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would this be a crazy thing to do?

Discussion in 'Pre-Medical - MD' started by percywilkins, May 11, 2007.

  1. percywilkins

    percywilkins Junior Member
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    First of all, here are my stats:

    Graduated from UWisconsin-Madison in 3 years (graduating this month) with a 3.85 gpa and 3.7 science gpa, majoring in political science. Studied abroad one semester in galway ireland. 1 year of clinical psychology research. 32 mcat (9 VR, 12 PS, 11 BS). will start an IRTA post-bacc research fellowship at the NIH doing alcoholism research, somewhat related to the research I did in undergrad).
    volunteered, yadda yadda.


    Ok, now here is the question. I was diagnosed with ADHD in my soph year of high school. I have taken tests with extended time, and have usually done far better on them because I simply cannot focus 100 percent of the time and will take longer to complete most exams. However, with this MCAT, I did not request extended time, because I felt that since the adcoms would know that I had the extra time, they would not take my score seriously. Recently, I found out through my doctor that the reason for my "ADHD" is because my brain receives 15-20 percent less oxygen than it should due to the fact that I am a mouth breather and cannot breath through my nose for anatomical reasons that require surgery to fix. because of this, I am kind of pissed because this means I truly have a disability that can be fixed in the near future, and am thinking about taking the MCAT with extra time this next spring.

    My question: I REALLY want to get into a top 10 school, because I am positive I want to enter into an extremely competitive specialty (integrated plastics). Do you think it would be crazy to apply for extended time on the MCAT, take the MCAT this spring, take 2 years off to do research instead of one, and apply to med school next year instead of this year? I know I would do far better on it, because on all my practice tests, I would pretty much get every question right on all of the questions I did get to, but would have to bubble in C's for the last 12-15 questions on each section (which is what I had to do for the real MCAT too).

    help!

    thank you.
     
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  3. inside_edition

    inside_edition Waitlisted Member
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    breathing through the mouth means that much less oxygen?
     
  4. Madame

    Madame SDN Mentor
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    Have surgery & retake after you have your nasal obstruction corrected even if it means taking 2 years off rather than just one.

    It is very likely that if you retake the MCAT with "non-standard conditions" that the adcom is going to be tempted to see your first attempt as a more valid measure of your ability and discount the second attempt so you will have gained nothing by retaking.

    Getting into a good school is not the best predictor of getting into an integrated plastics residency. Much depends on your personal performance in medical school including the step 1 exam and your clerkships.
     
  5. percywilkins

    percywilkins Junior Member
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    Yes, breathing through your nose does many things to increase the level of oxygen in your blood. The air is moisturized when it goes through your nose, and moisturized air carries more oxygen than dry air. Also, the air mixes with NO in the sinuses of your nose, which also helps pack more oxygen into your blood. These are only two examples, there are many more reasons.
     
  6. percywilkins

    percywilkins Junior Member
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    Well the thing is, I need to have jaw surgery first to correct what mouth breathing has done to my face. This will widen up my airways and set a decent base for the nasal surgery to be successful. It is a long story, but it will take about 1 year before I can even have the surgery, because it is mandatory that you wear braces for 1 year regardless of how your teeth are set up, before you have orthognathic surgery. Then I can only do the nasal surgery. So I would have to take a lot of time off (more than 2 years). Maybe I will just see how I end up this year. It really is irritating though to know that you could have done way better.
     
  7. inside_edition

    inside_edition Waitlisted Member
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    Let's make this the fact of the day. damn, i wonder if i'll become smarter if start breathing through my nose starting now. i've always inhaled through my mouth because it's much easier that way.

    i'm still amazed that i never knew this. wow.:thumbup:
     
  8. CATallergy

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    take the MCAT in a hyperbaric oxygen chamber. seems like this would be a much less criticized nonstandard condition than extra time.
     
  9. percywilkins

    percywilkins Junior Member
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    Do you think it is possible that they will look at the 32, and be like, "Okay, this kid can handle med school", and then look at my potentially far higher score, and say "Ok, I know this score was not under standardized conditions, but I already know that he is fine under non-standardized conditions in every other measure (GPA, MCAT), so why not accept him, and use this higher MCAT as a way to boost our schools averages? Or maybe I am just going crazy.
     
