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Abahuje E, Abbas A, Abd El Aziz Abd El Maksoud M, Abdelhady A, Abdelhamid S, Abdelkarem Ahmed Faraj H, Abdelqader B, Abdou H, Abdullah A, Abedua Harrison M, Abem Owusu E, Aboalazayem A, Aboulhosn R, Abu Oda S, Abubakar A, Abutaka A, Acevedo Fontalvo D, Acuna S, Adefemi A, Adegbola S, Adenuga T, Adeyeye A, Adil Hilmi A, Aditya K, Adjeso T, Aftab R, Afzal A, Aggarwal V, Aggarwal A, Aguilera R, Aguilera-Arévalo ML, Aguirre Salamanca EJ, Aguirre-Allende I, Ahari D, Ahmad H, Ahmad Rauf F, Ahmad Zartasht Khan A, Ahmed S, Ahmed Fieturi N, Ahmed Mohamed S, Ahmed-Bakhsh Z, Ahsan Javed M, Akano L, Akbar A, Akhbari M, Akhmedov P, Aksit G, Akula Y, Al Majid S, Al Mukhtar O, Al Omran H, Al-Asali N, Al-Azzawi M, Al-Habsi R, Al-Iraqi H, Al-Naggar H, Alameer E, Albirnawi H, Aldulaijan F, Alejandro Miranda Ojeda R, AlHasan A, Ali S, Ali A, Ali Khan M, Alimova Y, Aljanadi F, Aljubure R, Allopi N, Almedbal H, Almubarak M, Alqaidoom Z, Alselaim N, Alshaar M, Alshammari R, Altaf K, Altıner S, Altunpak B, Alvarez Lozada LA, Amal Nahal E, Amer A, Amin K, Aminu U, Amisi Numbi N, Amjad T, Amoah R, An Y, Anastasopoulos NA, Andrés Urrutia J, Angarita F, Angarita KL, Ángel FreirÍa Eiras M, Antypas A, Anwar MA, Anwar H, Apampa TO, Apostolou K, Aquina C, Arachchige Adithi Himika Randeni R, Archila Godínez MI, Arez O, et alAbahuje E, Abbas A, Abd El Aziz Abd El Maksoud M, Abdelhady A, Abdelhamid S, Abdelkarem Ahmed Faraj H, Abdelqader B, Abdou H, Abdullah A, Abedua Harrison M, Abem Owusu E, Aboalazayem A, Aboulhosn R, Abu Oda S, Abubakar A, Abutaka A, Acevedo Fontalvo D, Acuna S, Adefemi A, Adegbola S, Adenuga T, Adeyeye A, Adil Hilmi A, Aditya K, Adjeso T, Aftab R, Afzal A, Aggarwal V, Aggarwal A, Aguilera R, Aguilera-Arévalo ML, Aguirre Salamanca EJ, Aguirre-Allende I, Ahari D, Ahmad H, Ahmad Rauf F, Ahmad Zartasht Khan A, Ahmed S, Ahmed Fieturi N, Ahmed Mohamed S, Ahmed-Bakhsh Z, Ahsan Javed M, Akano L, Akbar A, Akhbari M, Akhmedov P, Aksit G, Akula Y, Al Majid S, Al Mukhtar O, Al Omran H, Al-Asali N, Al-Azzawi M, Al-Habsi R, Al-Iraqi H, Al-Naggar H, Alameer E, Albirnawi H, Aldulaijan F, Alejandro Miranda Ojeda R, AlHasan A, Ali S, Ali A, Ali Khan M, Alimova Y, Aljanadi F, Aljubure R, Allopi N, Almedbal H, Almubarak M, Alqaidoom Z, Alselaim N, Alshaar M, Alshammari R, Altaf K, Altıner S, Altunpak B, Alvarez Lozada LA, Amal Nahal E, Amer A, Amin K, Aminu U, Amisi Numbi N, Amjad T, Amoah R, An Y, Anastasopoulos NA, Andrés Urrutia J, Angarita F, Angarita KL, Ángel FreirÍa Eiras M, Antypas A, Anwar MA, Anwar H, Apampa TO, Apostolou K, Aquina C, Arachchige Adithi Himika Randeni R, Archila Godínez MI, Arez O, Armonis P, Arshad S, Arshad Salman M, Arshid A, Arteaga Asensio PC, Arthur T, Arumuga Jothi A, Aryo Damara F, Asensio Gomez L, Ashcroft J, Ashraf S, Asif A, Asif A, Atif M, Attaullah Khan M, Avellaneda N, Awad S, Awadh M, Axiaq A, Ayad Mohammed Shuwayyah A, Ayalew D, Aytac E, Azam F, Azevedo J, Azhar B, Aziz J, Aziz A, Azzam A, Baba Ndajiwo A, Baig M, Baker D, Bakko F, Balachandran R, Balachandran G, Balagizi Mudekereza J, Balai E, Balci B, Balduzzi A, Balhareth A, Bandyopadhyay S, Bandyopadhyay S, Banerjee D, Bangalore Mahalinga D, Bankhead-Kendall B, Bankole