 Thanks, Ashkan, and it's great to be here again this year. This is my third float conference, and it seems like every year it just gets better and better. And for me in particular, I think this year is probably my favorite conference yet, because we have some real data to show you today. So I know that we've already seen a lot of data earlier in Justin's talk. I hope you'll get sort of strapped in, and we're going to sort of surf some data together. I'll try to take a pause at, you know, some opportune times to kind of contextualize things. But I'm really excited to show you today the results of the first clinical trial involving eating disorders. So the outline for today's talk, I'm going to talk first and foremost about why would we study floating and eating disorders, sort of outline some methods for the study that we ran recently at the Laureate Institute for Brain Research, we'll talk about the results of the study, and then sort of the implications. And first and foremost, I think that as a clinician, motivation for doing any study, for trying to explore the potential clinical benefits of any intervention, really starts with the patient, with the individual who is experiencing suffering, who's experiencing symptoms. And specifically with eating disorders, I think that most of you are probably aware of a very prominent experience of somebody who had an eating disorder, Emily Noren, who wrote a book about this. And this is just some comments from her book about the positive benefit that she derived as an individual affected by an eating disorder. So she said, floating literally quieted the constant noise and chaos, allowed my body to rest and my mind to wander through the caves and tunnels of my unconscious, my most valuable tool for recovery, happiness, and health. And with respect to some of the specific symptoms of eating disorders, particularly the aspects of eating food, really for her she emphasized that the most difficult part about eating food was sitting with this feeling of fullness. And since the feeling of emptiness was my normal and it felt soothing and safe, this feeling of fullness was extremely uncomfortable. So much so that it was impossible to distract myself from how fat I felt. If I followed a meal with a float, however, I could allow my food to digest without the discomfort of fullness. So in previous years, we've talked a lot about how floating alters the balance of external and internal environmental stimuli, sensory stimuli. Here was an anecdotal example of how the interceptive experience of eating was quieted and was made more tolerable with floating. So here's how we think about floating in the brain. So you have a cerebral cortex, which processes lots and lots of information from outside and inside the body. And when you enter a float environment, you are attenuating visual input. Here's some general areas of the brain that are involved. You attenuate auditory, proprioceptive, tactile sensation, movement, and speech. And the question really here is, as a consequence, how does being in this environment, both individually and then after repeated sessions, how does floating potentially modulate some of these sensations and some of these symptoms in a way that could be relevant for eating disorders? So I'll try to make that case for you a little bit more. We focus a lot on interoception because in the absence of a lot of these other sensory stimuli, it seems in most of the unaffected individuals that we've studied, the interoceptive sense is enhanced. So the study that I'm going to talk about is really a study of anorexia nervosa, which is one of numerous eating disorders that are available to be diagnosed in an individual. We started with anorexia nervosa because it's a fairly homogenous. People who come in with a disorder have a lot of the same symptoms. And it's a disorder that I've personally studied for a number of years now and have a lot of experience with. But let's look at some of the symptoms of anorexia nervosa. So first thing you have to know is that it's a rare but deadly disease. So it affects less than 1% of the population, approximately 10 to 1 female to male. But it's deadly. It has a mortality rate over the long term of almost 20%. So that puts it on an even playing field with disorders like schizophrenia, with disorders like bipolar disorder. These individuals who have eating disorders, particularly anorexia nervosa, can really die because of the illness. Another challenge is that current treatments really only have moderate efficacy. So there's not a single treatment out there right now that shows a preponderance of clinical benefit. Usually you try one treatment. If that doesn't work, you try another or you try combinations of medication and psychotherapy. Unfortunately, medications are fairly unhelpful. Even medications that are helpful for other kinds of psychiatric disorders, anxiety and depression, don't seem to work very well with anorexia nervosa. So there's really sort of a need to investigate new interventions. Some of the clinical features that we see in the clinic all the time, the first one that's the most obvious is severe food restriction, causing distinct weight loss. So these aren't people who skip one meal here and there or who are going on a diet and sort of cutting back on their calories a little bit. These are people who rigidly adhere to a very, very limited amount of food that they will eat and it makes them lose weight and it's readily apparent to anyone even on the street. Accompanied by that, they have an intense fear of weight gain. So the idea of eating food is often assumed to immediately result in the deposition of the fat and the deposition of an increase in body size. And accompanying that, these individuals often have a substantial disturbance in how they see themselves. Literally, when they