Are you gaining weight without any apparent reason or you cannot manage to lose weight no matter how hard you try? Are you feeling sad and depressed? Do you catch colds often? Are you having a tough time focusing and you are feeling tired most of the time? All these could be thyroid disease symptoms, namely indicators of hypothyroidism. Since hormones affect all cells of the body, a deficiency in the activity of this gland is felt in a wide array of thyroid disease symptoms.



Hypothyroidism is a very frequent affliction, and statistics say that some 20% and 10% of men suffer from this disease. We are speaking of hypothyroidism when the gland does not produce enough hormones. The causes could be a malfunction of the hypophysis, the Hashimoto, the surgical removal of the goiter, some medicine, food that lacks enough iodine. The consequence of a reduced function of the thyroid gland does not remain unnoticed: the energy is used at a slower than normal pace, thus many of the functions of the body are slowed down.

In hypothyroidism the most important thyroid disease symptoms are as follows: 1. a state of drowsiness, even though you get enough sleep; 2. problems with memory, difficulties in focusing and attention problems; 3. slowed heart rate; 4. increased sensitivity to the cold; 5. a tingling sensation in the hands; 6. dry and harsh skin; 7. dry hair, lacking shine; 8. fragile, thin and easily broken finger nails; 9. slow motions and reactions (bradykinesia); 10. frequent constipation; 11. muscle cramps; 12. edema of the face (the face is shaped like a “full moon”); 13. decreased libido; 14. menstrual disorders.

Diagnosis is made based o blood tests, which measure the level of thyroidal hormones, namely the amounts of T3 and T4 hormones, as well as the TSH, which is secreted by the pituitary gland. A low level of thyroid hormones, added with high levels of TSH, indicate hypothyroidism. Still, if the thyroid hormones are only deficient to a small extent, the tests could show normal levels for these hormones, even if the patient presents symptoms that are specific to this disease. Also, the doctor could recommend the performance of some additional investigations, such as thyroidian ecography or a scintigraphy.

There is one pretty simple and precise test meant to detect deficiency of thyroid hormones: basic temperature. People who are suffering from hypothyroidism tend to have a body temperature lower than normal. The temperature reflects the metabolic rate, a rate which is mostly determined by the thyroid hormones. When the thyroid is not functioning normally, the body temperature is decreased. You only need a thermometer. How is this done? In the morning, as soon as you wake up, before getting out of bed, measure your temperature (be careful to keep a thermometer handy).

If you are using a classic thermometer, keep the thermometer under your arm for 10 minutes. Note the value obtained and do he same in the next 3 or 4 days, preferably at the same time. A value between 36.4 degrees and 36.7 degrees Celsius is normal. A value below 36.4 degrees Celsius indicates hypothyroidism.

The Krone disease is a chronic affection, with remissions that could last for a lifetime. The gravity of this affection differs from one patient to another. Some patients have relatively light symptoms, while other patients have serious symptoms and complications. In rare cases, the Krone’s disease symptoms can evolve and cause death.



The Krone disease diagnosis is realized taking into account the anamnesis and the general exam at the hospital. This diagnosis is later confirmed by the intestinal biopsy.

The Krone disease can sometimes be hard to diagnose. The first signs of the disease can be unspecific and can feel like pain in the joints, followed by extreme fatigue. In some cases, the diagnosis is confirmed years after the disease installed, because The Krone’s disease symptoms appear gradually and at the beginning are not very serious. In time, there will appear lesions of the intestine, resulted from the chronic inflammation of the intestine and these lesions lead to ulcer.

The colon and anus can be examined by performing a colonoscopy. This method consists of introducing a long and flexible device in the anus, which has optic fibers and which is connected to a monitor capable of illustrating images from inside the intestine.

Colonoscopy is very efficient because it can examine the entire colon. This method allows the doctors to do a biopsy which is necessary in order to confirm the diagnosis for Krone’s disease. The complementary exams include CT and RMN. A lab exam of the stool is also useful in order to identify the pathologic products at the level of the intestine, like blood, blood cells, infections, pus, bacteria or parasites.

The syndrome of the irritable colon is a functional affection and has less serious symptoms than the Krone disease. Some of the common Krone’s disease symptoms are abdominal pain, diarrhea and weight loss. Other common symptoms include poor appetite, fever, night sweats, rectal pain and rectal bleeding.

