Overview
SCIENTIFIC SCORE
Possibly Effective
Based on 10 Researches
7.2
USERS' SCORE
Good
Based on 3 Reviews
8.2
Supplement Facts
Serving Size: 5 Drops
Amount Per Serving
%DV
Vitamin D (as cholecalciferol)
10 mcg (400 IU)
100%
L.reuteriDSM 17938(L. reuteriProtectis®)
100 million CFU
†
Top Medical Research Studies
8
We explored the relationship between vitamin D (VD) supplementation and the risk of ear infections, specifically in children who frequently suffer from acute otitis media (AOM). The study involved 116 children with a history of recurrent ear infections, who were randomly assigned to receive either a daily dose of 1000 IU of vitamin D or a placebo for four months. Their number of AOM episodes was monitored for six months after the treatment period.
Our findings were quite revealing: the children who received vitamin D supplements had a significantly lower incidence of AOM compared to those who were given the placebo. Specifically, only 26 children in the vitamin D group experienced at least one episode of AOM, versus 38 in the placebo group—a notable difference that became even more pronounced when looking specifically at uncomplicated AOM cases.
We concluded that vitamin D deficiency is common among children who frequently experience ear infections. By restoring serum vitamin D levels to above 30 ng/mL through supplementation, we observed a significant reduction in the risk of uncomplicated AOM. This suggests that vitamin D could play a beneficial role in managing ear infections in children prone to these issues.
Our findings were quite revealing: the children who received vitamin D supplements had a significantly lower incidence of AOM compared to those who were given the placebo. Specifically, only 26 children in the vitamin D group experienced at least one episode of AOM, versus 38 in the placebo group—a notable difference that became even more pronounced when looking specifically at uncomplicated AOM cases.
We concluded that vitamin D deficiency is common among children who frequently experience ear infections. By restoring serum vitamin D levels to above 30 ng/mL through supplementation, we observed a significant reduction in the risk of uncomplicated AOM. This suggests that vitamin D could play a beneficial role in managing ear infections in children prone to these issues.
9
We investigated how vitamin D levels affect the occurrence of ear infections, specifically in children aged 2 to 7. By looking at data from a pediatric clinic in northwest Romania, we enrolled 118 children—87 with recent ear infections and 31 who hadn't experienced any episodes. This allowed us to compare vitamin D levels across different types of ear infections, like Acute Suppurative Otitis Media and Serous Otitis Media.
Our findings revealed that children suffering from these infections had notably lower vitamin D levels compared to the control group. The children with Acute Suppurative Otitis Media showed the most significant deficiencies. We found a clear link: as vitamin D levels decreased, the frequency of ear infections increased. Logistic regression pointed out that vitamin D insufficiency boosted the odds of ear infections significantly, while Poisson regression established a strong correlation between low vitamin D status and the incidence of these infections.
Overall, these results indicate that low serum vitamin D may play a critical role in the risk of developing ear infections in young children. This suggests that screening and potentially supplementing vitamin D could be valuable strategies for reducing the frequency of ear infections and their associated complications. By addressing this modifiable risk factor, we can help improve the health and quality of life for many children.
Our findings revealed that children suffering from these infections had notably lower vitamin D levels compared to the control group. The children with Acute Suppurative Otitis Media showed the most significant deficiencies. We found a clear link: as vitamin D levels decreased, the frequency of ear infections increased. Logistic regression pointed out that vitamin D insufficiency boosted the odds of ear infections significantly, while Poisson regression established a strong correlation between low vitamin D status and the incidence of these infections.
Overall, these results indicate that low serum vitamin D may play a critical role in the risk of developing ear infections in young children. This suggests that screening and potentially supplementing vitamin D could be valuable strategies for reducing the frequency of ear infections and their associated complications. By addressing this modifiable risk factor, we can help improve the health and quality of life for many children.
9
Vitamin D enhances tympanoplasty outcomes
We explored how vitamin D (VD) levels influence the outcomes for patients undergoing Type 1 tympanoplasty (T1T), which is a common surgery for chronic ear infections. In our study, we divided 101 patients into four groups based on their VD levels, ranging from severe insufficiency to optimal levels.
Over a 12-month follow-up, we observed that patients with optimal VD levels had significantly higher graft success rates and greater improvements in hearing. Additionally, these patients experienced fewer postoperative infections.
