Diving Into Diabetes

Diving Into Diabetes

por Diving Into Diabetes
Salud y estado físicoCiencias de la Vida
Temporada 3

Diabetes and data: digital ecosystems and connected devices for diabetes management

As technology advances, what are the current and future digital innovations that can best serve patients with diabetes and improve diabetes management? Our host, Dr. Ilana Halperin, discusses these innovations with Dr. Peter Lin, Director of Primary Care Initiatives at the Canadian Heart Research Centre, and a contributing author of the 2013 and 2018 Canadian Diabetes Guidelines. Our experts delve into the evolving role of continued glucose monitoring and how its increased usage can lead to positive patient behaviour change. Advances in insulin delivery are also discussed, and how connected innovations can lead to decreasing the burden on patients and healthcare providers. Finally, our speakers touch on the potential role for AI in diabetes management. Don’t miss the conversation! The views and opinions expressed in this episode are those of the speakers, and do not necessarily reflect the views or positions of any entities they represent. Declaration of conflict of interest: Dr. Ilana Halperin: Direct financial relationship, including receipt of honoraria: Sanofi, Novo Nordisk, Dexcom, Abbott. Membership on advisory board: Sanofi, Dexcom Dr. Peter Lin: Direct financial relationship, including receipt of honoraria: AstraZeneca, GlaxoSmithKline, Medexus, Moderna, Pfizer, Amgen, Novo Nordisk, Eli Lilly, Boehringer Ingelheim. Membership on advisory board or speaker’s bureaus: AstraZeneca, GlaxoSmithKline, Medexus, Moderna, Pfizer, Amgen, Novo Nordisk, Eli Lilly MAT-CA-2400907
T3 · E2
20 ago 2024
14:07

Timely basal insulin in T2D: A look at treatment intensification approaches in practice

Why does the timely addition of basal insulin remain an important issue in practice, despite the increasing use of glucagon-like peptide-1 receptor agonists (GLP1-RA) seen in recent years? Our host, Dr. Ronald Goldenberg, takes a deeper look into this topic with Dr. Meera Luthra, an endocrinologist at St. Joseph’s Healthcare Hamilton and Clinician Educator at McMaster University. The episode discusses clinical inertia and approaches you may use in practice for treatment intensification to improve glycemic control, particularly around initiating basal insulin, for patients with type 2 diabetes (T2D). The importance of real-world studies is discussed, namely, the RESTORE-G and DELIVER-G studies, in the context of the efficacy behind adding basal insulin to GLP1-RA therapy to optimize glycemic control. The RESTORE-G study examined treatment intensification approaches to adding basal insulin for patients with T2D already on a GLP1-RA therapy. The DELIVER-G study looked at the impact of the addition of second-generation basal insulin, glargine U300 for patients with T2D on GLP1-RA therapy. Our experts also dive into the relevance and applicability of some practical approaches for treatment intensification to improve glycemic control in clinical practice. Don’t miss the conversation! The views and opinions expressed in this episode are those of the speakers, and do not necessarily reflect the views or positions of any entities they represent. Declaration of conflict of interest: Dr. Ronald Goldenberg: Direct financial relationship, including receipt of honoraria: Abbott, Amgen, Bayer, Boehringer Ingelheim, CCRN, CMSKTRG, Eli Lilly, EOCI, Hamilton Academy of Medicine, HIT Global, HLS, Insulet, Janssen, LiV, LMC Physician Inc., MD Briefcase, Novartis, Novo Nordisk, Sanofi, SL Solutions, Unik, Virtual Hallway Consults Inc. Membership on advisory boards or speakers’ bureaus: Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, HLS, Janssen, Novo Nordisk, Sanofi. Funded grants, research, or clinical trials: Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck, Novo Nordisk, Sanofi. Dr. Meera Luthra: Direct financial relationship, including receipt of honoraria: Amgen, Bayer, Boehringer Ingelheim, Dexcom, Eisai, Pfizer, Eli Lilly, Novo Nordisk, Sanofi. Membership on advisory boards or speakers’ bureaus: Dexcom, HLS Therapeutics, Novo Nordisk, Sanofi. Funded grants, research, or clinical trials: None MAT-CA-2400799
T3 · E1
17 jun 2024
17:12
Temporada 2

