microlife BP3GX1-5X Blood Pressure Monitor Instruction Manual

Deluxe
Blood
Pressure
Monitor
Model # BP3GX1-5X
Instruction Manual

QUESTIONS? 1-800-568-4147

Introduction

1.1. Features of your Automatic Blood Pressure Monitor
Your blood pressure monitor is a fully automatic digital blood pressure measuring device for use by adults on the upper arm at home or in your doctor’s office. It enables very fast and reliable measurement of the systolic and diastolic blood pressure as well as the pulse by way of the oscillometric method. This device offers clinically proven accuracy and has been designed to be user-friendly.
Before using it, please read this instruction manual carefully and then keep it in a safe place. Please contact your doctor for further questions on the subject of blood pressure and its measurement.

Attention!
1.2. Important information about self-measurement

• Self-measurement means to control, not diagnose or treat. Unusual values must always be discussed with your doctor. Under no circumstances should you alter the dosages of any drugs prescribed by your doctor.
• The pulse display is not suitable for checking the frequency of heart pacemakers.
• In cases of irregular heartbeat, measurements made with this instrument should only be evaluated after consultation with your doctor.

Electromagnetic interference:
The device contains sensitive electronic components. Avoid strong electrical or electromagnetic fields in the direct vicinity of the device (e.g., mobile telephones, microwave ovens). These can lead to temporary impairment of the measuring accuracy.

Important information on blood pressure and its measurement

2.1. How does high/low blood pressure arise?
Your level of blood pressure is determined in the circulatory center of the brain and adjusts to a variety of situations through feedback from the nervous system. To adjust blood pressure, the strength and frequency of the heart (pulse), as well as the width of circulatory blood vessels is altered.
Blood vessel width is affected by fine muscles in the blood vessel walls.
Your level of arterial blood pressure changes periodically during heart activity. During the “blood ejection” (Systole), the value is highest (systolic blood pressure value). At the end of the heart’s “rest period” (Diastole), pressure is lowest (diastolic blood pressure value).
Blood pressure values must lie within certain normal ranges in order to prevent particular diseases.
2.2. Which values are normal?
Blood pressure is too high if your diastolic pressure is above 100 mmHg and/or your systolic blood pressure is over 160 mmHg, while at rest. In this case, please consult your physician immediately. Long-term values at this level endanger your health due to continual damage to the blood vessels in your body.
If your systolic blood pressure values are between 140 mmHg and 159 mmHg and/or the diastolic blood pressure values are between 90 mmHg and 99 mmHg, consult your physician. Regular self-checks are necessary.
If you have blood pressure values that are too low (i.e., systolic values under 105 mmHg and/or diastolic values under 60 mmHg), consult your physician.
Even with normal blood pressure values, a regular self-check with your blood pressure monitor is recommended. You can detect possible changes in your values early and react appropriately.
If you are undergoing medical treatment to control your blood pressure, keep a record of values along with the time of day and date. Show these values to your physician. Never use the results of your measurements to independently alter the drug doses prescribed by your physician.
Which values are normal?
The following standards for assessing high blood pressure (in adults) have been established by the National Institutes of Health JNC7, 2003.

Category| Systolic
(mmHg)| Diastolic
(mmHg)
---|---|---
Normal
Pre-Hypertension| <120
120-139| and <80
or 80-89
Hypertension
Stage 1 Hypertension
Stage 2 Hypertension| 140-159
≥160| or 90-99
or ≥100

Further information

• If your values are mostly normal under resting conditions but exceptionally high under conditions of physical or psychological stress, it is possible that you are suffering from so-called “labile hypertension.” Consult your doctor.
• Correctly measured diastolic blood pressure values above 120 mmHg require immediate medical treatment.

