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All Journal Jurnal Kedokteran Syiah Kuala Jurnal Kesehatan Hesti Wira Sakti Indonesian Journal of Urology Folia Medica Indonesiana Jurnal NERS Indonesian Journal of Tropical and Infectious Disease Indonesian Journal of Cancer The Indonesian Biomedical Journal Sari Pediatri Paediatrica Indonesiana Health Notions Jurnal Respirasi (JR) Biomolecular and Health Science Journal Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Green Medical Journal Indian Journal of Forensic Medicine & Toxicology Asian Journal of Health Research

I Dewa Gede Ugrasena

Department Of Child Health, Faculty Of Medicine, Airlangga University/Dr. Soetomo Hospital, Surabaya, East Java, Indonesia

Author-ID : 2762736

Biochemistry, Genetics & Molecular Biology Dentistry Earth & Planetary Sciences Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Other

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Family Factors that Affect Family Empowerment in Caring Children with Leukemia Arief, Yuni Sufyanti; nursalam, Nursalam; Ugrasena, I Dewa Gede; Devy, Shrimarti Rukmini; Saudah, Noer
Health Notions Vol 2 No 4 (2018): April 2018
Publisher : Humanistic Network for Science and Technology (Address: Cemara street 25, Ds/Kec Sukorejo, Ponorogo, East Java, Indonesia 63453)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (182.305 KB)

Introduction: Leukemia is one of the conditions of chronic disease in children. Families of children with chronic health conditions often feel helpless in meeting their childs health care needs. Powerlessness experienced by the family will affect the ability of families in providing care to their children. Many factors can affect the empowerment of families in providing care to their families. Method: This study aims to analyze family factors that affect family empowerment in treating children with leukemia leukemia. The research design used is explanation survey. The population in this study were families with children suffering from leukemia in Pediatric Ward RSUD Dr. Soetomo Surabaya. Result: The results showed that there was the influence of family factor to family empowerment in caring children with leukemia equal to t: 3.801. Discussion and Conclusions: Family factors need to be taken into account in family-centered empowerment, so families can improve their ability to care for leukemia children. Increased family-based health involves the strength and ability of families in coping mechanisms, the role of nurses, to encourage families to provide support in health care. More research is needed on family-centered empowerment models in the ability to care for children with leukemia. Factors that affect family empowerment in caring for child leukemia, can be considered nurse in giving nursing intervention especially child nurse in empowering parent at the time care of child leukemia. Keywords: Leukemia, Children, Family, Factor, Empowerment

Profile of Neuron-Specific Enolase, Lactate Dehydrogenase, Fine Needle Aspiration Biopsy, and Bone Marrow Aspiration Examination to Diagnose Neuroblastoma Patients in Hematology Oncology Division of Pediatric Department at Dr. Soetomo General Hospital Mutiani, Faradillah; Ugrasena, I Dewa Gede; Soedewo, Fery Hudowo
Indonesian Journal of Cancer Vol 12, No 4 (2018): October-December
Publisher : National Cancer Center - Dharmais Cancer Hospital

Background: Neuroblastoma is a malignant solid tumour in children which attacks sympathetic nervous system. Despite of increment in its number of incidence, it is still rarely investigated. This research aims to improve the understanding of neuroblastoma based on the profile of patients, and further, to improve services for patients.Methods: This was a retrospective study conducted by assessing and descriptively analyzed patients medical record.Results: From 52 patients, 56% were male and 71% were between age of 1-5 years. Neuron Specific Enolase (NSE) examination showed that most patients had high levels in 29 patients (56%) while Lactate Dehydrogenase (LDH) examination showed that 23 patients (44%) had low levels. Based on Fine Needle Aspiration Biopsy (FNAB) examination, 22 patients (42%) showed formation of malignant round cell tumor. Meanwhile, through Bone Marrow Aspiration (BMA) examination, it was found that the tumors had already spread to bone marrow in 17 patients (33%).Conclusions: Based on tumor markers and pathological finding, this study revealed that the majority of neuroblastoma patients had poor prognosis.

