natgillin/translations-raw huggingface dataset:
Effekt hos kvinder (16-45 år) med tegn på tidligere HPV-infektion med en af vaccinetyperne (seropositiv), men som ikke længere var detekterbar (PCR-negativ) på starttidspunktet for vaccination
Efficacy in women (16 to 45 years) with evidence of a prior infection with a vaccine HPV type (seropositive) that was no longer detectable at vaccination onset (PCR negative)
Der findes ingen data vedrørende sikkerhed, immunogenicitet eller effekt, der kan understøtte udskiftning af Silgard med andre HPV-vacciner i løbet af vaccinationsprogrammet.
There are no safety, immunogenicity or efficacy data to support change during vaccination with Silgard to other HPV vaccines which do not cover the same HPV types.
Der sås evidens for immunhukommelsesrespons hos vaccinerede kvinder, som var seropositive over for de(n) relevante HPV-type(r) forud for vaccination.
Evidence of an anamnestic response was seen in vaccinated women who were seropositive to relevant HPV type(s) prior to vaccination.
I vaccinegruppen blev 99,1 til 100 % seropositive for alle vaccine-serotyper 1 måned efter 3. dosis.
In the vaccine group, 99.1 to 100% became seropositive to all vaccine serotypes by 1 month Postdose 3.
Som for andre vacciner er der blevet rapporteret bivirkninger i forbindelse med brugen, herunder hævede lymfekirtler (hals, armhule eller lyske); muskelsvaghed, unormale fornemmelser, prikken i arme, ben og overkrop eller konfusion (Guillain-Barrés-syndrom, akut dissemineret encefalomyelitis); svimmelhed, opkastning, ledsmerter, ømme muskler, unormal træthedsfølelse eller svaghed, kuldegysninger, en generel følelse af utilpashed, blødning eller en øget tendens til at få blå mærker samt infektion i huden på injektionsstedet.
As with other vaccines, side effects that have been reported during general use include: swollen glands (neck, armpit, or groin); muscle weakness, abnormal sensations, tingling in the arms, legs and upper body, or confusion (Guillain-Barré Syndrome, acute disseminated encephalomyelitis); dizziness, vomiting, joint pain, aching muscles, unusual tiredness or weakness, chills, generally feeling unwell, bleeding or bruising more easily than normal, and skin infection at the injection site.
Silgard forebygger ikke læsioner, forårsaget af en vaccine-HPV-type, hos personer inficeret med denne HPV-type på vaccinationstidspunktet (se pkt.
Silgard does not prevent lesions due to a vaccine HPV type in individuals infected with that HPV type at the time of vaccination (see section 5.1).
Ligesom med andre vacciner vil vaccination med Silgard ikke nødvendigvis yde beskyttelse til alle vaccinemodtagere.
As with any vaccine, vaccination with Silgard may not result in protection in all vaccine recipients.
• Omrystes omhyggeligt før brug så det bliver en suspension.
• Shake well before use to make a suspension.
Vaccinen er derfor ikke indiceret til behandling af cancer i livmoderhalsen, high-grade dysplastiske læsioner i cervix, vulva, vagina eller kondylomer.
The vaccine is therefore not indicated for treatment of cervical cancer, high-grade cervical, vulvar, and vaginal dysplastic lesions or genital warts.
Omrystes omhyggeligt før brug.
Shake well before use.
En mild infektion såsom mild øvre luftvejsinfektion eller let feber er dog ikke en kontraindikation for
However, the presence of a minor infection, such as a mild upper respiratory tract infection or low-grade fever, is not a contraindication for immunisation.
Silgard vil kun yde beskyttelse imod sygdomme, som skyldes HPV-typerne 6, 11, 16 og 18 og i en begrænset udstrækning imod sygdomme forårsaget af visse relaterede HPV-typer (se pkt.
Silgard will only protect against diseases that are caused by HPV types 6, 11, 16 and 18 and to a limited extent against diseases caused by certain related HPV types (see section 5.1).
I alt var 83 % af mændene (87 % af de heteroseksuelle mænd og 61 % af MSM) naive (PCR-negative og seronegative) over for alle 4 HPV-typer på rekrutteringstidspunktet.
Overall, 83% of men (87% of heterosexual subjects and 61% of MSM subjects) were naïve (PCR negative and seronegative) to all 4 HPV types at enrolment.