This device is not intended for use on children 12 years of age or younger.
2.3. What can be done if regular high or low values are obtained?

a) Consult your doctor.
b) Increased blood pressure values (various forms of hypertension) are associated with considerable health risks over time. Arterial blood vessels in your body are endangered due to constriction caused by deposits in the vessel walls (arteriosclerosis). A deficient supply of blood to important organs (heart, brain, muscles) can result from arteriosclerosis. Furthermore, the heart will become structurally damaged with increased blood pressure values.
c) There are many different causes of high blood pressure. We differentiate between common primary (essential) hypertension and secondary hypertension.
The latter group can be ascribed to specific organ malfunctions.
Please consult your doctor for information about the possible origins of your own increased blood pressure values.
d) There are measures that you can take to reduce and even prevent high blood pressure. These measures must be permanent lifestyle changes.

1. Eating habits
   • Strive for a normal weight corresponding to your age. See your doctor for your ideal weight.
   • Avoid excessive consumption of common salt.
   • Avoid fatty foods.

2. Previous illnesses
   • Consistently follow all medical instructions for treating illnesses such as:
   • Diabetes (diabetes mellitus)
   • Fat metabolism disorder
   • Gout

3. Habits
   • Give up smoking completely.
   • Drink only moderate amounts of alcohol.
   • Restrict your caffeine consumption (e.g., coffee).

4. Physical constitution
   • After a preliminary medical examination, do regular exercise.
   • Choose sports that require stamina and avoid those which require strength.
   • Avoid reaching the limit of your performance.
   • With previous illnesses and/or age of over 40 years, please consult your doctor before beginning your exercise routine. You must receive advice regarding the type and extent of exercise that is appropriate for you.

Components of your blood pressure monitor

a) Measuring unit

b) Wide Range Cuff:
For arm circumference 22 cm – 42 cm (8.7” – 16.5 ”)
If you ever need to buy a replacement cuff, call us toll-free at 1-800-568-4147.
Please Note:
Arm circumference should be measured with a measuring tape in the middle of the relaxed upper arm. Do not force the cuff connection into the opening. Make sure the cuff connection is not pushed into the AC adapter port. If the cuff is too small, call 1-800-568-4147 for further information.

Using your blood pressure monitor for the first time

4.1. Inserting the batteries
After you have unpacked your device, insert the batteries. The battery compartment is located at the bottom of the device.
a) Remove the battery cover.
b) Insert the batteries (4 x size AA 1.5 V), observing the indicated polarity.
c) If a battery warning appears on the display, the batteries are discharged and must be replaced.

Attention!

• After the low battery indicator appears, the device won’t function until the batteries have been replaced.
• Please use “AA” Long-Life or Alkaline 1.5 V batteries.
• If the blood pressure monitor is not used for long periods, remove the batteries from the device.

4.2. Setting the date and time

1. After the new batteries are activated, the year number flashes on the display. You can advance the year by pressing the “M” button. To confirm and then set the month, press the TIME button.
2. You can now set the month using the “M” button. To confirm and then set the day, press the TIME button.
3. Please follow the instructions above to set the day, hour, and minutes.
4. Once you have set the last minute and pressed the TIME button, the date and time are set and the time is displayed.
5. If you want to change the date and time, press and hold the TIME button down for approximately 3 seconds until the year number starts to flash. Now you can enter the new values as described above.

4.3. Using the AC power adapter
You may also operate this monitor using the included AC adapter. Use only the included AC adapter to avoid damaging the unit.
a) Ensure that the AC adapter and cable are not damaged.
b) Plug the adapter cable into the AC adapter port on the right side of the monitor.
c) Plug the AC adapter into a 110 V power socket (the U.S. or Canada).
d) Test that power is available by pressing the POWER button.

Note:

• No power is taken from the batteries while the AC adapter is connected to the instrument.
• If the power is interrupted during a measurement (e.g., by removal of the adapter from the wall socket), the instrument must be reset by removing the plug from the instrument.
  If you have any questions regarding the AC adapter, call us at 1-800-568-4147.

4.4. Cuff tube connection
Insert the yellow cuff tube connector into the yellow socket on the left side of the instrument.

4.5. Select the user
This blood pressure monitor is designed to store 99 measurements for each the two users.

Before taking a measurement, be certain that the correct user has been selected.