The different subtypes of Krone’s disease and their symptoms are: Krone’s colitis, which is an inflammation confined to the colon. Some of the symptoms are abdominal pain and bloody diarrhea. Krone’s enteritis is an inflammation confined to the small intestine Obstruction of the small intestine also can occur.

Krone’s terminal ileitis is an inflammation that affects only the end of the small intestine- the part of the small intestine closest to the colon. Krone’s entero-colitis and ileo-colitis are terms which describe an inflammation that involve both the small intestine and the colon. The symptoms are bloody diarrhea and abdominal pain. Krone’s terminal ileitis and ileo-colitis are the most common types of Crohn's disease. Up to one third of patients with Krone’s disease may have one or several of the following conditions: swelling of the tissue of the anal sphincter, development of ulcers and fissures, development of anal fistulae and development of peri-rectal abscesses.

The inflammation of the pancreas, or pancreatitis, is probably the most common disease for this organ. Many pancreatic disease symptoms point to this affliction, but there are also times when pancreatic disease symptoms point to other, more severe symptoms. There are many factors associated with pancreatitis, including direct injury, certain drugs, viral infections, hereditary diseases and congenital problems in a system.



Even though the immediate cause of acute pancreatitis is not always clear, it seems to involve one or more of the following factors: increased pressure in one channel due to partial obstruction, bile stones or edemas; and afflictions of the channels in organs that allow the leaking of activated digestive enzymes in the pancreatic substance and in the surrounding tissues.



The over-stimulation of the secretion mechanism producing enzymes in the cell can lead to the energizing of intracellular enzyme systems, resulting in the conversion of proenzymes into active forms which begin digesting cellular organites. The gland thus begins to self destruct. Similar damage may also occur in other organs of the body, such as the lungs, kidneys and blood vessels that receive these enzymes activated through the cellular system. It is not clear how the trypsinogen proenzymes are transformed into trypsin in the affected cell.

However, it is known that the activation of other proenzymes begins with this conversion. The degree of cellular destruction seems to depend on the strength of causing factors. Strong localized pain, in the abdomen and in the back, due to the leaking of enzymes, destruction of the tissue and irritation of the nerves is the most often encountered symptom of acute pancreatitis. In serious cases there could be the occurrence of respiratory arrest, shock or even death.

The severity of the symptoms generally depends on the amount of damage suffered by the pancreas; the mortality rate reaches close to 50% in cases of severe pancreatitis, but it is below 5% in less severe cases. Diagnosis is confirmed by the detection of a high level of pancreas enzymes in the blood an, if the function of the cell is disturbed by the inflammation process, high levels of glucose in the blood.

Ultratomography scans of the upper abdomen have shown an increased and infected pancreas. Strong pain, often followed by fever, suggests the presence of a pseudocyst caused by outbreaks of infection in the pancreas. Acute pancreatitis is treatable through sustained therapy, with the replacement of fluid and salts, through the control of the pain. In severe cases, washing the dead tissue and additive enzymes from the abdominal cavity during surgery may be beneficial. During post-operatory recovery, the prevention of a new attack is the main objective.



In addition, the removal of stones, ceasing the consumption of alcohol, decreasing the amount of fat in the blood through an adequate diet and ceasing the consumption of drugs might be useful measures. Where repeated attacks have led to the scarring of the main pancreatic vein, surgical repairs may prevent further attacks.

Also known as the Hashimoto thyroid, the Hashimoto disease is part of the inflammatory thyroid diseases, among the acute thyroid and sub- acute thyroid. The Hashimoto disease has a media of 0.1 and 5% especially in western countries and it affects more frequently women, especially middle aged ones.



The auto immune acute thyroid is most times triggered because of antibodies (antibodies which affect their own tissue), which target proteins in the thyroid structure: thyroperoxidase and tireoglobulin. Because of the presence of these antibodies an inflammatory process occurs, most frequently with a circular evolution, which can affect in time the functionality of the thyroid.



Because it also happens to people who have a genetic predisposition for auto immune diseases, the Hashimoto disease can easily be associated with vitiligo, psoriasis or rheumatic polyarthritis. It is assumed that an increased consume of iodine favors the Hashimoto disease.

