Full Text DE-92-01


NIH GUIDE, Volume 21, Number 6, February 14, 1992

RFA:  DE-92-01

P.T. 04, FF

  Oral Diseases 
  Biomedical Research, Multidiscipl 

National Institute of Dental Research
National Center for Research Resources

Letter of Intent Receipt Date:  March 1, 1992
Application Receipt Date:  May 6, 1992


The National Institute of Dental Research (NIDR) and the Research
Centers in Minority Institutions (RCMI) Program of the National Center
for Research Resources (NCRR) invite applications for grants for the
development of Regional Research Centers for Minority Oral Health
(RRCMOH).  The purpose of these Phase I grants is to enable minority
dental schools or dental schools serving large minority populations to
develop the necessary alliances and organizational structure necessary
to compete for Phase II grants for the support of RRCMOHs.  A Request
for Applications (RFA) for Phase II, five-year grants for support of
RRCMOHs will be available in 1994.  The objectives of the RRCMOH
initiative are to:  (1) conduct research to improve the oral health of
U.S. racial and ethnic minorities; (2) enhance the research
capabilities and participation of members of racial and ethnic
minorities in oral health research; and (3) develop and strengthen the
minority oral health research infrastructure of minority dental schools
and of majority dental schools serving large minority populations.
African Americans (Blacks), Hispanics, Asians and Pacific Islanders,
and American Indians and Alaskan Natives are considered to be racial or
ethnic minorities.

An orientation meeting for potential applicants will be conducted by
NIDR and NCRR/RCMI Extramural Program staff in connection with the
annual meeting of the American Association for Dental Research, March
11, 1992, in Boston, Massachusetts.  Details of the time and location
of the meeting are available from the NIDR staff listed below.  A
summary of the meeting will be available from the NIDR staff.


The Public Health Service (PHS) is committed to achieving the health
promotion and disease prevention objectives of "Healthy People 2000,"
a PHS-led national activity for setting priority areas.  This RFA,
Developmental Grants for Regional Research Centers for Minority Oral
Health, is related to the priority area of reducing health disparities
among Americans by improving oral health.  Potential applicants may
obtain a copy of "Healthy People 2000" (Full Report:  Stock No.
017-001-00474-0) or "Healthy People 2000" (Summary Report: Stock No.
017-001-00473-1) through the Superintendent of Documents, Government
Printing Office, Washington, DC 20402-9325 (telephone 202-783-3238).


Two types of United States institutions are eligible to apply:
minority dental schools and other dental schools serving large
populations of minorities.  Only the following organizational
structures are acceptable:

1.  A minority dental school must propose an alliance with one or more
research-intensive dental schools and may include additional alliances
with one or more other minority institutions.

2.  A dental school serving a large minority population must propose an
alliance with one or more, research-intensive institutions and may
include alliances with one or more minority institutions.  If a dental
school serving a large minority population also qualifies as a
research-intensive institution, alliances must be proposed with one or
more minority institutions.

A dental school serving a large minority population is defined as one
in which the patient population served consists of more than 50 percent
individuals of the minority racial and ethnic groups listed above.  A
research-intensive institution is defined as one that received more
than one million dollars in support for dental research training and
research during Fiscal Year 1991.  A list of organizations receiving
$1,000,000 or more from the NIDR is provided as an appendix to this
RFA.  Additional institutions may apply.  A minority institution is
defined as any educational, health-care, or research institution
largely staffed by or serving racial/ethnic minorities.

To be responsive to this RFA, an application must propose collaborative
alliances with other institutions that conform to the organizational
structures listed above and address the objectives of the RRCMOH
initiative.  A research-intensive institution may not be the applicant
organization unless it serves a large minority population.
Applications proposing alliances between minority institutions without
involvement of research- intensive institutions are not acceptable.
Regional proximity of the allied institutions would be an asset but,
for a variety of reasons, may not be possible.

Applications from foreign institutions or those involving foreign
alliances are not eligible.


