Macologic cardioversion also is considered in AF as strategy to reduce the chance of atrial remodeling and scarring, which set the stage for increasingly frequent AF episodes. Pharmacologic cardioversion is most effective when initiated within 7 days after AF onset.1 The agents with the strongest recommendations for first-line use in this setting when the ejection fraction is normal include flecainide oral 200 to 300 mg; intravenous [IV] at 1.5 to 3.0 mg per kg over 10 to 20 minutes ; , ibutilide IV at 1 mg over 10 minutes, repeating 1 mg when necessary ; , and propafenone oral 450 to 600 mg; IV at 1.5 to 2.0 mg per kg over 10 to 20 minutes ; .1 Note that these dosages listed in the American College of Cardiology American Heart Association [ACC AHA] guidelines may differ from those recommended by the manufacturers. ; In patients with persistent AF, success rates are about 65% to 90% with electrical cardioversion39 but the relapse rates without concomitant antiarrhythmic therapy are high.1 Because of the risk of torsades de pointes, pharmacologic cardioversion with the agents mentioned above is often performed on an inpatient basis.1, 2 In addition, care must be taken to identify patients with structural heart disease defined as a low left ventricular ejection fraction, left ventricular hypertrophy, or coronary artery disease. Patients with structural heart disease are limited to specific antiarrhythmic agents only.
This study demonstrated that virtual ligands with high probable affinity also bind to target protein in solution and, if so verified, might also be suitable as ligands in affinity chromatography when the position of their matrix attachment is evaluated at the earlier stages of the design and selection process. Materials and methods Molecular modeling, for example, propafenone hci.
Perphenazine phenazopyridine phenobarbital phenylephrine and pyrilamine phenytoin PHOSLO pilocarpine hcl PILOPINE H.S. pindolol PIPERACILLIN piroxicam PLAN B PLAVIX PLENAXIS PODOCON-25 podofilox poly iron polymyxin b sulfate tmp pot bicarb pot chloride ca potassium bicarb ca potassium chloride potassium gluconate pramoxine hydrocortisone pramoxine hydrocortisone cream pramoxine hydrocortisone lotion PRANDIN prazosin PRECOSE prednisolone acetate prednisolone sod phosphate prednisone PREMARIN PREMARIN LOW DOSE PREMPHASE PREMPRO PREMPRO LOW DOSE prenatal vitamins primaquine primidone PRO-BANTHINE probenecid procainamide prochlorperazine edisylate prochlorperazine Maleate PROGLYCEM PROGRAF PROLASTIN promethazine PROMETRUIM propafenone propoxyphene napsylate apap propranolol propylthiouracil PROQUAD PROTONIX PROVENTIL HFA PROVIGIL pseudophredrine and hydrocodone PULMICORT PYRAZINAMIDE pyridostigmine Q quinapril quinidine gluconate quinidine sulfate quniapril hctz.
Abnormality is detected, then further higher-level ultrasonology is required. Lachlan de Crespigny felt not whether ultrasound examinations should be introduced into the clinics but how they should be introduced. As far as costs are concerned he felt that the costs of ultrasound examinations should be compared with the benefits of the ultrasound not with the clinical examination or money spent on confinements. Lachlan made the point that it is not cost effective for ultrasound to be carried out by doctors without adequate skills because of the potentially poor outcome and medico-legal risk. Our patients deserve the best treatment - introduction of ultrasound in the gynaecology outpatient clinic and other hospital areas should not be the introduction of a second rate service, but rather it should improve patient management and outcomes. Lachlan suggested the introduction of an ultrasound service should involve consideration of: 1. Training and the limits of training 2. Continuing education for the ultrasound provider 3. Who pays for the trainer and the trainees time 4. Appropriate equipment for the task 5. Protocols for appropriate usage 6. Review of both photographic record of images and the clinical report should be undertaken, for example, pregnancy.