I alt var 73 % af kvinderne naive (PCR-negative og seronegative) over for alle 4 HPV-typer på rekrutteringstidspunktet.
Overall, 73% of women were naïve (PCR negative and seronegative) to all 4 HPV types at enrolment.
I ITT-populationen var den tilsvarende reduktion 23,9 % (95 % CI: 15,2; 31,7).
In the ITT population the corresponding reduction was 23.9% (95% CI: 15.2, 31.7).
• Fastgør nålen ved at dreje med uret, indtil nålen sidder godt fast i sprøjten.
• Attach the needle by twisting in a clockwise direction until the needle fits securely on the syringe.
Vaccinationen påvirkede ikke CD4% eller plasma
The CD4% or plasma HIV RNA was not affected by vaccination.
Silgard har ingen effekt hos personer, som allerede har en infektion eller sygdom, der skyldes nogle af HPV-typerne i vaccinen.
Silgard does not have any effect in individuals who already have a persistent infection or disease associated with any of the HPV types in the vaccine.
Silgard er en vaccine til brug fra 9 års alderen til forebyggelse af: - præmaligne, genitale læsioner (cervikale, vulvale og vaginale), præmaligne anale læsioner, cervixcancer og analcancer kausalt relateret til visse onkogene typer af human papillomavirus
Silgard is a vaccine for use from the age of 9 years for the prevention of: - premalignant genital lesions (cervical, vulvar and vaginal), premalignant anal lesions, cervical cancers and anal cancers causally related to certain oncogenic Human Papillomavirus (HPV)
• Inspicér suspensionen visuelt for partikler og misfarvning før administration.
• Inspect the suspension visually for particulate matter and discolouration prior to administration.
Silgards effekt hos mænd overført til drenge
Bridging the Efficacy of Silgard from Men to Boys
Silgards virkning over for CIN (af enhver grad) og CIN 2/3 eller AIS forårsaget af 10 ikke-vaccineHPV-typer (HPV 31, 33, 35, 39, 45, 51, 52, 56, 58, 59), der er strukturelt relateret til HPV 16 eller HPV 18, blev evalueret i den kombinerede fase III-effektdatabase (N = 17.599) efter en median opfølgningstid på 3,7 år (ved studieafslutning).
The efficacy of Silgard against CIN (any grade) and CIN 2/3 or AIS caused by 10 non-vaccine HPV types (HPV 31, 33, 35, 39, 45, 51, 52, 56, 58, 59) structurally related to HPV 16 or HPV 18 was evaluated in the combined Phase III efficacy database (N = 17,599) after a median follow-up of 3.7 years (at end of study).
Hvis den anden vaccinedosis indgives tidligere end 6 måneder efter den første dosis, bør en tredje dosis altid indgives.
If the second vaccine dose is administered earlier than 6 months after the first dose, a third dose should always be administered.
Kvinder, som allerede var inficeret med en eller flere vaccinerelaterede HPV-typer forud for vaccination, var beskyttet imod klinisk sygdom forårsaget af de
Women who were already infected with one or more vaccine-related HPV types prior to vaccination were protected from clinical disease caused by the remaining vaccine HPV
Immunogenicitet var relateret til alder, og anti-HPV-niveauet ved måned 7 var signifikant højere hos
Immunogenicity was related to age and Month 7 anti-HPV levels were significantly higher in younger individuals.
Anti-HBS geometrisk antistofmiddeltitre var lavere ved co-administration.
AntiHBs geometric mean antibody titres were lower on co-administration, but the clinical significance of
Bortskaf vaccinen, hvis der er partikler til stede, og/eller hvis den fremstår misfarvet.
Discard the vaccine if particulates are present and/or if it appears discoloured.
• Silgard kan fremstå som en klar væske med et hvidt præcipitat (bundfald) før omrystning.
• Silgard may appear as a clear liquid with a white precipitate prior to agitation.
B. Tabeloversigt over bivirkninger
B. Tabulated summary of adverse reactions
- Hvis der medfølger 2 kanyler af forskellig længde i pakningen, skal man vælge den kanyle, hvis længde kan sikre intramuskulær injektion afhængig af patientens størrelse og vægt.
• If 2 needles of different lengths are provided in the pack, choose the appropriate needle to ensure an IM administration depending on your patient's size and weight.
