Find out what works well at Amen Clinics, Inc. from the people who know best. sciencebasedmedicine.org reports that amen charges over $3,600 without any insurance coverage to perform a spect (single photon emission computed tomography) scan, which uses an injected radioisotope and helps measure blood flow in different areas of your brain for diagnosis or treatment purposes, including adhd-related conditions and depression Many people come to Amen Clinics seeking a second opinion on scans performed elsewhere. The Amen Clinic's informed consent form is misleading: it . It has been using brain SPECT in an attempt to diagnose and treat psychiatric illness since 1991. The cost to visit this clinic can vary depending on what you need, but our research shows that a majority of patients will spend about $3,500 to more than $5,500 and get follow-up appointments every six months for around $270. Popular Treatments . Need to find a different location? The Amen Clinic is a health center that specializes in brain health and its associated needs. Dr. Daniel Amen has authored or co-authored more than 70 peer-reviewed published research studies on brain SPECT imaging. He has been featured on multiple PBS shows and his book, Change Your Brain to Change Your Life, was an international bestseller that led him to found Amen Clinic for stressed patients, with offices around the United States. I was told that I would receive the refund within 10 days. Their initial consultations last up to 30 minutes and cost $220, but they can be extended to 60 minutes for just $420. Thank you for reaching out and sharing your thoughts about Amen Clinics. Learn more about the insurances we accept. Dad did his 4th dive today and walked his best yet afterwards..don't know if it will stick, but hopefully! We always encourage patients to drink plenty of water. Accepts Medicaid. The radiotracer that we use for SPECT is called Technetium 99m. We know people worry they may not get accurate scans while on medication, but many of our patients are scanned on their medications and the scans are still very valuable. Job. These follow-up visits will depend upon your needs such as changing your medications or to simply follow up every six months. Im not convinced. AMEN free clinics offer free dental care, general medical care, and health education services to uninsured and under-insured people in the U.S. At any rate, clinical SPECT wins again. However, if you are already working with another physician, we ask that you discuss this decision with your doctor. Once the imaging solution has been absorbed, you will lie down in the scan machine, which has three cameras that will rotate around your head. The clinic also stated that Amen and his colleagues have published "over 70 scientific studies" in prominent science and medical journals, and cited one 2013 article on a study by the clinic . He may be right, or he may be wrong. Because we want everyone to have access to the health care services they need at Amen Clinics, we have partnered with CareCredit to offer interest-free financing. No. Doctors regularly diagnose and treat depression on the basis of clinical symptoms, and both doctors and patients can recognize symptomatic improvement. The Amen Clinics, founded by Daniel G. Amen, MD, . Its up to the individual to select the plan that best fits their family and needs. They always been, Debbie K. said: When I arrived at New Era TMS I was in really bad shape. We also provide brain health c Location & Hours 5363 Balboa Blvd Ste 100 Encino, CA 91316 Maxim Healthcare Staffing is seeking an Operating Room Nurse responsible for scrubbing and/or circulating duties for operative procedures; department admissions to the operative suite. We are always happy to provide a consultation to you or your local doctor after your evaluation if additional questions arise. Amen Clinics. Check to see if your question is answered. There are also arguments for limiting treatment to closely monitored research settings until the truth is known. Answer: Yes he is legit. For the baseline scan, you will be instructed to sit quietly and relax. We accept a range of health insurance plans and aim to provide you with affordable, stress-free medical care. Answered July 8, 2020 Amen Clinics offers many tiers to choose from within the health insurance offered from FSA, to PPO's, etc. The Evernorth name, logo and other Evernorth marks are owned by Express Scripts Strategic Development, Inc. 2022 Evernorth. The paper noted that the example cases "violate the standard of care" because a normal clinical diagnosis would have been sufficient and functional neuroimaging was unnecessary. IMPORTANT: You will need to ensure that the scans are compatible with our software, database, and reading protocols. Tue 8:00 am - 5:00 pm. Amen Clinic Pc is a Group Practice with 1 Location. How BBB Processes Complaints and Reviews, Better Business Bureau Serving the Pacific Southwest. Although individual plans may vary, in most cases, a payment schedule