Non-Genetic Risk Factors for The Formation of Factor VIII Inhibitors in Hemophilia A Patients in RSUD Dr. Soetomo Fauzi, Intani Dewi Syahti; Larasati, Maria C Shanty; Ugrasena, I Dewa Gede
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 1 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i1.1400

Background: Neutralizing alloantibodies (inhibitors) is one of the complications that affect the morbidity and quality of life of hemophilia patient and can be caused by multifactorials. Genetic and inhibitors examination are not routine and expensive. Therefore, identification of non-genetic factors is important to predict the formation of inhibitors. Objective: To analyze non-genetic risk factors for the formation of factor VIII inhibitors in children with Hemophilia A. Methods: A cross-sectional study of hemophilia children aged 1-18 years at the pediatric hematology oncology outpatient clinic of Dr. Soetomo hospital in March-April 2018. Factors analyzed included the severity of hemophilia, early age of diagnosis, initial age of therapy, type of replacement therapy, frequency of factor VIII administration, and severity of bleeding by bleeding score. Statistical analysis using Chi square, Fisher, ANOVA and logistic regression analysis. Results: A total of 29 children were evaluated, 7/29 mild, 15/29 moderate, and 7/29 severe hemophilia. Inhibitors were found in 11/29 subjects, 7/11 low (1-5 BU) and 4/11 high titer (> 5 BU). The initial age of diagnosis ≤ 1 year is associated with the formation of factor VIII inhibitors (OR 8.75; 95% CI = 1.5-50.2; p = 0.015). Severity of hemophilia, early age of therapy, type of replacement therapy, frequency of therapy, and bleeding score was not significantly associated with the formation of factor VIII inhibitors. Conclusion: The initial age of diagnosis less than 1 year is a significant risk factor for the formation of factor VIII inhibitors.

RISK FACTORS OF MORTALITY IN CHILDREN WITH WILMS’ TUMOR AT SOETOMO HOSPITAL SURABAYA Shanty, Maria Christina; Yuniarchan, Sherly; Andarsini, Mia Ratwita; Ugrasena, I Dewa Gede; Permono, Bambang; Prasetyo, Risky Vitria
Indonesian Journal of Urology Vol 26 No 2 (2019)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v26i2.469

Objective: Wilms’ tumor is the most common childhood renal tumor for about 6% of pediatric malignant disease. The 5-year survival rate in United States increased from approximately from 70% (1970-1973) to 92% (1989-1996). This study was aim to analyze the risk factors of mortality in children with Wilms’ tumor. Material & Methods: A cross-sectional study was conducted in children with Wilms’ tumor at Soetomo Hospital during 2006-2011. The data of demographic, clinical profile, complete blood count, blood urea nitrogen, glomerular filtration rate, histological type, disease stage, metastases and relapse were analyzed as risk factors of mortality using logistic regression. Results: There were 37 Wilms’ tumor children and 5 children were excluded because of incomplete data. The mean age was 3.0 (SD 2.6) years, and male-to-female ratio was 2.5 : 1. There were 5/32 children in stage I, 7/32 children in stage II, 8/32 children in stage III, 11/32 children in stage IV, and 1/32 children in stage V. There were 15/32 children underwent operation. Complete remission occurred in 12/32 children and 1/32 children relapsed. There were 20/32 children died, associated with anemia (P=0.033, OR=6.111, 95% CI=1.056-35.352) and advanced stage (P=0.021, OR=8.000, 95% CI=1.575-40.632). The risk of mortality increased 3.284 folds with every increased stage (P=0.007, 95% CI=1.338-7.775). Conclusion: Disease stage is the significant risk factor of mortality in children with Wilms’ tumor.