  10. LizzyM

    LizzyM the evil queen of numbers
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    Someone who has a 32 and retakes under non-standard conditions might be viewed as "high maintenance" and the school will find some excuse to steer clear (the trouble a high maintenance student can cause is not worth bump in avg MCAT that admitting him/her brings). Also, I'm not sure if MCATs taken under non-standard conditions are averaged in to the school's MCAT. It could be that they are not.
     
  11. diggitybop

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    its been awhile since i took physiology but i'm not buying your explanation. Air pressure in your upper airways is equal to barmoetric pressure. when you humidify the air the total between gas pressure and pressure of water vapor still equal barometric. so

    P total = Pgas + P H20

    the partial pressure of oxygen is gunna be

    PispiredO2 = FinspiredO2xPgas = Finspired02 x( P total - PH20)

    that whole minus sign kind of nullifies your argument. not saying that you don't have a medical issue. just not following your reasoning
     
  12. Old ortho

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    Your grades are good enough for most med schools. As others said, your academic performance in med schools carry far more weight in residency matching than going to a top 10 med school (there is no guaranteed acceptance even if you score a 36 in MCAT second time).

    Let's say you apply for med school for the 2008 cycle. You should consult an orthodontist and oral surgeon now, who together can design a treatment plan for you involving:

    1. Starting orthodontic treatment soon (it typically takes 6-12 months)
    2. Has orthognathic surgery in June/July 2009, during the summer break between MS1 and MS2. The most likely surgery for you problem consists of upper palatal expansion, and La Forte I - to impact your maxilla up to decrease your vertical facial height due to mouth breathing. If mandbular surgery is involved, you will wear a splint for 8 weeks, during which time you can still go to school and function normally. The surgery takes 2-4 hours. You can go back to school within 2-3 days after surgery.
    3. After surgery, you will usually finish your orthodontic treatment in 12-18 months.
    4. Perform nasal surgery.
    5. After surgery, your nasal breathing will improve. In addition, you will have a better occlusion, and your face will look better in that your mid face will be wider (from palatal expansion) and shorten a little (from La Forte I), assuming you have a typically long and narrow face due to mouth breathing.

    While nasal breathing is much better than mouth breathing for a person, I have not seen any conclusive proof in research or on patients that it is related to ADHD. I have seen many of my patients who are mouth breathers and do not have ADHD, and other patients who have ADHD who are not mouth breathers.
     
  13. lumbering

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    If you went to med school ASAP and did a general surgery residency with a plastics fellowship, you would start practicing at about the same time as if you took a few years off, went to med school, and got into an integrated plastics residency. Considering that it's not guaranteed that you won't get into a top 10 school now or that you will get into a top 10 school after retaking the MCAT, I recommend you try to start med school as soon as possible.

    One more thing: This thread reeks of arrogance. Bragging about how you got a 32 MCAT despite brain hypoxia...sheesh!
     
  14. cubbbie

    cubbbie Member
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    See, I definitely had to skip passages too because of the time constraint, as did many of my peers I know who took the test. I always thought that was just part of the challenge of the MCAT. I'm not doubting that you have a diagnosed condition, but it just makes me wonder about myself and all my MCAT friends who felt rushed while taking the test as well. If I had extra time, I also know I could have scored at least 3 points higher, but isn't part of getting good at taking the MCAT getting good at taking the MCAT fast?

    I don't mean to be critical, but this was my first thought when I read your post, and I'm thinking, as others like Lizzie M have mentioned, that this will also be the first thought of adcoms who see that you required extra time.
     
  15. klayn

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    I agree with LizzyM. I think that if you take the MCAT under non-standard conditions, then the assumption (accurate or not) is that you'd want to take exams in med school under non-standard conditions. There will come a point where you will not be able to do this anymore -- not saying that you want to continue doing this, but I think adcoms will consider this and the fact that it might catch up with you -- they might see this as ultimately contributing to failure down the line, and for that reason, try to avoid you.

    Also, if you re-take it under non-standard conditions and score higher, I think the whole idea that they'll see your original score with standard conditions and consider your score with non-standard conditions is wishful thinking. They only want to see one score, and excuses or attempted explanations would just have the potential to hurt you (just my opinion).

    32 is a good score. Along with your GPA and EC's, you're a very competitive candidate. I would say stick with that.
     
