Upcoming Classes

Herbal Medicine Making 101 Classes:

All classes are held on Saturdays through our year at the Markets of Hanover, located 1649 Broadway, Hanover, PA 17331.

Making a ShrubSaturday, October 12th, 2019, at 9am or 1 pm. More details to follow

Making an Herbal Syrup Saturday, September 7th, 2019, at 9 am or 1 pm. You choose which time suits you. The class includes instructions and education about herbal syrups, featuring elderberry, how to use different types of sweeteners – honey, raw cane sugar, raw stevia and agave, and a live demo. Each participant leaves with a goodie bag with ingredients to go home and make their own syrup. Class will last 2-3 hours depending. Cost is $30.

Herbal Syrup Making Class – September 7th, 2019

Please add the time in the comment box at checkout. If you can't find it. Just email us.


Elderberry Season!

At our little shop, Herbs & Sympathy

Elderberries have a long tradition and also empirical evidence to support their use for keeping our immune systems primed for the upcoming cold and flu season.   We are fast approaching the time when we will be sharing confined air with co-workers, family, and snotty nosed children – bless them. So, we need to get our bodies ready for the onslaught. One way to do so is to keep a bottle of elderberry syrup in the frig and swig about a teaspoon a day during the next several months.

Photo by Pixabay on Pexels.com

What they look like – Elderberries are the fruit of the flowering plant known as Sambucus, more commonly referred to as elder or elderflower. The scientific name of the most common variety, from which we get the majority of our elderberries, is Sambucus nigra. You generally find elderberries in the Northern hemisphere, particularly in Europe and North America. You can wildcraft the berries with permission of the landowner, cultivate them yourself or purchase them dried from a health food store or your friendly neighborhood herbalist. The berries are black or very dark blue and have a tart flavor which makes them ideal for desserts, syrups, jams, jellies, spreads, and as the base for various adult beverages.

Herbal actions: Elderberries have quite a few medicinal benefits for our bodies for this time of year in particular. Recent research suggests that elderberries boost our immune system by increasing cytokine production, offering antioxidants, and inhibit viral infections. Let’s break this down a little.  Cytokines are small chemical agents in our body that monitor potential infections and alert our immune system to respond. Elderberries are also a great source for antioxidants. Antioxidants are important for scooping up radical molecules in the body which will attach themselves to other molecules and create havoc. Finally, elderberries show potential in suppressing or inhibiting viral infection.  Some early laboratory testing has shown that elderberries have seem to coat the virus and render them useless. Please note these early studies have not reached human trials. So in sum and Faithspeak, elderberries are super great at keeping us healthy over the coming cold and flus season by bolstering our immune system, keeping infections at bay and if we do happen to get sick, shortening the length of the sickness.

Making Elderberry Syrup:   Making the syrup is relatively easy and there are a plethora of recipes online.  When I made elderberry syrup yesterday, I used a ratio of 1 dried cup of elderberries to 3 cups of filtered water.  So here are some basic instructions:

Pour 3 cups of water into a medium saucepan and 1 cup) of dried elderberries along with herbs of your choice – echinacea, ginger, cinnamon, cloves. Bring to a boil and then cover and reduce to simmer for about 45 minutes to an hour until the liquid has reduced by almost half. Remove from heat and cool enough to handle. Pour the mixture through a mesh strainer. Mash the berries with a flat spoon.  Discard the elderberries and let the liquid cool. Add sweetener of your choice to taste. Store in the refrigerator and take one teaspoon a day to increase immunity. 





Raspberry leaves and our lovely lady parts

One year I decided to put in a berry patch in the disused run of an old chicken coop. My friend, Cindy, came and helped us to clear the weeds and to lay out concrete blocks for a raised bed look.  We even used old crutches for bracing and training the vines. Along with this amazing plan, I had envisioned composting stalls on the western side of the enclosure. We planted raspberries, blackberries and blueberries.  Then I forgot about them.