The AR-DRG classification takes both diagnoses and procedures if relevant ; into account, along with length of stay and other patient factors. It is therefore a composite view of hospitalisations and is useful for describing the overall nature of hospital care. In 200304, 72.4% of acute hospital separations in the public sector were for medical that is, non-surgical ; AR-DRGs 2.9 million ; , compared with 37.8% in the private sector 1.0 million ; . In contrast there was a larger proportion of separations for surgical AR-DRGs in the private sector 41.1% ; than in the public sector 20.7% ; see also Tables S32 and S33 ; . In public hospitals, separations with medical AR-DRGs increased by 13.8% between 199900 and 200304, while those with surgical AR-DRGs decreased by 3.9% and other AR-DRGs decreased by 3.7% in the same period. In private hospitals, separations with medical AR-DRGs also increased, by 36.4%, and those with surgical and other AR-DRGs increased by 26.6% and 27.1% respectively. Thus in 200304 the number of surgical separations from private hospitals 1.0 million ; exceeded those from public hospitals 0.8 million ; . The AR-DRGs with the highest numbers of separations in 200304 featured several for which same-day separations dominated Table 7.14 ; . Among these were the top two groups in public hospitals, Admit for renal dialysis 621, 000 public sector separations ; and Chemotherapy 127, 000 separations ; . Chemotherapy topped the list in the private sector 144, 000 separations ; , followed by Other colonoscopy, same-day 140, 000 separations ; . Vaginal delivery without complicating diagnosis was the most common AR-DRG that was usually not a same-day hospitalisation. This group was the third most common in public hospitals 90, 000 separations ; and the fifteenth most common in private hospitals 35, 000 separations.
Parallel Symposium Room: C-D What benefits does Process Analytical Technology PAT ; bring to the design and assurance of product quality? Co-chairs S. Folestad, Moelndal, Sweden J. Pritchard, Loughborough, United Kingdom Real-time prediction and control of quality the mechanistic approach to PAT S. Folestad, Moelndal, Sweden The benefits of PAT in ICH and Japanese regulation Y. Hiyama, Tokyo, Japan Benefits of PAT for bioprocesses: Process design and quality assurance at the example of fermentation processes for recombinant protein production A. Luebbert, Halle, Germany Evaluation of in-line near infrared spectroscopy for predicting tablet content uniformity during powder mixing H. M. J. Salokangas, Espoo, Finland MO-S05-1 ; Raman spectroscopy as a PAT in tablet manufacturing A. Sakr, Cincinnati, USA MO-S05-2 and rythmol.
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully. If you have any questions about this Notice, please contact: Morris Soler, FLMI AVP, Privacy Officer One Moody Plaza, Galveston, Texas 77550 409.766.6420 This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. "Protected health information" is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services. We are required by law to protect the privacy of your information, provide this notice about our information practices, and abide by the terms of this Notice of Privacy Practices. We may change the terms of our notice at any time. The new notice will be effective for all protected health information that we maintain at that time. You can request a copy of our notice at any time. 1. Uses and Disclosures of Protected Health Information We use protected health information about you for health care operations, underwriting, claims processing and policyholder service. For example, we would use or disclose protected health information to MIB, a non-profit membership organization of life and health insurance companies, which operates an information exchange on behalf of its members. Any other uses or disclosures of your protected health information will be made only with your written authorization. You may revoke this authorization at any time, in writing, except to the extent that we have taken an action in reliance on the use or disclosure indicated in the authorization. We may use or disclose identifiable information about you without your authorization for other reasons. Subject to certain requirements, we may disclose protected health information without your consent or authorization for public health purposes, for auditing purposes, for research studies, and for emergencies. We also provide protected health information when otherwise required by law, or for law enforcement purposes, legal proceedings, military activity and national security, to a coroner, funeral director or medical examiner, and when required by the Secretary of the Department of Health and Human Services. 2. Your Rights.
CONCLUSIONS Amiodarone and propafenone appear to be safe and equally effective in the termination of chronic atrial fibrillation. Left atrial diameter and arrhythmia duration are independent predictors of conversion. J Coll Cardiol 1999; 33: 966 ; 1999 by the American College of Cardiology and pyrazinamide.