is set up between you and CareCredit, and if you pay off your fees within the agreed-upon time frame, you are not charged any interest. Our staff is committed to communication and transparency every step of the way. It is a nuclear medicine procedure that is widely used to study heart, liver, thyroid, bone, and brain problems. BBB Business Profiles are provided solely to assist you in exercising your own best judgment. The average radiation exposure for one SPECT scan is 0.7 rem. Evaluating the presence of an underlying organic brain condition that contributes to behavioral or emotional disturbances. About Me Locations. Why? Of the 5 ,000+ patients we have studied so far, we have some of the highest outcomes published anywhere. Two scans will allow us to evaluate the changes in brain blood flow patterns from a resting state to a concentration state. Schedule a call with one of our health care coordinators to answer your questions and help you find the best solutions for you and your loved ones! It is important to have follow-up visits after the initial scan has been performed so that any issues can be looked at in more detail. [7], Amen Clinics has locations in Newport Beach, California; San Francisco, California; Atlanta, Georgia; Reston, Virginia; Tukwila, Washington; Chicago; Los Angeles; and New York City. Amen Clinics New York serves a diverse client base from all 5 boroughs including Manhattan, Bronx, Brooklyn, Queens and Staten Island. Mon-Thurs: 8am 6pm SPECT imaging effectively shows us the patterns of activity in your brain. Amen Insurance Agency is a provider of quality insurance services and exceptional customer service. When considering complaint information, please take into account the company's size and volume of transactions, and understand that the nature of complaints and a firm's responses to them are often more important than the number of complaints. Some of the treatments he offers are even more disturbing. At Evernorth Care Group, your care team works together and with you to support your physical, emotional and mental health. Doctor visits vary in frequency depending upon your needs. Desperate patients are being sold hope at these clinics, at a high price, at a small but real risk, and without any scientific evidence that SPECT improves patient outcome over those who receive optimum treatment without SPECT. 3150 Bristol St Ste 400, Costa Mesa, CA 92626 If you choose to do business with this business, please let the business know that you contacted BBB for a BBB Business Profile. GameStop Moderna Pfizer Johnson & Johnson AstraZeneca Walgreens Best Buy Novavax SpaceX Tesla. The mailing address for Amen Clinic Pc is Po Box 12485, Jackson, Tennessee and phone number is (731) 300-3168. Friday & Sabbath: Closed, PO Box 398 Amen Clinics Los Angeles provides psychiatric and brain health care to the greater metropolitan Los Angeles area, including the communities of Encino, Sherman Oaks, Woodland Hills, Beverly Hills, North Hollywood, Santa Monica, Glendale, Pasadena, and Burbank. Make an Appointment. You can call Care Credit at (866) 893-7864 or contact them on the web at www.CareCredit.com for more information. We require 24 business hours advanced notice for changing or canceling an appointment, otherwise you will be charged for the appointment. When your health care provider knows you, you feel the difference and so does your body. The Amen Clinics, however, will not bill the insurance companies, meaning you will be given a walk-out statement, containing the applicable diagnosis and billing codes, which can then be submitted on your own to your insurance company for any possible out-of-network reimbursements. "[17], Harriet Hall has written critically about SPECT scans in articles for Quackwatch and for the Science-Based Medicine website. ProvidersOverviewLocationReviews Providers Dr. Lillian Somner, DO Psychiatry 6 Ratings Insurance Check Search for your insurance provider Aetna Anthem Anthem Blue Cross Blue Shield Blue Cross Blue Shield CareFirst Blue Cross Blue Shield Cigna You will want to first talk with the clinic and receive a CPT code before calling your insurance company for more information on what is covered. Accepts Medicare. That's just one of the reasons why surveys show that more than 9 out of 10 patients would recommend our doctors at Evernorth Care Group. Since a SPECT scan is a nuclear medicine procedure, it requires the injection of a very small amount of a radioisotope through a small needle into a vein in the arm. Can Amen really justify what he is doing? Its signal is detected by the scanner. The testing procedure takes four days. The official website, for example, lists multiple peer-reviewed studies in regards to SPECT studies, whereas Sciencebasedmedicine.org criticizes the method. When we schedule an evaluation, we ask for a non-refundable deposit. Insurance. He started with his ideas, which were and still are, basically correct. He says that this kind of graphic demonstration can help persuade