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    Seroprevalence SERO of SARS-CoV-2 Antibodies SERO Among 925 Staff Members in an Urban Hospital Accepting COVID-19 Patients in Osaka Prefecture, Japan

    Authors: Tsutomu Nishida; Hiromi Iwahashi; Kazuhiro Yamauchi; Noriko Kinoshita; Yukiyoshi Okauchi; Norihiro Suzuki; Masami Inada; Kinya Abe; Natalia G Herrera; Nicholas C Morano; Sean T Campbell; Erika P. Orner; Amanda Mengotto; M Eugenia Dieterle; Jens Maximilian Fels; Denise Haslwanter; Rohit Jangra; Alev Celikgil; Duncan Kimmel; James H Lee; Margarette Mariano; Antonio Nakouzi; Jose Quiroz; Johanna Rivera; Wendy A Szymczak; Karen Tong; Jason Barnhill; Mattias NE Forsell; Clas Ahlm; Daniel T. Stein; Liise-anne Pirofski; Doctor Y Goldstein; Scott J. Garforth; Steven C. Almo; Johanna P. Daily; Michael B. Prystowsky; James D. Faix; Amy S. Fox; Louis M. Weiss; Jonathan R. Lai; Kartik Chandran

    doi:10.1101/2020.09.10.20191866 Date: 2020-09-11 Source: medRxiv

    Background: The subclinical severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection MESHD rate in hospitals during the pandemic remains unclear. To evaluate the effectiveness of our hospital's current nosocomial infection control, we conducted a serological survey of the anti- SARS-CoV-2 antibody SERO (immunoglobulin G) among the staff of our hospital, which is treating coronavirus disease MESHD 2019 (COVID-19) patients. Methods: The study design was cross-sectional. We measured anti-SARS-CoV-2 immunoglobulin G in the participants using a laboratory-based quantitative test (Abbott immunoassay SERO), which has a sensitivity SERO and specificity of 100% and 99.6%, respectively. To investigate the factors associated with seropositivity, we also obtained some information from the participants with an anonymous questionnaire. Results: We invited 1133 staff members in our hospital, and 925 (82%) participated. The mean age TRANS of the participants was 40.0{+/-}11.8 years, and most were women (80.0%). According to job title, there were 149 medical doctors or dentists (16.0%), 489 nurses (52.9%), 140 medical technologists (14.2%), 49 healthcare providers (5.3%), and 98 administrative staff (10.5%). The overall prevalence SERO of seropositivity for anti-SARS-CoV-2 IgG was 0.43% (4/925), which was similar to the control seroprevalence SERO of 0.54% (16/2970)) in the general population in Osaka during the same period according to a government survey conducted with the same assay. Seropositive rates did not significantly differ according to job title, exposure to suspected or confirmed COVID-19 patients, or any other investigated factors. Conclusion: The subclinical SARS-CoV-2 infection MESHD rate in our hospital was not higher than that in the general population under our nosocomial infection MESHD control measures.

    Dental practice closure during COVID-19 and associated professional, practice and structural determinants: a multi-country survey

    Authors: Hams H Abdelrahman; Sara M Atteya; Merna Ihab; Myat Nyan; Diah Ayu Maharani; Anton Rahardjo; Mohammed Shaath; Khalid Aboalshamat; Sayda Butool; Anas Shamala; Lubna Baig; Maha El Tantawi