Silgard bør anvendes i overensstemmelse med officielle rekommandationer.
The use of Silgard should be in accordance with official recommendations.
De personer, der blev monitoreret ved hjælp af vaccinationsrapporteringskort, omfattede 10.088 personer (6.995 kvinder i alderen 9 til 45 år og 3.093 mænd i alderen 9 til 26 år på rekrutteringstidspunktet), der fik Silgard, og 7.995 personer (5.692 kvinder og 2.303 mænd), der fik placebo.
The individuals who were monitored using VRC-aided surveillance included 10,088 individuals (6,995 females 9 to 45 years of age and 3,093 males 9 to 26 years of age at enrolment) who received Silgard and 7,995 individuals (5,692 females and 2,303 males) who received placebo.
Silgards effekt hos kvinder overført på piger
Bridging the Efficacy of Silgard from Women to Girls
Silgards immunogenicitet vurderedes hos 20.132 (Silgard n = 10.723; placebo n = 9.409) piger og kvinder i alderen 9 til 26 år, hos 5.417 (Silgard n = 3.109; placebo n = 2.308) drenge og mænd i alderen 9 til 26 år samt hos 3.819 kvinder mellem 24 til 45 år (Silgard n = 1.911, placebo n = 1.908).
The immunogenicity of Silgard was assessed in 20,132 (Silgard n = 10,723; placebo n = 9,409) girls and women 9 to 26 years of age, 5,417 (Silgard n = 3,109; placebo n = 2,308) boys and men 9 to 26 years of age and 3,819 women 24 to 45 years of age (Silgard n = 1,911, placebo n = 1,908).
Evidens for immunhukommelsesrespons (anamnestisk respons)
Evidence of Anamnestic (Immune Memory) Response
Silgards indflydelse på den overordnede risiko for eksterne genitale læsioner blev evalueret efter den første dosis hos 2.545 personer rekrutteret i fase III-effektstudiet (Protokol 020).
The impact of Silgard against the overall risk for external genital lesions was evaluated after the first dose in 2,545 individuals enrolled in the Phase III efficacy trial (Protocol 020).
Studierne var ikke designet til at vurdere effekten over for sygdom forårsaget af individuelle HPV-typer.
The studies were not powered to assess efficacy against disease caused by individual HPV types.
Det foretrukne injektionssted er i regio deltoidea på overarmen eller i det øvre anterolaterale område på låret.
The preferred site is the deltoid area of the upper arm or in the higher anterolateral area of the thigh.
Brugen af Silgard hos voksne kvinder bør ske under hensyntagen til geografiske variationer i
The use of Silgard in adult women should take into consideration the variability of HPV type prevalence in different geographical areas.
Silgards virkning på den overordnede risiko for cervikal HPV-sygdom (dvs. sygdom forårsaget af enhver HPV-type) blev evalueret fra og med 30 dage efter den første dosis hos 17.599 personer rekrutteret til de to fase III-effektstudier (protokollerne 013 og 015).
The impact of Silgard against the overall risk for cervical, HPV disease (i.e., disease caused by any HPV type) was evaluated starting 30 days after the first dose in 17,599 individuals enrolled in the two phase III efficacy trials (Protocols 013 and 015).
Et klinisk studie (Protokol 016) sammenlignede Silgards immunogenicitet i 10- til 15-årige piger, med den der sås i 16- til 23-årige kvinder.
A clinical study (Protocol 016) compared the immunogenicity of Silgard in 10- to 15-year-old girls to those in 16- to 23-year-old women.
Silgard afstedkommer produktion af type-specifikke antistoffer og har i kliniske studier vist sig at kunne forebygge HPV 6-, 11-, 16-, og 18-relaterede sygdomme hos kvinder i alderen 16-45 år og hos mænd i alderen 16-26 år.
Silgard produces type-specific antibodies and has been shown in clinical trials to prevent HPV 6-, 11-, 16-, and 18-related diseases in women 16-45 years of age and in men 16-26 years of age.
brug.
IM use.
Tabel 2: Analyse af Silgards effekt imod high-grade cervixlæsioner i PPE-populationen Silgard Placebo
Table 2: Analysis of efficacy of Silgard against high grade cervical lesions in the PPE population Silgard Placebo % Efficacy at 2 years
Før omrystning kan Silgard fremstå som en klar væske med et hvidt bundfald.