Fast forward, two or three years ( I can’t remember how long because I forgot about them!) – maybe even four, my husband comes into the house from mowing and reminds me about the berry patch. He tells me that the vines are full of berries and I should go and pick them. So I did with a machete. Actually, with my husband leading the way with a pair of shears to trim back the jungle, we ventured forth into the area which had been closed off. He was not wrong.  There were berries everywhere. As I picked through I did notice a distinct difference between the wild black raspberries, rubus occidentalis, which grow all over the property and the red ones, Rubus idaeus, left to grow amuck in purposed patch. I also noted that there may have been some intermingling of the two species in this forgotten small ecosystem. Needless to say, the berries were very tasty. However, I am interested in more than just the berries.  I am also interested in harvesting the leaves.

Probably since the first raspberry leaf accidentally dropped into a sun warmed hollowed gourd of water, raspberry leaves have been used to make a refreshing medicinal tea. Women, in particular, have benefitted from drinking the tea, or in more recent times, taking capsules of powdered raspberry leaf. Raspberry leaves have a particular affinity for the uterus and pelvic area, providing toning and relaxation of the muscles. A warm infusion of raspberry leaves will bring balance to our lovely lady parts as well as our hair, teeth and bones. Raspberry leaf is a wonderful energizing overall tonic, rich in nutrients. Tonics in general, are great for long term use, particularly during stressful periods of life and during recovery from illness.

Not only do I suggest eating raspberries during pregnancy or at any time in a woman’s life, I also recommend drinking the tea made from the leaves. Raspberry leaves contain calcium, magnesium, potassium, zinc and iron. It will provide pain relief during a woman’s cycle by strengthening the uterus and pelvic muscles and by offering nutrients where there’s a deficiency.  Considered a nervine and an astringent, raspberry leaf will aid in clearing out a congested pelvis as well as relieving postpartum pain and depression. It may help with fibroids. 

This plentiful herb is one of the few considered safe during pregnancy.  Drinking raspberry leaf tea everyday will strengthen the uterus and pelvis, getting it ready for safe Baby Day delivery. Because of its nervine action, raspberry tea will also quell nausea during those first few months. It’s tonic and relaxing actions aid in decreasing pain during delivery while increasing efficiency of contractions, making for faster delivery. After delivery, a warm cup of raspberry leaf tea will hasten recovery and may encourage milk flow. Be careful of drinking raspberry tea in large amounts during those early breastfeeding months as it may slow milk production. But later an extra cup may help with weaning.

Raspberry leaf acts as an astringent in other areas of the body as well. The kidneys and urinary tract benefit as well as the mucus linings throughout the rest of the body. It may help with diarrhea and can stop hemorrhaging.

As an herbalist, I do tend to add raspberry leaves to many female specific formulas. Raspberry leaves pair well with mullein, oat straw, lemon balm, nettle and cranesbill. Here’s a comforting tea recipe for that not so comfortable time of the month:

1 part peppermint leaves, 1 part raspberry leaf, .5 part skullcap leaves, pinch of raw stevia. Place loose tea in an infuser. Pour hot water over leaves. Cover and steep for 8-10 minutes. Enjoy.

Roses are red (pink and white) and healthy for you…..

We see roses as a romantic gesture but they have traditionally been viewed as a symbol of fertility as well. So it’s not surprising that rose leaves, petals and hips have a long history as a tonic for the female productive system. But what might be surprising (to me, anyways) is that these aerial parts of the sweet smelling shrub have been used to increase sexual interest and decrease impotence in men. So, a bouquet of red roses to either sex has important overtures.

Roses have medicinal and nutritive value for us. Containing Vitamins C, B, E & K, tannins, pectin, carotene, fruit acids, fatty oil and nicotinamide, roses offer a cooling affect on the body. An infusion of leaves and petals can bring down a fever while clearing toxins and heat from the body. Rose tea works particularly well when the fever is accompanied by rash and inflammation.

Roses can also act as alterative by changing the course of illness or infection. Roses can enhance immunity and slow down or thwart the course of infection, particularly in the digestive tract. Bolstering the gut bacteria, the constituents in roses will help to balance the microbial flora in the body’s lower intestines. Rose petal tea can relieve cold and flu symptoms like sore throat, runny nose and chest congestion.

Roses also act as a decongestant, astringent and detox agent. These actions work very well together in several parts of the body to clear out inflammation and congestion while improving tissue quality. A tea or syrup made from petals or rose hips can clear out infection in lungs. Taken consistently, the tea or syrup can improve the resiliency of the lungs, especially for those who tend to experience these types of infection. A daily cup or two of lovely rose tea for a child who has frequent chest colds or for an older loved one who battles bronchitis may bring comfort and healing to them. Roses will also help with clearing congestion from the uterus, decreasing pain and heavy periods. A daily infusion may also regulate menses, decrease infertility and enhance the libido as it tones the tissues of the body’s female reproduction system.