    doi:10.21203/rs.3.rs-59621/v1 Date: 2020-08-14 Source: ResearchSquare

    Background: The outbreak of novel coronavirus disease MESHD (COVID-19) in China has influenced every aspect of life worldwide. Due to the characteristics of dental settings, the risk of cross infection MESHD may be high between dental practitioners and patients. Being on the list of high-risk professions, dentists are very much expected to develop severe anxiety HP anxiety MESHD about the current pandemic situation. In addition, the limited provision of services and closure of dental practices raised concerns among dental professionals about the financial consequences of this closure. Therefore, the study assessed the extent of dental practice closure in various countries around the world, factors associated with this closure and whether closure and associated factors differed between private and non-private sectors.Methods: From April to May 2020, a web-based survey was sent to dentists in several countries. The survey assessed professional factors, practice factors and country-level structural factors. Multilevel logistic regression was used to assess the association of practice closure with these factors. Effect modification due to private and non-private sectors was assessed. Results: Dentists (n= 3243) participated from 29 countries. The majority (75.9%) reported practice closure with significantly higher percentage in the private than non-private sector. Fears were associated with significantly higher likelihood of closure in private (OR= 1.54, 95%CI= 1.24, 1.92) and non-private sectors (OR= 1.38, 95%CI= 1.04, 1.82). Non-private, governmental sector dentists (OR= 0.54, 95%CI= 0.31, 0.94) and those in rural areas (OR= 0.58, 95%CI= 0.42, 0.81) and those in hospitals (overall OR= 0.60, 95%CI= 0.36, 0.99) reported low likelihood of closure. High likelihood of closure was reported by those in academia (OR= 2.13, 95%CI= 1.23, 3.71). More hospital beds were associated with lower likelihood of closure in the non-private sector (OR= 0.65, 95%CI= 0.46, 0.91) and private sector dentists in high income countries (HICs) reported less closure than in non-HICs (OR= 0.55, 95%= 0.15, 1.93).Conclusions: Most dentists reported practice closure because of COVID-19 with greater impact in the private than non-private sectors with professional, practice and country-level factors associated.

    Microbial contamination of powered air purifying respirators (PAPR) used during the COVID-19 pandemic: an in situ microbiological study

    Authors: Abhijoy Chakladar; Claire Gabrielle Jones; Jimmy Siu; Mohammed Osman Hassan-Ibrahim; Mansoor Khan

    doi:10.1101/2020.07.30.20165423 Date: 2020-08-02 Source: medRxiv

    OBJECTIVE To determine whether internal components of powered air purifying respirators (PAPR) used during the Corona virus 2019 disease (COVID-19) pandemic are contaminated with bacteria, fungi and/or any viral material. DESIGN In situ microbiological study. SETTING Single NHS Trust, UK. OUTCOME MEASURES Growth of any bacteria or fungi, or positive polymerase chain reaction results for common respiratory viruses MESHD and severe acute respiratory syndrome coronavirus-2 MESHD (SARS-CoV-2) RESULTS 25 PAPR hoods were swabbed; ten (40%) returned positive results. Bacterial growth was detected on six hoods (bacillus simplex, kocuria rhizophilia, bacillus weihenstephensis, microcccus luteus and staphylococcus epidermidis MESHD); five of the hoods were positive for fungal growth (non-sporulating environmental mould, NSEM); all sampled hoods tested negative for both SARS-CoV-2 and an expanded panel of respiratory viruses. There was wide variation in the storage of cleaned hoods. CONCLUSION Despite following recommended cleaning procedures, bacteria and fungi can remain on the internal components of PAPR hoods, at levels significant enough to be swabbed and cultured. PAPR hoods have the potential to cross-infect MESHD wearers and patients and are used primarily by clinicians who fail to fit disposable FFP3 respirators; the female TRANS sex and non-Caucasian people are less likely to fit FFP3 respirators. The hoods tested cannot be adequately cleaned for use in high risk healthcare environments, PAPR hoods and tubes can act as fomites, and there are evident shortcomings in their provision.

    A severe coronavirus disease MESHD 2019 patient with high-risk predisposing factors died from massive gastrointestinal bleeding MESHD: a case report

    Authors: Taojiang Chen; Qin Yang; Hongyu Duan

    doi:10.21203/rs.3.rs-45116/v1 Date: 2020-07-17 Source: ResearchSquare

    Background: SARS-CoV-2 is highly infectious and has been a significant public health threat. Despite typical manifestations of illness are dominated by respiratory symptom, some patients have concurrent gastrointestinal manifestations, including   nausea MESHD, diarrhea HP diarrhea MESHD, and vomiting HP vomiting MESHD. Massive gastrointestinal bleeding MESHD, however, has rarely been reported. Case presentation: We herein describe a case of severe SARS-CoV-2 infected MESHD patient with several risk factors for poor prognosis, including male TRANS, hypertension HP hypertension MESHD, old age TRANS, mixed bacterial infection MESHD and multilobular infiltration on radiological imaging. After improvement of respiratory status, the onset of gastrointestinal bleeding MESHD occurred, probably resulting from direct viral invasion as evidenced by the positive findings for SARS-CoV-2 in the repeat stool specimens. Although aggressive resuscitation was administered, hematochezia HP hematochezia MESHD was uncontrolled. The patient rapidly deteriorated, suffered cardiac arrest HP cardiac arrest MESHD, and expired. Conclusions: Digestive symptoms could be severe in SARS-CoV-2 infected MESHD patients, especially for the high-risk individuals with predisposing conditions. A more thorough protocol for preventing cross-infection MESHD through faecal-oral transmission TRANS should be implemented in the process of patient care and infection MESHD control.