Our findings highlight the importance of monitoring vitamin D levels in patients with chronic ear issues. We believe that addressing VD deficiency could enhance the success of tympanoplasty, suggesting that vitamin D replacement therapy might be beneficial for those with low preoperative levels.
Over a 12-month follow-up, we observed that patients with optimal VD levels had significantly higher graft success rates and greater improvements in hearing. Additionally, these patients experienced fewer postoperative infections.
Our findings highlight the importance of monitoring vitamin D levels in patients with chronic ear issues. We believe that addressing VD deficiency could enhance the success of tympanoplasty, suggesting that vitamin D replacement therapy might be beneficial for those with low preoperative levels.
Most Useful Reviews
9
Improved milk intake
1 people found this helpful
I was astonished at how it improved my baby's milk-feeding situation. Initially, I aimed to address his early morning colic. After using it for over four months, he suddenly began eating more consistently after just two days! Previously, he consumed about 90-120ml per meal, probably due to his digestion. Now, he can drink 160ml in one go, which means less frequent feeds! The smell of his stools has also increased quite a bit.
6
Reduced night crying
1 people found this helpful
Both my children have been using it for about a month now. It aims to prevent night crying and enhance their oral health. The taste is neutral, and as it contains natural ingredients, I felt reassured using it from an early age. They've hardly cried during the night and have been sleeping through since they were around two months old, which has been a great relief for me as a mother. I’m not certain how to compare it, but it likely contributes to their overall health. I prefer the tube for convenience, and with just 5 drops each day, it lasts quite a while.
6
Eased constipation issue
My daughter has struggled with constipation since she was about two months old, so I mixed this with her milk in hopes of alleviating her night crying. While cotton swab enemas provide immediate relief, she started sleeping through the night fairly soon after using this, suggesting it might have helped. It’s rather pricey; I bought it twice but then had to stop. Now she tends to go to the bathroom right after eating a banana.
Medical Researches
SCIENTIFIC SCORE
Possibly Effective
Based on 10 Researches
7.2
- All Researches
9
We investigated how vitamin D levels affect the occurrence of ear infections, specifically in children aged 2 to 7. By looking at data from a pediatric clinic in northwest Romania, we enrolled 118 children—87 with recent ear infections and 31 who hadn't experienced any episodes. This allowed us to compare vitamin D levels across different types of ear infections, like Acute Suppurative Otitis Media and Serous Otitis Media.
Our findings revealed that children suffering from these infections had notably lower vitamin D levels compared to the control group. The children with Acute Suppurative Otitis Media showed the most significant deficiencies. We found a clear link: as vitamin D levels decreased, the frequency of ear infections increased. Logistic regression pointed out that vitamin D insufficiency boosted the odds of ear infections significantly, while Poisson regression established a strong correlation between low vitamin D status and the incidence of these infections.
Overall, these results indicate that low serum vitamin D may play a critical role in the risk of developing ear infections in young children. This suggests that screening and potentially supplementing vitamin D could be valuable strategies for reducing the frequency of ear infections and their associated complications. By addressing this modifiable risk factor, we can help improve the health and quality of life for many children.
Our findings revealed that children suffering from these infections had notably lower vitamin D levels compared to the control group. The children with Acute Suppurative Otitis Media showed the most significant deficiencies. We found a clear link: as vitamin D levels decreased, the frequency of ear infections increased. Logistic regression pointed out that vitamin D insufficiency boosted the odds of ear infections significantly, while Poisson regression established a strong correlation between low vitamin D status and the incidence of these infections.
Overall, these results indicate that low serum vitamin D may play a critical role in the risk of developing ear infections in young children. This suggests that screening and potentially supplementing vitamin D could be valuable strategies for reducing the frequency of ear infections and their associated complications. By addressing this modifiable risk factor, we can help improve the health and quality of life for many children.
9
Vitamin D enhances tympanoplasty outcomes
We explored how vitamin D (VD) levels influence the outcomes for patients undergoing Type 1 tympanoplasty (T1T), which is a common surgery for chronic ear infections. In our study, we divided 101 patients into four groups based on their VD levels, ranging from severe insufficiency to optimal levels.
Over a 12-month follow-up, we observed that patients with optimal VD levels had significantly higher graft success rates and greater improvements in hearing. Additionally, these patients experienced fewer postoperative infections.