• User 1: slide the user switch upwards to the User 1 icon
• User 2: slide the user switch downwards to the User 2 icon

4.6. Select measuring mode: standard or Microlife Averaging Mode (MAM)
This instrument enables you to select either standard (single measurement) or measurement averaging mode (automatic triple measurement).
a) To select Standard mode, push the switch on the side of the instrument upward to Position “1.”
b) To select Averaging mode, push the switch downward to Position “3.” Note the “MAM” icon will illuminate on the display.
If you select 1, then only one measurement will be taken. If you select 3, the unit will inflate and deflate three times resulting in one final average.

4.7. Microlife Averaging Mode (MAM)

• In Microlife Averaging Mode (MAM), three measurements are automatically taken in succession and the result is then automatically analyzed and displayed. Because your blood pressure constantly fluctuates, a result determined in this way is more reliable than one produced by a single measurement.
• After pressing the POWER button the selected Microlife Averaging Mode appears in the display as the MAM symbol.
• The bottom, right-hand section of the display shows a 1, 2, or 3 to indicate which of the 3 measurements is currently being taken.

Measurement procedure

Please note: You should always be seated before and during measurement.

5.1. Before measurement:

• Avoid eating and smoking as well as all forms of exertion directly before measurement. These factors influence the measurement result. Find time to relax by sitting in an armchair in a quiet atmosphere for about ten minutes before your measurement.
• Remove any garment that fits closely to your upper arm.
• Always measure on the same arm (normally left).
• Compare measurements at the same time of day, since blood pressure changes during the course of the day (as much as 20–40 mmHg).

5.2. Common sources of error
Note: Comparable blood pressure measurements always require the same conditions. Conditions should always be quiet.

• All efforts by the user to support the arm can increase blood pressure.
  Make sure you are in a comfortable, relaxed position and do not flex any of the muscles in the measurement arm during the measurement.
  Use a cushion for support if necessary.

• If the arm artery lies considerably lower or higher than the heart, erroneously high or low blood pressure will be measured. Each 15 cm (6”) difference in height between your heart and the cuff results in a measurement error of 10 mmHg.

• Cuffs that are too narrow or too short result in false measurement values. Selecting the correct cuff is extremely important. Cuff size is dependent upon the circumference of the arm (measured in the center).
  The permissible range is printed on the cuff. If this is not suitable for your use, please call 1-800-568-4147.

• A loose cuff or a sideways protruding air pocket causes false measurement values.

• With repeated measurements, blood accumulates in the arm, which can lead to false results. Consecutive blood pressure measurements should be repeated after a 1-minute pause or after your arm has been held up in order to allow the accumulated blood to flow away.

5.3. Fitting the cuff
a) Pass the end of the cuff through the flat metal ring so that a loop is formed. The hook and loop material must be facing outward. (Ignore this step if the cuff has already been prepared.)
b) Slide the cuff onto your upper left arm. The rubber tube should be on the inside of your arm extending down to your hand.
Make certain the cuff lies approximately 1/2” to 3/4” (1 to 2 cm) above the elbow.

IMPORTANT: The red strip on the edge of the cuff (Artery Mark) must lie over the artery which runs down the inner side of the tharm.

TIP: Align the red artery mark to the pinky finger.
c) To secure the cuff, wrap it around your arm and press the hook and loop material together. Check the size range indicator on the cuff. The green arrow should point within the green size range on the inside of the cuff. d) There should be little free space between the arm and the cuff. You should be able to fit 2 fingers between your arm and the cuff. Clothing must not restrict the arm.
Any piece of clothing which does must be removed. Cuffs that don’t fit properly result in false measurement values.
Measure your arm circumference if you are not sure of the proper fit.

e) Lay your arm on a table so the cuff is at the same height as your heart. Make sure the tube is not kinked. f) Remain seated quietly for five minutes before you begin the measurement.

Comment
If it is not possible to fit the cuff to your left arm, it can also be placed on your right arm. However, all measurements should be made using the same armComparable blood pressure measurements always require the same conditions (relax for several minutes before a reading).

