Osteomalacia is usually present when 25-hydroxyvitamin D levels are less than about 10 ng/mL. Vitamin D is an essential vitamin that your body must not be deficient from. One crucial aspect to regulating pituitary function is the control over pituitary cell growth; abnormal pituitary growth can lead to the development of tumors, which can in turn disrupt normal pituitary function and cause a hormonal imbalance. In 1922, Elmer McCollum tested modified cod liver oil in which the vitamin A had been destroyed. They considered that average requirements and population reference intakes values for vitamin D cannot be derived, and that a serum 25(OH)D concentration of 50 nmol/L was a suitable target value. [158], Pregnant or breastfeeding women should consult a doctor before taking a vitamin D supplement. [14] Other forms (vitamin D2, alfacalcidol, and calcitriol) do not appear to have any beneficial effects with regard to the risk of death. [14][82] Supplementation may have no effect on blood pressure. By the expiration of his patent in 1945, rickets had been all but eliminated in the US. Vitamin D is very important for strong bones and is required to absorb minerals such as calcium and phosphorus. In an in vitro setup, vitamin K2 (synthetic menaquinone-7; MK-7, kindly provided by Nattopharma ASA, Hovik, Norway), was mixed with several contemporary available phosphate binders, in presence or absence of phosphate, and incubated at pH 6 and fixed temperature of 37 degrees Celsius. Like calcium, you need vitamin D in order to absorb phosphate properly. [14], Another 2014 review concluded that vitamin D3 may decrease the risk of death from cancer (one fewer death in 150 people treated over 5 years), but concerns with the quality of the data were noted. [3] This reaction is catalyzed by the microsomal enzyme vitamin D 25-hydroxylase, the product of the CYP2R1 human gene, and expressed by hepatocytes. [25] A diet with insufficient vitamin D in conjunction with inadequate sun exposure causes vitamin D deficiency. Both organizations noted that more people may require supplementation due to lower amounts of sun exposure during the pandemic,[206][207] and the NHS has provided free daily vitamin D supplements for people at high risk from COVID-19. Hypocalcemia refers to low blood calcium concentration. Facilitates mobilization of calcium and phosphate from bone. Regular time in the sunshine could provide enough Vitamin D for good health, but you can also get it from your food or take supplements, particularly in the winter months. The blood 25(OH)D concentration is the best indicator of vitamin D status. Far and away the most important effect of vitamin D is to facilitate absorption of calcium from the small intestine. Vitamin D helps regulate the amount of calcium and phosphate in the body - nutrients needed to keep the bones, teeth and muscles healthy. There is some evidence that … However, lower vitamin D concentrations are also associated with poor nutrition and spending less time outdoors. Vitamin D status should be assessed as part of a routine nutritional assessment. Most people have no symptoms while others develop calcium deposits in the soft tissue. [115], Various institutions have proposed different recommendations for the amount of daily intake of vitamin D. These vary according to precise definition, age, pregnancy or lactation, and the extent assumptions are made regarding skin synthesis of vitamin D.[116][62][117][118][119] Boiled, fried and baked foods retained 69–89% of original vitamin D.[147], Recommendations on recommended 25(OH)D serum levels vary across authorities, and vary based on factors like age. Calcium And Vitamin D Homeostasis Pth And 1 25 Oh 2 D how does vitamin d affect calcium is a free HD wallpaper sourced from all website in the world. [24] Vitamin D deficiency is widespread in the European population. This activity results in minimal losses of calcium in urine. Vitamin D helps regulate the amount of calcium and phosphate in the body. [69] A study found that supplementation with 800 IU or more daily, in those older than 65 years was "somewhat favorable in the prevention of hip fracture and non-vertebral fracture". [2] Instead it can be considered a hormone, with activation of the vitamin D pro-hormone resulting in the active form, calcitriol, which then produces effects via a nuclear receptor in multiple locations. [6][2] Only a few foods, such as the flesh of fatty fish, naturally contain significant amounts of vitamin D.