Photo by Irina Iriser on Pexels.com

An infusion of rose petals and hips can also help the body with elimination. Encouraging the kidneys to work effectively, a rose infusion will decrease fluid retention in the body and move toxins through the kidneys and out of the body. While the kidneys are doing their job even better, the liver will also improve with a good dose of rose hip or petal tea. Roses have a mild laxative effect. They encourage the liver to prompt the gall bladder to increase bile flow. By doing so, the liver is decongested. A sluggish liver can lead to chronic headaches and constipation.

Photo by Luizmedeirosph on Pexels.com

Finally, roses can act as a nervine. Think of getting a surprise bouquet of flowers. What is the first thing you do? Smile, right. Endorphins are released as you inhale the heady scent of the blooms. Using rose essential oil while meditating, may begin to soothe emotional trauma or problems surrounding impotency or frigidity. Roses also act upon the central nervous system. Using roses daily as a tea or syrup may lift mood, decrease insomnia and depression, improve fatigue and irritability. A bouquet of freshly snipped roses can be uplifting to those we love and cherish, no matter what age.

So, the next time, you receive a bunch of roses or give some roses, remember the lovely benefits you are receiving or passing along.

Photo by Rosie Ann on Pexels.com

Here’s a rose syrup recipe to try with some of those UNSPRAYED rose petals.

  • 1 cup UNSPRAYED and washed rose petals
  • 2 cups of distilled water
  • 1/2 – 1 cup raw honey

Place roses and water into a saucepan. Simmer covered for 20 minutes, reducing by 1/3-1/2. Let cool. Strain. Add honey once infusion has cooled to a warm temperature. Pour syrup into sterilized bottle. Take 1 tsp. daily.

Organic Dried Rose Petal

Rose petals make a lovely calming tea, are great for syrups, lotion and creams. Also used in spell work. Herbs & Sympathy sells organic dried rose petals for $3.00 an ounce.


Drying Rose Petals

Drying Rose Petals – June 2019

A lovely rose bush grows outside where the corner of the porch and steps leading up to the porch meet. The bush, laden with heavy pink flowers, smells heavenly when you walk by it.  My sister tells me the rose bush is the double sweetheart variety. Each bloom has an abundance of soft petals. I felt compelled to take some of the flowers for drying to use for teas and other medicines.  The following week, a lovely soul came into our booth and ask me if I could craft a self-love tea for her.  She had a list of ingredients. As an herbalist, I could extrapolate a general formula and create a tea close to what she had had before while she continued to shop the stalls at the market. This blend had rose petals.  Later that week, she sent me pictures of the brewed tea. It had a rich pink red color. 

Roses have long been a traditional symbol of not only love but fertility. This makes sense when we think about Valentine’s Day – chocolate and roses – aphrodisiacs, for sure. However, rose leaves, petals and hips also have other herbal actions in the body.  Containing Vitamins C,B,E & K, tannins, pectin, carotene and other constituents, parts of the rose bush can also act as a relaxant, diuretic, astringent, febrifuge, detoxifier, decongestant and nervine.   So, having dried rose petals on hand can prove to be very beneficial. 

Here’s how I dried the flowers which I harvested from our bush. I generally dry all my herbs this way. On occasion, I will dry them on the proofing setting in the oven but I have to remain fairly vigilant when doing so. I do not dry by hanging for several reasons. I have pets, live in the country where dust and insects abound, and use my dried herbs for medicines so I limit what can contaminate my end products.

Step 1: Gather freshly opened blooms. I use a sharp pair of scissors or snips. I also like to leave a little gift for the plant when I harvest and I do not harvest everything from the plant – just what I need. For this lovely bush,  I cleared all the potentially choking vines which had wound around her and spoke sweetly, thanking her for her flowers. Whether you believe in this kind of exchange or not, I find that having an attitude of gratefulness is at least helpful to my outlook. 🙂

Step 2: Lay out the fresh flowers stems up for a time. I like to think it gives an opportunity for all the little bugs to crawl out.  I also will rinse them in cool water to help the creatures along as well and remove dirt from the blooms. (But for these because I would not be selling them, I simply let them rest.) After a time, I will snip the base of the bloom to release the petals.