Role of Hepcidin in Pediatric Chronic Kidney Disease with Anemia Aras, Jusli; Kardani, Astrid Kristina; Soemaryo, Ninik Asmaningsih; Prasetyo, Risky Vitria; Noer, Mohammad Sjaifullah; Ugrasena, I Dewa Gede
Green Medical Journal Vol 3 No 3 December (2021): Green Medical Journal
Publisher : Fakultas Kedokteran Universitas Muslim Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33096/gmj.v3i3.87

Introduction: Anemia is a frequent complication of chronic kidney disease (CKD) in children and it causes an increase in morbidity, mortality and accelerates the rate of progression of CKD. Inflammation and impaired kidney clearance increase plasma hepcidin, inhibiting duodenal iron absorption and sequestering iron in macrophages. However, the role of hepcidin in increasing the risk of anemia in children with CKD is still uncertain. This study aimed to investigate the association between hepcidin levels and anemia in children with pre-dialysis CKD. Methods: A cross-sectional study was conducted at Dr. Soetomo Academic Hospital from December 2018 to February 2019. Children with pre-dialysis CKD were enrolled in this study. The subject had no history of erythropoietin administration and blood transfusion 3 months before the blood sample were withdrawn. A complete blood count, ferritin serum, transferrin saturation (TSAT) and hepcidin serum were performed. The correlations between Hepcidin and ferritin level, between ferritin level and anemia, and between TSAT and anemia were analyzed using Spearman correlation and the Mann-Whitney test. Results: A total of 47 children, 27 boys and 20 girls, ranged in age from 3 months to 18 years old. There was a significant correlation between hepcidin and ferritin levels (p=0.006) and the value of the Spearman correlation was r=0.392. While the correlation between ferritin level and anemia showed a significant result, p=0.001. However, TSAT did not show any significant correlation with anemia (p=0.230). Conclusion: There was an indirect association between hepcidin level and anemia by increasing ferritin level that induces anemia in pre-dialysis CKD children.

Family Factors that Affect Family Empowerment in Caring Children with Leukemia Yuni Sufyanti Arief; Nursalam Nursalam; I Dewa Gede Ugrasena; Shrimarti Rukmini Devy; Noer Saudah
Health Notions Vol 2, No 4 (2018): April
Publisher : Humanistic Network for Science and Technology (HNST)

Introduction: Leukemia is one of the conditions of chronic disease in children. Families of children with chronic health conditions often feel helpless in meeting their child's health care needs. Powerlessness experienced by the family will affect the ability of families in providing care to their children. Many factors can affect the empowerment of families in providing care to their families. Method: This study aims to analyze family factors that affect family empowerment in treating children with leukemia leukemia. The research design used is explanation survey. The population in this study were families with children suffering from leukemia in Pediatric Ward RSUD Dr. Soetomo Surabaya. Result: The results showed that there was the influence of family factor to family empowerment in caring children with leukemia equal to t: 3.801. Discussion and Conclusions: Family factors need to be taken into account in family-centered empowerment, so families can improve their ability to care for leukemia children. Increased family-based health involves the strength and ability of families in coping mechanisms, the role of nurses, to encourage families to provide support in health care. More research is needed on family-centered empowerment models in the ability to care for children with leukemia. Factors that affect family empowerment in caring for child leukemia, can be considered nurse in giving nursing intervention especially child nurse in empowering parent at the time care of child leukemia.Keywords: Leukemia, Children, Family, Factor, Empowerment

Microbiologically documented infection and antimicrobial sensitivities in pediatric malignancy patients with febrile neutropenia at Dr Saiful Anwar Hospital, Malang, Indonesia Savitri Laksmi Winaputri; Dominicus Husada; Budi Utomo; Irene Ratridewi; Susanto Nugroho; I Dewa Gede Ugrasena; Parwati Setiono Basuki; Ismoedijanto Ismoedijanto
Jurnal Kedokteran Syiah Kuala Vol 21, No 1 (2021): Volume 21 Nomor 1 April 2021
Publisher : Universitas Syiah Kuala