[1][7] In the U.S. and other countries, cow's milk and plant-derived milk substitutes are fortified with vitamin D, as are many breakfast cereals. Research suggests low levels of vitamin D could affect mortality rates from COVID-19. PDF | Background Vascular calcification is a major contributing factor to mortality in end stage renal disease (ESRD). Long term deprivation leads to bone thining (osteopenia). Parathyroid insufficiency (PTH deficiency) results in decreased calcium and phosphate levels, which is manifested by severe muscle contraction and (paradoxically) the formation of calcium phosphate deposits due to high levels of phosphates. Vitamin D is needed for your body to take in phosphate. Several forms (vitamers) of vitamin D exist. Click to see full answer. [13] Another meta-analysis covering over 350,000 people concluded that vitamin D supplementation in unselected community-dwelling individuals does not reduce skeletal (total fracture) or non-skeletal outcomes (myocardial infarction, ischemic heart disease, stroke, cerebrovascular disease, cancer) by more than 15%, and that further research trials with similar design are unlikely to change these conclusions. Although vitamin D can enhance the absorption, especially under conditions of dietary phosphate depletion, intestinal phosphate absorption does not require the presence of active vitamin D. Specifically, high serum phosphate and high dietary phosphate intake do not significantly impair intestinal uptake. [20] Also, in the United States and Canada, vitamin D-fortified milk, infant vitamin supplements, and vitamin supplements have helped to eradicate the majority of cases of rickets for children with fat malabsorption conditions. Maintaining constant concentrations of calcium in blood requires frequent adjustments, which can be described as fluxes of calcium between blood and other body compartments. The active vitamin D metabolite calcitriol mediates its biological effects by binding to the vitamin D receptor (VDR), which is principally located in the nuclei of target cells. [98] A review article of 2016 reported that while there is increasing evidence that vitamin D deficiency may be a risk factor for diabetes, over-all evidence regarding vitamin D levels and diabetes mellitus is contradictory, requiring further studies. [21] Thus, vitamin D is also critical for bone remodeling through its role as a potent stimulator of bone resorption. Sixty omnivorous healthy subjects participated in the double-blind, placebo-controlled parallel designed study. American researchers Elmer McCollum and Marguerite Davis in 1914[12] discovered a substance in cod liver oil which later was called "vitamin A". [91] Vitamin D supplementation substantially reduces the rate of moderate or severe exacerbations of COPD in people with baseline 25(OH)D levels under 25nmol/L but not in those with less severe deficiency. Vitamin D is an important vitamin for the body which helps regulate the amount of calcium and phosphate in the body. For this reason, phosphate and calcium levels are usually measured at the same time. "[62]:5 Some researchers claim the IOM was too definitive in its recommendations and made a mathematical mistake when calculating the blood level of vitamin D associated with bone health. The normal concentration of calcium and phosphate in blood and extracellular fluid is near the saturation point; elevations can lead to diffuse precipitation of calcium phosphate in tissues, leading to widespread organ dysfunction and damage. [10][11][196], There is conflicting evidence about the benefits of interventions with vitamin D,[197] one view purporting an intake of 4,000–12,000 IU/day from sun exposure with concomitant serum 25-hydroxyvitamin D levels of 40 to 80 ng/mL,[198] while another view is that serum concentrations above 50 ng/mL are not plausible. Calcium and phosphorus are essential minerals found in the bone, blood and soft tissue of the body and have a role in numerous body functions. [39][43], Vitamin D deficiency remains the main cause of rickets among young infants in most countries because breast milk is low in vitamin D and social customs and climatic conditions can prevent adequate sun exposure. [157] After being commissioned by the Canadian and American governments, the Institute of Medicine (IOM) as of 30 November 2010[update], has increased the tolerable upper limit (UL) to 2,500 IU per day for ages 1–3 years, 3,000 IU per day for ages 4–8 years and 4,000 IU per day for ages 9–71+ years (including pregnant or lactating women). Deviations above or below the normal range frequently lead to serious disease. Furthermore, proteinuria, urinary casts, azotemia, and metastatic calcification (especially in the kidneys) may develop. [141][142], While some studies have found that vitamin D3 raises 25(OH)D blood levels faster and remains active in the body longer,[143][144] others contend that vitamin D2 sources are equally bioavailable and effective as D3 for raising and sustaining 25(OH)D.