are far more likely to say that Black people face a lot of discrimination. There are often associated superficial satellite papules or pustules. Infants are especially susceptible to this inflammatory condition because of their flexed posture, relatively high percentage of body fat, and short neck. patches of small round bumps. I am not a racist. Scale is most prominent at the leading edge of the plaque. In the United States, tinea capitis most commonly affects children of African heritage between three and nine years of age. Like Ali in the 60s, Jackie Robinson was one of the most influential sports figures of his day. In 2014, African Americans constituted 2. Intertrigo is a superficial inflammatory skin condition of the skin's flexural surfaces, prompted or irritated by warm temperatures, friction, moisture, maceration, and poor ventilation. . Malcolm X. picture 4: Intertrigo rashes underneath the breasts. A survey of self-reported skin disease in the elderly African-American population. Prevalence of intertrigo in the large skin folds varies from 6% in hospital patients to 17% in nursing home clients and 20% in home care patients [6-12]. Mild cases of intertrigo can usually be treated in the comfort of your own home. were born outside the country as of 2019, meaning that 10% of the Black population was foreign born. 04. Sometimes bacterial or yeast infections develop. African American history began with slavery, as white European settlers first brought Africans to the continent to serve as enslaved workers. The diagnosis intertrigo refers to an inflammation of the body folds. Intertrigo is irritation and breakdown of skin (maceration) in areas where two skin surfaces rub together. S16 Abstract Intertrigo, also known as intertriginous dermatitis, is one of the four separate conditions that fall. Intertrigo is inflammation of skinfolds caused by skin-on-skin friction. They. 4 million, or 7% of the overall U. These include: Moisture. 12. 50 (paper-back) Systemic Candidiasis: Cutaneous Manifestations in Low Birth Weight Infants. "Intertrigo", Pediatric Dermatology: A Quick Reference Guide, American Academy of Pediatrics Section on Dermatology, Anthony J. Skin Mites such as Demodicosis Mites. Age Diaper rashes can start in the neonatal period as soon as the child begins to wear diapers. The diagnosis of intertrigo is based on the presence of erythema and is often accompanied by symptoms such as burning, itching, and tenderness. 4 There are three types of tinea capitis: gray patch, black dot, and favus. It also may affect antecubital fossae; umbilical, perineal, or interdigital areas; neck creases; and folds of the eyelids. It has a raised border and hollow center. As an opportunistic pathogen, it has further. Intertrigo. [1] Intertrigo commonly becomes secondarily. People of African descent (i. Latest news coverage, updates, videos and photos highlighting African American culture and perspective. Summary. . Treatment includes drying agents and sometimes topical antibacterial or antifungal medications. sprinter Jesse Owens taking home the win for America in the 200 meter dash at the 1936 Olympics in Berlin. Gil Yosipovitch, Ethel Tur, Ohad Cohen, Yael Rusecki; Skin Surface pH in Intertriginous Areas in NIDDM Patients: Possible Correlation to Candidal intertrigo. [7] How to use: Apply coconut oil on the affected area and leave it overnight. On this list you’ll find actors, models, philanthropists, community organizers, directors, filmmakers and more. intertrigo in the mammary folds. mentagrophytes. Friction, such as. The imprisonment rate for African American women is 2x that of white women. image source: doctordecides. African Americans are incarcerated at more than 5 times the rate of whites. Intertrigo is a superficial inflammatory dermatitis occurring on two closely opposed skin surfaces as a result of moisture, friction, and lack of ventilation. ointments that may block the skin. Lesions mostly develop in the neck, axilla, sub-mammary fold, and. Learn more about African Americans,. Intertrigo is an inflammatory condition of skinfolds caused by skin-on-skin friction. Green Terry side: 80% Micro Modal 20% Poly Black theatre, in the United States, dramatic movement encompassing plays written by, for, and about African Americans. 