look in the mirror, when everybody else sees somebody who's slender, this is what they see. They see a larger image of themselves and that appears to be connected with how they represent their own body image in the brain. Other symptoms that are not necessarily linked to the diagnosis of the disorder but are very common are anxiety, obsessionality and perfectionism. These are sort of trait-like characteristics. There are certainly lots of people who have more anxiety or more obsessionality but don't have anorexia nervosa or don't have any other kind of disorder. But these three typically are highly elevated in patients with AN. And emerging research in my lab and in other labs is really starting to show that these individuals seem to have a difficulty recognizing both their own internal body sensations as well as emotional states. So why floating and why anorexia nervosa? Well, these are the clinical features. This is the clinical problem. And floating seems to possibly modulate or operate on several of these symptoms. So Justin just finished giving a very nice illustration of how floating attenuates anxiety, how a single float session can do that. But I'm interested in sort of this idea of body image disturbance. This is actually one of the last things to change in treatment as well as how floating might alter internal body sensations and emotional experience. And so that's what we'll go through today. This is a clinical trial, but one thing that you have to understand about clinical trials is that they're fairly slow. It takes a long time to do it right. And you usually don't start by hitting a home run. So when Justin was talking about conducting a randomized controlled trial, oftentimes there are several studies that lead up to that point where you learn more about the intervention, you learn more about the population. If you think about testing a new treatment, like he was saying earlier, we want to know is floating safe? Do people have adverse side effects, et cetera? So this study that I'm going to present to you today is more of a safety study. And our basic hypothesis, I talked about this study a little bit last year, is that floating is safe for individuals with anorexia nervosa. So the idea of floating in a reduced environment is not going to make the symptoms of the disorder worse. And I'll show you several ways that we examine this. So the methods for the current study, there are several sort of predictions that drive the methods. So the first thing is that we really are interested in seeing whether there are any adverse physical effects of floating. It turns out that these patients, when they're very underweight, can feel dizzy. They can have lots of blood pressure changes when they go from lying down to sitting or standing. Kind of when you get out, if you've ever felt sort of dizzy on a hot day when you stood up. So we want to make sure that they don't have any effects like that. But then we're also interested in seeing whether there is an impact of floating on symptoms of anxiety, on stress, on mood, and of course on body image. We don't rule out the possibility of positive effects, but this study was not specifically designed to test the presence of positive effects. So if you think of a clinical trial as a trumped up hypothesis test, you can really only test one hypothesis, so you can only have what's called one primary outcome. So our outcome in this is really more about physical effects and safety, whereas we have some other secondary outcomes that I'll explore and I'll show to you today. Within this range of physical effects of floating, we really are going to focus very, very closely on blood pressure and specifically blood pressure drops. And I'll explain that next. So what we're really looking for in this study is this floating and do something called orthostatic hypotension. What that really means is simply a fall in your blood pressure when you stand up. So if you imagine that this is your body and this blue level here indicates your total blood volume, right? If your total blood volume is low, when you stand up, the volume drops. So if you're not fully hydrated, if you've ever stood up on a sunny day or a hot day and you felt a little dizzy, that's because your blood volume shifts when you stand up and causes something called orthostatic hypotension. Patients with eating disorders, especially who are underweight, are notoriously at risk for this and they can actually fall and hurt themselves. They can break bones, etc. So this is the physiology of orthostatic hypotension. So when you stand up, the blood literally is pulled away from your heart by gravity. It pools in your veins and your abdomen. You have sensors in your arteries, in your carotid arteries, which are on the neck, and also in the aorta, which is right next to the heart right here, which don't respond to the fall in blood pressure, to the fall in your blood volume away from the heart. And this is really a problem of the autonomic nervous system where the heart fails to beat faster to compensate. So the autonomic nervous system doesn't really tell the body, hey, you know, there's something changing. You've got to adjust to this. And the consequence is this lightheadedness or dizziness, literally because blood is not flowing to the brain at high enough of a level. So in the context of this study, and sort of a standard way that in the hospital we assess for orthostatic hypotension, is a very concrete measurement. So a drop of 20 millimeters of mercury in systolic blood pressure, kind of that top number, if you've seen like the patient has 120 over 60, right? Or something like that. That's the top number. So you look for a drop of 20 beats or 20 millimeters of mercury or more. Or you look for a drop in the diastolic blood pressure of 10 millimeters of mercury or more. So what you look