Prior to agitation, Silgard may appear as a clear liquid with a white precipitate.
I disse studier var personer, der var seronegative for anti-HPV 6, anti-HPV 11, anti-HPV 16 og antiHPV 18 ved cLIA, stadig beskyttet mod klinisk sygdom efter opfølgning i 9 år for kvinder i alderen 16-23 år, 10 år for kvinder i alderen 24-45 år og 10 år for mænd i alderen 16-26 år.
In these studies, individuals who were seronegative for anti-HPV 6, anti-HPV 11, anti-HPV 16, and anti-HPV 18 in the cLIA were still protected against clinical disease after a follow-up of 9 years for 16-23 year-old women, 10 years for 24-45 year-old women, and 10 years for 16-26 year-old men.
Desuden udviste en undergruppe af de vaccinerede kvinder, som modtog en belastningsdosis af Silgard 5 år efter påbegyndelsen af vaccinationerne en hurtig og kraftig immunhukommelsesrespons.
In addition, a subset of vaccinated women who received a challenge dose of Silgard 5 years after the onset of vaccination, exhibited a rapid and strong anamnestic response that exceeded the anti-HPV GMTs observed 1 month Postdose 3.
Tre kliniske studier (Protokollerne 016, 018 og 020) blev brugt til at sammenligne Silgards immunogenicitet hos 9-15-årige drenge med den, der sås hos 16-26-årige mænd.
Three clinical studies (Protocols 016, 018 and 020) were used to compare the immunogenicity of Silgard in 9- to 15-year-old boys to 16- to 26-year-old men.
Silgard beskytter ikke mod alle former for HPV.
Silgard will not protect against every type of Human Papillomavirus.
Vaccinen anvendes ikke til at behandle HPVrelaterede sygdomme.
The vaccine is not used to treat HPV related diseases.
Silgard beskytter ikke mod andre sygdomme, der ikke er forårsaget af HPV.
Silgard will not protect against other diseases that are not caused by Human Papillomavirus.
Beskyttelsens varighed mod analcancer er på nuværende tidspunkt ukendt.
The duration of protection against anal cancer is currently unknown.
Effekt hos kvinder med tegn på HPV 6-, 11-, 16- eller 18-infektion eller sygdom på dag 1
Efficacy in women with evidence of HPV 6, 11, 16, or 18 infection or disease at day 1
Silgards indflydelse på frekvensen af biopsi og behandling af EGL, uanset kausal HPV-type blev evalueret hos 2.545 personer rekrutteret til Protokol 020.
The impact of Silgard on rates of biopsy and treatment of EGL regardless of causal HPV types was evaluated in 2,545 individuals enrolled in Protocol 020.
Effekten blev vurderet imod HPV 6-, 11-, 16-, 18-relaterede kondylomer, penil/perineal/perianal intraepitelial neoplasi (PIN) grad 1/2/3 og persisterende infektion.
Efficacy was evaluated against HPV 6-, 11-, 16-, 18-related external genital warts, penile/perineal/perianal intraepithelial neoplasia (PIN) grades 1/2/3, and persistent infection.
De aktive stoffer er: højtrenset ikke-smitsomt protein for hver af human papillomavirus-typerne (6, 11, 16 og 18).
The active substances are: highly purified non-infectious protein for each of the Human Papillomavirus types (6, 11, 16, and 18).
Når Silgard blev givet sammen med en kombineret difteri, tetanus, pertussis [acellulær, komponent] og poliomyelitis [inaktiveret] boostervaccine under det samme besøg, var hovedpine og hævelser på
When Silgard was given with a combined diphtheria, tetanus, pertussis [acellular, component] and poliomyelitis [inactivated] booster vaccine during the same visit, there was more headache and injection-site swelling.
Meget almindelige (forekommer hos flere end 1 ud af 10 patienter): Bivirkninger på injektionsstedet, herunder smerte, hævelse og rødme.
Very commonly (more than 1 in 10 patients), side effects found at the injection site include: pain, swelling and redness.
I vaccinegruppen blev 97,4 til 99,9 % seropositive over for alle vaccine-serotyper 1 måned efter 3. dosis.
In the vaccine group, 97.4 to 99.9% became seropositive to all vaccine serotypes by 1 month Postdose 3.