Clinical signs - Most of the times, the Hashimoto disease does not have any clinical symptoms, because this disease is usually diagnosed in a laboratory after some tests. Sometimes, one of the Hashimoto’s disease symptoms is an increase of the thyroid gland because of the chronic inflammatory process- any increase in the volume of the thyroid is called gout. If after the inflammatory process the thyroid cannot fulfill its function of producing thyrotropin hormones, there is a lack of thyroid hormones in the body, known as hypothyroidism.

Some of the Hashimoto’s disease symptoms are: fatigue, weight gain, depression, excessive sleepiness, cold intolerance, dry hair, constipation, dry skin, muscle cramps, increase of the cholesterol level, decreased concentration, vague aches and pain or swelling of the legs. At the moment there is no known cure for the Hashimoto disease. There is also no way to know how long the autoimmune process and inflammation will continue. For most patients, the Hashimoto disease results come from the inflammatory process.

Thyroid hormone drugs can replace the hormones which the thyroid made before the inflammation occurred. There are two major thyroid hormones secreted by a healthy gland (T3, T4). Replacing one or both of the hormones can ease the symptoms caused by the absolute or relative lack of hormones as a consequence of Hashimoto's disease. Without medication, there are few chances for the thyroid to be able to maintain hormone levels within the normal scale, and symptoms and signs of Hashimoto’s disease will occur or worsen.

Many women are worried because of this disease, especially if they are pregnant. But the Hashimoto disease is not a reason to avoid pregnancy. However, some women with Hashimoto's disease might have trouble conceiving a baby. For some patients, treatment with selenium is used to try and diminish antibody levels. The story is that lower antibody levels may direct to success in conception. Both before and during pregnancy, the levels of thyroid hormones need to be monitor to make sure they are in the optimal level for pregnancy. This usually happens within the range for non-pregnant women, but at the higher end of this level.



If you think you may have Hashimoto's disease, you should ask your doctor to check your thyroid and have some blood tests to help make a diagnosis. If you know you have Hashimoto's disease, stay on your medication as required by your doctor and follow up with him or her for regular thyroid blood tests, which will help you to optimize the treatment for the Hashimoto’s disease.

Are you in pain while walking, do you feel like your feet are cold, numb or itchy, do you have ulcerations that won’t heal or a family history of aorta aneurism (dilation)? The you need to evaluate your peripheral arterial system (namely those blood vessels that carry the blood to the legs), since there might be a connection between pain or numbness in legs, symptoms and disease.



In medical terms, the progressive narrowing of these vessels bears the name of obliterating peripheral arteriopathy of the lower limbs. It determines a decrease in functional capacity and affects the quality of life, while also leading to amputation of the legs and increasing the risk of death. Why? Because the main cause id arteriosclerosis and this is a (systemic) generalized process, where in most cases narrowing of the lower limb arteries coexists with lesions found in other territories (brain, kidneys, heart).



It is known at the moment that patients with pain or numbness in legs, symptoms and disease diagnosed as peripheral arterial disease have a 50% risk of suffering a heart attack, a 40% higher chance of suffering a stroke or renal failure, compared to the general population. Therefore, the more risk factors there are for arteriosclerosis the higher the risk is for you to develop this disease. Some of these risk factors can be corrected: smoking, arterial hypertension, diabetes, high cholesterol, while other risk factors cannot be corrected: age (patients aged over 50 develop this condition more often), sex (more men than women are patients) as well as heredity.

Rarely, other causes are noted, such as: an exaggerated vascular reactivity that determines arterial spasms, the occlusion of a vessel due to the migration of a blood clot or the existence of arterial dilation (aneurism) located most often in the aorta.

The most often symptom is the pain occurring while walking, which goes away, in the early stages, while pausing, but returns after walking approximately the same distance. This is called intermittent claudication. Its center varies depending on the narrowing of the vessels. Most often it is located in the calf, rarely in the thigh or buttocks, and in this latter case it can also be accompanied by sexual dysfunction. It will occur after smaller and smaller distances of walking until it starts appearing even in pauses, especially at night, at which point the patient tends to keep their leg hanging at the side of the bed.



Claudication, namely the pain caused by the narrowing of the arteries, needs to be distinguished from that produced by other diseases of veins, nerves, joints or muscles. Sometimes it is not typical, and can be felt as a tingling sensation, numbness or cold, which is why you should go to a doctor who, through simple maneuvers such as noticing the aspect of the teguments, feeling pulses, listening to arteries and determining arterial blood pressure in the arms and legs can tell you if you are suffering from arteriopathy or not.