Phase I awards will be the National Institutes of Health developmental
grants (P20).  Awards will be for three years and the earliest funding
date is September 1, 1992.  Responsibility for the planning, direction,
and execution of the proposed project will be solely that of the
applicant institution; however periodic consultation with NIDR and
NCRR/RCMI staff will be expected.  This may take the form of periodic
site visits.  This RFA is a one-time solicitation by the NIDR and the
NCRR/RCMI, unless it is determined that there is a continuing program
need.  A second RFA, soliciting applications for Phase II, five-year,
P50 awards to support RRCMOH, will be available in 1994.  The receipt
of a Phase I grant will not be a prerequisite for submission of an
application for a Phase II grant.


If a sufficient number of highly meritorious applications are received,
it is anticipated that six, three-year awards may be made.  No award
will exceed $225,000 in direct costs for the first year.  Additional
support, up to $50,000 in direct costs for the first year, may be
provided to minority dental schools or other qualified minority
institutions for RRCMOH-related faculty development activities.
Increases in costs for subsequent years, including those for faculty
development, will be limited to four percent.  Award of grants pursuant
to this RFA is contingent upon the availability of funds.



Since the NIDR was established over 43 years ago, there has been a
remarkable improvement in the oral health of the American population,
primarily based on advances in oral disease prevention and the
appropriate practice of oral hygiene.  Today, almost half of all
children between 5 and 17 years of age have no cavities in their
permanent teeth. However, recent surveys show substantial variations in
oral health among socio-demographic groups.  The most rapidly growing
segments of the population, minorities and the elderly, have not
experienced the gains in oral health status enjoyed by many children
and adolescents.  There are still substantial gaps in the application
of known preventives in populations at high risk of oral diseases,
particularly minority populations who may not have access to dental
services and other health promoting services.

This disparity in oral health between minority and other population
groups in America is highlighted in the NIDR Long-Range Research Plan
for the Nineties, BROADENING THE SCOPE, a plan that calls for
addressing all diseases affecting the oral cavity among all populations
and at all ages.  Representatives from the research community,
including minorities, who participated in developing the plan,
encouraged the NIDR to focus research on high-risk and other special
care groups.  They called for emphasizing social and behavioral
research to develop culturally sensitive strategies for encouraging and
maintaining changes in behavior.  This initiative is intended to
overcome institutional and cultural barriers that prevent access by
minorities to oral health and well-being.  In addition, it is intended
to facilitate enhanced participation in the oral health research and
research training enterprise available to other groups.  The concept
was endorsed by the National Advisory Dental Research Council (NADRC)
and by an ad hoc Working Group on Regional Research Centers for
Minority Oral Health, convened by the NIDR in August 1991.

The necessity for a concerted effort in achieving the three major
objectives of the RRCMOH initiative is based on the rapidly increasing
number and diversity of minorities in the U.S. population and the
generally poor status of oral health among minority populations.
Between 1980 and 1990, the U.S. population increased by 10 percent.
During the same period, Blacks in the population increased by 13
percent, Asians and Pacific Islanders by over 100 percent, American
Indians and Alaska Natives by 38 percent, and Hispanics increased by 53
percent.  The Census Bureau projects even steeper demographic growth in
these groups over the next few years, further widening the gap in the
oral health status of minorities and non-minorities.  Although there is
a clear need for more systematic, comprehensive, and usable information
on the oral health status of racial and ethnic minorities, the
available statistics dramatically portray a bleak picture of their oral
health status.  Between 1980 and 1987, U.S. school children of all
races combined experienced a 36 percent decrease in dental caries, but
Black school children experienced only a 20 percent decrease.  Among
the adult population, 18-64 years of age, during the same period,
Blacks had a higher percentage of missing teeth than did Whites.
Blacks also had a higher percentage (82 versus 50 percent) of decayed
but untreated teeth than did Whites.  In both adults and children,
Blacks were 20 percent more likely to have clinical gingivitis than
were Whites, and Blacks had a higher percentage of diagnosable sites
with gingivitis.  On all three parameters of periodontitis, depth of
pockets, attachment loss, and number of pockets, the prevalence for
Black adults and school-aged children exceeded those for Whites.
Blacks were at much greater risk for all forms of early onset
periodontitis than Whites, and Black males were 2.9 times as likely to
have localized juvenile periodontitis as were Black females.  With
regard to oral and pharyngeal cancer in adults, Blacks experienced a
one to three-fold greater incidence than did Whites, but in males, a
one to five-fold greater incidence was seen.  The mortality rate for
oral and pharyngeal cancer among Blacks was about twice, 5.2 versus
2.8, that of Whites.  Similarly, the survival rates of Blacks diagnosed
with these cancers was about 22 percentage points lower than it was for
Whites.  Thus, on most measures of oral health status, Blacks appear to
be considerably worse off than are Whites.  The information available
on Asians and Pacific Islanders and American Indians and Alaskan
natives is too sparse for similar comparisons.  Anecdotal reports of
the health status of these groups indicate that they may be more
disadvantaged than Blacks.