1. Psychotropic drug use, total and by gender for the Texas foster care population n 29, 820 ; 2. Psychotropic drug use by race and age for the Texas foster care population n 29, 820 ; 3. Psychotropic drug use by age, race and gender in a mid-Atlantic foster care population n 12, 925 ; 4. Age, race and gender of a random sample of foster care medication recipients n 472 ; 5. Psychotropic drug class and subclass use in monotherapy or concomitant use n 472!
The authors summarize briefly their experiences and methods of administration of a number of drugs used in the treatment of hypertension. All the more common hypotensive drugs are briefly introduced, mode of administration discussed and the kind of response to be anticipated covered. This presentation is not concerned with the results of treatment carried out over periods of several months. As in all methods of medical treatment of hypertension, the proof of effectiveness can be determined only by trial. Predictability of effectiveness of a program of treatment is of a very low order; the physician may need to try various combinations of drugs in varying closes until a satisfactory program is achieved. They believe that physicians should approach the problem of medical treatment of essential hypertension with optimism, for this attitude coupled with information and skill produces gratifying results on many occasions. One need only recall the intense and prolonged effort devoted to the care of patients with such conditions as leukemia, malignancy and tuberculosis to justify the same devotion to the care of patients with essential hypertension. SIMON and
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Epidemiological studies consistently show that the majority of strokes are directly attributable to high blood pressure. An overview of reviews highlighted that the association of blood pressure and the risk of stroke is log linear.7 This means that for any given absolute decrease in blood pressure from a baseline level, there is a similar relative risk reduction of stroke. The.
If you notice other effects, not listed above, contact your doctor or pharmacist and
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Forty years ago, before there were big chain drug stores, all pharmacies were compounding pharmacies.
GSK R&D has over 16, 000 employees based at 24 sites in seven countries.The company has a leading position in genomics genetics and new drug discovery technologies. The GSK R&D budget is about 2.4 billion US$4 billion and
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Accept Caution Delay Refer No medical reason prevents performing the procedure in a routine setting. The procedure can be performed in a routine setting but with extra preparation and precautions. Delay the procedure. Condition must be treated and resolved before the procedure can be performed. Provide temporary methods. Refer client to a center where an experienced surgeon and staff can perform the procedure. Setting should be equipped for general anesthesia and other medical support. Provide temporary methods. WHO calls this category "Special, for instance, mechanism of action.
Global Schema specification IST-2000-30090 D5.3.1 Some national databases do not define a boundary feature but model administrative units only by area feature. In this case the boundary lines have be derived from the outlines of the area features. Temporal characteristics are not considered in the GiMoDig Global Schema. The date of the establishment of administrative features might become important if national datasets are merged that refer to administrative hierarchy at different position in time and rebetol.
Evidence suggests that between 29 percent and 46 percent of depressed patients fail to fully respond to antidepressant treatment with marketed drugs, for example, lanoxin.
Referenz 670a Neurologie, 11. Auflage ; Mitler MM, Guilleminault C, Harsh J et al for the US Modafinil in Narcolepsy Multicenter Study Group: Randomized trial of Modafinil for the treatment of pathological somnolence in narcolepsy. Ann. Neurol. 43, 88-97 1998 ; . Oder: Mizuno Y., Komori S., Shigetomo R., Kurihara E, Tamagawa K, Komiya K.: Poliomyelitis-like illness after acute asthma Hopkins syndrome ; : A histological study of biopsied muscle in a case. Brain Develop. 17, 126-129 1995 ; . Mitler MM, Guilleminault C, Harsh J et al for the US Modafinil in Narcolepsy Multicenter Study Group: Randomized trial of Modafinil for the treatment of pathological somnolence in narcolepsy. Ann. Neurol. 