for is when the person goes from lying to standing or sitting to standing, a drop in that level. And at the Laureate Institute of Brain Research, we have an adolescent and an adult inpatient eating disorders unit two floors above us. And this is a very real concern that the clinicians have with the patients. So frequently I will see patients being wheeled around in a wheelchair. And the reason is that they are, that day, they're orthostatic and they're considered at an increased fall risk if they were to be walking around and getting up. So this is really a key safety variable that is something we wanted to measure, clinically relevant. So here's how the study was set up. Participants came in and they consented. They did a psychiatric evaluation with myself or Dr. Scott Mosman who is the director of the Laureate Eating Disorders Program. And then they did a behavioral assessment. They filled out a lot of questionnaires, etc. And then they came in for a float. And the first float that we had them do was float in this zero gravity chair that we've presented to you in the past at the float conference. And we did that for a very specific reason because we wanted to see, first of all, could people tolerate being supine for 90 minutes? Our floats were 90 minutes. We also used it as an opportunity to measure their orthostatic blood pressure while they were clothed and while we had my research coordinator who's a nurse with them so that we could make sure that they did not show evidence of orthostasis before we put them into a float tank without anybody in the room. So that was the first float. Our second float was in the open pool. And as Justin has mentioned before, we have psychiatric patients start in the open pool in case they have claustrophobia. But we have also this enclosed or this domed pool at Liber. And many of you know that you can change the humidity and you have a little bit finer control over some of the environmental aspects. So we wanted to make sure that we also used sort of more of a standard setting. And we wanted to do it twice so we could really get a good sense as to what would the effects be. So this was not a randomized clinical trial or RCT. This was a fixed order. This was also not blinded. There's no treatment condition. This is a sequential open label where everybody in the study started in the chair. Then they went to the open pool and then to the enclosed pool. And again what we're looking at are measures of physical safety. So what we measured was orthostatic blood pressure. We also measured heart rate and EEG. We did the same thing in the open pool. And you know by this point in the study design we were thinking to ourselves you know we don't really have we haven't really given somebody a normal experience of floating because this blood pressure cuff is going off every 10 minutes. So we thought let's give everybody just sort of a float without any sensors attached so that it would be a little bit more comparable to something that you might experience in the community. And then finally with the fourth float we measured these devices again. I'm not going to show or discuss any data related to heart rate or EEG but we will talk about the blood pressure which was the primary outcome of the study. So it turns out measuring these variables is very important. You have to do it in a standardized way. We had people where we measured everybody from lying to sitting to standing in that order and we waited exactly three minutes in between so that we could allow the person's autonomic nervous system to adjust to the positional constraints. This is sort of a standard approach in the clinic. And then we measured blood pressure before and after the float. And when I say after the float I mean literally while they were still in the pool. So in order to do that we had to use a couple different devices. So this is an example of the device that we used. This is sort of what you'll see in the hospital if you ever have a loved one who's there and they're getting their vital signs measured. This is obviously not compatible with a float tank. You can't take it into the water. So we used the same Bluetooth waterproof device that Justin has been using and we measured blood pressure before the float using the standard clinical device and then using the float compatible device. And so then we can compare the two. This is sort of the timeline for our study. It took our participants about three and a half hours from start to finish. So this was kind of a long intensive data collection. But these are the procedures. So they came in, they filled out some questionnaires to assess their baseline state. They took a shower. Then we measured their pre-float orthostatics with both the clinical standard and then the float compatible device. We applied our sensors and then we had them float. Again, all floats were 90 minutes. Immediately afterwards we measured their orthostatic vital signs again. They took a shower and then they filled out some questions and they completed an interview. So here's the results. Are you guys all with me? All right. So let's get to the data. Four floats in 10 minutes. All right. So first of all, this study was approved by the Western Institutional Review Board. We also registered the study on clinicaltrials.gov. So if you go to that website, you can look up sort of all the variables that I've just described for you. This is a standard way of ensuring quality. And so that when you submit these results for publication, the reviewers can look back and say, oh, okay, well, what did you actually say you were going to do at the beginning of the study and how did that relate to what you actually found and what you actually measured? So you can find it there. And this was who completed the study. So with the help of the Laureate Eating Disorders Program, we contacted