Our findings highlight the importance of monitoring vitamin D levels in patients with chronic ear issues. We believe that addressing VD deficiency could enhance the success of tympanoplasty, suggesting that vitamin D replacement therapy might be beneficial for those with low preoperative levels.
Over a 12-month follow-up, we observed that patients with optimal VD levels had significantly higher graft success rates and greater improvements in hearing. Additionally, these patients experienced fewer postoperative infections.
Our findings highlight the importance of monitoring vitamin D levels in patients with chronic ear issues. We believe that addressing VD deficiency could enhance the success of tympanoplasty, suggesting that vitamin D replacement therapy might be beneficial for those with low preoperative levels.
8
We conducted a study to explore the relationship between vitamin D levels and ear cholesteatoma, a type of middle ear infection. Our research included 62 patients diagnosed with cholesteatoma and compared them with a control group of 62 patients with simple chronic otitis media. Both groups were similar in age and gender, which allowed us to focus solely on the differences in vitamin D levels.
After analyzing the data, we found that vitamin D levels were significantly lower in patients with cholesteatoma compared to those in the control group. This suggests that there might be a connection between low vitamin D levels and the development of cholesteatoma. Furthermore, we noticed that lower vitamin D levels were associated with increased symptoms like hearing loss, tinnitus, and vertigo.
While our findings indicate that vitamin D deficiency could be linked to ear cholesteatoma, we did not evaluate the direct effects of vitamin D treatment on ear infections. Therefore, while vitamin D appears to play a role in this condition, more research is needed to determine whether supplementation might help with symptoms or improve outcomes in patients suffering from cholesteatoma.
After analyzing the data, we found that vitamin D levels were significantly lower in patients with cholesteatoma compared to those in the control group. This suggests that there might be a connection between low vitamin D levels and the development of cholesteatoma. Furthermore, we noticed that lower vitamin D levels were associated with increased symptoms like hearing loss, tinnitus, and vertigo.
While our findings indicate that vitamin D deficiency could be linked to ear cholesteatoma, we did not evaluate the direct effects of vitamin D treatment on ear infections. Therefore, while vitamin D appears to play a role in this condition, more research is needed to determine whether supplementation might help with symptoms or improve outcomes in patients suffering from cholesteatoma.
8
We explored the connection between vitamin D levels and chronic otitis media with effusion (COME) in children. In a well-structured case-control study, we analyzed serum 25(OH)D concentrations in 178 children who were referred for tympanostomy tube placement due to COME, compared to 179 healthy children. Our subjects, aged three and four, were recruited from Auckland, New Zealand, and data was collected from May 2011 to November 2013.
Our findings revealed that higher serum 25(OH)D levels were associated with a lower risk of COME. Specifically, with each 10 nmol/L increase in vitamin D levels, the odds of developing COME decreased significantly, even after adjusting for various factors such as age, sex, and breastfeeding duration. This indicates that vitamin D may play a protective role against this type of ear infection.
These results encourage further investigation into whether increasing vitamin D levels—through sun exposure, dietary changes, or supplements—could effectively reduce the risk of ear infections in children. It highlights an area of vitamin D's potential benefits that warrants additional exploration.
Our findings revealed that higher serum 25(OH)D levels were associated with a lower risk of COME. Specifically, with each 10 nmol/L increase in vitamin D levels, the odds of developing COME decreased significantly, even after adjusting for various factors such as age, sex, and breastfeeding duration. This indicates that vitamin D may play a protective role against this type of ear infection.
These results encourage further investigation into whether increasing vitamin D levels—through sun exposure, dietary changes, or supplements—could effectively reduce the risk of ear infections in children. It highlights an area of vitamin D's potential benefits that warrants additional exploration.
8
We explored the relationship between vitamin D (VD) supplementation and the risk of ear infections, specifically in children who frequently suffer from acute otitis media (AOM). The study involved 116 children with a history of recurrent ear infections, who were randomly assigned to receive either a daily dose of 1000 IU of vitamin D or a placebo for four months. Their number of AOM episodes was monitored for six months after the treatment period.
Our findings were quite revealing: the children who received vitamin D supplements had a significantly lower incidence of AOM compared to those who were given the placebo. Specifically, only 26 children in the vitamin D group experienced at least one episode of AOM, versus 38 in the placebo group—a notable difference that became even more pronounced when looking specifically at uncomplicated AOM cases.