43, 88-97 1998 ; .Narcolepsy is a central nervous system disorder characterized by excessive daytime sleepiness and cataplexy. This placebo-controlled, double-blind, randomized, parallel-group, 18-center study assessed the efficacy and safety of modafinil, a new wake-promoting drug for treating sleepiness in narcolepsy. Subjects with narcolepsy n 283 ; received daily modafinil, 200 or 400 mg, or placebo, for 9 weeks, followed by an open-label treatment period. Subjective sleepiness was measured with the Epworth Sleepiness Scale. Objective sleepiness was assessed with the Multiple Sleep Latency Test and the Maintenance of Wakefulness Test. Level of illness was measured with the Clinical Global Impression of Change. Modafinil significantly reduced all measures of sleepiness and was associated with significant improvements in level of illness. Medication-related adverse experiences were few, dose-dependent, and mostly rated mild to moderate. Modafinil taken once daily was a very well tolerated and effective wake-promoting agent in the treatment of excessive daytime somnolence associated with narcolepsy. Modafinil demonstrated an excellent safety profile for up to 40 weeks of open-label treatment and efficacy was maintained, suggesting that tolerance will not develop with long-term use. Modafinil is a pharmacologically and clinically promising compound for the treatment of pathological daytime somnolence. Publication Types: * Clinical Trial * Multicenter Study * Randomized Controlled Trial Oder Mizuno Y., Komori S., Shigetomo R., Kurihara E, Tamagawa K, Komiya K.: Poliomyelitis-like illness after acute asthma Hopkins syndrome ; : A histological study of biopsied muscle in a case. Brain Develop. 17, 126-129 1995 ; . Department of Neuropediatrics, Tokyo Metropolitan Neurological Hospital, Japan. A case of Hopkins syndrome is presented. The patient was a 4-year-old boy who developed weakness of the right leg 2-3 days after a mild asthmatic attack. Needle electromyography revealed fasciculation discharges in the right gastrocnemius muscle. A histological study of the biopsied right quadriceps femoris muscle revealed scattered atrophic fibers, indicating lesions in the anterior horn cells of the spinal cord. This is the first reported case of Hopkins syndrome including muscle pathology. Publication Types: Review Review of Reported Cases and ribavirin.
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's without conducting any diagnostic test for gerd, like an endoscopy, figuring that success with the medicine will demonstrate that the patient's problem was excess acid.
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Numerous pre-clinical and clinical studies using P-gp modulating compounds like verapamil, cyclosporin A, reserpine, staurosporine, propafenone, phenoxazine, chloroquine, phenothiazine and their derivates have been undertaken to overcome MDR and several substances have been identified that are effective in vitro reviewed in [3] ; . However, to revert MDR in vivo, most MDR-modulating drugs require serum concentrations that have unacceptable toxicity and therefore they are currently not used in standard chemotherapy regimens. The development of better, less toxic inhibitors might be aided by insights into the specificity of these inhibitors for other molecules and the spectrum of molecules bound by P-glycoprotein. Two of the most commonly used MDR-modulating substances are verapamil and cyclosporin A CsA ; , or their derivates. Interestingly, CsA has recently been identified as an inhibitor of the 26S proteasome [4]. The 26S proteasome is a highly conserved multicatalytic protease responsible for ATP- and ubiquitin-dependent degradation of all short-lived and 7090% of all long lived proteins including cyclin A, B and E, p21 and p27, p53, cJun, cFos, and IB. As such, the 26S proteasome controls cell cycle, signal transduction pathways, apoptosis and major functions of the immune system. Indeed some of the immunosuppressive properties of CsA, such as decreases in the expression of MHC-I molecules on the surface of target cells [5] and apoptotic death of lymphocytes through inhibition of the transcription factor NF-B [6], may be due to its inhibitory effect on proteasome function. Vinblastine, a known P-gp substrate has also been shown to inhibit proteasome activity [7]. And, remarkably, the HIV protease inhibitor ritonavir was identified as an inhibitor of P-gp [8] and the proteasome [9]. Since CsA and ritonavir have been shown to inhibit both proteasome and P-gp activities, we questioned whether there was cross specificity between P-gp and proteasome activities. Cross specificity might explain effects of P-gp inhibitors on multiple cellular parameters that seem extrinsic to a pumping function of P-gp. Insights into substrate cross specificity of P-gp could offer a basis for the development of more selective P-gp inhibitors. They could also indicate reasons for the toxicity of these inhibitors, and why they affect cellular functions other than those related to P-gp. Using an in vitro model, we show that anthracyclines and verapamil both inhibit proteasome function. Additionally, we demonstrate that the proteasome inhibitor MG132 inhibits P-gp function, thereby increasing the uptake of doxorubicin in the cytoplasm and the nucleus and
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I can understand the cya-above-all-else policy, but in this case, though, i think patient education and discussion would be a far superior option than removing a novel drug from the shelves entirely.