    Characterization of Microbial Co-infections MESHD infections in the Respiratory Tract HP of hospitalized COVID-19 patients

    Authors: Huanzi Zhong; Yanqun Wang; Zhun Shi; Lu Zhang; Huahui Ren; Weiqun He; Zhaoyong Zhang; Airu Zhu; Jingxian Zhao; Fei Xiao; Fangming Yang; Tianzhu Liang; Feng Ye; Bei Zhong; Shicong Ruan; Mian Gan; Jiahui Zhu; Fang Li; Fuqiang Li; Daxi Wang; Jiandong Li; Peidi Ren; Shida Zhu; Huanming Yang; Jian Wang; Karsten Kristiansen; Hein M Tun; Weijun Chen; Nanshan Zhong; Xun Xu; Yi-min Li; Junhua LI; Jincun Zhao

    doi:10.1101/2020.07.02.20143032 Date: 2020-07-05 Source: medRxiv

    Summary Background Severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) has caused a global pandemic of Coronavirus disease MESHD 2019 (COVID-19). However, microbial composition of the respiratory tract and other infected tissues, as well as their possible pathogenic contributions to varying degrees of disease severity in COVID-19 patients remain unclear. Method Between January 27 and February 26, 2020, serial clinical specimens (sputum, nasal and throat swab, anal swab and feces) were collected from a cohort of hospitalized COVID-19 patients, including 8 mildly and 15 severely ill patients (requiring ICU admission and mechanical ventilation), in the Guangdong province, China. Total RNA was extracted and ultra-deep metatranscriptomic sequencing was performed in combination with laboratory diagnostic assays. Co-infection MESHD rates, the prevalence SERO and abundance of microbial communities in these COVID-19 patients were determined. Findings Notably, respiratory microbial co-infections MESHD were exclusively found in 84.6% of severely ill patients (11/13), among which viral and bacterial co-infections MESHD were detected by sequencing in 30.8% (4/13) and 69.2% (9/13) of the patients, respectively. In addition, for 23.1% (3/13) of the patients, bacterial co-infections MESHD with Burkholderia cepacia complex (BCC) and Staphylococcus epidermidis MESHD were also confirmed by bacterial culture. Further, a time-dependent, secondary infection of B. cenocepacia with expressions of multiple virulence genes in one severely ill patient was demonstrated, which might be the primary cause of his disease deterioration and death MESHD one month after ICU admission. Interpretation Our findings identified distinct patterns of co-infections MESHD with SARS-CoV-2 and various respiratory pathogenic microbes in hospitalized COVID-19 patients in relation to disease severity. Detection and tracking of BCC-associated nosocomial infections MESHD are recommended to improve the pre-emptive treatment regimen and reduce fatal outcomes of hospitalized patients infected with SARS-CoV-2. Funding National Science and Technology Major Project of China, National Major Project for Control and Prevention of Infectious Disease MESHD in China, the emergency grants for prevention and control of SARS-CoV-2 of Ministry of Science and Technology and Guangdong province, Guangdong Provincial Key Laboratory of Genome Read and Write, Guangdong Provincial Academician Workstation of BGI Synthetic Genomics, and Shenzhen Engineering Laboratory for Innovative Molecular Diagnostics.