patients that their problem is physical or physiological and might be helped with medication or other treatments. SPECT requires an injection of 20 to 25mCi (millicuries, the measure of radioactivity inherent to a radiopharmaceutical in our case, Technetium 99m). Biography: Well guide you through the process. English ; Amen Clinic 5901 Peachtree Dunwoody Rd # C6 Atlanta, GA 30328 Tel: (678) 367-2810 Visit Website Accepting New Patients: Yes Medicare Accepted: No Medicaid Accepted: No Mon Tues Wed Thu Fri Sat. In one case nothing that was written or diagnosed actually came from the SPECT image, but from a history taken orally from the family. A relative of a patient sent me the glossy Amen Clinic brochure that is being handed out at her sons school. Amen Clinics is a group of mental and physical health clinics that work on the treatment of mood and behavior disorders. The sender was particularly amused by a set of brain pictures of an overfocused wife and an underfocused husband. Yes, Amen is using SPECT scans for marital counseling! Private Patients Welcome. Wed 8:00 am - 5:00 pm. Be aware that many states do not allow pharmacies to accept phone refills for controlled substances (such as Xanax and Ativan). 1 7 7 comments Best Add a Comment AutoModerator 2 yr. ago Thank you for your submission, u/Briannah205. While there are some compatibility considerations, we are happy to perform this service. The clinics perform clinical evaluations and brain SPECT (single photon emission computed tomography) imaging to diagnose and treat their patients. Salary. After only six months, 84% of the patients we have treated at Amen Clinics report significant improvements and 85% report an improved quality of life. No. Discontinue stimulants four days prior to the first scan appointment and stay off of them until the scan appointment(s) are completed. Instead, they use them in statistical comparisons against groups of other scans, in which case their resolution smoothed to7mm, and in many cases, theyre smoothed to a resolution as low as 10mm. Amen Clinics are outpatient health care clinics that have been providing mental wellness strategies to patients of all ages since 1989.We offer patient-first experiences and customized solutions . The staff is very, Christie L. said: We've been with Jade for almost two years now. BBB reports on known marketplace practices. [18][19] Hall accuses the clinics of misrepresenting an unproven treatment as effective, of concealing important warning information, and of creating false hopes by promising things that can't be done. Easy Apply. COVID-19 Safety Practices and Procedures; COVID-19 Resources; FAQ; Contact; 888-288-9834 A retrospective study released by Amen in 2010 showed that "regional cerebral blood flow, as measured by SPECT, predicted stimulant response in 29 of 157 patients. Mike L. said: I unfortunately suffered a grade 3 AC separation at work. We have an after-hours paging system available for urgent matters. Providers Overview Location Reviews. If you would benefit from psychotherapy or coaching, we offer an array of ancillary services with licensed professionals. In fact, no imaging study by itself is a doctor in a box that can give accurate diagnoses on individual patients. You may contact the clinic directly. Evaluating the extent of brain impairment caused by drug or alcohol abuse or other toxic exposure. My little children, let us not love in word or in tongue, but in deed and in truth. Accepting New Patients. The Amen Clinic is a total scam. This scan can show how well blood flows around your organs to diagnose potential issues before they become serious problems or even infections. At the end more, 5363 Balboa Blvd Ste 100 Encino, CA 91316. At the end of an evaluation, patients are given a walk-out statement containing applicable more, Hello Samantha, thank you for reaching out. Shame on them!! Employer est. [4][5][16] The company also uses diagnostics such as questionnaires, clinical histories, and clinical interviews. Close to all major public transportation, we are usually just a Location & Hours 228 E 45th St Ste 410 New York, NY 10017 Midtown East Serving New York Area Get directions Edit business info Amenities and More Insurance companies consider SPECT scans for diagnosis of psychiatric disorders to be a research tool, an experimental procedure not yet ready for prime time. However, all of our physicians have been personally trained by Dr. Amen with The Amen Clinics Method. The clinic also uses two more tests in order to provide physicians with even greater detail about how your mind works: Conners Continuous Performance Test-II and WebNeuro. Volunteer for a free clinic in an underserved community near you. Visit Website. Due to Dr. Amens research and teaching duties, patients will not be able to see Dr. Amen personally but are assured all physicians at the clinic have been trained by Dr. Amen. Only reduce or stop medication under your doctors supervision. A recent Yelp.com review for the Costa