New Guidelines on Hypoglycemia Management from Diabetes Canada

Hypoglycemia associated with commonly used diabetes medications can be distressing and potentially lethal. What are the latest recommendations on prevention and treatment of hypoglycemia from the Diabetes Canada Clinical Practice Guidelines (CPG)? Our host, Dr. Alexandria Ratzki-LeeWing, takes a deeper look into this topic together with Dr. Stewart Harris, a family doctor and professor at Western University in London. This episode discusses highlights from the 2023 CPG chapter updates on hypoglycemia in adults. Our speakers explore how guidance on hypoglycemia has evolved in these new recommendations, and its impact on diabetes care for both people living with diabetes and clinicians. They also touch on practical strategies to reduce hypoglycemia risk, and offer their perspectives on topics that may be expanded on in future CPG iterations. Don’t miss the conversation! The views and opinions expressed in this episode are those of the speakers and do not necessarily reflect the views or positions of any entities they represent. Declaration of conflict of interest: Dr. Ratzki-LeeWing Direct financial relationship including receipt of honoraria: Eli Lilly, Novo Nordisk, American Diabetes Association. Funded grants, research, or clinical trials: Sanofi Global. Dr. Harris: Direct financial relationship including receipt of honoraria or in-kind compensation: Abbott, AstraZeneca, Bayer Inc., Dexcom, Eli Lilly, HLS Therapeutics, Janssen, Novo Nordisk, Sanofi Aventis. Membership on advisory boards: Abbott, AstraZeneca, Bayer Inc., Dexcom, Eli Lilly, HLS Therapeutics, Janssen, Novo Nordisk, Sanofi Aventis. Funded grants, research, or clinical trials: Abbott, Applied Therapeutics Inc., AstraZeneca, Boehringer Ingelheim, Eli Lilly, Novartis, Novo Nordisk, Sanofi Aventis. MAT-CA-2400059
T2 · E5
21 feb 2024
8:05

New Insights on Type 2 Diabetes Remission from Diabetes Canada Guidelines

Diabetes remission is a concept that has been gaining attention as new treatments and interventions become available in the Diabetes Canada Clinical Practice Guidelines. How do we define diabetes remission, and what strategies can we employ to sustain it once it has been attained? Our host, endocrinologist Dr. Hertzel Gerstein, professor of medicine at McMaster University and Hamilton Health Sciences, takes a deeper look into this topic with Dr. Kaberi Dasgupta, a physician scientist and professor of medicine at McGill University and the McGill University Health Centre. This episode explores the latest updates from the Diabetes Canada Clinical Practice Guidelines on remission of type 2 diabetes (T2D) and other new approaches in development. In their discussion, they detail the definition of remission in diabetes and what it means for the patient, before explaining the importance of early intervention in T2D. Together, they review two approaches included in the Canadian clinical practice guidelines to achieving remission: bariatric surgery and low-energy diets. They also discuss the importance of sustaining weight loss by continuing to adhere to the same healthy diet and lifestyle modifications that were implemented to attain remission. Ongoing research efforts focused on prevention, treatment, and remission of diabetes continue to emerge, with more discoveries expected in the future. Don’t miss the conversation! The views and opinions expressed in this episode are those of the speakers and do not necessarily reflect the views or positions of any entities they represent. Declaration of conflict of interest: Dr. Gerstein Membership on advisory board or speakers’ bureaus: Sanofi, Lilly, Merck, AstraZeneca, DKSH, Zuellig, Novo Nordisk, Abbott, Pfizer, Kowa, Hanmi, Carbon Brand, Jiangsu Hanson Pharma. Funded grants, research, or clinical trials: Eli Lilly, Merck, AstraZeneca, Novo Nordisk Dr. Dasgupta: Funded grants, research, or clinical trials: CIHR, The Lawson Foundation, The JR McConnell Foundation. MAT-CA-2300840
T2 · E4
15 ago 2023
16:49