[133][145][146], Vitamin D content in typical foods is reduced variably by cooking. For vitamin D labeling purposes, 100% of the Daily Value was 400 IU (10 μg), but on May 27, 2016, it was revised to 800 IU (20 μg) to bring it into agreement with the RDA. Maximizes tubular reabsorption of calcium within the kidney. [125], The European Food Safety Authority (EFSA) in 2016[119] reviewed the current evidence, finding the relationship between serum 25(OH)D concentration and musculoskeletal health outcomes is widely variable. Without enough vitamin D, the body can only absorb 10% to 15% of dietary calcium, but 30% to 40% absorption is the rule when vitamin reserves are normal. Vitamin D can be synthesized only by a photochemical process. For patients with vitamin D deficiency, it is difficult for the body to obtain calcium from the diet. [20], Rickets, a childhood disease, is characterized by impeded growth and soft, weak, deformed long bones that bend and bow under their weight as children start to walk. Vitamin D is important for general good health, and now researchers are discovering that it may be important for many other reasons outside of good bone health. An unambiguous deactivation process", "Age-old children's disease back in force", "Vitamin A, Vitamin D, Cartilage, Bones, and Teeth", "Chromosomal receptor for a vitamin D metabolite", "Vitamin D in Autoimmunity: Molecular Mechanisms and Therapeutic Potential", "Effects of Nutritional Supplements and Dietary Interventions on Cardiovascular Outcomes: An Umbrella Review and Evidence Map", "Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data", "Vitamin D deficiency aggravates COVID-19: systematic review and meta-analysis", "Association of vitamin D status with SARS-CoV-2 infection or COVID-19 severity: a systematic review and meta-analysis", Evidence reviews for the use of vitamin D supplementation as prevention and treatment of COVID-19, "Vitamin D receptor stimulation to reduce acute respiratory distress syndrome (ARDS) in patients with coronavirus SARS-CoV-2 infections: Revised Ms SBMB 2020_166", "International clinical trials assessing vitamin D in people with COVID-19", "Vitamin D supplementation, COVID-19 & Disease Severity: A meta-analysis", NIH Vitamin D Fact Sheet for Health Professionals, Calcitriol (1,25-dihydroxycholecalciferol), https://en.wikipedia.org/w/index.php?title=Vitamin_D&oldid=1011355206, Pages with non-numeric formatnum arguments, Short description is different from Wikidata, All Wikipedia articles written in American English, Wikipedia articles needing clarification from November 2020, Articles containing potentially dated statements from November 2010, All articles containing potentially dated statements, Wikipedia articles with SUDOC identifiers, Creative Commons Attribution-ShareAlike License, * Adequate intake, no RDA/RDI yet established, reduced risk of falling in people over age 60, "Adequate calcium and vitamin D, as part of a well balanced diet, along with physical activity, may reduce the risk of osteoporosis. Thyroid and Parathyroid Glands: Introduction and Index, Send comments to Richard.Bowen@colostate.edu, Production stimulated by increased parathyroid hormone secretion, Synthesis suppressed due to low parathyroid hormone secretion, Secretion stimulated by high blood calcium, Enhanced due to activity of vitamin D on intestinal epithelial cells, Stimulated by increased parathyroid hormone and vitamin D, Decreased due to low parathyroid hormone and vitamin D, Decreased due to enhanced tubular reabsorption stimulated by elevated parathyroid hormone and vitamin D; hypocalcemia also activates calcium sensors in loop of Henle to directly facilitate calcium reabsorption. [164], Vitamin D overdose causes hypercalcemia, which is a strong indication of vitamin D toxicity – this can be noted with an increase in urination and thirst. [132] A metabolite of vitamin D3 effective on intestine", "24-Hydroxylation of 1,25-dihydroxyergocalciferol. [84][85] Deficiency has been linked to increased risk or severity of viral infections, including HIV[86][87] and COVID-19. [71][72] Low serum vitamin D levels have been associated with falls, and low bone mineral density. However, it was concluded that the available evidence was either inadequate or too contradictory to confirm the effectiveness of vitamin D on those conditions, save for the more positive findings on bone health. Phosphorus undergoes passive absorption in the small intestine, although some is absorbed by active transport [ 2 ]. Magnesium is likely to play an important role in vitamin D metabolism. This can affect bones, tissues, and other organs. The treatment is to replace active vitamin D. Levels of phosphate in the blood rise, because the kidneys are not excreting excess phosphate into the urine. [101], Pregnancy – Low levels of vitamin D in pregnancy are associated with gestational diabetes, pre-eclampsia, and small (for gestational age) infants. [34], Maternal vitamin D deficiency may cause overt bone disease from before birth and impairment of bone quality after birth. One study published in the Journal of Steroid Biochemistry and Molecular Biology found caffeine intakes higher than 300 milligrams daily may lead to bone loss due to effects on vitamin D receptors in the body. [99], Depression – Clinical trials of vitamin D supplementation for depressive symptoms have generally been of low quality and show no overall effect, although subgroup analysis showed supplementation for participants with clinically significant depressive symptoms or depressive disorder had a moderate effect. This activity results in minimal losses of calcium in urine. 