5.4. Measuring procedure
After the cuff has been appropriately positioned the measurement can begin:
a) Press the POWER button. After the system check, the monitor displays OK and the pump begins to inflate the cuff. On the display, the increasing cuff pressure is continually shown. b) After automatically reaching an individual pressure, the pump stops and the pressure slowly falls. The cuff pressure is displayed during the measurements) When the device has detected your pulse, the heart symbol in the display begins to blink. d) When the measurement has been concluded, the air will automatically release from the cuff. The measured systolic and diastolic blood pressure values, as well as the pulse, are now displayed. e) The measurement results are displayed until you switch the device off. If no button is pressed for 1 minute, the device switches off automatically.
f) When the unit is set to the MAM (Microlife Averaging Mode) setting, 3 separate measurements will take place in succession, after which your result is calculated and displayed as a single, averaged measurement (individual results are not displayed). There is a 15-second resting time between each measurement. A count-down indicates the remaining time between measurements.
If one of the measurements causes an error message, it will be repeated one more time. If any additional error occurs, the measurement will be discontinued and the error code displayed.

5.5. Memory – displaying the last 99 measurements
At the end of a measurement, this monitor automatically stores each result with the date and time. This unit stores 99 memories for every 2 users.
Viewing the stored values
With the unit, off, press the “M” button. The display first shows “A,” and then shows an average of all measurements stored in the unit. Please note:
Measurements for each user are averaged and stored separately. Be certain that you are viewing the measurements for the correct user. Pressing the “M” button again displays the previous value. To view a particular stored memory, press and hold the “M” button to scroll to that stored reading.

Memory full
When the memory has stored 99 results, a new, measured value is stored by overwriting the oldest value.
Clear all values
If you are sure that you want to permanently remove all stored values, hold down the “M” button (the instrument must have been switched off beforehand) until “CL” appears, and then release the button. If you do not want to clear the values, press the POWER button. To permanently clear the memory, press the “M” button while “CL” is flashing.
Individual values cannot be cleared.

5.6. Discontinuing a measurement
If it is necessary to interrupt a blood pressure measurement for any reason (e.g., the patient feels unwell), the POWER button can be pressed at any time. The device then immediately lowers the cuff pressure automatically and enters sleep mode.

5.7. Hypertension risk indicator
The bars on the left-hand edge of the display show you the range within which the indicated blood pressure value lies. Depending on the position of the triangle indicator, the readout value is either within the normal (green), borderline (yellow), or danger (orange, dark orange) range.
The classification is based on standards established by the National Institutes of Health JNC7, 2003.
Refer to the chart in section 2.2 of this instruction manual for details of the classifications.

A triangle is displayed to the right of the traffic light bar according to your measurement.

• If your triangle is in the green zone, your measurement is “Normal,” according to NIH standards.
• If your triangle is in the yellow zone, your measurement is “Pre-Hypertension.”
• If your triangle is in the orange zone, it is “Stage 1 Hypertension.”
• If your triangle is in the dark orange zone, it is “Stage 2 Hypertension.”.

5.8. Irregular heartbeat detector
The appearance of this symbol indicates that certain pulse irregularities were detected during the measurement. In this case, the result may deviate from your normal basal blood pressure – repeat the measurement. In most cases, this is no cause for concern. However, if the symbol appears on a regular basis (e.g., several times a week with measurements taken daily), we advise you to tell your doctor.
Please show your doctor the following explanation:

Information on the frequent appearance of the irregular heartbeat symbol
This instrument is an oscillometric blood pressure monitor device that also analyzes pulse frequency during measurement. The instrument is clinically tested.
If pulse irregularities occur during the measurement, the irregular heartbeat symbol is displayed with the measurement.
If the symbol appears frequently or if it suddenly appears more often than usual, we recommend the patient seek medical advice. The instrument does not replace a cardiac examination but serves to detect pulse irregularities at an early stage.

5.9. Battery charge indicator
Batteries almost discharged
When the batteries are approximately 75% used, the battery symbol will flash a few times as soon as the instrument is switched on (if at least one of the batteries still has some charge).
Although the instrument will continue to measure reliably, you should obtain replacement batteries.