Step 3: While waiting on the petals, prepare the dehydrator. I try and clean it after every use, running the trays through the dishwasher.  But it always helps to double check before using again to avoid cross contamination of different herbs. 

Step 4: Arrange the petals on each tray. I don’t worry too much about touching because as they dry they will shrink a good bit.They tend to separate or can be gently pulled apart. Plants can be up to 90% water so taking out the moisture decreases their size a good bit. 


Step 5: Stack trays, cover the top one and turn on the dehydrator. I do keep a watch, checking on them every half hour or so, depending if I get caught up in another project or chore. I have dried herbs to a crisp before which is what you do not want. The more delicate the lower the heat if you can adjust the temperature on your dehydrator. 

Step 6: Let the dried petals cool and then place them in a glass container.  A dark one would be better if you have it. They may fade as they cool and if they are exposed to sunlight.  

Rose Petal Tea:   

1-2 teaspoons dried rose petals*

6-8 ounces of water

Honey and lemon to taste, if desired. Place petals in an infuser or directly into a cup. Heat water to almost a boil. Pour water over petals and cover the cup. Let steep for 5-10 minutes. Remove infuser or strain out petals. Sit with your feet up and enjoy. 

*please make sure that these petals are pesticide free. I would not use the bouquet of roses that you received on Valentine’s Day unless you absolutely know from where they were harvested. 

Thanks for stopping in and for reading about how to dry your own roses. You can purchased already dried rose petals at our booth at The Markets of Hanover or here through this website.  I hope you found this helpful and please remember that this information is for educational purposes only. This information has not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

I Love Coffee – here’s why

Coffee has been the center of controversy for many years.  Conflicting studies have depicted this lovely and robust beverage as a culprit in cardiovascular diseases or as a stalwart protector against cardiovascular disease (Greenland, 1993; Jick, Miettinen, Neff, Shapiro, Heinonen & Slone, 1973; Noordzij, Uiterwall, Arends, Kok, Grobbee & Geleijnse, 2005; Wu, Ho, Zhou, et. Al, 2009).  However, current research indicates that coffee can indeed be beneficial for heart disease, postmenopause and depression as well as diabetes and weight loss (Choi, Choi, Park, Shin, Joh & Cho, 2016; Freedman, Park, Abnet, Hollenbeck, & Sinha, 2012; O’Keefe, DiNicolantanio & Lavie, 2018; Wang, Shen, Wu & Zhang, 2016). Go, coffee!

So, what is coffee exactly and why is it so wonderful?
Americans spend over $40 billion for coffee a year, and the world drinks over 1 billion cups of coffee a day according to the National Coffee Association (n.d.).  Coffee, as most of us recognize it, is the liquid brewed from roasted beans of the coffee tree. These trees grow all over the world in a range of climates but generally prefer rich soil, balmy temperatures, plentiful rain and some shade from the sun (National Coffee Association, n.d.).
 So, to rationalize the amount of coffee that I drink, I scoured EBSCO for pertinent research.  I have found the following potential benefits:

  1. Drinking coffee may assist in bone health with postmenopausal women (Choi, Choi, Park, Shin, Joh & Cho, 2016).
  2. Drinking coffee may reduce the risk of depression (O’Keefe, DiNicolantanio & Lavie, 2018; Wang, Shen, Wu & Zhang, 2016).
  3. Drinking coffee may reduce  lower risk for type 2 diabetes, as well as liver and colon cancer (O’Keefe, DiNicolantanio & Lavie, 2018; Wierzejska, 2016).
  4. Drinking coffee may also prevent cardiovascular diseases (O’Keefe, DiNicolantanio & Lavie, 2018; Wierzejska, 2016).
  5. One of coffee’s constituents, caffeine, has several benefits. As a stimulant, caffeine blocks the effects of Adenosine, an inhibiting neurotransmitter and in turn, releases dopamine and norepinephrine (Fredholm, 1995).
  6. Coffee also has nutrients and antioxidants (SELF Nutrition Data, 2014).
  7. Drinking coffee may have neuroprotective applications for some neurodegenerative diseases (O’Keefe, DiNicolantanio & Lavie, 2018).
  8. Drinking coffee helps with improved asthma control (O’Keefe, DiNicolantanio & Lavie, 2018).