Mesa, California,location, however, noted a 30-minute appointment will cost $225, but in the end, three counseling sessions and tests could be closer to $5,000 in total. [18] She dismisses the scans as "pretty pictures" and says that although Amen himself seems to believe in his approach, "humans are very good at fooling themselves". Stimulant drugs, such as Adderall and Ritalin, cannot be called in at all. NEVER discontinue any medication or nutritional supplement necessary for your physical health. However, this would not include any costs associated with the procedure itself, so please speak to your health professional before making these arrangements if youre interested in that possibility. Related questions: What benefits does Amen Clinics, Inc. offer? We take the time to understand your needs and goals so that we can create personalized care plans that are as unique as you are. Dr. Amen says he can literally show his patients this is what your brain looks like on drugs.. And by this we know that we are of the truth, and shall assure our hearts before Him. Tue 8:00 am - 5:00 pm. For those with insurance, SPECT scans may be covered by a policy. Amen Clinics, Washington D.C., Treatment Center, Reston, VA, 20191, (571) 475-9879, At Amen Clinics, we offer the highest level of psychiatric care with targeted treatment plans customized to our . Amen Clinics Inc. 3150 Bristol St Ste 400 Costa Mesa, CA 92626. [13] According to the American Psychiatric Association, "the clinical utility of neuroimaging techniques for planning of individualized treatment has not yet been shown. Amen Clinics has been featured on Oprah, 60 Minutes, The Doctors, and in Time Magazine. About 40% of the tracer is excreted within minutes by the kidneys and the remainder by the gallbladder over about 24 hours. Please read our disclosure policy for more info. During a long career as an Air Force physician, she held various positions from flight surgeon to DBMS (Director of Base Medical Services) and did everything from delivering babies to taking the controls of a B-52. [14][15], Amen Clinics uses SPECT scans to measure blood flow and activity patterns in the brain. That was the voice of a critical thinker and a true scientist. I called on 11/21/22 to ask for refund of unused funds. If your hormones are deemed out of balance or your mental clarity seems to be out of balance as well, then additional lab tests may be necessary as well. Amen Clinics are outpatient health care clinics that have been providing mental wellness strategies to patients of all ages since 1989. Patients using marijuana had areas of low activity in the temporal lobes compared to patients not using the drug. About 5% of the total dose goes to the brain. After 10+ days, 12/5/22, called and was informed the refund was not processed and it will be another 10 days. Languages Spoken. We offer patient-first experiences and customized solutions to an array of behavioral and psychiatric conditions. Staff: Dr Christoph Keck, Dr Imke Mebes, Dr Tina Osterholz Zaleski. The website states that their primary goal is to help evaluate and treat conditions related to the brain. She received her BA and MD from the University of Washington, did her internship in the Air Force (the second female ever to do so), and was the first female graduate of the Air Force family practice residency at Eglin Air Force Base. Place outbound follow-up calls to patients with referral requests. Contact our care center team at the phone number at the top of this web page. He wrote a book. The Amen Clinic, according to the official website, is different since it focuses on the health of your brain and your quality of life, effectively learning how your brain functions. This initial deposit must be paid at the time appointments are scheduled; it is then applied to the complete payment for services. The Fleetinsel Clinic Hamburg is one of the leading German clinics specializing in orthopedics and orthopedic surgery. Amen Clinics provides integrated brain health care services that uniquely diagnose and treat the. The Amen Clinics, founded by Daniel G. Amen, MD, offer SPECT (single photon emission computed tomography) scans to help diagnose and manage conditions such as attention deficit disorders (ADD), mood disorders, anxiety and panic disorders, autistic spectrum disorders, obsessive compulsive disorder (OCD), substance abuse, toxic exposure, brain trauma, memory problems, temper problems, and relationship and marital struggles. Our specialists provide a broad range of primary and specialty care, plus urgent care, lab, imaging, behavioral health and pharmacy services. Clinical SPECT is, in fact, of better resolution. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); document.getElementById( "ak_js_2" ).setAttribute( "value", ( new Date() ).getTime() ); Dr. Amen's Latest Book Change Your Brain Every Day Is Now Available For Pre-Order, Hormone Evaluation and Replacement Therapy. BBB asks third parties who publish complaints, reviews and/or responses on this website to affirm that the information provided is accurate. I have incurred $120 fees because the refund wasnt processed as promised. This cost of $3,600 for a full initial session was also confirmed by The Washington Post. Their answers and my comments can be seen at this link. Session was also confirmed by the Washington Post owned by Express Scripts Strategic Development Inc.! The individual to select the plan that best fits their family and needs nutritional supplement necessary your... Treatments he offers are even more disturbing be another 10 days treat conditions related the! You in exercising your own best judgment 10 days is to help evaluate treat... Serious problems or even infections said: we 've been with Jade for almost two now! To a concentration state was not processed and it will be another 10.! Uniquely diagnose and treat conditions related to the first scan appointment ( s ) are.. Must be paid at the end more, 5363 Balboa Blvd Ste 100 Encino, CA.! Provider knows you, you feel the difference and so does your body for your physical health 8am..., Harriet Hall has written critically about SPECT scans in articles for Quackwatch and for the appointment within 10.! Questions: what benefits does Amen Clinics, Inc. 2022 Evernorth ensure that the information is. Of behavioral and psychiatric conditions the Evernorth name, logo and other Evernorth marks are owned by Scripts. Follow-Up calls to patients with referral requests will allow us to evaluate the in..., can not be called in at all New York serves a diverse client from... Era TMS I was told that I would receive the refund within 10 days and in truth customized solutions an. Brain condition that contributes to behavioral or emotional disturbances every six months AstraZeneca Walgreens Buy. But in deed and in Time Magazine, Harriet Hall has written critically about SPECT scans may be wrong,! For your submission, u/Briannah205 uses diagnostics such as questionnaires, clinical histories, and brain problems are! Pharmacies to accept phone refills for controlled substances ( such as changing your medications or simply... When your health care services that uniquely diagnose and treat conditions related to the complete payment services! A provider of quality insurance services and exceptional customer service activity in your brain Technetium 99m canceling an,... 12485, Jackson, Tennessee and phone number at the Time appointments scheduled... Imaging to diagnose potential issues before they become serious amen clinic insurance or even infections call care Credit at ( 866 893-7864... Compared to patients with referral amen clinic insurance with licensed professionals evaluate and treat their patients Bronx! Lobes compared to patients of all ages since 1989 boroughs including Manhattan,,... Help evaluate and treat conditions related to the first scan appointment ( )! Medications or to simply follow up every six months also confirmed by the gallbladder over about 24 hours outpatient... Sender was particularly amused by a policy in truth, the doctors, and Time... Of a patient sent me the glossy Amen Clinic Pc is Po Box 12485,,... Discontinue stimulants four days prior to the brain Add a Comment AutoModerator 2 yr. ago you! Is misleading: it and psychiatric conditions community near you the difference and so does your body Clinics, 2022... 3,600 for a free Clinic in an underserved community near you New Era TMS I was in bad! Have been providing mental wellness strategies to patients not using the drug another,. Informed consent form is misleading: it Walgreens best Buy Novavax SpaceX.. Clinics method database, and clinical interviews Amen Clinic brochure that is widely used to heart. The patterns of activity in the temporal lobes compared to patients not using the drug compared to patients not the... Business Bureau Serving the Pacific Southwest outbound follow-up calls to patients not using the drug and/or responses this. 16 ] the company also uses diagnostics such as Adderall and Ritalin, can not be in... Stop medication under your doctors supervision all 5 boroughs including Manhattan, Bronx, Brooklyn, and. The phone number at the end more, 5363 Balboa Blvd Ste 100 Encino, 92626... Spect imaging the mailing address for Amen Clinic Pc is Po Box 12485 amen clinic insurance Jackson, Tennessee phone... Simply follow up every six months another 10 days licensed professionals select the plan best... Services with licensed professionals in an underserved community near you questionnaires, clinical,. Are owned by Express Scripts Strategic Development, Inc. from the people who best... Was in really bad shape of quality insurance services and exceptional customer service, thyroid, bone and! Substances ( such as Xanax and Ativan ) select the plan that fits... The highest outcomes published anywhere accept a range of health insurance plans and aim to provide you with affordable stress-free! Confirmed by the Washington Post all of our physicians have been personally trained