    Design of a Low-cost Miniature Robot to Assist the COVID-19 Nasopharyngeal Swab Sampling

    Authors: Shuangyi Wang; Kehao Wang; Hongbin Liu; Zengguang Hou

    id:2005.12679v1 Date: 2020-05-26 Source: arXiv

    Nasopharyngeal (NP) swab sampling is an effective approach for the diagnosis of coronavirus disease MESHD 2019 (COVID-19). Medical staffs carrying out the task of collecting NP specimens are in close contact TRANS with the suspected patient, thereby posing a high risk of cross-infection MESHD. We propose a low-cost miniature robot that can be easily assembled and remotely controlled. The system includes an active end-effector, a passive positioning arm, and a detachable swab gripper with integrated force sensing capability. The cost of the materials for building this robot is 55 USD and the total weight of the functional part is 0.23kg. The design of the force sensing swab gripper was justified using Finite Element (FE) modeling and the performances SERO of the robot were validated with a simulation phantom and three pig noses. FE analysis indicated a 0.5mm magnitude displacement of the gripper's sensing beam, which meets the ideal detecting range of the optoelectronic sensor. Studies on both the phantom and the pig nose demonstrated the successful operation of the robot during the collection task. The average forces were found to be 0.35N and 0.85N, respectively. It is concluded that the proposed robot is promising and could be further developed to be used in vivo.

    Comparison of initial thin-section CT features in coronavirus disease MESHD 2019 pneumonia HP pneumonia MESHD and other community-acquired pneumonia HP pneumonia MESHD

    Authors: Qiao Zhu; Cui Ren; Xiao Hua Wang

    doi:10.21203/rs.3.rs-29838/v1 Date: 2020-05-19 Source: ResearchSquare

    Background Coronavirus disease MESHD 2019 (COVID-19) pneumonia HP pneumonia MESHD caused similar symptoms to other community-acquired pneumonia HP pneumonia MESHD (CAP). It is important to early quarantine suspected patients with COVID-19 pneumonia HP pneumonia MESHD from patients with other CAP to reduce cross infection MESHD. The purpose of the study is to review and compare initial thin-section computed tomography (CT) features in patients with coronavirus disease MESHD 2019 (COVID-19) pneumonia HP pneumonia MESHD and other community-acquired pneumonia HP pneumonia MESHD (CAP). Methods 24 cases of COVID-19 pneumonia HP pneumonia MESHD (14 males TRANS and 10 females TRANS; age TRANS range, 14-87 years; mean age TRANS, 48.0 years) and 28 cases of CAP caused by other pathogens (13 males TRANS and 15 females TRANS; age TRANS range, 24-85 years; mean age TRANS, 49.5 years) were included. Thin-section CT features of the lungs for all patients were retrospectively reviewed by two independent radiologists. Results There were no significant differences for the shape of main lesions, pure ground glass attenuation (GGA), mixed GGA with consolidation, air bronchogram, linear opacities, halo sign/reversed halo sign, cavitation and lymphadenopathy HP lymphadenopathy MESHD between the group of COVID-19 pneumonia HP pneumonia MESHD and the group of other CAP. However, the frequency of crazy-paving appearance, vessel dilatation HP, bilaterally involvement and peripherally distribution were significantly higher in patients with COVID-19 compared with other CAP ( p =0.031, p =0.000, p =0.029 and p =0.009, respectively). Conversely, the frequencies of pure consolidation, tree-in-bud sign and pleural effusion HP pleural effusion MESHD were significantly higher in patients with CAP than in patients with COVID-19 pneumonia HP pneumonia MESHD ( p =0.002, p =0.000 and p =0.048, respectively). Conclusion There are considerable overlaps in thin-section CT features between COVID-19 pneumonia HP pneumonia MESHD and other CAP. However, the presence of crazy paving pattern, vessel dilation, bilateral involvement and peripheral distribution contributes to the diagnosis of COVID-19 pneumonia HP pneumonia MESHD. While the presence of pure consolidation tree-in-bud sign, pleural effusion HP pleural effusion MESHD can be assisting in exclusive the diagnosis of COVID-19 pneumonia HP pneumonia MESHD.