If coffee is so healthy, why is there controversy?
Coffee initially got a bad name mostly in part due to flaws in the research designs of several studies. In several of the studies, certain “confounders” were not identified. Proper screening of pre-existing conditions or habits like smoking or lack of exercise were not completed In the earlier studies (Greenland, 1993; Jick, et al., 1973), Once these confounders were discovered and considered in future studies, coffee got a well deserved reputation for being beneficial. However, certain clarifications should be made about the coffee being consumed in these studies and there are certain situations when coffee consumption should be very limited or avoided sadly. With all good things, it’s important to remember that there must be balance.

  1. A cup of coffee is considered 6 ounces and not the giant cups (24 oz) found at most convenience stores.
  2. A cup of coffee means a hot water infusion of coffee beans – boiling hot water slowly poured over ground beans – and not a double mocha frappuccino. Unfortunately, consuming large amounts of sugary coffee beverages can lead to diabetes and heart disease!
  3. Drinking more than 4 six ounce cups of coffee a day can have side effects like anxiety, insomnia, headaches, tremulousness, and palpitations (O’Keefe, DiNicolantanio & Lavie, 2018). Think about drinking an herbal tea like skullcap or a mushroom coffee. Both of these have the effects of drinking coffee without the caffeine.
  4. Pregnancy and coffee or any beverage with caffeine may not be a good mix. Limiting to one small cup a day while pregnant may be prudent (O’Keefe, DiNicolantanio & Lavie, 2018). Drinking coffee while pregnant can increase the risk for low birth weight and preterm labor (Australian Breastfeeding Association, n.d.). So if an expectant mother had trouble getting pregnant or is susceptible to premature labor, she should avoid coffee while pregnant.
  5. Most breastfeeding mothers can drink a moderate amount of coffee or tea without it affecting their babies. However, newborns are very sensitive to caffeine as they take a long time to process it. The wait can lead to cranky babies.  As babies reach the age of six months or so, they can work through caffeine in about 2-3 hours. Research is scant on this topic and what is there suggests that there does not appear to be effect (Santos, Matijasevich & Domingues, 2012). However,  I would err on the side of caution.  My recommendation would be to enjoy a cup of Joe right after nursing or even while nursing and then express breast milk 1-2 hours afterwards to insure that very little if any caffeine would be present at the next nursing.

So, how much coffee should we drink?

     In sum, coffee is safe to drink in moderation. Coffee can have positive effects on the body and some even protective. For coffee lovers under the age of 55 years, no more than three to four, 6 to 8 ounce cups of coffee should be drank in a day, not to exceed 28 cups in a week.  Coffee drinkers over the age of 55 years can drink as much as they want within reason. Coffee is a bitter and full of tannins so it can get rough on the digestive tract. Coffee drinkers should be mindful of what they are adding to their coffee. Additives may minimize the overall perks of drinking coffee.  I think in light of these findings, I will go and joyfully refill my coffee cup, and leave you with one of my favorite coffee poems:

Coffee, coffee,

Coffee, coffee, coffee,

Everyone, shut up.



Acheson, J., Zahorska-Markiewicz, B., Pittet, P., Anantharaman, K. & Jéquier, E. (1980). Caffeine and coffee: their influence on metabolic rate and substrate utilization in normal weight and obese individuals [Abstract]. American Journal of Clinical Nutrition(33)5, 989-97. Retrieved November 28,2014, from http://ajcn.nutrition.org/content/33/5/989.short.

Australian Breastfeeding Association. (n.d.). Breastfeeding and Maternal Caffeine Consumption. Retrieved May 30, 2019 fromhttps://www.breastfeeding.asn.au/bfinfo/breastfeeding-and-maternal-caffeine-consumption.

Choi, E., Choi, K., Park, S. M., Shin, D., Joh, H., & Cho, E. (2016). The Benefit of Bone Health by Drinking Coffee among Korean Postmenopausal Women: A Cross-Sectional Analysis of the Fourth & Fifth Korea National Health and Nutrition Examination Surveys. Plos ONE, 11(1), 1-14. doi:10.1371/journal.pone.0147762

Fredholm, B. (1995). Adenosine, Adenosine Receptors and the Actions of Caffeine  [Abstract]. Pharmacology and Toxicology(76)2. Retrieved November 28, 2014, from http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0773.1995.tb00111.x/abstract.