Closing the Loop in the Management of Type 1 Diabetes

Numerous challenges afflict patients with type 1 diabetes (T1D) throughout their disease journey. How can newer, more innovative management approaches help patients overcome these challenges? This episode discusses the challenges that regularly burden patients with T1D, and how recent technological breakthroughs, such as automated insulin pumps and continuous glucose monitoring (CGM), have been transformative in diabetes management. Our host, Dr. Ronald Goldenberg, takes a deeper look into this topic with Dr. Bruce Perkins, Professor, Endocrinologist, Epidemiologist, and Clinician Scientist in the Faculty of Medicine and the Institute for Health Policy Management and Evaluation at the University of Toronto, and Director of Leadership at the Sinai Centre for Diabetes. Together, they provide practical advice for patients and their healthcare team in managing T1D and discuss emerging developments that have the potential to shift the treatment paradigm in diabetes care. Don’t miss the conversation! The views and opinions expressed in this episode are those of the speakers, and do not necessarily reflect the views or positions of any entities they represent. Declaration of conflict of interest: Dr. Ronald Goldenberg: Direct financial relationship including receipt of honoraria: Abbott, Agora, Amgen, Antibody, AstraZeneca, Bayer, Boehringer Ingelheim, CCRN, CMSKTRG, Eli Lilly, EOCI, HIT Global, HLS, Inceptus, Janssen, LiV, Master Clinician Alliance, MD Briefcase, Merck, Mylan, Novo Nordisk, Sanofi, Script Medical, Servier, STA, Takeda, Toronto Knowledge Translation Working Group, Unik, Valeant. Membership on advisory boards or speakers’ bureaus: Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, HLS, Janssen, Merck, Novo Nordisk, Sanofi. Funded grants, research or clinical trials: Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck, Novo Nordisk, Sanofi. Dr. Bruce Perkins: Direct financial relationship including receipt of honoraria: Novo Nordisk, Sanofi, Abbott, Insulet, Medtronic. Membership on advisory boards: Abbott, Insulet, Novo Nordisk, Sanofi, Vertex. Funded grants, research, or clinical trials: Bank of Montreal, Novo Nordisk. Patent on a drug, product, or device: Boehringer Ingelheim. MAT-CA-2300841
T2 · E3
15 ago 2023
18:48

The Future of CGM Use in Type 2 Diabetes

With the abundance of various glucose monitoring technologies, how can healthcare providers guide patients with type 2 diabetes (T2D) toward the most appropriate choice? Our host, Dr. Ronald Goldenberg, takes a deeper look into this topic with Dr. Ilana Halperin, Endocrinologist at Sunnybrook Health Sciences Centre and Assistant Professor at the University of Toronto. This episode discusses the limitations of previous-generation glucose monitoring devices and highlights the advantages of continuous glucose monitoring (CGM) with an emphasis on the most important parameters, namely time-in-range (TIR), time-below-range (TBR), and coefficient of variation (CV). The importance of clinical trials is discussed, namely, the IMMEDIATE and two-part MOBILE studies in the context of CGM for T2D. The IMMEDIATE study examined the efficacy of intermittently scanned CGM in patients with T2D using non-insulin therapies. The MOBILE Phase 1 study explored the impact of CGM discontinuation after 8 months of use in adults with T2D treated using basal insulin without bolus insulin. Similarly, the MOBILE Phase 2 study assessed the effectiveness of CGM in adults with T2D treated with both basal insulin and bolus insulin in primary care practices. Our experts also dive into the relevance and applicability of these recent study findings to clinical practice. Don’t miss the conversation! The views and opinions expressed in this episode are those of the speakers and do not necessarily reflect the views or positions of any entities they represent. Declaration of conflict of interest: Dr. Ronald Goldenberg: Direct financial relationship including receipt of honoraria: Abbott, Agora, Amgen, Antibody, AstraZeneca, Bayer, Boehringer Ingelheim, CCRN, CMSKTRG, Eli Lilly, EOCI, HIT Global, HLS, Inceptus, Janssen, LiV, Master Clinician Alliance, MD Briefcase, Merck, Mylan, Novo Nordisk, Sanofi, Script Medical, Servier, STA, Takeda, Toronto Knowledge Translation Working Group, Unik, Valeant. Membership on advisory boards or speakers’ bureaus: Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, HLS, Janssen, Merck, Novo Nordisk, Sanofi. Funded grants, research or clinical trials: Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck, Novo Nordisk, Sanofi. Dr. Ilana Halperin: Direct financial relationship including receipt of honoraria or in-kind compensation: Abbott, Dexcom, Novo Nordisk, Sanofi. Membership on advisory boards: Dexcom, Sanofi. MAT-CA-2300748
T2 · E2
9 jun 2023
20:40