NDA, Banwell V, Baris Bengur F, Baris Ozmen B, Barnard M, Barnett R, Barreras Espinoza JA, Barrios A, Bass G, Bass M, Bausys A, Bavikatte A, Bayram J, Beamish A, Beattie C, Belia F, Bellato V, Bellikatti S, Benjamens S, Benlice C, Bennedsgaard S, Bennett S, Bentounsi Z, Bergenfeldt H, Bhandoria G, Bhatia M, Bhatti MT, Bilgili Z, Bislenghi G, Bisset C, Biswas S, Blake J, Blanco R, Boccalatte L, Boden R, Bojanic C, Boland M, Boland P, Bollen E, Bonci EA, Booth A, Borakati A, Borunda Escudero GE, Bosco SJ, Boström P, Botelho de Alencar Ferreira Cruz P, Bouchagier K, Bouhuwaish A, Boutros M, Boyce K, Boyle C, Bradshaw L, Brandl A, Brar A, Brenkman H, Brennan C, Brines C, Brookmyre A, Brosnan C, Brouwers L, Brown A, Brown L, Brown C, Brown C, Brown J, BS V, Buksh M, Bunani Emmanuel M, Burbano D, 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Dawidziuk A, Dawson A, de Andres Crespo M, de Berker H, de Dieu Ngo P, de la Caridad Espinosa Luis R, de Lacy B, de Montserrat Medina Sifuentes A, De Silva S, del Rio C, Delaune V, Dell A, Demirbaş I, Demirli Atici S, Deniz Tepe M, Derebey M, Desai G, Desai M, Devarakonda S, Deveras N, Di Franco G, Di Martino M, Di Martino M, Di Marzo F, Díaz Á, Diaz del Gobbo G, Diaz-Castrillon C, Dick L, Dickinson K, Diego E, Dimasi I, Dingemans S, Dixon L, Dixon B, Doherty W, Dooreemeah D, Dornseifer M, Dossa F, Dossou W, Drake T, Drami I, Drevin G, du Plessis MC, Dudi-Venkata N, Dudley R, Duffy S, Duklas D, Dumbrava BD, Duygu Avlar F, Dworzynska A, Ebrahim W, Ebrahim A, Efrén Lozada Hernández E, Ehigie N, El Boghdady M, El Hasnaoui C, El Sheikh M, El-Hussuna A, Eldurssi O, Elfeki H, Elhadi M, Elhassan M, Elhissi A, Elliot B, Elsenbroek C, Elsolh B, Elson N, Eltyeb H, Emerson H, Endalle G, English W, Ercisli C, Espinosa G, Essam Abdelraheem M, Essangri H, Etienne P, Evans T, Ezeme C, Ezzahraa F, 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N, Kumar S, Kumar Bandyopadhyay S, Kumar Garg P, Kumar Venkatappa S, Kung J, Kural S, Kushairi A, Kuuzie E, Kvietkauskas M, Kwek I, La J, Lai L, Lakpriya S, Lam K, Lami M, Lapolla P, Larsen H, Latif J, Laudari U, Laurnezi A, Lawal A, Lawday S, Lederhuber H, Lednev A, Lee R, Lee R, Lefevbre G, Lesmus M, Leyva Moraga FA, Leyva Moraga E, Leyva Moraga F, Li HL, Li Z, Licardie E, Light A, Lin A, Lincango E, Litta F, Liu H, Lofthouse B, Londoño MA, Lopes R, Lopes de Freitas R, Lopez L, López AI, Lopez-Gomez J, Lopez-Pena G, Lowe R, Lowe D, Lowey M, Loy G, Lozanovski V, Luzon J, Lynn P, Maccabe T, Machielsen A, Mafla Herrería CA, Maggino L, Mahmood D, Mahmoud M, Mahtani K, Maitra I, Maji S, Majiet I, Mal L, Mal L, Malherbe J, Malhotra K, Malkomes P, Man E, Manan Sheikh A, Manjunath S, Manzano Nuñez R, Manzoor S, Maqsood R, Marchegiani G, Marchegiani G, Marchegiani F, Marín D, Marin A, Marks I, Marks I, Marson E, Martensen A, Martin D, Martín Martín G, Martin-Perez B, Martinez P, Marwaha P, Mashauri C, Mashbari H, Masior Ł, Masri R, Masud L, Masudi S, Mateu Calabuig G, Math S, Matrachisia A, Mazingi D, Mazzotta A, McAlinden J, McCabe G, McColm L, McElvaney H, McGivern K, McGovern J, McGuinness E, McInerney N, Mckay S, McKee C, McKenna M, McKenna N, McLean K, Mediratta S, Medkova Y, Medzhidov O, Mehraj A, Mekhael M, Mekinde