Necrotizing fasciitis, also known as the flesh eating disease, represents a progressive infection, with necrotizing effect, of the fasciitis and of the subcutaneous tissue. This rare bacteria infection can destroy the skin and the underlying tissue, but it does not strike at the muscle. The infection progresses very fast and is usually accompanied by general toxic manifestations.



The most often incriminating etiological agent in the occurrence of flesh eating disease is Streptococcus Pyogenes (or group A strep). When the fasciitis is localized within the scrotum, perineum or genital region, it is called Fournier gangrene. The disease, although rare, is very serious: 30% of patients die if the infection is not treated adequately (Fournier gangrene comes with significantly higher mortality, some 75%). The average age of those who survive is 35, while patients aged above 50 fight off the infection with greater difficulty.



Flesh eating disease mostly targets adults (the average age of patients reaches 38-44), and children are only very rarely diagnosed with this disease. Most patients that develop this type of infection have a health considered to be satisfactory prior to the occurrence of the disease.

Signs and symptoms of flesh eating disease - The patient can develop intense pain after suffering a lesion of variable intensity and depth. Initially, the signs and symptoms of flesh eating disease decrease in intensity within 24 to 36 hours, but they intensely increase afterwards. Often, the pain felt is much more intense than it would be expected, considering the size of the initial wound. The patient could also claim fever, trembling, nausea and modifications in the abdominal transit (mostly manifested through the sudden occurrence of diarrhea).

Changes in the skin include redness in the area of the injury, painful tumefaction as well as increased temperature in the area targeted. If the infection is deep, the signs of inflammation occur later on. The symptoms evolve rapidly in seriousness and they occur suddenly, without premonition signs, as the infection spreads. This situation can become life threatening.

The develop complications including sepsis and shock (complications of the widespread tissue necrosis). Necrotizing fasciitis can even evolve towards multiple organ failure and death, if the symptoms are not recognized and the cause is not treated promptly and aggressively.

Diagnosis - Patients with necrotizing fasciitis show symptoms before going top the doctor. Clinical suspicion of necrotizing fasciitis occurs following careful analysis and the investigation of symptoms (especially if the rapid progression of the necrosis is recognized, as well as the worsening of the patient’s state in a relatively short amount of time).

For a certified diagnosis the doctor could collect a sample of necrotizing tissue. This tissue can be subject to microbiological analysis to precisely identify the bacteria responsible for the infection. In order to evaluate the health of the other organs and to establish the width and depth of the infectious process, the doctor will perform image testing (x ray scans, CR, MRI).



Therapeutic principles - Necrotizing fasciitis requires immediate and extremely aggressive treatment. Often, the condition requires supportive treatment to prevent the occurrence of liver, renal or respiratory failure, as well as shock. Medical treatment, based on antibiotics to which the bacteria is sensitive, is added with surgical treatment aimed at removing the dead tissue and stopping the expansion of the infection.

Preventive measures include washing the hands frequently, adequate hygiene and the rigorous cleaning of various injuries, scratches, burns or other types of lesions, penetrating or not.

Amyotrophic lateral sclerosis, also known as Lou Gehrig’s disease, is characterized through a progressive reduction of the number of nervous cells in the brain and spine, called motor neurons. The motor neurons regulate the contraction and relaxation of the voluntary muscles, which make the motion of the body possible.



ALS is a progressive disease, which is invalidating and fatal. Walking, speaking, eating, swallowing and other fundamental functions of the body become more difficult in time. These afflictions can cause various injuries and other complications.



One, maybe two, people in 100000 develop ALS every year. The men are affected slightly more often than women. Even though the condition can start at any age, it is more frequent in middle aged people and the elderly. The causes for ALS are unknown. Some 5-10% of people with ALS present an inherited form of the disease. ALS is not infectious.

Symptoms

Lou Gehrig’s disease early symptoms and later symptoms include: - weakness of lack of precision and dexterity in the hands and feet; - gradual loss of strength in the arms and legs; - inability of voluntary control of the arms and legs; - muscle spasms ; - rigid and unsteady walking; - difficulty with swallowing, swallowing and speaking; - fatigue; - muscle cramps, more frequent during the night, which can start later in the evolution of the disease; - pain in the final stages of the disease.