I et klinisk studie med i alt 843 raske drenge og piger i alderen fra 11-17 år viste indgivelse af den første dosis af Silgard samtidig med en kombineret difteri, tetanus, pertussis [acellulær, komponent] og poliomyelitis [inaktiveret] boostervaccine, at der var flere tilfælde af hævelser på injektionsstedet og hovedpine ved samtidig indgivelse.
In a clinical trial of 843 healthy adolescent males and females 11-17 years of age, administration of the first dose of Silgard concomitantly with a combined diphtheria, tetanus, pertussis [acellular, component] and poliomyelitis [inactivated] booster vaccine showed that there was more injection-site swelling and headache reported following concomitant administration.
Alternativt kan Silgard indgives efter et program med 3 doser (0,5 ml ved måned 0, 2 og 6).
Alternatively, Silgard can be administered according to a 3-dose (0.5 ml at 0, 2, 6 months) schedule.
Som forventet var de observerede antistoftitre lavere hos kvinder fra 24 til 45 år (protokol 019) end hos kvinder fra 16 til 25 år.
As expected for women 24 to 45 years of age (Protocol 019), the observed antibody titres were lower than that seen in women 16 to 26 years.
Silgard inducerede et specifikt antistofrespons mod HPV-type 6, 11, 16 og 18 i drægtige rotter efter en eller flere intramuskulære injektioner.
Silgard induced specific antibody responses against HPV types 6, 11, 16, and 18 in pregnant rats, following one or multiple intramuscular injections.
4.1, refererer til high-grade cervikal intraepitelial neoplasi (CIN 2/3), high-grade vulval intraepitelial neoplasi (VIN 2/3) og high-grade vaginal intraepitelial neoplasi (VaIN 2/3).
The term "premalignant genital lesions" in section 4.1 corresponds to high-grade cervical intraepithelial neoplasia (CIN 2/3), high-grade vulvar intraepithelial neoplasia (VIN 2/3) and highgrade vaginal intraepithelial neoplasia (VaIN 2/3).
Vaccination med Silgard sker med henblik på at beskytte imod sygdomme og infektioner forårsaget af human papillomavirus (HPV) type 6, 11, 16 og 18.
Vaccination with Silgard is intended to protect against diseases caused by Human Papillomavirus (HPV) types 6, 11, 16, and 18.
Cervikal intraepitelial neoplasi (CIN) grad 2/3 (moderat til high-grade dysplasi) og adenocarcinoma in situ (AIS) blev anvendt som en surrogatmarkør for cervikal cancer i de kliniske studier.
Cervical Intraepithelial Neoplasia (CIN) Grade 2/3 (moderate to high-grade dysplasia) and adenocarcinoma in situ (AIS) were used in the clinical trials as a surrogate marker for cervical cancer.
Beskyttelse imod den overordnede byrde af cervikal HPV-sygdom hos 16- til 26-årige kvinder
Protection Against the Overall Burden of Cervical HPV disease in 16- Through 26-Year-Old Women
Fortæl det altid til lægen eller på apoteket, hvis du eller dit barn bruger anden medicin eller har brugt det for nyligt.
Please tell your doctor or pharmacist if you or your child are taking or have taken recently any other medicines, including medicines obtained without a prescription.
• Injiceres straks intramuskulært (IM), helst i deltoidområdet i overarmen eller i det øvre anterolaterale område af låret.
• Inject immediately using the intramuscular (IM) route, preferably in the deltoid area of the upper arm or in the higher anterolateral area of the thigh.
I per protokol-populationen var immunresponset hos piger i alderen 9-13 år (n=241), som fik 2 doser Silgard (ved måned 0 og 6) ved måned 7 non-inferiort til og numerisk højere end immunresponset hos kvinder i alderen 16-26 år (n=246), som fik 3 doser Silgard (ved måned 0, 2 og 6).
At Month 7, in the Per Protocol population, the immune response in girls aged 9-13 years (n = 241) who received 2 doses of Silgard (at 0, 6 months) was non-inferior and numerically higher to the immune response in women aged 16-26 years (n = 246) who received 3 doses of Silgard (at 0, 2,
Resultaterne for relevante effektmål analyseret ved studiets afslutning (median opfølgningstid = 2,4 år) i per-protokol-populationen er gengivet i Tabel 5.