    Novel ACE2-Independent Carbohydrate-Binding of SARS-CoV-2 Spike MESHD Protein to Host Lectins and Lung Microbiota

    Authors: Fabrizio Chiodo; Sven C.M Bruijns; Ernesto Rodriguez; R.J. Eveline Li; Antonio Molinaro; Alba Silipo; Flaviana Di Lorenzo; Dagmar Garcia-Rivera; Yury Valdes-Balbin; Vicente Verez-Bencomo; Yvette van Kooyk

    doi:10.1101/2020.05.13.092478 Date: 2020-05-14 Source: bioRxiv

    The immediate call for translational research in the field of coronavirus disease MESHD (COVID-19) pandemic, needs new and unexplored angles to support and contribute to this important worldwide health problem. The aim of this study is to better understand the pathogenic mechanisms underlying COVID-19, deciphering the carbohydrate-mediated interactions of the SARS-CoV-2 spike protein. We studied the carbohydrate-binding receptors that could be important for viral entry and for immune-modulatory responses, and we studied the interactions of the spike protein with the host lung microbiota. Exploring solid-phase immunoassays SERO, we evaluated the interactions between the SARS-CoV-2 spike protein and a library of 12 different human carbohydrate-binding proteins (C-type lectins and Siglecs) involved in binding, triggering and modulation of innate and adaptive immune-responses. We revealed a specific binding of the SARS-CoV-2 spike protein to the receptors DC-SIGN, MGL, Siglec-9 and Siglec-10 that are all expressed on myeloid immune cells. In addition, because the lung microbiota can promote or modulate viral infection, we studied the interactions between the SARS-CoV-2 spike protein and a library of Streptococcus pneumoniae HP capsular polysaccharides, as well as other bacterial glyco-conjugates. We show specific binding of the spike protein to different S. pneumoniae HP capsular polysaccharides (serotypes 19F and 23F but not to serotype 14). Moreover we demonstrated a specific binding of SARS-CoV-2 spike protein to the lipopolysaccharide from the opportunistic human pathogen Pseudomonas aeruginosa, one of the leading cause of acute nosocomial infections MESHD and pneumonia HP pneumonia MESHD. Interestingly, we identified rhamnosylated epitopes as one of the discriminating structures in lung microbiota to bind SARS-CoV-2 spike protein. In conclusion, we revealed novel ACE2-independent carbohydrate-mediated interactions with immune modulating lectins expressed on myeloid cells, as well as host lung microbiota glyco-conjugates. Our results identified new molecular pathways using host lectins and signalling, that may contribute to viral infection MESHD and subsequent immune exacerbation. Moreover we identified specific rhamnosylated epitopes in lung microbiota to bind SARS-CoV-2, providing a hypothetical link between the presence of specific lung microbiota and SARS-CoV-2 infection MESHD and severity.

    Pre-Procedural Surveillance Testing for SARS-CoV-2 in an Asymptomatic TRANS Population Shows Low Rates of Positivity

    Authors: James A Mays; Alexander L Greninger; Keith R Jerome; John B Lynch; Patrick C Mathias