Ref ID: 3328 72. Chaudhry GM, .Haffajee CI. Antiarrhythmic agents and proarrhythmia. Critical Care Medicine 2000; 28: N158-N164. Ref ID: 3329 73. Podrid PJ. Proarrhythmia, a serious complication of antiarrhythmic drugs. Current Cardiology Reports 1999; 1: 289-96. Ref ID: 3331 74. Mooss AN, Wurdeman RL, Mohiuddin SM, Reyes AP, Sugimoto JT, Scott W et al. Esmolol versus diltiazem in the treatment of postoperative atrial fibrillation atrial flutter after open heart surgery. American Heart Journal 2000; 140: 176-80. Ref ID: 2183 75. Hilleman DE, Reyes AP, Mooss AN, Packard KA. Esmolol versus diltiazem in atrial fibrillation following coronary artery bypass graft surgery. Current Medical Research & Opinion 2003; 19: 376-82. Ref ID: 1862 76. Intravenous digoxin in acute atrial fibrillation. Results of a randomized, placebo-controlled multicentre trial in 239 patients. The Digitalis in Acute Atrial Fibrillation DAAF ; Trial Group. European Heart Journal 1997; 18: 649-54. Ref ID: 3332 77. Jordaens L, Trouerbach J, Calle P, Tavernier R, Derycke E, Vertongen P et al. Conversion of atrial fibrillation to sinus rhythm and rate control by digoxin in comparison to placebo. European Heart Journal 1997; 18: 643-8. Ref ID: 3333 78. Falk RH, Knowlton AA, Bernard SA, Gotlieb NE, Battinelli NJ. Digoxin for converting recent-onset atrial fibrillation to sinus rhythm. A randomized, double-blinded trial. Annals of Internal Medicine 1987; 106: 503-6. Ref ID: 3334 79. Andrivet P, Boubakri E, Dove PJ, Mach V, Vu NC. A clinical study of amiodarone as a single oral dose in patients with recent-onset atrial tachyarrhythmia. European Heart Journal 1994; 15: 1396-402. Ref ID: 208 80. Boriani G, Capucci A, Lenzi T, Sanguinetti M, Magnani B. Prkpafenone for conversion of recentonset atrial fibrillation. A controlled comparison between oral loading dose and intravenous administration. Chest 1995; 108: 355-8. Ref ID: 2009 81. Botto GL, Bonini W, Broffoni T, Espureo M, Cappelletti G, Lombardi R et al. Randomized, crossover, controlled comparison of oral loading versus intravenous infusion of propafneone in recent-onset atrial fibrillation. Pacing and Clinical Electrophysiology 1998; 21: 2480-4. Ref ID: 2012 82. Boriani G, Biffi M, Capucci A, Botto G, Broffoni T, Ongari M et al. Conversion of recent-onset atrial fibrillation to sinus rhythm: effects of different drug protocols. Pacing and Clinical Electrophysiology 1998; 21: 2470-4. Ref ID: 2022 and tretinoin.
The means by which psychological gains are made remain obscure. It is clear from component studies that it is neither the case that specific interventions result in gains in the relevant variables only, and conversely that those gains are only made by the specific intervention, nor that gains are altogether non-specific with respect to inter-vention; 308 nor is it a simple matter of enhancing patient confidence or control. However, interpretation of studies of psychological treatment is problematic. As is clear from Tables 32 and 33, the majority of studies use component-dismantling approaches to address the question of the value of a particular component when added to others, or to a basic treatment. There is a fundamental problem.
Mechanism underlying the block of ito by proppafenone in human atrial myocytes lropafenone inhibited ito with an ic 50 value of 9 m figure 3 ; and its effect on ito showed no significant voltage- or use-dependence figures 4 and 5.
Sometimes physicians don't indicate a daw, in which case a phone call to them would be appropriate depending on the schedule of drug, of course.