over 55 people. And over the course of a little more than a year, we consented 23 and completed four floats in 21 individuals. We had two people who dropped out after their second float. So each of them did have an experience of floating in the open pool. But 21 individuals. Okay. So what are their characteristics? They're on average 26 years old. As you can see, the majority of them are female, which is consistent with what you find epidemiologically. Nearly a college education. Importantly, they all had a normal current body mass index. So we recruited people specifically who were not on the inpatient unit, but people who were in the community, who we were sure were unlikely to have orthostatic hypotension and who sort of you could think of as like the walking well, just to get an initial sense of floating in this population. Nevertheless, they had elevated eating disorder symptoms. They also had elevated trait anxiety. And they also had evidence of residual body image disturbance, which as I said before, is probably the last thing that changes even after people normalize their weight. So before I show you the results of the primary outcome measure, just a reliability check. So we're going to really rely on the float-compatible wireless Bluetooth blood pressure device that you won't see in the hospital, but we're going to look for the reliability between that and the clinical standard to see whether it's even reasonable to try and trust this device in making any conclusions. And the good news is, is I think that we can. So when you look at systolic blood pressure, this shows literally every float session where we measured orthostatics. This is actually lying down. This is sitting. And this is standing. And these are the two devices. And what you can see is that overall, there's a very high degree of correlation between the values. Anything above 0.7 is traditionally considered to be acceptable. And the same is true for the diastolic blood pressure. So everything that I'll show you from now on is using the wireless Bluetooth device. If you remember our criteria for orthostasis is that 20 millimeter mercury drop. So again, you're looking for whether the blood pressure dropped. The systolic blood pressure by 20. These are the individual float sessions, the chair and the pool one and pool three where we collected blood pressure during the float and afterwards. And what you're looking for is, does anybody show a drop of more than 20? So these are each of the individual 21 participants. So minus 20 would be kind of down here. And does anybody see any dots sort of falling off the graph? No. So we saw no evidence of orthostatic hypotension in this sample using the systolic blood pressure as the criteria. So again, that's our primary outcome measure. How about diastolic blood pressure? We see the same thing. So here we're looking for 10 millimeters of mercury. We don't see any drop of less than 10 millimeters of mercury. In fact, what we tend to see if anything is in the pool, the blood pressure actually tends to rise a little bit when people stand up. If we go back and we look at the groups, here's the group blood pressure for systolic blood pressure. So this is pre from lying to sitting to standing in the chair, lying, sitting, standing, post chair. You can see that it actually stays pretty level. Whereas in the two pool conditions, here's post pool one and post pool two. You can see that actually rather than dropping, which is what we would be concerned about, we see a very healthy and vigorous increase in blood pressure. So this, again, is an indication that the autonomic nervous system is doing what it needs to be doing. And we see the same thing in the systolic blood pressure. So the difference in the diastolic, I'm sorry, so you can see diastolic increasing from lying to sitting to standing. So that's good news, right? So we have kind of initial evidence that across multiple floats, this patient population is not showing evidence of orthostasis. How about during the float? So we have multiple conditions that we can look at. We can look at the zero gravity chair condition, and this is what you would see. So blood pressure starts out a little bit on the lower side compared to what you would expect from the normal population. Normal blood pressures tend to be around 120 over 70-ish. That would be kind of considered normal. Whereas here you can see that this patient population is starting somewhat low, about 102. And this is just the average blood pressure. And these vertical lines just show, reflect the standard error. So it's a measure of the variability. It's not the same as the confidence interval that Justin talked about. But it just gives you a sense of how much wiggle room there is from the mean. And overall what you can see is that with floating and systolic blood pressure, the blood pressure is about the same. In the pool, however, we see that before their first float, their patient's blood pressure was actually somewhat elevated. And then it takes about 20 minutes or so before it starts to decrease. It kind of changes a little bit, goes back down. Whereas in the third float, you can see that it just pretty much immediately levels out. And that looks a lot more similar, I think, to the graph that you saw with the anxiety patients. We see a very similar thing with diastolic blood pressure. So again, their diastolic is a little bit lower. If anything, it kind of increases across the float itself and the chair. Starts out a little bit higher in the first pool and then comes down. And maybe decreases even a little bit more in the third pool. So if I had to characterize overall the similarities between the anxious patients and the eating disorder patients, I would say that the direction of the autonomic change in terms of blood pressure is similar. But what you see is