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Mahajan M, Prasad MK, Ashok C, Guria RT, Marandi S, Vidyapati, Subrat S, Chowdhury A. The Correlation of the Neutrophil-to-Lymphocyte Ratio With Microvascular Complications in Patients With Diabetes Mellitus. Cureus 2023; 15:e44601. [PMID: 37799262 PMCID: PMC10548773 DOI: 10.7759/cureus.44601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2023] [Indexed: 10/07/2023] Open
Abstract
Background High neutrophil-to-lymphocyte ratio (NLR) may be used as a reliable measure of vascular complications and an indicator of poor outcomes in cases of diabetes mellitus (DM). Methods A prospective analytical cross-sectional observational study was conducted at the Rajendra Institute of Medical Sciences (RIMS), Ranchi, Jharkhand, India. A total of 100 patients with DM who met the inclusion and exclusion criteria were included in the study. A pre-tested and semi-structured questionnaire was given to the patients. IBM SPSS software version 26 (IBM Corp., Armonk, NY, USA) and MedCalc trial version 20.114 (MedCalc Software Ltd., Ostend, Belgium) were used for data analysis. Logistic regression analysis was performed to determine the association of the NLR with microvascular complications. Results In our study, the male-to-female ratio was 1.78:1 (male: 64 (n)%, female: 36 (n)%). The mean age of our study population was 56.28 ± 13.24 years. Of 58 patients with microvascular complications, 34 had a high NLR, and 24 patients had a normal NLR. Of 42 patients without microvascular complications, only 14 had a high NLR, and the remaining 28 patients had a normal NLR (p = 0.012). Logistic regression was performed to analyze the association between the NLR and microvascular complications, which demonstrated a significant association (odds ratio (OR): 2.833, 95% confidence interval (CI): 1.238-6.481; p = 0.013). Conclusions Our study demonstrated the higher odds of having microvascular complications among diabetics with a high NLR compared with non-diabetics. Therefore, the NLR may be used as a measure of microvascular complications in the diabetic population.
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Affiliation(s)
- Mayank Mahajan
- Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
| | | | - Chanchal Ashok
- Pathology, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Rishi Tuhin Guria
- Internal Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Sujeet Marandi
- Internal Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Vidyapati
- Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
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Kumar A, Kumari S, Saroj U, Verma A, Kiran KA, Prasad MK, Sinha R, Sinha MBK. Impact of the COVID-19 Pandemic on Blood Donation Patterns: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e43384. [PMID: 37700994 PMCID: PMC10495075 DOI: 10.7759/cureus.43384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2023] [Indexed: 09/14/2023] Open
Abstract
Blood centers, which are arguably the backbone of every hospital, depend on blood donors for a constant and regular supply of blood. Like many other fields, the COVID-19 pandemic severely affected blood donations. In this article, we aim to systematically search the studies done on blood donation during the COVID-19 pandemic period, analyze the pandemic's effect on blood donation, and examine the methodology used to overcome the problem. We performed a systematic review and meta-analysis to investigate the effect of the COVID-19 pandemic on blood donation. Two independent reviewers searched different databases, such as PubMed, ProQuest, Scopus, and Google Scholar. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Joanna Briggs Institute critical appraisal checklist for overall study characteristics. We included a total of 15 studies. There was an overall decrease in blood donation of 25%, with some regions showing a decrease of as much as 71%. However, some regions were able to experience a 2-10% increase in blood donation after taking stringent and early measures to prevent such decreases. The COVID-19 pandemic and consequent lockdown greatly affected blood transfusion services, resulting in a progressive decline in blood donations that threatened the lives of many patients who were fully dependent on blood transfusion. However, by making appropriate and early decisions and taking action, policymakers and the rest of society can prevent such shortages, potentially saving millions of lives.