It is especially important to check with your doctor before combining paxil with any of the following: alcohol antidepressants such as elavil, tofranil, norpramin, pamelor, prozac cimetidine tagamet ; diazepam valium ; digoxin lanoxin ; flecainide tambocor ; lithium eskalith ; phenobarbital phenytoin dilantin ; procyclidine kemadrin ; propafenone rythmol ; propranolol inderal, inderide ; quinidine quinaglute ; sumatriptan imitrex ; tryptophan warfarin coumadin ; special information if you are pregnant or breastfeeding the effects of paxil during pregnancy have not been adequately studied.
No current evidence supports using more than one of the approved drugs at a time and rythmol.
Guanfacine hydrochloride is a white to off-white powder; sparingly soluble in water and alcohol and slightly soluble in acetone. Each tablet, for oral administration, contains guanfacine hydrochloride equivalent to 1 mg or 2 mg guanfacine. In addition, each tablet contains the following inactive ingredients: microcrystalline cellulose, pregelatinized starch, and stearic acid. CLINICAL PHARMACOLOGY Guanfacine hydrochloride is an orally active antihypertensive agent whose principal mechanism of action appears to be stimulation of central 2-adrenergic receptors. By stimulating these receptors, guanfacine reduces sympathetic nerve impulses from the vasomotor center to the heart and blood vessels. This results in a decrease in peripheral vascular resistance and a reduction in heart rate. The dose-response relationship for blood pressure and adverse effects of guanfacine given once a day as monotherapy has been evaluated in patients with mild to moderate hypertension. In this study, patients were randomized to placebo or to 0.5 mg, 1 mg, 2 mg, 3 mg or 5 mg of guanfacine. Results are shown in the following table. A useful effect was not observed overall until doses of 2 mg were reached, although responses in white patients were seen at 1 mg; 24-hour effectiveness of 1 mg to 3 mg doses was documented using 24-hour ambulatory monitoring. While the 5 mg dose added an increment of effectiveness, it caused an unacceptable increase in adverse reactions. Mean Changes mm Hg ; from Baseline in Seated Systolic and Diastolic Blood Pressure for Patients Completing 4 to 8 Weeks of Treatment with Guanfacine Monotherapy Mean Change S D * Seated White Patients Black Patients n range ; 11-30 8 - 28 -1 -5 -3 -5 -6 -8 0 -2 -8 -9 -3 -5 -12 -11 -15 -12 -7 -7 -8 -9 -18 -16 -19 -15 Placebo 0.5 mg 1 mg 2 mg 3 mg 5 mg.
Insurance, patient advocacy groups, product manufacturers, insurance companies, and policy makers. In accordance with a presidential directive, a major federal initiative was launched, and the Quality Interagency Coordination QuIC ; Task Force was established in 1998 to reduce medical errors and improve patient safety in federally funded health care programs. Many private health care organizations are also examining their current patient safety efforts, and exploring ways to improve their records. M-CARE is among those organizations contributing to the national effort to increase patient safety. Since the release of the IOM report, M-CARE has begun meeting quarterly with representatives from other health plans, large employer groups, and hospitals in Southeast Michigan. The goals of these meetings are to raise awareness about patient safety among providers, identify the current status of patient safety efforts in our hospitals, and establish expectations for the future. Here are some other components of M-CARE's effort to reduce medical error and safeguard patients: M-CARE requires its participating physicians to be board-certified. Before a physician is accepted into the network, M-CARE does an extensive check of his or her credentials to ensure they meet our standards. M-CARE monitors the federal and state program fraud and abuse lists and removes physicians from the network who appear on those lists.
The Medicare-approved discount card fell short for seniors on two fronts. First, as noted in the Findings, private vendors participating in the discount card program consistently offered seniors and others in Medicare prices that were higher than the prices the government negotiated through the VA. Second, significant variations in drug prices between different discount cards made it hard for seniors to ensure that they got the lowest price the cards offered on all of the drugs they take.
Figure 11. Drug release profiles of Aminophyllin 125TM tablets in the paddle apparatus at 75 rpm ; and half of an Aminophyllin 125TM tablet in the mini paddle apparatus at paddle speeds of 50 ; , 75 ; , and 100 x ; rpm.
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