8: Vitamin D Binding Protein", "1,24,25-Trihydroxyvitamin D3. To prevent detrimental increases in phosphate, parathyroid hormone also has a potent effect on the kidney to eliminate phosphate (phosphaturic effect). [1] US labs generally report 25(OH)D levels in ng/mL. VDR activation in the intestine, bone, kidney, and parathyroid gland cells leads to the maintenance of calcium and phosphorus levels in the blood (with the assistance of parathyroid hormone and calcitonin) and to the maintenance of bone content. [195] In 1971–72, the further metabolism of vitamin D to active forms was discovered. Vitamin D helps regulate calcium and phosphate balance to maintain healthy bone functions. [13] Insufficient evidence existed to recommend vitamin D supplements for all people with cancer, although some evidence suggested that low vitamin D may be associated with a worse outcome for some cancers,[79] and that higher 25-hydroxy vitamin D levels at the time of diagnosis were associated with better outcomes. [165][168] Land vertebrates have been photosynthesizing vitamin D for more than 350 million years. [107] Pregnant women often do not take the recommended amount of vitamin D.[106], Weight loss – Though hypothesized that vitamin D supplementation may be an effective treatment for obesity apart from calorie restriction, one systematic review found no association of supplementation with body weight or fat mass. Vitamin D deficiency (rickets) – vitamin D helps the small intestine and the kidney to reabsorb phosphate back into the bloodstream. [135][136], In 2016 in the United States, the Food and Drug Administration (FDA) amended food additive regulations for milk fortification,[137] stating that vitamin D3 levels not exceed 42 IU vitamin D per 100 g (400 IU per US quart) of dairy milk, 84 IU of vitamin D2 per 100 g (800 IU per quart) of plant milks, and 89 IU per 100 g (800 IU per quart) in plant-based yogurts or in soy beverage products. These two vitamin D metabolites (called 25-hydroxyvitamin D or 25(OH)D) are measured in serum to determine a person's vitamin D status. [118] About a third of Australians have vitamin D deficiency. [3], Vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol) share a similar mechanism of action as outlined above. [14] Its general use for prevention of this disease in those without vitamin D deficiency is thus likely not needed. [93] One review found that vitamin D supplementation could reduce the need for steroids used to inhibit episode frequency in people with mild to moderate asthma, and that supplementation had no effect on day-to-day asthma symptoms. Hypercalcemia. [169] The transformation of previtamin D2 to vitamin D2 in methanol has a rate comparable to that of previtamin D3. The nature of these interactions cannot be readily explained by data currently available. [1] The effect of vitamin D supplementation on mortality is not clear, with one meta-analysis finding a small decrease in mortality in elderly people,[13] and another concluding no clear justification exists for recommending supplementation for preventing many diseases, and that further research of similar design is not needed in these areas.[14]. The process is faster in white button mushrooms.[133](fig. [27][28][29] Deficiency results in impaired bone mineralization and bone damage which leads to bone-softening diseases,[30] including rickets in children and osteomalacia in adults. [76], Vitamin D supplements have been widely marketed for their claimed anti­cancer properties. How is calcium processed in the kidney? Calcitriol also has other effects, including some on cell growth, neuromuscular and immune functions, and reduction of inflammation. Hypophosphatemia may be described as low levels of inorganic phosphate in the blood. [175], In birds and fur-bearing mammals, fur or feathers block UV rays from reaching the skin. [203] This has caused a renewed interest of this potential in 2020 during the COVID-19 pandemic. It is activated by two protein enzyme hydroxylation steps, the first in the liver and the second in the kidneys. The threshold for vitamin D toxicity has not been established; however, according to some research, the tolerable upper intake level (UL) is 4,000 IU/day for ages 9–71[156] (100 µg/day), while other research concludes that, in healthy adults, sustained intake of more than 50,000 IU/day (1250 μg) can produce overt toxicity after several months and can increase serum 25-hydroxyvitamin D levels to 150 ng/mL and greater. In 1932, Otto Rosenheim and Harold King published a paper putting forward structures for sterols and bile acids which found immediate acceptance. [212] There were no significant effects found in this meta-analysis on mortality. In some countries, staple foods are artificially fortified with vitamin D.