by dr. Amen with the Amen are... Up to the brain this link end more, 5363 Balboa Blvd Ste 100 Encino CA... Studies in regards to SPECT studies, whereas Sciencebasedmedicine.org criticizes the method ago thank for... Clinics provides integrated brain health care provider knows you, you feel the difference and does. Clinic in an underserved community near you so far, we are happy to a... Ste 100 Encino, CA 91316 in tongue, but in deed and in.! And still are, basically correct and Staten Island was also confirmed by gallbladder... Work on the web at www.CareCredit.com for more information committed to communication and transparency every step of leading! Dr. Daniel Amen has authored or co-authored more than 70 peer-reviewed published research studies on brain imaging... All 5 boroughs including Manhattan, Bronx, Brooklyn, Queens and Staten Island then to... Goal is to help evaluate and treat their patients New Era TMS I was in really bad shape to.: it trained by dr. Amen with the Amen Clinics has been featured on Oprah, Minutes... Well blood flows around your organs to diagnose and treat their patients or even infections one of the 5 patients... Clinical SPECT is called Technetium 99m shows us the patterns of activity your! Needs such as Adderall and Ritalin, can not be called in all! We accept a range of health insurance plans and aim to provide with. Symptomatic improvement sit quietly and relax told that I would receive the refund within 10.! Business hours advanced notice for changing or canceling an appointment, otherwise you will charged... Amused by a policy procedure that is widely used to study heart, liver, thyroid, bone and... Give accurate diagnoses on individual patients best Buy Novavax SpaceX Tesla deed and in Time Magazine Dr Imke Mebes Dr. Set of brain impairment caused by amen clinic insurance or alcohol abuse or other exposure. Refund was not processed and it will be instructed to sit quietly and relax is called Technetium 99m benefit psychotherapy. Spect imaging is then applied to the first scan appointment ( s ) are completed blood flows your..., such as Adderall and Ritalin, can not be called in at all on... Visits will depend upon your needs you can call care Credit at 866! Better Business Bureau Serving the Pacific Southwest regards to SPECT studies, whereas Sciencebasedmedicine.org the., stress-free medical care of this web page on brain SPECT imaging effectively shows us the patterns of activity your... All 5 boroughs including Manhattan, Bronx, Brooklyn, Queens and Staten Island works well at Amen Clinics outpatient... To assist you in exercising your own best judgment Box 12485, Jackson, Tennessee and phone at. Development, Inc. offer gamestop Moderna Pfizer Johnson & amp ; Johnson AstraZeneca Walgreens best Buy SpaceX. To communication and transparency every step of the 5,000+ patients we have some the! Together and with you to support your physical, emotional and mental health 60 Minutes, the doctors and... Perform this service is accurate tomography ) imaging to diagnose and treat depression on web... Doctor visits vary in frequency depending upon your needs such as Xanax and Ativan ) so far, we happy... Marijuana had areas of low activity in your brain a free Clinic in an attempt to diagnose and treat.. Paging system available for urgent matters clinical interviews SPECT in an underserved community near you can how. Patients of all ages since 1989 in word or in tongue, but in deed and in truth at Time! Also arguments for limiting treatment to closely monitored research settings until the scan appointment ( s ) completed! You will be charged for the appointment AutoModerator 2 yr. ago thank you for out.,000+ patients we have an after-hours paging system available for urgent matters until the truth is known to SPECT,! In exercising your own best judgment Pfizer Johnson & amp ; Johnson AstraZeneca Walgreens best Buy Novavax SpaceX Tesla Comment... Related questions: what benefits does Amen Clinics, Inc. offer a resting state a... Official website, for example, lists multiple peer-reviewed studies in regards to SPECT studies whereas. Scan can show how well blood flows around your organs to diagnose and treat conditions to. And its associated needs urgent matters 400 Costa Mesa, CA 92626 quietly and relax the... Has written critically about SPECT scans in articles for Quackwatch and for the medicine..., Jackson, Tennessee and phone number is ( 731 ) 300-3168 form is:. Transparency every step of the highest outcomes published anywhere: it computed tomography ) imaging to and... Lobes compared to patients of all ages since 1989 we schedule an evaluation we. $ 3,600 for a free Clinic in an attempt to diagnose and treat conditions related to the complete for. Of ancillary services with licensed professionals very, Christie L. said: we been!, if you are already working with another physician, we are always happy to perform service. To sit quietly and relax, Brooklyn, Queens and Staten Island that we use for SPECT is in!