  16. MattD

    MattD Curmudgeon
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    This is incorrect. Moisturized air carries less oxygen than dry air, for reasons mentioned by a previous poster. The NO bolus will help decrese pulmonary vascular resistance, but oxygen levels in the blood are unaffected. Next time you're around a pulse oximeter, do a little experiment and see if your sats actually go down with mouth breathing. I don't claim to know what will happen, I'm just curious.

    http://www.blackwell-synergy.com/doi/abs/10.1046/j.1365-201x.1998.00352.x?cookieSet=1&journalCode=aps

    http://www.blackwell-synergy.com/doi/abs/10.1111/j.1399-6576.2007.01277.x
     
  17. percywilkins

    percywilkins Junior Member
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    For all the people that are using their vast medical knowledge from general chemistry and introductory physics to tell me my diagnosis, from an actual doctor, is wrong:

    Taken from one of many websites that correlate with everything I have posted: http://www.westonaprice.org/healthissues/facial-development.html

    Here are some snippets:

    Typically children with bags under their eyes have short attention spans because they do not have good circulation and oxygenation of the head and can tire easily. They are literally suffocating.

    Furthermore, they don’t sleep very well--they are always tossing and turning and they wake up tired. Your body recuperates during sleep and sleep is especially important for teenagers. Teenagers need to go to bed before 10:00 pm because certain brain cycles designed for recuperation of the body kick in at around that time. These cycles will be interrupted if sleep mode is delayed to after 10:30-11:00 pm. The recuperation and rebuilding necessary to cope with stressful daily activities will then be compromised. These are the tired, sleepless kids who tend to have a diet high in sugar, trans fats and grains. They may end up labeled as ADD or ADHD and treated with drugs.

    A mouth breather will not be humidifying the air, or slowing it down to allow the proper mixing of NO with it. The lungs will have difficulty providing maximum oxygenation for the body with this dry, unhumidified, unfiltered and, most importantly, NO-lacking air. This constant and chronic condition affects the cardiovascular system and the heart because the smooth muscles that line all of the arteries react to this poorly oxygenated air with a kind of tightness, a kind of permanent tension, which can be very stressful and depleting to the body. Furthermore it has been clinically shown that blocking NO production in healthy individuals results in moderate hypertension and reduced heart output as well as shortened bleeding times by activation of platelet blood-clotting factors.

    Due to the lack of proper oxygenation, the ability to deliver fully oxygenated blood to the cells is also much reduced. Thus mouth breathing has a negative effect on every cell in the body as it deprives them of oxygen. Overall wellness and health requires proper oxygen as every particle of our being requires oxygen.
     
  18. geneticclone

    geneticclone Guest

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    Or it could be that there just insanely tired.... so they can't concentrate.
     
  19. 35m

    35m New Member
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    Carry around a tank of oxygen and wear a mask.
     
  20. spicedmanna

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    It's a "chicken or the egg" type question. What results in clinical tiredness? There are a number of pathologies and habits that can create that result and vise versa.
     
  21. Winged Scapula

    Winged Scapula Cougariffic!
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    Hardly a peer-reviewed journal with RCT Level 1 evidence.

    As a fellow mouth breather (at night when I sleep), I would love to think that any "failure" I might have experienced in life, could be the result of my "deformity". But I have failed to see any real data that:

    1) mouth breathing results in 10-15% less oxygen delivery to the brain

    2) and most importantly, that 10-15% less oxygen delivery to the brain results in any intellectual dysfunction.

    Observing an event does not automatically translate in clinical significance.

    But then again, I'm a deformed mouth breather and perhaps I can't understand this logic.:rolleyes:
     
  22. SoCuteMD

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    You are a surgeon, that should be reason enough when you don't understand something. You only understand when it's communicated in the form of butt-scratching and ball-grabbing, right ;)?

    (Just kidding Dr. Cox - got nothing but :love:)
     
  23. MirrorTodd

    MirrorTodd It's a gas.
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    Oh snap! :laugh: This is the first thread I've enjoyed in a really long time. :thumbup:
     
  24. Rickybobby

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  25. percywilkins

    percywilkins Junior Member
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    First of all, unless you have the facial deformities and symptoms that correllate with a person who is a 100 percent mouth-breather, why would you consider yourself to have "suffered" to the same degree as me or anyone else that requires major surgery to fix the problem? In response to your initial statement: How can somebody possibly know that they breathe through ONLY their mouth ALL night?