Information about the oral health status of Hispanics in the United
States is similarly sparse.  A recent survey indicated that there are
significant differences in oral health among different groups of
Hispanic Americans. Dentate Cuban and Puerto Rican American adults had
about twice as many missing teeth as White non-Hispanics. Cuban and
Puerto Rican Americans had a higher number of filled and missing teeth
than did Mexican Americans.  The prevalence of dental caries in Mexican
Americans was similar to that found in Blacks.  Puerto Ricans and Cuban
Americans had a caries prevalence between that of Black and White
Americans.  The prevalence of gingivitis in Hispanics was higher than
that in White non-Hispanics.  Puerto Rican children and adults had the
highest prevalence of gingivitis among the Hispanic groups.  The
challenge of combating the oral health problems of Hispanics is
increased by the rapid growth of the Hispanic population.

The oral health status of the minority U.S. population may reflect the
sparsity of minorities in the oral health manpower pool.  The dearth of
minority basic and clinical investigators can be attributed to the lack
of opportunities for minorities to participate in research activities.
According to the American Association of Dental Schools, approximately
4,000 students graduate from dental school each year, but only 216 are
Black and 320 are Hispanic.  Less than five percent of these, 11 Blacks
and 16 Hispanics, are expected to enter research.  Although the NIDR
supports research training through a variety of mechanisms, very few
minorities participate in these programs.  For example, as of July
1991, there were only 26 self-identified minorities (15 percent) among
173 trainees supported by National Research Service Awards from the
NIDR.  Only 14 so-designated minorities (11 percent) were among the 129
individuals receiving training under the Career Development Award (K
Series) mechanism.  The Research Supplements for Underrepresented
Minorities initiative seems to be a partial solution to the low level
of minority participation in the traditional training mechanisms.
However, it is too early to determine if this mechanism will have a
sustained positive effect, and complementary approaches appear to be
needed to attract and retain minorities in the research enterprise.

Center Characteristics

Each center will be a consortium consisting of two or more
institutions, as described under ELIGIBILITY REQUIREMENTS.  The
consortium will be structured to foster an alliance capable of
addressing each of the objectives of the RRCMOH initiative in a
productive manner.  A director, affiliated with the applicant
institution, and a co-director affiliated with the principal
collaborating institution, will be responsible for the scientific and
administrative leadership.  The director will be assisted by an
advisory committee of staff from the principal participating
institutions and consultants with appropriate research experience and
accomplishments, who are not associated with the participating
institutions.  This committee will assist in preparation of the
application and advise the director on the merits and progress of
research projects and faculty development activities.

The center will consist of a series of related research projects and
cores, relevant to the oral health of minorities.  The research
projects may be of a pilot nature or a small-scale research project.
Some may involve basic biomedical or behavioral research and others may
be epidemiological or clinical in scope.  Each project will involve
participation by co-investigators from two or more of the collaborating
institutions.  Core resources such as center development activities,
administrative services, unique clinical facilities, animal facilities,
biostatistical and computer services, and shared equipment will be
supported.  The center development core might include meetings and
other activities to explore new and expanded collaborative research and
training opportunities.  Budgetary constraints preclude expenditures
for expensive items of equipment and renovations.  In general, study
populations will be drawn from the clinics and the neighborhood of the
minority dental school or of the dental school serving a large minority
population.  Projects involving outreach to minority community
organizations are encouraged.

It is expected that the RRCMOHs will provide opportunities to foster
the development of minority faculty as investigators.  Career
development is considered a natural adjunct of a productive research
environment.  Minority dental school applicants may request up to
$50,000 per year for support of faculty development.  These funds will
be provided by the RCMI Program of the NCRR and are in addition to
those provided by the NIDR for support of the developing RRCMOH.  These
activities may be conducted at any of the collaborating institutions.
Formal training activities cannot be supported directly by this grant
mechanism.  Research training for minority high school, undergraduate
and graduate students, and postdoctoral fellows at the RRCMOH is highly
desirable, but must be supported from other sources, including other
components of the NIH.  Research-intensive dental school applicants are
expected to obtain support for training and career development from
other sources. However, support for development of faculty from a
collaborating minority dental school or institution may be requested.
It is anticipated that during Phase II, the RRCMOHs will be able to
compete effectively for National Research Service Awards to support
training programs and for Research Career Development Awards.

