The Importance of Indication Creep in Respiratory Support

John raised an important issue which is indication creep of therapy that in some settings does harm not assessed in this paper but you know people read the paper and then they think they may think about a clinical condition differently. Kathy, I'm wondering how you would respond to John's question. The belief of the oxygen should you know is unquestionably an important component of respiratory support first of all started off with low flow and then escalate. Are there questions from the audience? Go ahead.