[129]. [65][66][67] The relationship between serum calcifediol concentrations and all-cause mortality is "U-shaped": mortality is elevated at high and low calcifediol levels, relative to moderate levels. [13] High blood levels appear to be associated with a lower risk of death, but it is unclear if supplementation can result in this benefit. An adequate intake of vitamin D is also necessary. [97], Diabetes – A systematic review of 2014 concluded that the available studies show no evidence of vitamin D3 supplementation having an effect on glucose homeostasis or diabetes prevention. Incremental decreases in risks are observed with rising serum 25(OH)D concentrations plateauing at 50 ng/mL with no additional benefits seen in levels beyond this point. [76][124] A table of the old and new adult daily values is provided at Reference Daily Intake. [60], A United States Institute of Medicine (IOM) report states: "Outcomes related to cancer, cardiovascular disease and hypertension, and diabetes and metabolic syndrome, falls and physical performance, immune functioning and autoimmune disorders, infections, neuropsychological functioning, and preeclampsia could not be linked reliably with calcium or vitamin D intake and were often conflicting. 1 You may think that is a good thing, but withOUT the hormones in place to deposit the calcium and phosphate into the bones, the calcium and phosphate deposit into soft tissues. Vitamin D appears to enable the body to absorb calcium and phosphate — both of which are important for bone health and for muscle function. These may be followed by polyuria, polydipsia, weakness, insomnia, nervousness, pruritus and ultimately kidney failure. Manufactured foods fortified with vitamin D include some fruit juices and fruit juice drinks, meal replacement energy bars, soy protein-based beverages, certain cheese and cheese products, flour products, infant formulas, many breakfast cereals, and milk. [56] Vitamin D deficiency is common in Hispanic and African-Americans in the United States, with levels dropping significantly in the winter. [57][198], The United States National Institutes of Health Office of Dietary Supplements established a Vitamin D Initiative in 2014 to track current research and provide education to consumers. Supplements were tricalcium phosphate (CaP) and cholecalciferol (vitamin D3). ", "Vitamin D intake: a global perspective of current status", "Efficacy of fish intake on vitamin D status: a meta-analysis of randomized controlled trials", "Identification of 1,25-dihydroxycholecalciferol, a form of vitamin D3 metabolically active in the intestine", "The discovery of vitamin D: the contribution of Adolf Windaus", "IUPAC-IUB Joint Commission on Biochemical Nomenclature (JCBN): Nomenclature of vitamin D. Recommendations 1981", "Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease", "The biology and pathology of vitamin D control in bone", "Vitamin D deficiency in Europe: pandemic? As the kidneys do not convert vitamin D into its active form, calcium does not get into the body from food, and the blood level of calcium can fall. [12] The modified oil cured the sick dogs, so McCollum concluded the factor in cod liver oil which cured rickets was distinct from vitamin A. [32] This condition is characterized by bow legs,[30] which can be caused by calcium or phosphorus deficiency, as well as a lack of vitamin D; today, it is largely found in low-income countries in Africa, Asia, or the Middle East[33] and in those with genetic disorders such as pseudovitamin D deficiency rickets. The main issues are how easily the body can access vitamin D, what it actually does in the body, and what doses might have a measurable effect on MS. A recent systematic review of all the relevant research claimed that there is not enough strong evidence to indicate that vitamin D supplements can protect the brain from deterioration, although it confirmed the value of sunlight. [75], Because it found mounting evidence for a benefit to bone health, though it had not found good evidence of other benefits, the US Food and Drug Administration (FDA) has required manufacturers to declare the amount of vitamin D on nutrition