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Affiliation(s)
- Abhay Kumar
- Department of Internal Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Sushma Kumari
- Department of Blood Bank, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Usha Saroj
- Department of Blood Bank, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Ashwini Verma
- Department of Microbiology, Phulo Jhano Medical College, Dumka, IND
| | - Kumari Asha Kiran
- Department of Preventive Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Manoj Kumar Prasad
- Department of Internal Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Rashmi Sinha
- Department of Internal Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
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Mahajan M, Prasad ML, Kumar P, Kumar A, Chatterjee N, Singh S, Marandi S, Prasad MK. An Updated Systematic Review and Meta-Analysis for the Diagnostic Test Accuracy of Ascitic Fluid Adenosine Deaminase in Tuberculous Peritonitis. Infect Chemother 2023; 55:264-277. [PMID: 37407244 DOI: 10.3947/ic.2023.0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 03/23/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Tuberculous peritonitis is difficult to diagnose due to its non-specific clinical manifestations and lack of proper diagnostic modalities. Current meta-analysis was performed to find the overall diagnostic accuracy of adenosine deaminase (ADA) in diagnosing tuberculous peritonitis. MATERIALS AND METHODS PubMed, Google Scholar, and Cochrane library were searched to retrieve the published studies which assessed the role of ascitic fluid ADA in diagnosing tuberculous peritonitis from Jan 1980 to June 2022. This meta-analysis included 20 studies and 2,291 participants after fulfilling the inclusion criteria. RESULTS The pooled sensitivity was 0.90 (95% confidence interval [CI]: 0.85 - 0.94) and pooled specificity was 0.94 (95% CI: 0.92 - 0.95). The positive likelihood ratio was 15.20 (95% CI: 11.70 - 19.80), negative likelihood ratio was 0.10 (95% CI: 0.07 - 0.16) and diagnostic odds ratio was 149 (95% CI: 86 - 255). The area under the summary receiver operating characteristic curve was 0.97. Cut- off value and sample size were found to be the sources of heterogeneity in the mete-regression analysis. CONCLUSION Ascitic fluid ADA is a useful test for the diagnosis of tuberculous peritonitis with good sensitivity and specificity however, with very low certainty of evidence evaluated by Grading of Recommendations, Assessment, Development and Evaluation approach. Further well- designed studies are needed to validate the diagnostic accuracy of ascitic fluid ADA for tuberculous peritonitis.
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Affiliation(s)
- Mayank Mahajan
- Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | | | - Pramod Kumar
- Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Amit Kumar
- Department of Laboratory Medicine, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Neha Chatterjee
- Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Shreya Singh
- Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Sujeet Marandi
- Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
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Prasad MK, Kumar A, Nalini N, Kumar P, Mishra B, Lata D, Ashok C, Kumar D, Marandi S, Kumar D, Singh S, Mahajan M. Diagnostic Accuracy of Cerebrospinal Fluid (CSF) Adenosine Deaminase (ADA) for Tuberculous Meningitis (TBM) in Adults: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e39896. [PMID: 37404432 PMCID: PMC10316459 DOI: 10.7759/cureus.39896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2023] [Indexed: 07/06/2023] Open
Abstract
Tuberculous meningitis is the most serious complication of tuberculosis. Early diagnosis is crucial to start relevant treatment to prevent death and disability. Electronic databases PubMed, Google Scholar, and Cochrane Library were used to find relevant articles from January 1980 to June 2022. The random-effect model in terms of pooled sensitivity, specificity, and diagnostic odds ratio (DOR) with 95% confidence interval was adopted to derive the diagnostic efficacy of cerebrospinal fluid (CSF) adenosine deaminase (ADA) for the diagnosis of tuberculous meningitis (TBM) in adult patients. A total of 22 studies (20 prospective and two retrospective data) have been included in this meta-analysis, having 1927 participants. We perceived acceptable pooled sensitivity, specificity, summary receiver operating characteristics (SROCs), and diagnostic odds ratio (DOR) of 0.85 (95% CI: 0.77-0.90), 0.90 (95% CI: 0.85-0.93), 0.94 (95% CI: 0.91-0.96) and 48 (95% CI: 26-86), respectively, for CSF-ADA for differentiating TBM from non-TBM in adult patients. To ascertain the certainty of evidence for CSF-ADA as a diagnostic marker for TBM, Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) analysis was used. CSF-ADA is an auspicious diagnostic test with a high degree of specificity and acceptable sensitivity for the diagnosis of tuberculous meningitis, however, with very low certainty of evidence.