O, Mellenthin C, Melucci A, Mentor K, Merchant J, Messias H, Meza C, Mhango P, Miladinov M, Milagros Niquen Jimenez M, Miller P, Mills E, Milton A, Mischlinger H, Möckli B, Modi R, Mohamed HM, Mohamed M, Mohamed Abulghasm T, Mohammad SA, Mohammed TO, Mohammed A, Mohan H, Mohan M, Moin I, Mok V, Molina G, Moloney J, Moneim J, Monfort Mira M, Montcusí Ventura B, Montouri M, Moossdorff M, Mora-Guzmán I, Moran B, Morán RAR, Moreno-Ordaz S, Morera Á, Morgan R, Morley R, Moro-Valdezate D, Moros S, Moss JL, Moynihan A, Moyón M, Muduli N, Mugla N, Mugla W, Müller P, Mun G, Mundhada R, Munir I, Muñoz F, Muñoz E, Muñoz A, Muñoz Balderas DC, Murgitroyd E, Murray V, Murthy S, Mushiwokufa W, Mustafa H, Mustakimov B, Mutambanengwe P, Myint P, Nadkarni S, Nadkarni S, Nahar S, Naidoo P, Nam R, Nandhra S, Nanjappa N, Narasimhan V, Nardi W, Nasir M, Nasir M, Naughton A, Naumann D, Navarro S, Nawaaz Karimbocus M, Nazir A, Ndereya S, Ndong A, Negoi I, Nel D, Nelson D, Nepal S, Neufeld J, Ng J, Ng J, Ng D, Ng CE, Ng J, Ngaserin S, Ngu L, Ngwenya E, Fhearaigh RN, Nikolousakis TK, Ninkovic M, Nita G, Nitschke C, Noren E, Noton T, Novikova A, Nowinka Z, Nyakunengwa T, Nyalundja A, Nzenwa I, Kristensen HØ, O’Brien L, O’Brien S, O’Reilly J, O’Rourke S, O’Sullivan M, O’Dwyer M, Ochieng L, Oderoha E, Oh KE, Öhlberger L, Ölçüm M, Olkina A, Omkumar M, Omnitel B, Oncel Yakar D, Ong K, Ong Wei Lin L, Ooi R, Ooi S, Oomman A, Oon Tyjet D, Opiyo S, Oscullo Yepez JJ, Osei-kuffour N, Osunronbi T, Ottlakán A, Oussama Kacimi S, Ovaere S, Ozair A, Pachler F, Pai Oo S, Paiella S, Panaiotti L, Panda N, Pandarinath S, Pandey D, Pandrowala S, Pandrowala S, Papa Mamadou F, Paranathala M, Park J, Parmar C, Parvez A, Pasovic L, Pasquer A, Pasumarthy N, Pata F, Patel T, Patel P, Patel N, Patel M, Patel P, Patron Uriburu N, Patrone R, Paul A, Pavan Kumar OM, Pavithran A, Pedraza Ciro M, Peloso A, Peña Gallardo MT, Peña Velazquez A, Perea J, Pérez-Sánchez LE, Perra T, Perrotta G, Petersson P, Petra G, Petrucciani N, Pickin C, Pino V, Pinotti E, Pinto F, Plum P, Podesta F, Pollini T, Pompeu Sá M, Ponce Leon F, Ponniah HS, Ponte de Sousa X, Ponton J, Pontula A, Popa M, Portilla AL, Posner F, Potolicchio A, Pouwels S, Povo A, Prasad P, Preciado S, Preece R, Proud D, Pulido Segura JA, Puliyath N, Qui M, Quimbaya Rodríguez AS, Raby-Smith W, Racoviţă A, Radwan R, Rafaih Iqbal M, Rafik A, Raguan B, Rahi M, Rahiri JL, Rahme J, Rai L, Raj A, Raj Saksena A, Raja M, Ramirez J, Ramzi J, Rao C, Rashid A, Ratnayake B, Rattanasirivilai K, Raubenheimer K, Ravikumar N, Ravn S, Razoz N, Rea W, Regan A, Rela M, Remme A, Rey Chaves CE, Reyes A, Riad A, Rice D, Rios Quintana K, 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Yalcinkaya A, Yang W, Yang PC, Yanishev A, Yanzon de la Torre A, Yao H, Yaqoob E, Yen Ling Quake S, Yeo D, Yeom B, Yershov D, Yiasemidou M, Yildiz A, Yiu A, Yong E, Yoshimura R, Younis MU, Younis Ringshawl Z, Youssef M, Yue Y, Yuen S, Yuldashev R, Yurttas C, Yves B, Zaborowski A, Zackeri R, Zafar A, Zahra W, Zaidi A, Zainudin S, Zakeri R, Zamora I, Zamora AT, Zawistowski M, Zbikowska G, Zegers W, Zehra S, Zeyra A, Zhagniyev Z, Zivanovic M, Zmuc J, Zope M, Zubayraeva A, Zucker B. BJS commission on surgery and perioperative