Debunking Myths Around Hypoglycemia

Hypoglycemia is a major concern for people living with diabetes; however, there are numerous myths and misconceptions surrounding its role in diabetes management. What are the common misunderstandings about hypoglycemia in diabetes care? Our host, Dr. Alexandria Ratzki-LeeWing, takes a deeper look into this topic together with Dr. Stewart Harris, a family doctor and professor at Western University in London. This episode explores the impact of hypoglycemia on individuals with diabetes, and examines its consequences and associated risks in everyday life. In the past decade, real-world evidence has emerged, with long-term prospective studies indicating an alarmingly high burden of severe hypoglycemia. Our speakers today cover practical strategies for preventing and managing hypoglycemia in patients with diabetes, such as patient education on identifying low blood glucose symptoms and promoting effective self-management. Other approaches discussed include employing newer therapies with reduced hypoglycemia risk or safer long-acting basal insulin, and leveraging technology such as continuous glucose monitors (CGMs) combined with regular consultations for optimal use. Don’t miss the conversation! The views and opinions expressed in this episode are those of the speakers and do not necessarily reflect the views or positions of any entities they represent. Declaration of conflict of interest: Dr. Ratzki-LeeWing Direct financial relationship including receipt of honoraria: Eli Lilly, Novo Nordisk, American Diabetes Association. Funded grants, research, or clinical trials: Sanofi Global. Dr. Harris: Direct financial relationship including receipt of honoraria or in-kind compensation: Abbott, AstraZeneca, Bayer Inc., Dexcom, Eli Lilly, HLS Therapeutics, Janssen, Novo Nordisk, Sanofi Aventis. Membership on advisory boards: Abbott, AstraZeneca, Bayer Inc., Dexcom, Eli Lilly, HLS Therapeutics, Janssen, Novo Nordisk, Sanofi Aventis. Funded grants, research, or clinical trials: Abbott, Applied Therapeutics Inc., AstraZeneca, Boehringer Ingelheim, Eli Lilly, Novartis, Novo Nordisk, Sanofi Aventis. MAT-CA-2300744
T2 · E1
30 may 2023
11:07
Temporada 1