Freedman, N., Park, Y., Abnet, C. C., Hollenbeck, A. R., & Sinha, R. (2012). Association of coffee drinking with total and cause-specific mortality. The New England Journal Of Medicine, 366(20), 1891-1904. doi:10.1056/

Getting to Know Americans – Age 50 Plus. (2014). Retrieved November 28,2014 from http://www.aarp.org/content/dam/aarp/research/surveys_statistics/general/2014/Greenland S. (1993). A meta-analysis of coffee, myocardial infarction, and coronary

Greenland S. (1993). A meta-analysis of coffee, myocardial infarction, and coronary Death [Abstract]. Epidemiology 4:366-374.

Higdon, J. (2005). Coffee. Retrieved November 30, 2014 from the Linus Pauling Institute At Oregon State University Website: http://lpi.oregonstate.edu/infocenter/foods/coffee/

Jick, H., Miettinen, O. S., Neff, R. K., Shapiro, S., Heinonen, O. P., & Slone, D. (1973). Coffee and myocardial infarction [Abstract]. The New England Journal Of Medicine, 289(2), 63-67.

Junxiu, L., Xuemei, S., Lavie, C. J., Hebert, J. R., Earnest, C. P., Jiajia, Z., & Blair, S. N. (2013). Association of Coffee Consumption With All-Cause and Cardiovascular Disease Mortality. Mayo Clinic Proceedings, 88(10), 1066-1074.

McCready, A., Bird, S., Brown, L. Shaw-Stewart, J. & Chen, Y. (2018). Effects of maternal caffeine consumption on the breastfed child: a systematic review. Swiss Medical Weekly 148, 39-40. https://doi.org/10.4414/smw.2018.14665

Noordzij, M., Uiterwaal, C. M., Arends, L. R., Kok, F. J., Grobbee, D. E., & Geleijnse, J. M. (2005). Blood pressure response to chronic intake of coffee and caffeine: a meta-analysis of randomized controlled trials [Abstract]. Journal Of Hypertension, 23(5), 921-928.

O’Keefe, J., DiNicolantonio, J., & Lavie, C. (2018). Coffee for Cardioprotection and Longevity [Abstract]. Progress in Cardiovascular Diseases, 61(1), 38-42.  doi: 10.1016/j.pcad.2018.02.002.

Physicians For Responsible Medicine. (n.d.). Ask the Expert: Caffeine. Retrieved November 30, 2014, from http://www.pcrm.org/health/cancer-resources/ask/ask-the-Expert-caffeine.

Santos, I. S., Matijasevich, A., & Domingues, M. R. (2012). Maternal caffeine consumption and infant nighttime waking: prospective cohort study. Pediatrics, 129(5), 860–868. doi:10.1542/peds.2011-1773

SELF Nutrition Data. (2014) Coffee, brewed from grounds, prepared with tap water. Retrieved November 28, 2014, from http://nutritiondata.self.com/facts/beverages/3898/2.

The Council for Responsible Nutrition. (n.d.). Caffeine Know the Facts.

The National Coffee (n.d.). Coffee Facts. Retrieved November 28, 2014, from http://www.ncausa.org/i4a/pages/index.cfm?pageid=825.

Wang, L., Shen, X., Wu, Y., & Zhang, D. (2016). Coffee and caffeine consumption and depression: A meta-analysis of observational studies. Australian & New Zealand Journal Of Psychiatry, 50(3), 228-242 15p. doi:10.1177/0004867415603131

Wierzejska, R. (2016). Coffee Consumption and Cardiovascular Diseases – Has the Time Come to Change Dietary Advice? A Mini Review. Polish Journal Of Food & Nutrition Sciences 66(1), 5-10. doi:10.1515/pjfns-2015-0048

Wu, J., Ho, S. C., Zhou, C., Ling, W., Chen, W., Wang, C., & Chen, Y. (2009). Coffee  consumption and risk of coronary heart diseases: A meta-analysis of 21 prospective cohort studies. International Journal Of Cardiology, 137(3), 216-225. doi:10.1016/j.ijcard.2008.06.