5 million African men, women, and children were. American Podiatric Medical Association 2008; 98 (1):. Intertrigo. James Q. The result can be a red, irritated, and inflamed skin rash that sometimes has a smell. Confluent and reticulated papillomatosis is an uncommon skin condition affecting the trunk, neck and axillae. American Family Physician, 01 Sep 2005, 72(5): 833-838. More than 4. Alcohol Use and Abuse within the Black Community. The latin word for wolf, lupus, is a medical term for conditions that destroy skin and leave scars . Elk Grove Village, IL: American Academy of Pediatrics; 2012. Intertrigo develops when friction and trapped moisture in intertriginous areas cause skin maceration. It is possible the name you are searching has less than five occurrences per year. Erythema may be variable, and lesions may be solitary or multiple. Del Rosso, DO: We have a 60-year-old African American woman with moderate obesity with chronic intertrigo under her breast and under the abdominal folds. Coconut Oil. 8 million people. For German-speking countries, the ICW has recommended that the traditionally used synonym “Hautwolf” (skin wolf) no longer be used. Another North American study 28 assessed all forms of MASD in 1427 patients over one year in an acute teaching hospital, finding an overall prevalence of MASD of 4. picture 2: Intertrigo rashes as manifested by redness and scaly skin. adults who self-identify as Black, either alone or in combination with other races or Hispanic identity. S. It is a properly fitted bra!. You need to shower every day (especially after excessive sweating or physical activity) and properly dry yourself with a clean towel by gently tapping it on your skin, rather than rubbing it forcefully. But with herpes, the lesions can be preceded by flu-like symptoms such as fever, chills, and fatigue and by tingling of the skin (“nerve pain”) on the side of the evolving skin lesion. Treatment is aimed at drying the skin and. Intertrigo's Latin translation,. Most Black immigrants (88%) were born in African or. Candidal rashes are commonly encountered in primary care and typically respond promptly to therapy. Trapped moisture, which is usually due to sweating, causes the surfaces of your skin to stick together in your skin folds. Prolonged use of corticosteroid creams can result in skin atrophy, which is thinning and weakening. J. Through this lesson, students examine the conflicting perspectives over slavery, abolition, and equality. Pseudofolliculitis barbae affects around 45% of African American Service Members, a much lower percentage of Hispanics and about 3% of Caucasians. This is called a “herald patch” or “mother patch. Family fall festivals and summers that are humid but not unbearable, Richmond is a great place for families in general. picture 1: Intertrigo rashes appear in the skin folds. 2. Schwartz and Jacek Cezary Szepietowski and Adam Reich}, journal={American family physician}, year={2005}, volume={72 5}, pages={ 833. B. [7] How to use: Apply coconut oil on the affected area and leave it overnight. Dry the affected area with a hand fan, fan, or blow dryer. In response to several high-profile deaths of African Americans in recent months, some black people are saying that enough is enough. picture 4: Intertrigo rashes underneath the breasts. It is characterized by skin that is red, inflamed, and occasionally itchy or unpleasant. See moreIntertrigo is a superficial inflammatory dermatitis occurring on two closely opposed skin surfaces as a result of moisture, friction, and lack of ventilation. Loïs Mailou Jones. It reduces itching that leads to skin irritation and infection. Tip: Blow your skin with a hair dryer set at its lowest setting 2 to 3 times a day to keep your skin dry. Intertrigo, also known as intertriginous dermatitis, is a form of moisture-associated skin damage resulting from prolonged exposure to perspiration within skin-to-skin contact areas and beneath devices. Spirit in the Dark: Religion in Black Music, Activism, and Popular Culture November 18, 2022 – April 21, 2024 African American History and Culture Museum. Candidal Intertrigo (skin-fold infection caused by yeast) Our Fabrics Floral Smooth side: 100% Modal - Modal fibers are produced by Eco Soft technology offering exquisite softness to textiles. Yeast infections underneath or around the breasts can cause intertrigo, a rash that. Mme A. MD *; Cassarino, David MD †; Patail, Hassan MD ‡; Khan, Nabeela MD ‡ The American Journal of Dermatopathology: August 2017 - Volume 39 - Issue 8 - p e104–e105. Intertrigo is triggered by constant moisture in skin folds: Around the groin; Under the armpits; In the inner thigh area; Under the breasts; Abdominal skin foldsIn 1971, the average African-American 17-year-old could read no better than the typical white child who was six years younger. Under-breast soreness usually occurs in women who are larger breasted or very sporty. For German-speking countries, the ICW has recommended that the traditionally used synonym “Hautwolf” (skin wolf) no longer be used. She does have a history of what is clinically evidence of. It usually looks like a reddish rash. Intertrigo (intertriginous dermatitis) is a clinical inflammatory condition that develops in opposing skin surfaces in response to friction, humidity, maceration, or reduced air circulation. Every Black History Month and Juneteenth, pioneers in African American history are often mentioned like Dr. Celebrate Black History Month during February 2023 with. The moist, irritated skin allows bacteria and yeast to grow in the folds ( Figure 1 ). Treatment includes the use of an antifungal cream or ointment. Elk Grove Village, IL: American Academy of Pediatrics; 2012. While psoriasis can be easily confused with other allergy symptoms, inverse psoriasis triggers and treatments are different from intertrigo. Intertrigo is a common inflammatory skin condition that is caused by skin-to-skin friction (rubbing) that is intensified by heat and moisture. Black Americans are incarcerated in state prisons at nearly five times the rate of White Americans, according to a new report by The Sentencing Project. These areas tend to be warm and trap moisture next to the skin. Great Migration, in U. 8M 2. Tinea Cruris (Jock Itch) Tinea cruris is a dermatophyte infection of the groin. 