A typical center might consist of three small research projects,
several pilot research projects, two or more cores including that for
developmental activities, and a faculty development component.

Additional Information

Applicants are reminded that this solicitation requests applications
for Phase I grants to enable institutions to develop the necessary
collaborative alliances and organizational structure necessary to
compete for Phase II grants for the support of a RRCMOH.  Applications
must explain and justify how existing and potential human and physical
resources will be utilized during the three years of developmental
support to create a functioning center capable of meeting the
objectives of the RRCMOH initiative.  The NIDR plans to issue in FY
1995 an RFA for large Phase II grants to support RRCMOHs.



NIH policy is that applicants for NIH clinical research grants will be
required to include minorities and women in study populations so that
research findings can be of benefit to all persons at risk of the
disease, disorder or condition under study; special emphasis should be
placed on the need for inclusion of minorities and women in studies of
diseases, disorders and conditions which disproportionately affect
them.  This policy is intended to apply to males and females of all
ages.  If women or minorities are excluded or inadequately represented
in clinical research, particularly in proposed population-based
studies, a clear compelling rationale should be provided.

The composition of the proposed study population must be described in
terms of gender and racial/ethnic group.  In addition, gender and
racial/ethnic issues should be addressed in developing a research
design and sample size appropriate for the scientific objectives of the
study.  This information should be included in form PHS 398 in Section
2, A-D of the Research Plan and summarized in Section 2, E, Human

Applicants are urged to assess carefully the feasibility of including
the broadest possible representation of minority groups.  However, NIH
recognizes that it may not be feasible or appropriate in all research
projects to include representation of the full array of United States
racial, ethnic minority populations.

The rationale for studies on single minority population groups should
be provided.

For the purpose of this policy, clinical research includes human
biomedical and behavioral studies of etiology, epidemiology, prevention
(and preventive strategies), diagnosis, or treatment of diseases,
disorders or conditions, including but not limited to clinical trials.

The usual NIH policies concerning research on human subjects also
apply.  Basic research or clinical studies in which human tissues
cannot be identified or linked to individuals are excluded.  However,
every effort should be made to include human tissues from women and
racial/ethnic minorities when it is important to apply the results of
the study broadly, and this should be addressed by applicants.

If the required information is not contained within the application,
the application will be returned.

Peer reviewers will address specifically whether the research plan in
the application conforms to these policies.  If the representation of
women or minorities in a study design is inadequate to answer the
scientific question(s) addressed AND the justification for the selected
study population is inadequate, it will be considered a scientific
weakness or deficiency in the study design and will be reflected in
assigning the priority score to the application.

All applications for clinical research submitted to the NIH are
required to address these policies.  NIH funding components will not
award grants or cooperative agreements that do not comply with these


Prospective applicants are asked to submit, by March 1, 1992, a letter
of intent that includes a descriptive title of the proposed center, the
name, address and telephone number of the center director, co-director,
the identities of other key personnel and participating institutions,
and the number and title of this RFA.  Although a letter of intent is
not required, is not binding, and does not enter into the review of
subsequent applications, the information that it contains is helpful in
planning for the review of applications.  It allows NIDR staff to
estimate the potential review workload and to avoid possible conflict
of interest in the review.

The letter of intent is to be addressed to:

Matthew Kinnard, Ph.D.
Director, Oral Soft Tissue Diseases and AIDS Program
Extramural Program
National Institute of Dental Research
Westwood Building, Room 509
5333 Westbard Avenue
Bethesda, MD  20892
Telephone:  (301) 496-7784


Prospective applicants are advised to communicate with program and
grants management staff of the NIDR Extramural Program as early as
possible in the planning phase of application preparation.  NIDR staff
are available to assist applicants to ensure that the objectives,
structure, and the budget format for the proposed center are

The research grant application form PHS 398 (rev. 9/91) is to be used
in applying for these grants.  These forms are available at most
institutional business offices; from the Office of Grants Inquiries,
Division of Research Grants, National Institutes of Health, 5333
Westbard Avenue, Room 449, Bethesda, MD 20892; and from the program
administrator named below.