We concluded that vitamin D deficiency is common among children who frequently experience ear infections. By restoring serum vitamin D levels to above 30 ng/mL through supplementation, we observed a significant reduction in the risk of uncomplicated AOM. This suggests that vitamin D could play a beneficial role in managing ear infections in children prone to these issues.
Our findings were quite revealing: the children who received vitamin D supplements had a significantly lower incidence of AOM compared to those who were given the placebo. Specifically, only 26 children in the vitamin D group experienced at least one episode of AOM, versus 38 in the placebo group—a notable difference that became even more pronounced when looking specifically at uncomplicated AOM cases.
We concluded that vitamin D deficiency is common among children who frequently experience ear infections. By restoring serum vitamin D levels to above 30 ng/mL through supplementation, we observed a significant reduction in the risk of uncomplicated AOM. This suggests that vitamin D could play a beneficial role in managing ear infections in children prone to these issues.
User Reviews
USERS' SCORE
Good
Based on 3 Reviews
8.2
- All Reviews
- Positive Reviews
- Negative Reviews
9
Improved milk intake
1 people found this helpful
I was astonished at how it improved my baby's milk-feeding situation. Initially, I aimed to address his early morning colic. After using it for over four months, he suddenly began eating more consistently after just two days! Previously, he consumed about 90-120ml per meal, probably due to his digestion. Now, he can drink 160ml in one go, which means less frequent feeds! The smell of his stools has also increased quite a bit.
6
Reduced night crying
1 people found this helpful
Both my children have been using it for about a month now. It aims to prevent night crying and enhance their oral health. The taste is neutral, and as it contains natural ingredients, I felt reassured using it from an early age. They've hardly cried during the night and have been sleeping through since they were around two months old, which has been a great relief for me as a mother. I’m not certain how to compare it, but it likely contributes to their overall health. I prefer the tube for convenience, and with just 5 drops each day, it lasts quite a while.
6
Eased constipation issue
My daughter has struggled with constipation since she was about two months old, so I mixed this with her milk in hopes of alleviating her night crying. While cotton swab enemas provide immediate relief, she started sleeping through the night fairly soon after using this, suggesting it might have helped. It’s rather pricey; I bought it twice but then had to stop. Now she tends to go to the bathroom right after eating a banana.
Frequently Asked Questions
9
Improved milk intake
1 people found this helpful
I was astonished at how it improved my baby's milk-feeding situation. Initially, I aimed to address his early morning colic. After using it for over four months, he suddenly began eating more consistently after just two days! Previously, he consumed about 90-120ml per meal, probably due to his digestion. Now, he can drink 160ml in one go, which means less frequent feeds! The smell of his stools has also increased quite a bit.
6
Reduced night crying
1 people found this helpful
Both my children have been using it for about a month now. It aims to prevent night crying and enhance their oral health. The taste is neutral, and as it contains natural ingredients, I felt reassured using it from an early age. They've hardly cried during the night and have been sleeping through since they were around two months old, which has been a great relief for me as a mother. I’m not certain how to compare it, but it likely contributes to their overall health. I prefer the tube for convenience, and with just 5 drops each day, it lasts quite a while.
6
Eased constipation issue
My daughter has struggled with constipation since she was about two months old, so I mixed this with her milk in hopes of alleviating her night crying. While cotton swab enemas provide immediate relief, she started sleeping through the night fairly soon after using this, suggesting it might have helped. It’s rather pricey; I bought it twice but then had to stop. Now she tends to go to the bathroom right after eating a banana.
8
We explored the relationship between vitamin D (VD) supplementation and the risk of ear infections, specifically in children who frequently suffer from acute otitis media (AOM). The study involved 116 children with a history of recurrent ear infections, who were randomly assigned to receive either a daily dose of 1000 IU of vitamin D or a placebo for four months. Their number of AOM episodes was monitored for six months after the treatment period.
Our findings were quite revealing: the children who received vitamin D supplements had a significantly lower incidence of AOM compared to those who were given the placebo. Specifically, only 26 children in the vitamin D group experienced at least one episode of AOM, versus 38 in the placebo group—a notable difference that became even more pronounced when looking specifically at uncomplicated AOM cases.