    I never claimed that the above article was 100% credible, or that it was "peer reviewed' with "RCT Level 1 evidence". I just used it as a simple example of the info thats out there. I also find it hard to believe that you actually searched to find real data that supports your points numbered 1 and 2.

    Also, using a rolleyed smiley at the end of your post doesn't make your response any more clever, it just makes you look like a douchebag.
     
  26. MedStudentWanna

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    Whoa, buddy, do you even know who you're replying to? Dr. Cox is an attending physician (surgeon). She knows her stuff and doesn't need to be told off by a pre-med.

    As to your situation, I personally think you're going to make your case so much worse. If you take it again, you're saying that you need special treatment during med school too. Will you need it during rotations? During Step 1? IMO, you'll give them a reason NOT to accept you rather a reason to accept you. You got a 32 for crying out loud. That's good enough with your GPA for even Harvard. Quit complaining and apply!
     
  27. percywilkins

    percywilkins Junior Member
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    I absolutely do know who I am replying to. If she was an ENT or orthodontist, or any kind of professional on this particular subject, then I would have shut up. But she isn't, and she was being a bit of an ass, so I didn't really care. (don't misunderstand; I am aware of my pathetic position on the totem pole as a lowly pre-med, and am aware she knows far more about medicine than I do). Anyway, thanks for the encouragement. Everybody's posts made me decide that I will go ahead and apply.

    Also, in RE: to your "special treatment" question. I would only request it for the MCAT, and afterwards would have both surgeries completed so that I would not need it anymore for step 1 or any other med exams.
     
  28. spicedmanna

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    FWIW, I have been told this many times, by many healthcare professionals, but it is worth repeating here: people tend to see things to the extent and specificity of their knowledge. It is oversimplifying things a tad, but it is often true.
     
  29. MedStudentWanna

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    First of all, whether or not Dr. Cox is an ENT, as a surgeon, I think she's probably more well-versed in the physiology of anything than you or I. She's a successful, intelligent doctor who, like I said, knows her stuff and when she doesn't, she says so. I don't think I've ever seen her act like an "ass," as you put it and your post to her out of line, IMO.

    As for the special treatment, why should med schools believe that? It isn't like they can say "oh well, we'll accept you under the condition that you have surgery". If, on the first day of second year, you still haven't had the surgery, they can't make you. Then they're forced with the dilemma of going to bat for you in hopes of letting you get extra time on the USMLE or letting you sink or swim, thereby bringing down their average board scores. You're crazy if you think you can get in on a "but if you let me in, I promise I'll do something so as to never need special treatment again, as long as you grant it to me during the application process (i.e. taking the MCAT).
     
  30. diosa428

    diosa428 SDN Angel
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    I wouldn't do it. Regardless of what your actual underlying condition is, it's going to look bad. You did well on the MCAT the first time around, so retaking with extended time is just going to make you look like an anal premed that decided they needed special considerations to improve their score. I remember when I was graduating high school and kids were getting diagnosed with ADHD left and right right before the SAT so that they could have extended time for a problem that they probably didn't have. Again, I'm not saying this is you (it's obviously not), but these are things that the adcom might think that will hurt your application a lot more than a 32. Perhaps if you're not happy with your score, you should just try to take it again under normal conditions.
     
  31. munnabhai

    munnabhai Junior Member
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    eh go ahead and do it... with that kinda attitude during interviews, your app best be stacked.
     
  32. MattD

    MattD Curmudgeon
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    What is the specialty and credentials of the 'doctor' who diagnosed you? Because the oxygen content of humidified vs. dehumidified air is pretty basic physiology/chemistry/thermo knowledge. Instead of attacking people who are trying to give you good advice, try critically examining what they are saying. And no, that doesn't mean compare it to what some other person told you then dismiss it. Consider what's being said to you, and if there's a conflict with what you thought you already knew, then do some independant research and see what you come up with. Here's a website with a decently simple and quick overview of respiratory physiology. Note the section titled "Atmosphere to alveolus".

    http://www.nda.ox.ac.uk/wfsa/html/u10/u1003_01.htm

    As far as the text you quoted is concerned, yes, sleep apnea and sleep hypoxia can result in excessive tiredness and cognitive problems. I'm not arguing that point. All I said was that the physiological points you attempted to make were inaccurate. The NO thing was new to me, so I looked at those couple journals. It was a very brief review. If you have evidence that says otherwise I'd be interested in seeing it. I always like to learn. But the idea that humidification increases oxygen content is plain wrong. The percentage of oxygen stays the same, and humidification decreases the partial pressure of that oxygen. Decreased PO2 = decreased hemoglobin sats. It's the basic oxygen dissociation curve. You saw it in undergrad bio. You likely saw it on the MCAT. I sure as heck saw it in physio. You'll see it again there too, if you don't tell your interviewers how unqualified they are to do their jobs and thus 'for some reason' fail to gain acceptance to med school.