The efficacy results for relevant endpoints analysed at end of study (median duration of follow-up 2.4 years) in the per-protocol population are presented in the Table 5.
Silgard kan indgives samtidig med en kombineret boostervaccine indeholdende difteri (d) og tetanus (T) med enten pertussis [acellulær, komponent] (aP) og/eller poliomyelitis [inaktiveret] (IPV) (TdaP, Td-IPV, TdaP-IPV vacciner)) uden betydende interferens i antistofresponset mod nogen af vaccinekomponenterne.
Silgard may be administered concomitantly with a combined booster vaccine containing diphtheria (d) and tetanus (T) with either pertussis [acellular, component] (ap) and/or poliomyelitis [inactivated] (IPV) (dTap, dT-IPV, dTap-IPV vaccines) with no significant interference with antibody response to any of the components of either vaccine.
Beskyttelse mod den overordnede byrde af HPV-sygdom hos 16-26-årige mænd
Protection Against the Overall Burden of HPV disease in 16- Through 26-Year-Old Men
Silgards virkning på frekvensen af definitive cervikale behandlingsprocedurer uanset udløsende HPVtyper blev evalueret hos 18.150 personer rekrutteret til protokollerne 007, 013 og 015.
The impact of Silgard on rates of Definitive Cervical Therapy Procedures regardless of causal HPV types was evaluated in 18,150 individuals enrolled in Protocol 007, Protocols 013 and 015.
Effekt hos mænd fra 16 til 26 år
Efficacy in women 16 through 26 years
** Baseret på virologiske evidens er det ene tilfælde af CIN 3 hos en patient, der var kronisk inficeret med HPV 52, sandsynligvis kausalt relateret til HPV 52.
*Number of individuals with at least one follow-up visit after Month 7 **Based on virologic evidence, the first CIN 3 case in a patient chronically infected with HPV 52 is likely to be causally related to HPV 52.
Tabel 1: Bivirkninger efter indgivelse af Silgardi kliniske studier og fra bivirkningsovervågning efter
Table 1: Adverse Events Following Administration of Silgard from Clinical Trials and Post-Marketing
HPV 16/18-relateret CIN 2/3 eller AIS
HPV 16/18related CIN 2/3 or AIS HPV 16/18
På rekrutteringstidspunktet var i alt 67 % af personerne naive (PCR-negative og seronegative) over for
Overall, 67% of individuals were naïve (PCR negative and seronegative) to all
Resultater for relevante effektmål analyseret 2 år efter rekruttering og ved studiets afslutning (median varighed for opfølgning = 3,6 år) i per-protokol populationen er gengivet i tabel 2.
The efficacy results for relevant endpoints analysed at 2 years post-enrolment and at end of study (median duration of follow-up = 3.6 years) in the per-protocol population are presented in the Table 2.
De primære effektmål omfattede HPV 6-, 11-, 16- eller 18-relateret vulva- og vaginallæsioner (kondylomer, VIN, VaIN) og alle grader af CIN og cervixcancer (Protokol 013, FUTURE I), HPV 16eller 18-relateret CIN 2/3 og AIS og cervixcancer (Protokol 015, FUTURE II), HPV 6-, 11-, 16-, eller 18-relateret persisterende infektion og sygdom (Protokol 007) og HPV 16-relateret persisterende infektion (Protokol 005).
The primary efficacy endpoints included HPV 6-, 11-, 16-, or 18-related vulvar and vaginal lesions (genital warts, VIN, VaIN) and CIN of any grade and cervical cancers (Protocol 013, FUTURE I), HPV 16- or 18-related CIN 2/3 and AIS and cervical cancers (Protocol 015, FUTURE II), HPV 6-, 11-, 16-, or 18-related persistent infection and disease (Protocol 007), and HPV 16-related persistent infection (Protocol 005).
Ubrugt eller overskydende vaccine skal bortskaffes i overensstemmelse med lokal krav.
Any unused vaccine or waste material should be disposed of in accordance with local requirements.
I FAS-populationen var den tilsvarende reduktion 45,7 % (95 % CI: 29,0; 58,7) og 38,1 % (95 % CI: 19,4; 52,6).
In the FAS population, the corresponding reduction was 45.7% (95% CI: 29.0, 58.7) and 38.1% (95% CI: 19.4,