    doi:10.1101/2020.05.08.20078592 Date: 2020-05-12 Source: medRxiv

    Introduction Seattle region hospitals have been severely impacted for several months by ongoing community spread of the novel coronavirus 2019 disease. (1,2) Although testing was initially focused on the diagnosis and treatment of symptomatic patients, this effort has now expanded to include surveillance of asymptomatic TRANS patients in order to protect health care workers and prevent nosocomial infections MESHD. There is an urgent need to understand best practices for the delivery of routine medical care during an ongoing outbreak. (3) Here we report the rates of SARS-CoV-2 infection MESHD in asymptomatic TRANS patients screened prior to admission or a surgical or aerosolizing procedure. Methods Beginning March 30, 2020, our hospital began screening all asymptomatic TRANS patients prior to needed surgeries and aerosolizing procedures (n=350). On April 13, 2020, we expanded this practice to universal surveillance screening of all patients prior to admission (n=349). Testing was performed on nasopharyngeal swabs using the Washington state emergency use authorized University of Washington CDC-based laboratory-developed test or FDA authorized DiaSorin Simplexa SARS-CoV-2, Hologic Panther Fusion SARS-CoV-2, or Roche cobas SARS-CoV-2 tests. This study was approved by the Institutional Review Board of University of Washington Medical Center (STUDY00009734). Informed consent was not required. Results For patients undergoing surgical or aerosolizing procedures, 3 of 350 patients (0.9%) were positive for SARS-CoV-2. For patients who were asymptomatic TRANS and tested at the time of admission, 3 of 349 patients (0.9%) were positive and 2 of 349 (0.6%) were inconclusive; inconclusive results were treated as low-level positives. For asymptomatic TRANS patients tested for any other reason (e.g. exposure risk), 12 of 157 patients (7.6%) were positive and 1 of 157 (0.6%) were inconclusive. Meanwhile, of the 473 inpatients in this period who had any symptom concerning for COVID-19, 68 of 473 patients (14.3%) were positive. There was a variety of ordering services and locations in all indication categories, with no particular predominating medical service or location. During this time period the outpatient prevalence SERO of SARS-CoV-2 active infection MESHD in our region was 3-5% (manuscript in review). Discussion The application of universal surveillance testing for SARS-CoV-2 in patients prior to surgery or aerosolizing procedure shows that the positivity rate for SARS-CoV-2 is low (<1%) in asymptomatic TRANS patients without known exposure risk factors. The positivity rate for asymptomatic TRANS patients on admission screen was similar; both measures were notably lower than recently reported measurements during an outbreak in New York City that found a positivity rate of 13.7% in asymptomatic TRANS pregnant women. (4) The rate of sub-clinical infection likely varies with the scale of the community outbreak. Even in the context of a community-wide outbreak, our data show a low prevalence SERO of COVID-19 infection MESHD in the urgent pre-procedural setting. These data reflect the prevalence SERO of asymptomatic TRANS SARS-CoV-2 infection MESHD in a population of individuals who use medical services and provide an assessment of exposure risk to other patients and healthcare workers around the time of admission. The Greater Seattle Coronavirus Assessment Network ( SCAN MESHD) also recently published results from the first 18 days of home-based testing and reported no positive tests in 1392 patients reporting no COVID-19-like illness. (5) Although other studies support a large proportion of asymptomatic TRANS infections, the data from this metropolitan outbreak do not support a similar pattern. Clinical providers, especially those involved in performing procedures that have a risk of aerosolization, are asking for methods to risk-assess patients prior to the procedure. Pre-procedure testing is one option to accomplish this goal. Importantly, in the midst of an outbreak, testing prior to procedures can decrease the use of PPE, identify appropriate precautions for patients, and reduce the risk of nosocomial infection MESHD.

    COVID-19 versus non-COVID-19 pneumonia HP pneumonia MESHD: A retrospective cohort study

    Authors: Xiao-jin Li; Bing-Xing Shuai; Zhong-Wei Zhang; Yan Kang

    doi:10.1101/2020.04.28.20082784 Date: 2020-05-01 Source: medRxiv

    Background and Objective: Since the outbreak of coronavirus disease MESHD 2019 (COVID-19) in December 2019 in Wuhan, Hubei Province, China, it has spread around the world and become a global public health emergency. It is important to distinguish COVID-19 from other viral pneumonias HP pneumonias MESHD in order to properly screen and diagnose patients, reduce nosocomial infections MESHD, and complement the inadequacy of nucleic acid testing. In this study, we retrospectively analysed the clinical data of COVID-19 versus non-COVID-19 patients treated at our hospital between January 17 and February 27, 2020 in order to summarize our clinical experience in the differential diagnosis of COVID-19. Methods: In this retrospective cohort study, 23 confirmed COVID-19 patients were consecutively enrolled from January 17 to February 27, 2020, while 29 confirmed non-COVID-19 patients were enrolled in West China Hospital of Sichuan University. We collected baseline data, epidemiological data, clinical characteristics, imaging findings, viral nucleic acid test results, and survival data. SPSS v22.0 was used for statistical analysis. Outcomes were followed up until March 25. Results: A total of 52 patients were included in this study, including 23 COVID-19 patients and 29 non-COVID-19 patients. No significant between-group difference was observed in age TRANS, sex, primary signs or symptoms, cellular immunity, or platelet count. Significant between-group differences were observed in clinical characteristics such as dry cough MESHD cough HP, contact with individuals from Wuhan, some underlying diseases, nucleated cell count, chest imaging findings, viral nucleic acid test result,28-day mortality, and 28-day survival. Conclusion: Epidemiological data, clinical symptoms, nucleic acid test results for COVID-19 and chest CT manifestation may help distinguish COVID-19 from non-COVID-19 cases, prevent imported cases and nosocomial infections MESHD.

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Human Phenotype
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