Titration Investigation: Basal Insulin and Fixed-Ratio Combination Protocols

Titration is a crucial element for individuals with diabetes taking basal insulin to achieve their glycemic targets, so how do we ensure we’re doing it optimally? Our host, Dr. Ronald Goldberg, takes a deeper look into this topic with Dr. Irene Hramiak, a Professor of Medicine at Western University, and the current Department of Medicine Site Chief and Endocrinologist at St. Joseph’s Hospital. This episode discusses the history of basal insulin titration and how standard protocols have changed over time, with new advances brought on by clinical evidence from trials like the INSIGHT study, and patient empowerment. Our experts also take a deeper look into the recent LixiLan ONE CAN study, of which Dr. Hramiak was the primary investigator: Comparing a daily versus weekly titration algorithm in people with type 2 diabetes switching from basal insulin to iGlarLixi in the LixiLan ONE CAN randomized trial. Don’t miss the conversation! The views and opinions expressed in this episode are those of the speakers and do not necessarily reflect the views or positions of any entities they represent. Declaration of conflict of interest: Dr. Goldenberg: Direct financial relationship including receipt of honoraria: Abbott, Agora, Amgen, Antibody, AstraZeneca, Bayer, Boehringer Ingelheim, CCRN, CMSKTRG, Eli Lilly, EOCI, HIT Global, HLS, Inceptus, Janssen, LiV, Master Clinician Alliance, MD Briefcase, Merck, Mylan, Novo Nordisk, Sanofi, Script Medical, Servier, STA, Takeda, Toronto Knowledge Translation Working Group, Unik, Valeant. Membership on advisory boards or speaker’s bureau: Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, HLS, Janssen, Merck, Novo Nordisk, Sanofi. Funded grants, research or clinical trials: Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck, Novo Nordisk, Sanofi. Dr. Hramiak: Membership on advisory boards or speaker’s bureau including receipt of honoraria: CCRN, Canadian Medical & Surgical Knowledge Translation Research Group, Boehringer Ingelheim/Eli Lilly (BI-LILLY joint venture), Eli Lily & Co, Insulet Corp, Medtronic, Merck & Co Inc, Novo Nordisk, Sanofi-Aventis, Western University. Membership on advisory boards or speaker’s bureau: CCRN, Canadian Medical & Surgical Knowledge Translation Research Group, Boehringer Ingelheim/Eli Lilly (BI-LILLY joint venture), Eli Lily & Co, Insulet Corp, Medtronic, Merck & Co Inc, Novo Nordisk, Sanofi-Aventis. Funded grants, research or clinical trials: Eli Lilly, Novo Nordisk, Sanofi.
T1 · E12
1 feb 2023
13:39

Navigating the Diabetes Canada Algorithm for Pharmacologic Glycemic Management of Type 2 Diabetes

Diabetes Canada updated their recommendations for the pharmacologic glycemic management of type 2 diabetes in adults in 2020, but how can clinicians interpret and implement these guidelines in their everyday practice? Our host, Dr. Ronald Goldenberg, takes a deeper look into this topic with Dr. Peter Lin, the Director of Primary Care Initiatives at the Canadian Heart Research Centre and a Family Physician based in Toronto. He has been heavily involved in physician education, serving as an Associate Editor for the Elsevier WebPortal – Practice Update Primary Care, and was a contributing author to the 2013 and 2018 Diabetes Canada Clinical Practice Guidelines on Cardiovascular Protection in People With Diabetes. This episode discusses how the newly updated recommendations by Diabetes Canada have shifted the focus of pharmacologic management of type 2 diabetes, to now include consideration of other clinically relevant outcomes such as cardiovascular and renal benefits. Our experts take a comprehensive, in-depth walkthrough of the treatment algorithms presented in these updated guidelines. They also discuss practical considerations when selecting an antihyperglycemic agent at various points throughout the type 2 diabetes patient journey: at diagnosis; when reviewing, adjusting, or advancing therapy; and when starting or advancing insulin. Don’t miss the conversation! The views and opinions expressed in this episode are those of the speakers and do not necessarily reflect the views or positions of any entities they represent. Declaration of conflict of interest: Dr. Goldenberg: Direct financial relationship including receipt of honoraria: Abbott, Agora, Amgen, Antibody, AstraZeneca, Bayer, Boehringer Ingelheim, CCRN, CMSKTRG, Eli Lilly, EOCI, HIT Global, HLS, Inceptus, Janssen, LiV, Master Clinician Alliance, MD Briefcase, Merck, Mylan, Novo Nordisk, Sanofi, Script Medical, Servier, STA, Takeda, Toronto Knowledge Translation Working Group, Unik, Valeant. Membership on advisory boards or speaker’s bureau: Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, HLS, Janssen, Merck, Novo Nordisk, Sanofi. Funded grants, research or clinical trials: Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck, Novo Nordisk, Sanofi. Dr. Lin: Direct financial relationship including receipt of honoraria: Astrazeneca, BoehringerIngelheim, Bayer, Eli Lilly, Merck, Sanofi, Amgen, mdBriefCase, Canadian Heart Research Center, Bayer, Lincorp Medical Inc., CCRN, CoreCare, CHIEF, LMC Diabetes & Endocrinology Group, Diabetes Canada, Novo Nordisk, Humber River Hospital, Canadian Medical & Surgical Knowledge Translation Research Group, HLS, Medexus, Pri-med Canada, liV Agency, Meducomm, The Rounds, Peterborough Medical Society, the Peterborough Regional Health Centre Foundation and Peterborough Public Health, WebMD, Medscape, Moderna, LifeLabs, Acino. Membership on advisory boards or speaker’s bureau: Astrazeneca, Boehringer Ingelheim, Bayer, Eli Lilly, Merck, Sanofi, Amgen, mdBriefCase, Canadian Heart Research Center, Lincorp Medical Inc., CCRN, CoreCare, CHIEF, LMC Diabetes & Endocrinology Group, Diabetes Canada, Novo Nordisk, Humber River Hospital, Canadian Medical & Surgical Knowledge Translation Research Group, HLS, Medexus, Pri-medCanada, liV Agency, Meducomm, TheRounds, Peterborough Medical Society, the Peterborough Regional Health Centre Foundationand Peterborough Public Health, WebMD, Medscape, Moderna, LifeLabs, Acino.
T1 · E11
15 nov 2022
28:12