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24815/jks.v21i1.20903

Abstract. Background: Febrile neutropenia in malignancy children increase the risk of infection, morbidity and mortality. Microbiologically documented infection in pediatric malignancy has not been studied in Saiful Anwar Hospital. Purpose: Determine profile of blood, urine, sputum, and wound bed culture and antimicrobial sensitivities pattern in pediatric malignancy patients with febrile neutropenia. Methods: Pediatric malignancy patients with febrile neutropenia and microbiologically documented infection admitted to dr Saiful Anwar General Hospital Malang, were studied from 2016 to 2019. Bacterial and fungal etiology were identified, along with antimicrobial sensitivities patterns. Results: 53 (17%) of 307 pediatric malignancy patients with febrile neutropenia experienced 75 episodes of microbiologically documented infection. 40 (53,3%) gram-negative and 34 (45,3%) gram-positive isolated from 75 isolated pathogens. The most common gram-negative were Klebsiella pneumonia (n=15) and Escherichia coli (n=8). The most common gram-positive were Coagulase-negative Staphylococci (n=14) and Enterococcus faecalis (n=7). Escherichia coli, Coagulase-negative Staphylococci, Enterococcus faecalis, and Staphylococcus aureus were 100% sensitive to all tested antimicrobials. Klebsiella pneumonia and Acinetobacter baumanni were 100% sensitive to almost all tested antimicrobials. Pseudomonas aeruginosa was found less sensitive (0-80%) to all tested antimicrobials. Conclusion: Investigation of antimicrobial sensitivities of these organisms may guide successful antimicrobial therapy and improve quality of pediatric malignancy care. Abstrak. Latar Belakang: Demam neutropenia pada keganasan anak meningkatkan risiko infeksi, morbiditas dan mortalitas. Microbiologically Documented Infection merupakan masalah utama di dunia, namun belum dilakukan penelitian di RSUD Dr. Saiful Anwar. Tujuan: Melihat gambaran kultur darah, urine, sputum, dan dasar luka dan pola sensitivitas antimikroba pada keganasan anak dengan demam neutropenia. Metode: Pasien keganasan anak dengan demam neutropenia di bangsal Hemato-onkologi Departemen Ilmu Kesehatan Anak RSUD Dr. Saiful Anwar Malang dan terdiagnosis Microbiologically Documented Infection pada tahun 2016-2019, ditentukan etiologi, serta pola sensitivitas antimikroba. Hasil: Dari 307 pasien keganasan anak dengan demam neutropenia, 53(17%) pasien mengalami 75 episode microbiologically documented infection. Didapatkan 40(53,3%) bakteri gram negatif dan 34(45,3%) gram positif dari 75 hasil kultur. Bakteri gram negatif yang paling banyak ditemukan adalah Klebsiella pneumonia (n=15) dan Escherichia coli (n=8), serta Coagulase-negative Staphylococci (n=14) dan Enterococcus faecalis (n=7) pada gram positif. Escherichia coli, Coagulase-negative Staphylococci, Enterococcus faecalis, dan Staphylococcus aureus 100% sensitif terhadap semua antimikroba yang diuji. Klebsiella pneumonia dan Acinetobacter baumanni 100% sensitif terhadap hampir semua anitmikroba yang diuji. Pseudomonas aeruginosa memiliki sensitivitas rendah (0-80%) terhadap semua antimikroba yang diuji. Kesimpulan: Penelitian tentang sensitivitas antimikroba pada organisme tersebut dapat menjadi panduan untuk keberhasilan terapi dan meningkatkan kualitas pelayanan pada keganasan anak.

MTHFR C677T and TS 5’-UTR 3R/3R Gene Polymorphism in Methotrexate-Resistant Childhood Acute Lymphoblastic Leukemia I Dewa Gede Ugrasena; Harianto Notopuro; Subijanto Marto Sudarmo; Ketut Sudiana; Djajadiman Gatot; Ponpon Idjradinata
The Indonesian Biomedical Journal Vol 12, No 2 (2020)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v12i2.1109