6% Black or African American, which equals 47. Manifesting as intense, fiery-red erythema and maceration in the intertriginous folds of the neck, axillae, or inguinal spaces. Family. Intertrigo is a common skin condition in care homes and home care. Intertrigo is irritation and breakdown of skin (maceration) in areas where two skin surfaces rub together. The International African American Museum tells the unvarnished stories of the African American experience across generations, the trauma and triumph that gave rise to a resilient people. 2% of Native Americans. S. Apply a cold compress to the affected area to relieve the itchiness and the burning sensation. Intertrigo is a skin condition that causes inflammation (redness and swelling) and a rash. Malassezia furfur (formerly known as Pityrosporum ovale) is a species of yeast (a type of fungus) that is naturally found on the skin surfaces of humans and some other mammals. The minstrel shows of the early 19th century are believed by some to be the roots of Black theatre, but they initially were written by whites, acted by whites in blackface, and performed for white audiences. It has a raised border and hollow center. At the end of World War II, African Americans were poised to make far-reaching demands to end racism. Se pueden encontrar manchas y placas rojas brillantes, bien definidas y supurantes en los pliegues del cuello, axilas, la fosa del codo, las ingles, en medio de los dedos de las manos y de los pies o en la parte posterior de las rodillas. Intertrigo is most commonly seen in skin fold areas, where skin becomes inflamed, such as under the arms, in the thigh and groin folds, under breast or belly folds, and in neck creases. In the late 19th century, it was improved upon by Sarah Boone, an African American woman who was born enslaved. Similarly, African-Americans today must navigate the social fault lines exposed by the Great Migration and the country’s reactions to it: white flight, police brutality, systemic ills flowing. Intertrigo refers to inflammation of opposed skin and commonly occurs in the inframammary region, axillae, groin, gluteal folds, and between redundant skin folds of the abdominal pannus in obese patients. 7546 F 916. "Jock itch is associated with sweating, friction/abrasion, occlusive clothing, and the direct rubbing of. Michael Corleone. Rosacea (roe-ZAY-she-uh) is a long-term (chronic) skin condition of adults that causes facial flushing. Toxic erythema of chemotherapy (TEC) encompasses a broad spectrum of cytotoxic effects on the skin. 1412 Blue Oaks Blvd, Roseville, CA 95747 P 916. Conclusions: Intertrigo is a common skin condition in care homes and home care. Stereotypes of African Americans grew as a natural consequence of both scientific racism and legal challenges to both their personhood and citizenship. Table of Contents What is intertrigo? Intertrigo is a rash that usually affects the folds of the skin, where the skin rubs together or where it is often moist. Intertrigo definition: chafing between two moist closely opposed skin surfaces, as under the breasts or at the. Eczema. Intertrigo usually starts as redness or small bumps or spots in skin folds. Black people. The area may ooze or be sore or itchy. The medical term for intertrigo is intertriginous dermatitis . People with a weakened. Diabetes Care 1 April 1993; 16 (4): 560–563. The National Survey on Drug Use and Health (NSDUH) publishes that approximately 43. She has a 10-year history of psoriasis on the scalp and lateral face and notable disease relapses in this area. Mission US 2: Flight to Freedom : In Mission 2. By Angelica Bottaro Angelica Bottaro is a professional freelance writer with over 5 years of experience. Home Remedies. Treatment includes drying agents and sometimes topical antibacterial or antifungal medications. In many people, a yeast How unique is the name Intertrigo? Out of 6,311,504 records in the U. Friction of the skin folds. INTRODUCTION. Our History IAAM’s own journey has involved many passionate people and carefully calibrated decisions — and a few impromptu ideas and unforseen discoveries. "African American" caught on in the US in the 1980s as a more "particular and historical" term than the generic "Black," Mayes says.