The RFA label available in form PHS 398 must be affixed to the bottom
of the face page. Failure to use this label could result in delayed
processing of the application such that it may not reach the review
committee in time for review.  In addition, the RFA title and number
must be typed on line 2 of the face page of the application form and
the YES box checked.

The instructions accompanying form PHS 398 must be followed, but some
modification will be necessary. For example, a new Table of Contents
must be prepared giving page numbers for all items in the application.
Pagination must be consecutive throughout the application.  Each
research project, the faculty development activities and core must be
identified by number and investigator.  A consolidated budget for the
complete center over the entire project period must be presented (see
page 5, form PHS 398). Separate detailed, annual and total budgets for
the entire project period for each research project and core must be
presented (use pages 4-5, form PHS 398).  Direct and indirect costs are
to be given.  Funds may be requested for professional, technical, and
administrative personnel; consultant services; equipment; supplies;
travel; patient costs directly related to the research; minor
renovations; and other costs.  Detailed justification of the budget
requests will be required.  Document the commitment of collaborating
institutions to the center.

Provide a summary of financial support from non-NIDR sources for
studies that will complement and expand the program supported by the
NIDR.  Explain how these studies will further the goals of the center
and make it more cost effective.

Under Section 2, Research Plans, describe the goals of the center and
discuss the background and significance of the topics being addressed.
Explain how each research project, core, and the faculty development
activities will contribute to achieving those goals.  Describe the
organizational and administrative structure, the responsibilities of
the director and co-director, individual investigators, and the
proposed mechanisms for monitoring scientific progress.  Describe the
relationship of all existing and pending institutional research
projects that may be relevant to the center, regardless of funding

Each small research project must be presented as in a research project
grant application, that is, the instruction pages 19-23 of form PHS 398
must be followed.  Because these are small projects, each project
description is expected to be significantly less then the 20-page limit
that applies to traditional research project grant applications.  Each
pilot project must be presented in 400 words or less.  Faculty
development activities must be presented as a separate project.
Describe the core units and explain the manner in which the resources
will be utilized by other scientifically related projects.

Abstracts (page 2, PHS 398) must be completed for the entire
application, each small research project, the combined pilot research
projects, the faculty development activities, and the cores.

Submit a signed, typewritten original of the application, including the
Checklist, and four signed, exact photocopies, in one package to:

National Institutes of Health
Westwood Building, Room 240
Bethesda, MD  20892**

At the time of submission, two additional copies must also be sent to:

Dr. George Hausch
Chief, Scientific Review Office
National Institute of Dental Research
Westwood Building, Room 519
5333 Westbard Avenue
Bethesda, MD  20892

Applications must be received by May 6, 1992.  If an application is
received after that date, it will be returned to the applicant.


Upon receipt, applications will be reviewed by NIH staff for
completeness and responsiveness.  Applications that are incomplete,
nonresponsive to this RFA, or exceed the first year budget limit of
$225,000 in direct costs will be returned to the applicant without
further consideration.  Applications requesting support of faculty
development activities may exceed the budget limit by up to $50,000 in
direct costs attributable to faculty development.  Waivers of the
receipt date deadline and budget limitation will not be granted.
However, where indirect costs are assigned to a subcontract and counted
as direct costs on the parent grant, the allowable direct cost maximum
may be exceeded by the amount of the indirect costs assigned to the
subcontract.  Those applications that are complete and responsive will
be evaluated in accordance with the criteria stated below for
scientific and technical merit by a special review committee convened
by the NIDR Scientific Review Office.  Applications may be subjected to
triage by the committee to determine scientific merit relative to other
applications received in response to this RFA.  The NIDR will withdraw
from further competition those applications judged by triage to be
noncompetitive for award and notify the applicant and institutional
official.  Applications judged to be competitive will undergo further
scientific merit review.  This review may involve an applicant
interview or site visit.  The second level of review will be provided
by the NADRC.