It is important to remember that Lou Gehrig’s disease early symptoms are not sure indicators of ALS, since these effects could be noted in many other circumstances as well.

The first sign of ALS is usually represented by a slight feeling of weakness in one leg, arm, the face or the tongue. Other problems are represented by greater imprecision and difficulty in the performance of actions that require precise movements of the fingers and hands. There can also be muscle spasms. The weakness extends to the arms and legs for months, or even years. While the neurons continue to decrease in numbers, the muscle cells that would have normally be stimulated by these nerves begin to decrease in number and the muscles atrophy.

Respiratory afflictions are perhaps some of the most frequent severe complications of ALS. While the muscles of the throat and chest atrophy, swallowing and coughing become more difficult, which sometimes triggers the aspiration of food or saliva into the trachea. This determines the occurrence of pneumonia (inflammation of the pulmonary tissue). Respiratory afflictions worsen as the disease progresses, increasing the risk of infections and respiratory insufficiency.



Pneumonia, pulmonary embolism, respiratory insufficiency and cardiac insufficiency (probably due to the inexistence of adequate respiration following the atrophy of the muscles) are the most common causes of death among ALS patients. In most cases, death occurs at the latest after three to six years from the initial symptoms, otherwise there are individual who survive with the disease even for decades. Even if there is no remedy for ALS, treatment may help maintain stability and independence, control of the symptoms and can avoid complications for as long as possible. The treatment is aimed at promoting emotional support as the invalidity increases.

The Alzheimer disease is a degenerative illness which affects certain areas of the brain that control memory, intelligence, and capacity of judgment, language and behavior. This disease represents the most common type of mental decline or dementia for elders.



The Alzheimer disease is a much serious affection than temporary memory loss which is characteristic to most elders. This disease is also associated with behavior disorders, personality disorders, loss of the ability to think correctly and loss of the capacity to perform daily tasks.



Family and friends notice in the beginning these changes, but these changes can be noticed by the patient in cause. The cause of Alzheimer disease remains unknown, but there could be several factors which could lead to this disease. Some of the deteriorations which occur in some areas of the brain are connected to the loss of chemical messengers of the neurons. The cause of these modifications is unknown, but scientists are still researching in order to determine these causes. Even though most of the patients do not have this disease in their family medical background, the risk of developing the Alzheimer disease is increased at patients who have a relative suffering of this disease.

Some studies suggested the fact that zinc and aluminum might have a role in starting this disease, but these theories have not been supported by proof. Memory loss is most of the times one of the first symptoms of Alzheimer’s disease. Many elders are worried when they have short term memory loss. Some of episodes occur at people older than 60- 70 years old, but only a small part of them can develop the Alzheimer disease. If you notice you or someone close having short memory loss episode you should consult a specialist doctor.

Normal short term memory loss episodes include: forgetting a certain experience, forgetting where you parked your car, forgetting events from your past, the name of a person which you will recall later or forgetting where you left an object, like your car keys. Some of the early symptoms of Alzheimer’s disease are: forgetting you ever had an experience, forgetting how to read the clock or drive your car, forgetting about current experiences or the fact that you left the gas on or even forgetting you know a person.

There is little evidence of the fact that maintaining a special intellectual activity might diminish the risk of developing the Alzheimer disease. Some activities like reading the newspaper, books, magazines, playing society games, solving puzzles, visits to the museum or even listening to the radio can help in preventing the development of Alzheimer disease.



The more scientists are uncovering the causes of Alzheimer’s disease, the more they will be able to find a cure as well as a way to prevent it. The medication used for preventing some disease will be available for preventing the Alzheimer’s disease or for people who have an increased risk of developing this disease. The scientists are trying now to develop a vaccine for Alzheimer.

Hodgkin’s disease is a type of malignant lymphoma that especially attacks the ganglions of the throat and armpit. It often occurs in young adults and elderly people. As opposed to several years ago, today’s Hodgkin’s disease has a pretty high cure rate. So if you are suffering from this disease or have just been diagnosed with it, then you should not despair, because there are solutions for you out there.



Here I will tell you about the nature of this disease, its origins, the Hodgkin ’s disease progressive symptoms, diagnosis, treatment and evolution.