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Affiliation(s)
| | - Amit Kumar
- Laboratory Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Neelam Nalini
- Obstetrics and Gynecology, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Pramod Kumar
- Biochemistry, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Brajesh Mishra
- Pulmonary Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
| | | | - Chanchal Ashok
- Pathology, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Dewesh Kumar
- Community Medicine/Preventive and Social Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Sujeet Marandi
- Internal Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Divakar Kumar
- Internal Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Shreya Singh
- Internal Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Mayank Mahajan
- Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
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Vats A, Roy D, Prasad MK. Direct versus indirect transfer for traumatic brain injury to James Cook University Hospital: a retrospective study. Ann R Coll Surg Engl 2020; 103:23-28. [PMID: 32820664 DOI: 10.1308/rcsann.2020.0180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Patients with traumatic brain injury are referred to the neurosurgical unit at James Cook University Hospital, Middlesbrough, either from local accident and emergency departments (direct transfer from the scene) or from other hospitals (indirect transfer). This study looked at the outcome in both groups. MATERIAL AND METHODS This was a retrospective observational study using trauma audit research network data for patients treated for traumatic brain injury at the neurosurgery department at the neurosurgical unit at James Cook University Hospital. RESULTS A total of 356 patients with traumatic brain injury were admitted under the care of neurosurgeons; 143 (40%) of these patients had a neurosurgical procedure. Of the patients undergoing a neurological procedure, 111 patients were transferred directly while 32 were indirect transfers; 213 patients were managed conservatively. Of those managed conservatively, 165 were transferred directly while 48 were indirect transfers. We compared the length of hospital stay and Glasgow Outcome Scale score for the patients based on whether they were conservatively managed or required surgery in the direct and indirect transfer groups. The difference in the length of stay in the surgical and conservative groups following direct and indirect transfer was insignificant (p = 0.07). The time to the operation in direct and indirect transfer was also not statistically significant (p = 0.06). CONCLUSION Patients are as safe, if not safer, by reaching the nearest trauma unit with facilities for resuscitation and imaging.
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Affiliation(s)
- A Vats
- James Cook University Hospital, Middlesbrough, UK
| | - D Roy
- James Cook University Hospital, Middlesbrough, UK
| | - M K Prasad
- James Cook University Hospital, Middlesbrough, UK
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Abstract
Amelogenesis imperfecta (AI) is a clinically and genetically heterogeneous group of diseases characterized by enamel defects. The authors have identified a large consanguineous Moroccan family segregating different clinical subtypes of hypoplastic and hypomineralized AI in different individuals within the family. Using targeted next-generation sequencing, the authors identified a novel heterozygous nonsense mutation in COL17A1 (c.1873C>T, p.R625*) segregating with hypoplastic AI and a novel homozygous 8-bp deletion in C4orf26 (c.39_46del, p.Cys14Glyfs*18) segregating with hypomineralized-hypoplastic AI in this family. This study highlights the phenotypic and genotypic heterogeneity of AI that can exist even within a single consanguineous family. Furthermore, the identification of novel mutations in COL17A1 and C4orf26 and their correlation with distinct AI phenotypes can contribute to a better understanding of the pathophysiology of AI and the contribution of these genes to amelogenesis.
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Affiliation(s)
- M K Prasad
- Laboratoire de Génétique Médicale, INSERM U1112, Institut de Génétique Médicale d'Alsace, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - S Laouina
- Department of Pediatric Dentistry, Faculty of Dental Medicine, Mohammed V University, Rabat, Morocco
| | - M El Alloussi
- Department of Pediatric Dentistry, Faculty of Dental Medicine, Mohammed V University, Rabat, Morocco
| | - H Dollfus
- Laboratoire de Génétique Médicale, INSERM U1112, Institut de Génétique Médicale d'Alsace, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
- Centre de Référence pour les Affections Rares en Génétique Ophtalmologique, Service de Génétique Médicale, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - A Bloch-Zupan
- Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaires, Centre de Référence des Manifestations Odontologiques des Maladies Rares, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Institut de Génétique et de Biologie Moléculaire and Cellulaire, CNRS UMR7104, INSERM U964, Centre Européen de Recherche en Biologie et en Médecine, Université de Strasbourg, Illkirch, France
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Kirk E, Prasad MK, Abdelhafiz AH. Hospital readmissions: patient, carer and clinician views. Acute Med 2006; 5:104-107. [PMID: 21611626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
To explore patients, carers, and clinician views and identify factors, which affect the likelihood of hospital readmission. Methods A cross sectional retrospective study of adult medical patients readmitted to hospital within 28 days of discharge. Medical and nursing records were reviewed and patients and their carers were interviewed regarding their views about their discharge and readmission. Data were collected regarding demographic, social and medical profiles. Results Seventy-seven patients were readmitted over a five-week period out of 1289 patients discharged during the previous five weeks, representing a 6% readmission rate. Mean (SD) age of readmitted patients was 71.3 (14.6) years. Forty patients (51.9%) were aged =75 and 39 (50.6%) were males. Mean (SD) number of comorbidities was 3.68 (1.82). Mean (SD) number of medications was 7.79 (4.14). Most common reasons for readmission were exacerbation of chronic obstructive pulmonary disease and acute coronary syndrome. Mean (SD) time to readmission was 11.6 (8.2) days. Fifty (64.9%) patients were readmitted within 14 days of discharge. Forty eight (62.3%) patients were readmitted with the same medical condition as their previous discharge. Fifty (64.9%) patients and 45 (66.2%) carers felt that discharge was appropriate. Forty five (58.0%) patients and 44 (57.0%) carers thought that readmission was unavoidable. Clinicians considered 56 (72.7%) discharges appropriate and 55 (71.5%) readmissions unavoidable. A trend towards higher readmission rate among patients = 75 years was noted (7.2% vs 5.1%, p=0.1). Conclusion Although the majority of discharges are appropriate, up to a third of readmissions may be avoidable in the views of carers, patients and clinicians. Patients and carers should be consulted regarding readiness for discharge before leaving hospital.