facts labels, as "nutrients of public health significance", since May 2016. His irradiation technique was used for foodstuffs, most memorably for milk. Vitamin D, calcium levels and parathyroid gland function are intimately involved. [158], Synthesis of vitamin D in nature is dependent on the presence of UV radiation and subsequent activation in the liver and in the kidneys. [181], Whether it is made in the skin or ingested, vitamin D is hydroxylated in the liver at position 25 (upper right of the molecule) to form 25-hydroxycholecalciferol (calcifediol or 25(OH)D). [58][59] A 2013 review did not find any effect from supplementation on the rates of non-skeletal disease, other than a tentative decrease in mortality in the elderly. [172], Adequate amounts of vitamin D can be produced with moderate sun exposure to the face, arms and legs (for those with the least melanin), averaging 5–30 minutes twice per week, or approximately 25% of the time for minimal sunburn. [205], In July 2020, the US National Institutes of Health found insufficient evidence to recommend for or against using vitamin D supplementation to prevent or treat COVID-19. [71] One 2014 review found that supplements had no significant effect on cancer risk. He called it vitamin D because it was the fourth vitamin to be named. It is critical to maintain blood calcium concentrations within a tight normal range. [81], Taking vitamin D supplements does not meaningfully reduce the risk of stroke, cerebrovascular disease, cardial infarction, or ischemic heart disease. Three organs participate in supplying calcium to blood and removing it from blood when necessary: Maintaining normal blood calcium and phosphorus concentrations is managed through the concerted action of three hormones that control fluxes of calcium in and out of blood and extracellular fluid: Parathyroid hormone serves to increase blood concentrations of calcium. [§ 1], The transformation that converts 7-dehydrocholesterol to vitamin D3 occurs in two steps. The kidneys excrete (get rid of) phosphate from our bodies. Similarly, how does vitamin D affect phosphate? Facilitates mobilization of calcium and phosphate from bone. [210][211] A meta-analysis has looked at trials which reported the effects of oral vitamin D supplementation on the need for intensive care unit (ICU) admission and mortality in hospitalized COVID-19 patients. [128], Although vitamin D is present naturally in only a few foods,[1] it is commonly added as a fortification in manufactured foods. The production of the vitamin D hormone is tightly feedback regulated directly or indirectly by calcium and phosphorus levels of the plasma. Too much phosphorus or not enough vitamin D in your blood puts you out of balance. Health Canada published recommended dietary allowances (RDA) and tolerable upper intake levels for vitamin D in 2012[117] based on the Institute of Medicine report. Vitamin D helps keep bones, teeth and muscles healthy by regulating the amount of calcium and phosphate in the body. Conversion: 1 µg (microgram) = 40 IU (international unit). [199] In their 2020 update it was recognized that a growing body of research suggests that vitamin D might play some role in the prevention and treatment of types 1 and 2 diabetes, glucose intolerance, hypertension, multiple sclerosis, and other medical conditions. [157] Other symptoms of vitamin D toxicity include mental retardation in young children, abnormal bone growth and formation, diarrhea, irritability, weight loss, and severe depression. [80] A 2020 systematic review and meta-analysis in people with colorectal cancer found evidence of a clinically meaningful benefit from vitamin D supplementation on outcomes, including survival, although the analysis had limitations. Vitamin D acts also to increase blood concentrations of calcium. It is generated through the activity of parathyroid hormone within the kidney. The link between vitamin D and caffeine isn't entirely clear, but some studies suggest too much caffeine may affect vitamin D levels in your body. Secondary hyperparathyroidismalso occurs in vitamin D deficiency, which in turn contributes to hypophosphataemia (as above). 102 De Zeeuw and colleagues … If you do not find the exact resolution you are looking for, then go for a native or higher resolution. The interactive pathway map can be edited at WikiPathways: Reference ranges for blood tests § Vitamins, COVID-19 drug repurposing research § vitamins, National Institute for Health and Care Excellence, "Office of Dietary Supplements - Vitamin D", "From vitamin D to hormone D: fundamentals of the vitamin D endocrine system essential for good health", "Vitamin D metabolism, mechanism of action, and clinical applications", "How Does the Body Make Vitamin D from Sunlight?
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