What is this disease? Hodgkin’s disease is a form of lymphoma, therefore a disease that affects the lymph nodes. It usually develops in young people with ages between 15 and 34, or in elderly people aged over 60. The occurrence of the disease is higher in Europe and in the United States of America than it is in Asia, and also, the incidence is higher in well developed countries as opposed to countries that are now developing.

Origins of the disease - It is not exactly known what is the element that triggers this disease or where it comes from. It seems that the disease is not contagious. Specialists often assume that the favorable grounds for the development of this disease are secured by infection with the Epstein-Barr virus.

Hodgkin’s disease progressive symptoms - The main symptom is the swelling of the ganglions. This swelling is not painful and does not present an apparent infection. These ganglions are especially situated in the cervical area and in the armpit. The increase in volume of the ganglions is sometimes, but not always, accompanied by symptoms such as:
- fever, which can persist for several days, then disappear for weeks in a row, and then return suddenly and with no apparent cause; - sweating during the night; - loss of weight; - high levels of physical fatigue; - depending on the location of the ganglions afflicted, there can be other symptoms. For example, if the ganglions are placed in the chest, on a thorax level, there can coughing or chest pains.

Diagnosis - Aside from the clinical exam, a biopsy is the one that allows a diagnosis, added with blood tests performed by the doctor.

Treatments that are currently available - The treatment of Hodgkin’s disease involves radiotherapy or chemotherapy, and the two are often associated, or combined, in the treatment scheme.



The evolution of Hodgkin’s disease - Today, Hodgkin’s disease is well treated in the wide majority of cases. There are four stages to this illness, from I, which is the least advanced, to IV, which is the most severe. For stages I and II, the cure rate is higher than 80%. The cure rate reaches between 70% and 80% in stage III and a percentage of 50% in stage IV, a level where one in two cases I cured. In exchange, the chemotherapy used in the treatment of Hodgkin’s disease can sometimes have late consequences, sometimes triggering leukemia, lung cancer or stomach cancer.

The Parkinson disease can affect one’s capacity of controlling the movements of their body. Some nervous cells inside the brain normally produce a chemical substance called dopamine. Dopamine is a chemic mediator or neurotransmitter through which the nervous cells control the movement of the body.



In Parkinson disease, these nervous cells which produce dopamine, self destruct and lead to low amounts of dopamine. When this starts to happen, the body can start showing sign of difficulty in even the simplest movements. The Parkinson disease comes with a wide range of symptoms and complications.



Treatment of the Parkinson disease can control the symptoms in the early stages of the disease and it is applied as soon as the symptoms are affecting the daily activities and an ill person’s ability to work. For example, a right handed person who starts trembling on the left side might not feel bothered by this symptom and they might not feel the need for treatment until the symptoms start to worsen and start growing in intensity.

A person who is not able to fulfill their daily tasks because of the symptoms of Parkinson disease will want to start treatment faster than a person who does not work or who is not affected in their daily tasks by the symptoms of Parkinson disease. The symptoms of Parkinson disease are usually found on people aged 50 to 60 year old. The affection evolves slowly and sometimes can not be noticed by family, friends or even the person who has the Parkinson disease. A small number of people develop the Parkinson disease symptoms on one side of the body and most of them usually do not cross to the other side of the body.

Medication can somewhat control the symptoms of Parkinson disease, but it becomes more and more inefficient as the disease evolves. The Parkinson disease can cause a wide range of complications as the disease evolves. The connection between the Parkinson disease and the risk factors is still in question. Some of these factors can be: genetic factors, age, toxins from the environment or antioxidants. Even if research is about to reveal some answers, the experts do not know for sure what is it that causes the Parkinson disease.

There are studies, which are still in development, and that are trying to identify a cause for the Parkinson disease. Only a small percentage of the people diagnosed with the Parkinson disease have a parent, brother or sister who have this disease. However, the transmission of some abnormal genes seems to be the cause of the Parkinson disease which starts precocious in some families on which this affection is discovered at younger ages.



The low levels of dopamine- the chemic mediator- involved in the control of movements lead to the symptoms of Parkinson disease. The lack of this neurotransmitter shows up when the nervous cells from one side of the brain- the black substance- which produce dopamine start to self destruct or deteriorate. The exact cause of this affection of the nervous cells is unknown to specialist and researchers.