    G'day!
     
  33. Cirrus83

    Cirrus83 Too old for this
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    I don't doubt that someone diagnosed you with something, but the other posters (much like myself) simply found your explanation to be horribly wrong. You specifically wrote that air with more moisture can carry more oxygen than dry air, which is in fact the complete opposite of the truth, because dry air can carry more oxygen by the simple fact that more of it is actually air and not water vapor.

    That's why they criticized your explanation, because it's like posting that your doctor said you had a cold and 2+3=7. Sure your doctor may have said you have a cold but the 2+3=7 part is horribly wrong, so people were pointing out that it made no sense. It's not that like they said you couldn't possibly have a cold, just that your explanation included along with it made no sense. Get it?

    Oh and the random link you provided just makes it seem like this entire field is, quite frankly, quacktastic. If you're so damned convinced that your brain is suffering horribly, so be it. But when you explain to med schools that mouth-breathing is the reason why you retook the MCAT with a longer time they'll think you're a huge tool. Do you even have ANY evidence that getting slightly less oxygen even harms your intelligence?!!?

    People with cystic fibrosis are quite intelligent and don't all have ADD, even though their blood O2 sats are MUCH lower than regular people (in fact many of them would have even less oxygen than you would, and they don't just have this limitation when they're sleeping, they get less oxygen 24/7), so your arugment that your mouth breathing is giving you ADD sounds like complete and utter bull****.

    Not only did you not actually show evidence that mouth breathing even leads to 15% less oxygen going to your brain, there's no evidence that less oxygen going to your brain gives you ADD. It's not like your mouth-breathing was something that had a sudden onset and cut your brain oxygen drastically-in that case you might actually feel the effects since your brain wasn't used to getting less oxygen. But if it's chronic, one look at CF patients and it's damned obvious that having a lower O2 sat since childhood doesn't mean you'll have ADD.

    But whatever, you don't really seem like you even give a crap about what other people think. Do you just post threads to find people to agree with you? Seriously, you need to check your own attitude issues and maybe consider that taking the test with extra time because you're a mouth breather will just make you look like a complete and utter tool who's just looking for any excuse he can to get extended time, who flips out on anyone who dares questions that perhaps his condition doesn't at all warrant such a thing. Go ahead though, since you apparently don't give a crap about anybody else's opinion anyway you should totally go ahead and take the test with extended time and make sure to explain to the med schools that your needed the extra time because you breathe through your mouth at night. Oh and at interviews, if anybody expresses doubts as to the neccessity of this retake, tell them that they're not an ENT doctor and that they don't know anything. Don't forget to also explain to them how it's because dry air holds less oxygen than moist air though.
     
  34. emaj1n

    emaj1n M1
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    You would be stupid to retake the exam. You did well. Yes, retaking would be a "crazy" thing to do.
     
  35. DrVanNostran

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    I am loving this tread.

    OP, a 32 with your gpa..there is no need to retake. G'luck!
     
  36. blargh

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    i knew it! i always told my cross country teammates it was better to breathe through your nose than your mouth while running!
     
  37. MattD

    MattD Curmudgeon
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    Especially in cold, dry air. Not for the "increased oxygen carrying capacity" LOL, but because you DO need to humidify the air somewhat or tissues get a little dry. The nose does a much better job of warming and humidifying than the mouth does.

    Plus, and I'm just throwing this out there as something that occurred to me and could be totally wrong, but mouth breathing allows hyperventilation much more readily than nose breathing, because you can move bigger volumes. The advice may have something to do with avoiding the negative effects of hyperventilation as well.
     
  38. pennybridge

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    if I can learn how to breathe through my eye sockets I'm totally taking that MCAT thing again. Hell yeah! 40 here I come!
     
  39. geneticclone

    geneticclone Guest

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    LOL, if you learn will you teach me? Im a 100% mouth breather so please who needs a nose when they have an eyesocket.
     

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