BACKGROUND: Childhood acute lymphoblastic leukemia (ALL) is the most common pediatric malignancy in Indonesia and often treated by methotrexate (MTX). Though it can be cured in 30-60% of patients, MTX resistance remains the major cause of treatment failure in childhood ALL. Previous sudies showed that its anti-leukemic property was moderated by MTX ability to inhibitmethylene tetra hydrofolate reductase (MTHFR) and thymidylate synthase (TS) in folate metabolism. This study investigates the correlation between MTHFR and TS polymorphism and MTX resistance in ALL children.METHODS: A total of 155 subjects obtained from all subjects prior to chemotherapy. DNA from blood samples were extracted and underwent polymerase chain reactionrestriction fragment length polymorphism (PCR-RFLP) to evaluate MTHFR C677T and TS 5’-UTR 3R/3R polymorphism.RESULTS: There was significant correlation between MTHFR C677T and TS 5’-UTR 3R/3R gene polymorphism with MTX resistance. Subjectswith MTHFR C677T and TS 5’-UTR 3R/3R gene polymorphism were 4 times (p=0.007) and 6.4 times (p=0.001) more likely to be MTX resistant than those without gene polymorphisms, respectively.CONCLUSION: MTHFR C677T andTS 5’-UTR 3R/3R represent dominant gene polymorphism related to MTX resistance in childhood ALL.KEYWORDS: gene polymorphism, folate metabolism, acute lymphoblastic leukemia

Luaran Pengobatan Fase Induksi Pasien Leukemia Limfoblastik Akut pada Anak di Rumah Sakit Umum Dr. Soetomo Surabaya Widiaskara IM; Bambang Permono; Ugrasena IDG; Mia Ratwita
Sari Pediatri Vol 12, No 2 (2010)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp12.2.2010.128-34

Latar belakang. Kasus baru leukemia limfoblastik akut (LLA) menduduki peringkat pertama keganasanpada anak di RSU Dr. Soetomo â€“ SurabayaTujuan. Mengetahui gambaran klinis, laboratorium, dan melihat hasil aspirasi sumsum tulang pada faseinduksi pada pasien LLAMetode. Penelitian menggunakan rancangan deskritif, secara retrospektif menggunakan catatan medisterhadap pasien LLA selama 1 tahun (1 Januari 2006 s/d 31 Desember 2006). Semua pasien berumur<15 tahun yang pertama kali didiagnosis sebagai LLA dan belum mendapat terapi sitostatik. Pengobatanmenggunakan protokol Indonesia tahun 2006.Hasil. Didapatkan 82 pasien baru, umur 4 bulan â€“ 15 tahun, sebagian besar berumur antara 2 â€“ 5 tahun.Gambaran klinis berupa demam 70,7%, pucat 50%, perdarahan 62,1%, hepatomegali 60,9%, splenomegali52,4%. Pada aspirasi sumsum tulang fase induksi didapatkan remisi 33(48,5%), non remisi 10 (14,7%)dan meninggal 25 (36,8%), sisanya tidak dikerjakan oleh karena menolak sitostatik 6 pasien dan pulangpermintaan keluarga 8 pasien.Kesimpulan. Aspirasi sumsum tulang fase induksi didapatkan remisi 48,5 %, meninggal 36,8% dan nonremisi 14,7%. Pasien LLA dengan risiko tinggi mempunyai angka kematian 2 kali lebih tinggi daripadarisiko standar, dan penyebab kematian tersering adalah infeksi 19 (76%).

Gambaran Hematologi Anemia Defisiensi Besi pada Anak IM Widiaskara; PT Pramitha; I Wayan Bikin Suryawan; IDG Ugrasena
Sari Pediatri Vol 13, No 5 (2012)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp13.5.2012.362-6