We concluded that vitamin D deficiency is common among children who frequently experience ear infections. By restoring serum vitamin D levels to above 30 ng/mL through supplementation, we observed a significant reduction in the risk of uncomplicated AOM. This suggests that vitamin D could play a beneficial role in managing ear infections in children prone to these issues.
Our findings were quite revealing: the children who received vitamin D supplements had a significantly lower incidence of AOM compared to those who were given the placebo. Specifically, only 26 children in the vitamin D group experienced at least one episode of AOM, versus 38 in the placebo group—a notable difference that became even more pronounced when looking specifically at uncomplicated AOM cases.
We concluded that vitamin D deficiency is common among children who frequently experience ear infections. By restoring serum vitamin D levels to above 30 ng/mL through supplementation, we observed a significant reduction in the risk of uncomplicated AOM. This suggests that vitamin D could play a beneficial role in managing ear infections in children prone to these issues.
9
We investigated how vitamin D levels affect the occurrence of ear infections, specifically in children aged 2 to 7. By looking at data from a pediatric clinic in northwest Romania, we enrolled 118 children—87 with recent ear infections and 31 who hadn't experienced any episodes. This allowed us to compare vitamin D levels across different types of ear infections, like Acute Suppurative Otitis Media and Serous Otitis Media.
Our findings revealed that children suffering from these infections had notably lower vitamin D levels compared to the control group. The children with Acute Suppurative Otitis Media showed the most significant deficiencies. We found a clear link: as vitamin D levels decreased, the frequency of ear infections increased. Logistic regression pointed out that vitamin D insufficiency boosted the odds of ear infections significantly, while Poisson regression established a strong correlation between low vitamin D status and the incidence of these infections.
Overall, these results indicate that low serum vitamin D may play a critical role in the risk of developing ear infections in young children. This suggests that screening and potentially supplementing vitamin D could be valuable strategies for reducing the frequency of ear infections and their associated complications. By addressing this modifiable risk factor, we can help improve the health and quality of life for many children.
Our findings revealed that children suffering from these infections had notably lower vitamin D levels compared to the control group. The children with Acute Suppurative Otitis Media showed the most significant deficiencies. We found a clear link: as vitamin D levels decreased, the frequency of ear infections increased. Logistic regression pointed out that vitamin D insufficiency boosted the odds of ear infections significantly, while Poisson regression established a strong correlation between low vitamin D status and the incidence of these infections.
Overall, these results indicate that low serum vitamin D may play a critical role in the risk of developing ear infections in young children. This suggests that screening and potentially supplementing vitamin D could be valuable strategies for reducing the frequency of ear infections and their associated complications. By addressing this modifiable risk factor, we can help improve the health and quality of life for many children.
9
Vitamin D enhances tympanoplasty outcomes
We explored how vitamin D (VD) levels influence the outcomes for patients undergoing Type 1 tympanoplasty (T1T), which is a common surgery for chronic ear infections. In our study, we divided 101 patients into four groups based on their VD levels, ranging from severe insufficiency to optimal levels.
Over a 12-month follow-up, we observed that patients with optimal VD levels had significantly higher graft success rates and greater improvements in hearing. Additionally, these patients experienced fewer postoperative infections.
Our findings highlight the importance of monitoring vitamin D levels in patients with chronic ear issues. We believe that addressing VD deficiency could enhance the success of tympanoplasty, suggesting that vitamin D replacement therapy might be beneficial for those with low preoperative levels.
Over a 12-month follow-up, we observed that patients with optimal VD levels had significantly higher graft success rates and greater improvements in hearing. Additionally, these patients experienced fewer postoperative infections.
Our findings highlight the importance of monitoring vitamin D levels in patients with chronic ear issues. We believe that addressing VD deficiency could enhance the success of tympanoplasty, suggesting that vitamin D replacement therapy might be beneficial for those with low preoperative levels.
8
We aimed to understand how vitamin D levels might influence recurrent ear infections, specifically otitis media, in young children. By comparing the serum vitamin D levels of 84 children suffering from recurrent ear infections to 108 healthy peers, we could explore the potential link between vitamin D deficiency and this common childhood ailment.