sort of evidence of an accumulation over time in this population. Okay. So those are all the primary outcome measures. But we do have these other secondary outcome measures which are fairly exploratory. And I'm going to race through these at lightning speed. But before I do that, are you guys ready? All right. So in order to interpret these graphs, you just really need to know two things. One is this black line, you can think of this as no change, sort of your sort of zero level. Justin already did a very nice job of introducing this idea of the POMP score, the percentage of maximum possible change on the scale. It's a way of equating the degree of change that's possible and comparing it across measures. So what you're going to look for in these graphs is the change going above zero or is it going below zero? Okay. So let's go. And remember, we have four floats. So the first is the chair, open pool, and then the two closed pools over time. Okay. First thing is negative affect seems to decrease slightly across the board. Okay. These are statistically significant. Positive affect doesn't seem to change much with the chair, but you see this sort of linear effect where it increases statistically significantly by the fourth float. Okay. Positive affect gets better. Joviality doesn't change a whole lot early on, but you see it changes the most at the end. Fatigue sort of decreases across the board. And serenity increases both with the chair and the two pool conditions, but you see the largest effect, almost 30%, with the final float. The largest effect with the final float. How about stress and anxiety? It's the same sort of graph. You can see that energy increases kind of across the board. Relaxation also increases across the board, but again you see this finding where with the fourth float, the final float, you have the most accumulation of effect over time. Same with feelings of refreshment. And stress, again, seems to show the greatest decrease by the fourth float in these patients. How about interoceptive sensation changes? We've talked a lot about that over the years. Well, in this population, you get about a 10% increase in the feeling of the heartbeat, as well as the breath, but the stomach interestingly doesn't seem to show as much of a change. So this, if anything, it decreases a little bit in the chair, but doesn't really seem to show a change in the intensity of the sensations over time, which I thought is kind of interesting. It may match up somewhat with Emily Noren's findings from her own personal experience. We also looked at the affect. So this is a little bit different. We didn't have a pre and post to look at a change. This is sort of, 50 would be them indicating that a neutral level of pleasantness or unpleasantness across the float. So you can see that the pleasantness of the heart doesn't increase from the float, whereas breathing sensations actually seem to increase somewhat, although not a clear pattern. And again, you see this sort of odd, not a clear linear pattern, but you see a hint at some decreases in the pleasantness of affect, but this is on a range from zero to 100. So some decrease with some of the floats, but not a clear substantial decrease across all the floats. All right. Getting towards the end. Are you guys with me? All right. So body image disturbance. So again, black line. You're looking for things that increase or decrease. So we had several different measures of body image. The first one related more to feelings of attractiveness, self ratings of attractiveness called the body image state scale. You can see that across the board, there's a tendency to maybe report feeling a little bit less attractive, but this is not statistically significant. We had another scale where people were rating their physical body size, called the photographic figure rating scale. And here, and the first thing we found is that when they looked at a series of silhouettes and they rated out of these different silhouettes from underweight to overweight, which one represents most closely your ideal body image? There's actually a tendency to, a small tendency to choose the body that was a little bit larger than they had before the float. That was their ideal body image. When you look at their current body image, so they looked at the same pictures and they said, pick the figure that best shows what your body looks like right now. This is what they picked. So you can see that they actually across all the floats picked a more slender body. And when you combine the two scores into something called a body image dissatisfaction, sort of the subtraction of the two, you can see that body dissatisfaction actually decreases across all the conditions. And you can see this sort of linear trend where with the pool, it's continuing to decrease. What does that look like from the perspective of a single person? Well, these are the actual images. So this is a hypothetical example of a patient whose body actually looks like this. And in the pre-float state, you can think of this more as sort of like what somebody who's acutely experiencing the symptoms of the disorder would say that even though their body actually looks like this, they think their body looks more like this. This would be the image that they would pick. And then if you ask them to rate what they think their body should look like, this is what they would pick. So they would pick a more overweight body relative to what their current body looks like and think that their ideal body should look even more emaciated. And so the kind of change in body image dissatisfaction I'll illustrate right here, this is what they looked like before the float and this would be more like what they looked like after the float. So you can see that after the float, the person's body, their actual body hasn't changed shape, but they're picking