Exploring Second-Generation Basal Insulin Analogues 

Do second-generation basal insulin analogues really offer any advantages over their first-generation counterparts? Our host, Dr. Ronald Goldenberg, takes a deeper look into this topic with Dr. Alice Cheng, an endocrinologist at Credit Valley Hospital in Mississauga and St. Michael's Hospital in Toronto. She is also an Associate Professor in the Department of Medicine at the University of Toronto and the current the Chair of the Professional Section of Diabetes Canada and an Associate Editor for the Canadian Journal of Diabetes. This episode focuses on second-generation basal insulin analogues, and the clinical benefits they confer compared to previous generations. Dr. Cheng discusses how the design of next-generation basal insulin analogues allow flatter and longer time-action profiles, which translate to less hypoglycemia for those using it. Given that fear of hypoglycemia is a significant barrier for both physicians and patients, choosing therapies that limit those episodes can be an important consideration. Our experts also touch on the topics of biosimilars, populations for which second-generation basal insulin analogues may be most appropriate, and how different basal insulins can offer more dosing flexibility. Don’t miss the conversation! The views and opinions expressed in this episode are those of the speakers and do not necessarily reflect the views or positions of any entities they represent. Declaration of conflict of interest: Dr. Goldenberg: Direct financial relationship including receipt of honoraria: Abbott, Agora, Amgen, Antibody, AstraZeneca, Bayer, Boehringer Ingelheim, CCRN, CMSKTRG, Eli Lilly, EOCI, HIT Global, HLS, Inceptus, Janssen, LiV, Master Clinician Alliance, MD Briefcase, Merck, Mylan, Novo Nordisk, Sanofi, Script Medical, Servier, STA, Takeda, Toronto Knowledge Translation Working Group, Unik, Valeant. Membership on advisory boards or speaker’s bureau: Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, HLS, Janssen, Merck, Novo Nordisk, Sanofi. Funded grants, research or clinical trials: Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck, Novo Nordisk, Sanofi. Dr. Cheng: Direct financial relationship including receipt of honoraria: Abbott, Astra Zeneca, Bayer, Boehringer Ingelheim, Dexcom, Eli Lilly, Insulet, HLS Therapeutics, Janssen, Novo Nordisk, Sanofi, Takeda, Antibody, EOCI, Six Degrees, Liv, CPD Network, Canadian Collaborative Research Network, Master Clinical Alliance, Canadian Medical & Surgical Knowledge Translation Research Group, Sea Courses, Alliance of Best Practices in Health Education, Partners in Progressive Medical Education, Agence Unik, MD Briefcase, LMC Physician Inc., Meducomm, Humber Hospital, Timed Right, The ACADEMY. Membership on advisory boards or speaker’s bureau: Abbott, Amgen, Astra Zeneca, Bayer, Bausch, Boehringer Ingelheim, Dexcom, Eli Lilly, GSK, HLS Therapeutics, Insulet, Janssen, Merck, Medtronic, Novo Nordisk, Pfizer, Sanofi, Takeda. Funded grants, research or clinical trials: Applied Therapeutics, Sanofi.
T1 · E10
15 nov 2022
13:56
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