Our findings revealed that a significant number of children with recurrent otitis media had low vitamin D levels, with an average serum level of just 11.4 ng/mL. In contrast, the healthy control group had an average level of 29.2 ng/mL. Notably, the majority of children in the study group—about 69%—had vitamin D levels below the 20 ng/mL threshold, which is often considered deficient.
To address this deficiency, children who were found to have low vitamin D levels received vitamin D therapy alongside their standard treatment for the ear infections. Over the course of one-year follow-up, we observed that vitamin D supplementation seemed to contribute positively, as only a handful of infections occurred during that period.
While our study did show a correlation between low vitamin D levels and recurrent ear infections, it’s essential to mention that the vitamin D treatment was given alongside conventional therapies. Thus, we cannot definitively conclude that vitamin D alone was responsible for reducing ear infections. Nevertheless, it suggests that integrating vitamin D supplementation could be a beneficial approach in managing recurrent otitis media in children.
Our findings revealed that a significant number of children with recurrent otitis media had low vitamin D levels, with an average serum level of just 11.4 ng/mL. In contrast, the healthy control group had an average level of 29.2 ng/mL. Notably, the majority of children in the study group—about 69%—had vitamin D levels below the 20 ng/mL threshold, which is often considered deficient.
To address this deficiency, children who were found to have low vitamin D levels received vitamin D therapy alongside their standard treatment for the ear infections. Over the course of one-year follow-up, we observed that vitamin D supplementation seemed to contribute positively, as only a handful of infections occurred during that period.
While our study did show a correlation between low vitamin D levels and recurrent ear infections, it’s essential to mention that the vitamin D treatment was given alongside conventional therapies. Thus, we cannot definitively conclude that vitamin D alone was responsible for reducing ear infections. Nevertheless, it suggests that integrating vitamin D supplementation could be a beneficial approach in managing recurrent otitis media in children.
References
- Manole A, Mărcuț LF, Cârciumaru R, Manole F. Preventing Recurrent Otitis Media in Children Aged 2-7 Years: A Cross-Sectional Evaluation of Serum Vitamin D as a Modifiable Factor. Diagnostics (Basel). 2025;15. doi:10.3390/diagnostics15050519
- Kelleş M, Guler Y, Guler R. Vitamin D: A Factor affecting the Success of Type 1 Tympanoplasty. Ear Nose Throat J. 2022. doi:10.1177/01455613221137224
- Fanimolky F, Amizadeh M. Investigation of the Serum Level of Vitamin D in Patients with Ear Cholesteatoma. Iran J Otorhinolaryngol. 2022;34:89. doi:10.22038/IJORL.2021.52513.2793
- Kim HB, Lim SH, Cho CG, Choi HS. Influence of Vitamin D Deficiency on Progression of Experimental Otitis Media in Rats. Endocrinol Metab (Seoul). 2018;33:296. doi:10.3803/EnM.2018.33.2.296
- Akcan FA, Dündar Y, Akcan HB, Uluat A, Cebeci D, et al. Clinical role of vitamin D in prognosis of otitis media with effusion. Int J Pediatr Otorhinolaryngol. 2018;105:1. doi:10.1016/j.ijporl.2017.11.030
- Walker RE, Bartley J, Camargo CA, Flint D, Thompson JMD, et al. Higher serum 25(OH)D concentration is associated with lower risk of chronic otitis media with effusion: a case-control study. Acta Paediatr. 2017;106:1487. doi:10.1111/apa.13908
- Li HB, Tai XH, Sang YH, Jia JP, Xu ZM, et al. Association between vitamin D and development of otitis media: A PRISMA-compliant meta-analysis and systematic review. Medicine (Baltimore). 2016;95:e4739. doi:10.1097/MD.0000000000004739
- Cayir A, Turan MI, Ozkan O, Cayir Y. Vitamin D levels in children diagnosed with acute otitis media. J Pak Med Assoc. 2014;64:1274.
- Marchisio P, Consonni D, Baggi E, Zampiero A, Bianchini S, et al. Vitamin D supplementation reduces the risk of acute otitis media in otitis-prone children. Pediatr Infect Dis J. 2013;32:1055. doi:10.1097/INF.0b013e31829be0b0
- Cayir A, Turan MI, Ozkan O, Cayir Y, Kaya A, et al. Serum vitamin D levels in children with recurrent otitis media. Eur Arch Otorhinolaryngol. 2014;271:689. doi:10.1007/s00405-013-2455-7