care post-COVID-19. Br J Surg 2021; 108:1162-1180. [PMID: 34624081 DOI: 10.1093/bjs/znab307] [Show More Authors] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 07/26/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) was declared a pandemic by the WHO on 11 March 2020 and global surgical practice was compromised. This Commission aimed to document and reflect on the changes seen in the surgical environment during the pandemic, by reviewing colleagues' experiences and published evidence. METHODS In late 2020, BJS contacted colleagues across the global surgical community and asked them to describe how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had affected their practice. In addition to this, the Commission undertook a literature review on the impact of COVID-19 on surgery and perioperative care. A thematic analysis was performed to identify the issues most frequently encountered by the correspondents, as well as the solutions and ideas suggested to address them. RESULTS BJS received communications for this Commission from leading clinicians and academics across a variety of surgical specialties in every inhabited continent. The responses from all over the world provided insights into multiple facets of surgical practice from a governmental level to individual clinical practice and training. CONCLUSION The COVID-19 pandemic has uncovered a variety of problems in healthcare systems, including negative impacts on surgical practice. Global surgical multidisciplinary teams are working collaboratively to address research questions about the future of surgery in the post-COVID-19 era. The COVID-19 pandemic is severely damaging surgical training. The establishment of a multidisciplinary ethics committee should be encouraged at all surgical oncology centres. Innovative leadership and collaboration is vital in the post-COVID-19 era.
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MESH Headings
- Adult
- Biomedical Research/organization & administration
- COVID-19/diagnosis
- COVID-19/economics
- COVID-19/epidemiology
- COVID-19/prevention & control
- Education, Medical, Graduate/methods
- Education, Medical, Graduate/trends
- Female
- Global Health
- Health Resources/supply & distribution
- Health Services Accessibility/trends
- Humans
- Infection Control/economics
- Infection Control/methods
- Infection Control/standards
- International Cooperation
- Male
- Middle Aged
- Pandemics
- Perioperative Care/education
- Perioperative Care/methods
- Perioperative Care/standards
- Perioperative Care/trends
- Practice Patterns, Physicians'/standards
- Practice Patterns, Physicians'/trends
- Surgeons/education
- Surgeons/psychology
- Surgeons/trends
- Surgical Procedures, Operative/education
- Surgical Procedures, Operative/methods
- Surgical Procedures, Operative/standards
- Surgical Procedures, Operative/trends