Major factors to be considered in the evaluation of applications

1.  The scientific merit of each pilot and small research project
including its significance, originality, feasibility, and experimental

2.  The technical merit and justification for core resources requested
including the extent to which they will assist in developing the

3.  The combination of the various pilot and small research projects,
core units, and faculty development activities into a cohesive program
that will address the center objectives.

4.  The adequacy of the administrative and organizational structure to
ensure efficient inter- and intra-institutional collaboration,
interaction, and dissemination of information among investigators
necessary to attain center objectives.

5.  The competence and mix of the investigators from collaborating
institutions and their commitment to the accomplishment of the research
goals and objectives of the center.

6.  The qualifications, experience, and commitment of the center
director and co-director including their ability to provide effective
leadership of the center.  Provisions for selection of replacement
directors if it should become necessary.

7.  The composition and use of the director's advisory committee.
Provisions for quality control during development of the application
and procedures for monitoring research.

8.  The commitment of collaborating institutions to the center; the
adequacy of their facilities, resources, and administrative

9.  The effectiveness of the faculty development opportunities offered,
including the quality of research experiences and mentoring to be

10.  The appropriateness of the period of support and budget requested
for pilot and small research projects, cores, faculty development
activities and for the entire center.  This includes the distribution
of responsibilities and funding among collaborating institutions.

11.  The availability and appropriateness of study populations and the
utilization of minorities and women as study subjects.

The inclusion of projects that are deemed to have little or no
scientific merit or that are deemed peripheral to the objectives of the
RRCMOH may be considered a reflection of the director's judgement and
may adversely affect the rating.  Component projects without
significant and substantial merit will not be recommended for further
consideration.  If such projects are deemed not essential to the
success of the center, they will be recommended for deletion.


The NIDR appreciates the value of complementary funding from other
public and private sources, including foundations and industrial
concerns, for activities that will complement and expand those
supported by the NIDR and NCRR/RCMI.  Such circumstances will be
considered in making any award.


Written and telephone inquiries concerning this RFA are encouraged.
The opportunity to clarify any issues or questions from potential
applicants is welcome.  Direct inquiries regarding programmatic issues
to Dr. Matthew Kinnard at the address under LETTER OF INTENT.

Direct inquiries concerning fiscal matters to:

Theresa Ringler
Grants Management Officer
Extramural Program
National Institute of Dental Research
Westwood Building, Room 518
5333 Westbard Avenue
Bethesda, MD  20892
Telephone:  (301) 496-7437


This program is described in the Catalog of Federal Domestic Assistance
No. 93.121.  Awards are under authorization of the Public Health
Service Act, Title IV, Part A (Public Law 78-410, as amended by Public
Law 99-158, 42 USC 241 and 285) and administered under PHS grants
policies and Federal Regulations 42 CFR 52 and 45 CFR Part 74.  This
program is not subject to the intergovernmental review requirements of
Executive Order 12372 or Health Systems Agency review.


U.S. Research Intensive Institutions Receiving More Than $1.0 Million
for Dental Research and Research Training from the NIDR in Fiscal Year

Institution                                            City       State

University of Washington                               Seattle       WA
State University of New York at Buffalo                Buffalo       NY
Forsyth Dental Center                                  Boston        MA
University of Alabama at Birmingham                    Birmingham    AL
University of Florida                                  Gainesville   FL
University of Pennsylvania                             Philadelphia  PA
University of Michigan at Ann Arbor                    Ann Arbor     MI
University of Iowa                                     Iowa City     IA
Univ. of Texas Health Science Center at San Antonio    San Antonio   TX
University of North Carolina, Chapel Hill              Chapel Hill   NC
University of Rochester                                Rochester     NY
University of Minnesota                                Minneapolis   MN
University of Southern California                      Los Angeles   CA
University of California, San Francisco                San Francisco CA
University of Connecticut Health Center                Farmington    CT
Virginia Commonwealth University                       Richmond      VA
Harvard University                                     Boston        MA
American Dental Association Health Foundation          Chicago       IL
University of Texas Health Science Center Houston      Houston       TX
University of California, Los Angeles                  Los Angeles   CA
Emory University                                       Atlanta       GA
Columbia University New York                           New York      NY
Louisiana State University Medical Center New Orleans  New Orleans   LA
Medical College of Georgia                             Augusta       GA
University of Massachusetts Medical School             Worcester     MA

Additional institutions may apply.


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