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Affiliation(s)
- Elinor Kirk
- Consultant Geriatrician, Department Of Elderly Medicine, Rotherham General Hospital, Moorgate Road, Rotherham, S60 2UD
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Batra YK, Prasad MK, Arya VK, Chari P, Yaddanapudi LN. Comparison of caudal tramadol vs bupivacaine for post-operative analgesia in children undergoing hypospadias surgery. Int J Clin Pharmacol Ther 1999; 37:238-42. [PMID: 10363622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
In a prospective double-blind study, 40 children scheduled for hypospadias repair were allocated randomly to receive either caudal tramadol (1 mg/kg) or 0.25% plain bupivacaine (0.5 ml/kg). Postoperative pain score, side-effects and oxygen saturation (SaO2) were recorded during 24-hour observation period. The results point toward a significantly lower pain scores with caudal bupivacaine in the immediate postoperative period, whereas caudal tramadol caused a significantly lower pain score in the late postoperative period. Total consumption of rescue analgesics was significantly higher in bupivacaine group as compared to tramadol group during the study period (p < 0.001). The incidence of side-effects such as vomiting was more frequent with caudal tramadol, but there was no detectable difference in SaO2. We conclude that caudal tramadol can safely be used for postoperative analgesia with a longer duration as compared to caudal bupivacaine.
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Affiliation(s)
- Y K Batra
- Department of Anaesthesiology, Post-Graduate Institute of Medical Education and Research, Chandigarh, India
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Prasad MK, Puri GD, Chari P. Glove finger for fixing pulse oximeter probe. Anaesthesia 1994; 49:831. [PMID: 7978157 DOI: 10.1111/j.1365-2044.1994.tb04482.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Villeneuve DM, Baker K, Drake RP, Sleaford B, Estabrook K, Prasad MK. Observation of plasma waves by Thomson scattering: Saturation of stimulated Raman scattering. Phys Rev Lett 1993; 71:368-371. [PMID: 10055253 DOI: 10.1103/physrevlett.71.368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Maxon S, Estabrook KG, Prasad MK, Osterheld AL, London RA, Eder DC. High gain x-ray lasers at the water window. Phys Rev Lett 1993; 70:2285-2288. [PMID: 10053522 DOI: 10.1103/physrevlett.70.2285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Peiris V, Prasad MK, Bradley D, Zawistowicz W, Sivayoham S, Naqvi SN, Hutchinson DN. Legionnaires' disease in elderly people: the first sign of an outbreak in the community? Age Ageing 1992; 21:451-5. [PMID: 1471585 DOI: 10.1093/ageing/21.6.451] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Legionella pneumophila is responsible for up to 5% of cases of community-acquired pneumonia and mainly affects people aged over 50 years. The confirmation of legionellosis in two elderly patients living close to each other prompted a search for other cases. A total of eleven subjects with legionnaires' disease was recognized. The clinical findings are described and the diagnosis of legionellosis is discussed. Environmental investigations pointed to a cooling tower in the local town centre as the probable source of infection.
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Affiliation(s)
- V Peiris
- Public Health Laboratory, Royal Preston Hospital
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