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Meyer J, Dupret L, Galetti K, Regusci L, Grischott M, Malugani M, Mouhandes AEF, Danial AK, Khayat M, Sbahi MHE, Marawy MK, Abdullah MA, Douba Z, Mansour A, Niazi A, Hamza A, Mohamad AH, Awead M, Mohammad S, Salloum S, Jabar AA, Zazo A, Shebli B, Ayoub K, Younes L, Bannoud MH, Zazo R, Saad A, Hamdan A, Wakkaf H, Adra L, Souliman M, Anton M, Hannouf S, Li KL, Cheng KI, Ji SJ, Hsieh YC, Parlak EA, Demir M, Kara U, Peker YS, Yiğit D, Unal N, Iflazoğlu N, Yalkin Ö, Topal S, Gulcu B, Ozturk E, Gümbelek G, Terkanlıoğlu S, Koklucan A, Ince G, Sen M, Isik O, Kural S, Akesen S, Yilmazlar T, Sungurtekin H, Sungurtekin U, Vural U, Ozgen U, Isik A, Onk D, Kurnaz E, Ozker TS, Ipek A, Ferlengez A, Erturk C, Tatar C, Sevik H, Akay O, Sensoy O, Hayirlioglu MB, Aktas S, Ozben V, Aliyeva Z, Mutlu AU, Gökay BV, Saraçoğlu C, Aytaç E, Gülmez M, Işık MÜ, Hacim A, Akbas A, Soyhan F, Turgut MA, Demirgan S, Meric S, Altinel Y, Baris B, Akova E, Kahraman E, Kucuk HF, Saracoglu KT, Kaya S, Lel S, Gurbulak EK, 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Tezas S, Zaidi SN, Raj G, Wright J, Hallam S, Karandikar S, Gates Z, Marshall A, Thompson A, Tennakoon A, Rao M, Callan R, Tufail S, Rajendran G, Polisetty K, Husain N, Clarke N, Naranayanasamy S, Hallett A, Lorejo E, Ward N, Antakia R, Xanthis A, Simillis C, Tweedle E, Panagiotopoulou I, Grimes L, Mounstephen L, Bocancia R, Carden C, Lynch J, Noveros MS, Shaalan R, Khalil T, Marshall W, Hodge K, Balfour J, Mcintosh K, Buijs L, Yule M, Vaughan-Shaw PG, Smith S, Anderson T, Mcdermott FD, Daniels IR, Tapp J, Smart N, Rajaretnam N, Bethune R, Clark T, Delimpalta C, Liao C, Banham G, Induruwage L, Velchuru V, Lawrence A, Rahman A, Bennett J, Badawi M, Harshen R, Bhargava A, Gorrela K, Jumah M, Hanson M, Arya S, Atendido T, Shrestha A, Cook E, Rakhimov I, Collins J, Alamin N, Vigneswaran N, Basnyat P, Shamardal A, Chacko A, Wanshantha D, Bisheet G, Ebdewi H, Abdellatif M, Adu-Poku P, Tore A, Adams F, Allen K, Ahmed K, Kulkarni N, Chitnis A, Patel H, Magsino J, Sarodaya V, Minicozzi A, Dempsy C, Ahmed H, Jayasinghe JD, Okail MH, Thaha M, Hallworth S, Parmar C, Chua L, Pizanias M, Samin R, Young T, Sagar J, Yorkmui L, Cirocchi N, Ahmed S, Barreda SC, Kudchadkar S, Baker A, Jayasankar B, Jackson J, Abdelsaid K, Hassan M, Shetty S, Coldwell C, Davies E, Nader H, Raistrick M, Ryska O, Hawkin P, Raymond T, Witjes C, Van de Steen K, Crabtree N, Boyce S, Somera W, Woodward A, Ryan K, Kassai M, Aleem M, Keogh-Bootland S, Ghosh A, Rixson D, Lewis E, Lynch N, Shovelton C, Zywicka E, Guest F, Barton J, Purnell R, Bamford R, Teare T, Adams B, Chmielewski G, Smith L, Connolly L, Niblett R, Singh A, Halliwell G, Paraoan M, Doree N, Asaad P, Kilbride C, Carpenter H, Wilson J, Fletcher J, Vijayagopal KA, Abbakar M, Zaimis T, Walsh A, Kubisz-Pudelko A, Nono J, Pippard L, Chowdhary M, Dalton R, Moussa T, Dominguez F, Solla G, Curbelo J, Laurini M, Viola M, Brito N, Al-Alnsi A, Al-Naggar H, Saryah L, Al-Shehari M, Alsayadi R, Al-Hutheifi R, Shream S, Saeed S, Spurring EM. Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries. Br J Surg 2024; 111:znad370. [PMID: 38029386 PMCID: PMC10771257 DOI: 10.1093/bjs/znad370] [Show More Authors] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/10/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. METHODS The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. RESULTS A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). CONCLUSION Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov).
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