a current body that is more closely similar to their own body and also rating an ideal body that is closer to their own body and less emaciated. In terms of effect sizes, right? Justin talked about this and showed you the comparison of effect sizes across the different conditions. So now we want to see how much do our results in the eating disorder population relate to patients with anxiety. So this is a subset of the effect sizes that he showed you before. Again, anything in red or blue is considered very large. So this is the anxious group. This is the first chair float and you can see that with a lot of these variables we're seeing similar effect sizes. And then this is all three pools. And so there's sort of two things that I would like to emphasize here. The first is look at the similarity between these two patient populations across all the different floats. We're seeing very large effect sizes, very large reductions in state anxiety and stress, very large increases in refreshment, serenity and relaxation. Here is the body dissatisfaction. You can see that on the final float you get the largest effect. But the other thing that we really have to acknowledge here is that we have this chair condition. And some of you may not agree that this is floating, but these are people who were lying supine in a room with the lights dimmed and with less sound. Not to the same extent as the float pool, but you can see that there are some effects that are similar on some of these variables. And so I think that future research is going to need to evaluate what are the relative influences of modulating the environment. And if you can't get access to a float pool, are there other ways that you could temporarily alter your environment to get some of the effects? Clearly we see that the effects increase over time. You can see over here energy, happiness and positive affect continue to build. But again, just thinking about what is this reduced environment that we're talking about. Just to finish up, in the participants' own words, here are what some of them said. So we asked them after each float what did you experience. This is just a sampling. This person said, I didn't feel my outer body for a good amount of time, so that felt really refreshing. And I noticed that even my view of my physical appearance before and after had changed a bit. So this would certainly go in line with some of the body image changes that I showed you. Another person said, I could feel my breath and hear my breath and hear my heartbeat. And then I experienced not being able to feel my outer body for like not the entire time, but a majority of the time and then just feeling relaxed. Another person said they felt relaxed, a little more focused than before. My mind is not quite as loud as it was before. And another subject said, my back quit hurting. I was in no pain and that was the best part. I was in so much pain when I came in and the pain was just gone for the rest. I think many of you have probably seen these reports and heard these reports from individuals before, but to see it in the context of a research study in a clinical population that's so severely affected, I think is quite positive. Now, this was a safety study, so we want to know what are some of the negative effects of floating or the potential negative effects. So here, this was actually the first question we asked people. Any negative experiences during the float? And this is all 21 subjects' responses. Not regarding the float, not at all. Nope. No. Not really. I'm not really. No. Not applicable. This person got salt in their eye, they dropped the towel in the water again, which is not very helpful if you want to wipe your salt eyes with a wet towel that is also salted. There's just salt everywhere. I think something you guys can all relate to. I would say that we do still see some evidence of people experiencing anxiety in the float, like Justin talked about. This person said they felt a short time of panic. They were in the dark. They felt like I can't communicate with the research coordinator for some reason, but that was my only negative experience. And this was not enough to get the person out of the pool. But again, this is likely to happen at times, and you really want to be vigilant for when it happens and how you'll respond. So the implications of the study are very simple. This is an initial clinical trial. It's not a randomized clinical trial, but it is a study that suggests that individuals with anorexia nervosa can safely tolerate the physical effects of floating, and they may experience improvements in some of the symptoms of anxiety, mood, and body image as a result of floating. So a lot further than where we were a year ago. And what does this indicate? That floating, in my opinion, should be studied for clinical benefit in eating disorders, particularly in people who are more acutely affected. So this was a study of the walking well, and it's a great first step. But most of those people weren't orthostatic to begin with. Their symptom severity was lower. We have seen evidence that some of the more recalcitrant symptoms appear to budge somewhat, like the body image disturbance. But what we really want to do is we really want to follow this up with a study in more acutely ill populations and see how we can integrate this with other forms of treatment for eating disorders. So I'd just like to acknowledge all of my colleagues, especially Justin, Henry Yeh, who's our biostatistician, Scott Mosman, who's the director of the eating disorders program, Valerie Upshaw, who's my research coordinator who we could not have done the study without her. She's a nurse. She was there for safety monitoring in my entire lab and the funding from the William K. Warren Foundation. And especially to Ashkan Graham and Jake for inviting me. Thank you.