Latar belakang.Anemia defisiensi besi (ADB) menjadi masalah kesehatan di dunia, baik di negara maju maupun negara berkembang seperti di Indonesia. Sekitar 30% penduduk dunia menderita anemia dan lebih dari setengahnya merupakan anemia defisiensi besi. Dampak negatif yang diakibatkan oleh anemia defisiensi besi pada anak balita sangat serius.Tujuan.Mengetahui gambaran hematologis anemia defisiensi besi pada anak yang dirawat di RSUD Wangaya Denpasar.Metode.Penelitian deskritif potong lintang, pada anak yang dirawat di RSUD Wangaya Denpasar pada periode Januari â€“ Juni 2009, umur 6-59 bulan. Diagnosis anemia defisiensi besi berdasarkan kriteria WHO, diberikan pengobatan bagi yang menderita ADB dengan sulfas ferosus (SF) selama 1 bulan. Hasil.Didapatkan 75 anak usia 6â€“59 bulan yang dirawat di RSUD Wangaya dengan anemia. Sebagian besar (52%) laki-laki, terbanyak usia 12 â€“ 35 bulan (46,7%) dan 65,3 % menderita dengan rerata kadar Hb, MCHC, SI, TIBC, saturasi transferin berturut-turut adalah 9,9 g/dl , 31,8 g/dl, 37,9 Ug/dl, 361 Ug/dl dan 12,3 %, HCT 30,7% dan feritin serum 75,6 ug/L. Pengobatan dengan SF selama 1 bulan menunjukkan peningkatan Hb 1 gr/dl dan HCT 2,8%.Kesimpulan.Anak yang dirawat dengan anemia 65,3% anemia defisiensi besi dan. sebagian besar (57,1%) mempunyai status besi yang kurang. Selama 1 bulan pengobatan dengan sulfas ferosus terjadi peningkatan Hb 1 gr % dan HCT 2,8%

Co-Authors Ahmad Suryawan Anang Endaryanto Andi Cahyadi Andi Cahyadi Andi Cahyadi Aras, Jusli Arief, Yuni Sufyanti Aryati Aryati Bambang Permono Budi Utomo Diah Kusuma Arumsari Dimarzsiana Dara Sjahruddin Djajadiman Gatot Djajadiman Gatot Dominicus Husada Dominicus Husada Eileen Savage Endang Retnowati Endang Retnowati Erawati Armayani Erfina Lim Esthy Poespitaningtyas Evisina Hanafiati Frans Fauzi, Intani Dewi Syahti Hapsari Widya Ningtiar Harianto Notopuro I Gusti Ayu Putu Eka Pratiwi I Wayan Bikin Suryawan I. G.A.A Putri Sri Rejeki IGAA Putri Sri Rejeki IM Widiaskara Intani Dewi Syahti Fauzi Irene Ratridewi Irwanto, Irwanto Ismoedijanto Kaoru Nishiyama Kardani, Astrid Kristina Kezia Warokka Putri Larasati, Maria C Shanty Mahrus A Rahman, Mahrus A Mangihut Rumiris Maria C Shanty Larasati Maria Christina Shanty Larasati Maria Christina Shanty Larasati Maria Christina Shanty Larasati Masafumi Matsuo Maulidia, Rahmawati Mia Ratwita Mia Ratwita Andarsini Mohammad Sjaifullah Noer Muchtaruddin Mansyur Muhammad Faizi Murti Andriastuti, Murti Mutiani, Faradillah Nathalya Dwi Kartikasari Ninik Asmaningsih Soemyarso Noer Saudah Noer Saudah, Noer Nunki, Nastasya Nursalam Nursalam Nursalam, Nursalam Parwati Setiono Basuki Ponpon Idjradinata Priscilla Putri Harmany PT Pramitha Puspa Wardhani R Fatchul Wahabe Retno Asih Retno Asih Setyoningrum Riadi Wirawan Rianto Setiabudy Risky Vitria Prasetyo Roedi Irawan S.Pd. M Kes I Ketut Sudiana . Savitri Laksmi Winaputri Shanty, Maria Christina Sherly Yuniarchan, Sherly Shrimarti Rukmini Devy Soedewo, Fery Hudowo Soeprapto Ma’at Sudarmo, Subijanto Marto Suprapto Ma'at Ma'at Susanto Nugroho Syntia TJ Taku Shirakawa Tanzilia, May Fanny Teddy Ontoseno Tigor Pandapotan Sianturi Widiaskara IM Yetti Hermaningsih Yetti Hernaningsih

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