Batteries discharged – replacements required
When the batteries are discharged, the battery symbol will appear, unblinking, as soon as the instrument is switched on. You cannot take any further measurements and must replace the batteries.

1. Open the battery compartment on the bottom of the instrument.
2. Replace the batteries – ensure they are correctly connected, as shown on the symbols in the compartment.
3. The memory retains all values although date and time (and possibly also set alarm times) must be reset – the year number will flash automatically after the batteries are replaced.
4. To set the date and time, follow the procedure described in Section 4.3.

Note:
Use four new, Long-Life 1.5 V AA batteries. Do not use batteries beyond their expiration date. If the monitor is not going to be used for a prolonged period, the batteries should be removed.

Using rechargeable batteries
You can also operate this instrument using rechargeable batteries.

• Please use only type “NiMH” reusable batteries.
• If the battery symbol ( ) appears, the batteries must be removed and recharged. They must not remain inside the instrument, as they may become damaged through total discharge even when switched off. The batteries must NOT be discharged in the blood pressure monitor. If you do not intend to use the instrument for a week or more, always remove the rechargeable batteries.
• Recharge these batteries using an external charger and follow the manufacturer’s instructions carefully.

Software functions

This unit can be used in connection with your personal computer (PC) running the PC Link blood pressure analyzer software. Your PC will allow a capacity of monitoring 80  patients, each with 1000 data (note: overuse will lower system efficiency). The memory data can be transferred to the PC by connecting the monitor via the included USB cable.
Note: The software does not work with Mac computers.

System Requirements for Blood Pressure Analyzer Software:

• Windows XP, Vista, 7,8
• CD-ROM Drive
• Minimum 256MB RAM
• 500MB Available Hard Disk Space
• USB Port Version 1.0 or Higher
• Compatible Blood Pressure Monitor with USB Port

6.1. Installation and data transmission
a) Insert CD into the CD ROM drive of your PC. The installation will start automatically. If not, click on SETUP.EXE.
b) Connect the monitor via a USB cable with the PC. Three horizontal bars will appear on the display and last for 3 seconds. c) The bars will then flash to indicate that the connection between the computer and the device is successfully made. As long as the cable is plugged, the bars will keep flashing and the buttons are disabled. During the connection, the device is completely controlled by the computer. Please refer to the “Help” file in the software for detailed instruc- tions or call 1-800-568-4147.

Error messages/troubleshooting

If an error occurs during a measurement, the measurement is discontinued and a corresponding error code is displayed (example: Error no. 2).

Error No. Possible cause(s)/Solutions

ERR 1| The tube may have loosened, or no pulse was detected.
Ensure cuff connections are tight with proper cuff placement.
See section 5.3.
---|---
ERR 2| Unnatural pressure impulses influenced the measurement result.
Reason: The arm was moved during the measurement (artifact). Repeat measurement, keeping still and quiet.
ERR 3|  Inflation of the cuff takes too long. The cuff is not correctly seated or the hose connection is not tight.
Re-position the cuff and repeat the measurement.
ERR 5| The measured readings indicated an unacceptable difference between systolic and diastolic pressures.
Take another reading following directions carefully.
Contact your doctor if you continue to get unusual readings.
HI| The cuff pressure is too high. Relax for 5 minutes and repeat the measurement.
LO| The pulse is too low (less than 40). Repeat the measurement.*

*If this or any other problem occurs repeatedly, please consult your doctor.

Other possible errors and their solutions
If problems occur when using the device, the following points should be checked and, if necessary, the corresponding measures are to be taken:

The display remains blank when the instrument is switched on although
the batteries are in place.| 1. Check batteries for the correct polarity.
2. If the display is unusual, remove the batteries and exchange them for new ones.
The pressure does not rise although the pump is running.| Check the connection of the cuff tube and connect it properly.
The device frequently fails to measure blood pressure values or the values measured are too low or high.| 1. Check the positioning of the cuff.
2. Measure blood pressure again in peace and quiet, carefully following the
details in Section 5.
Every measurement results in a different value, although the device functions normally and normal values are displayed.| Please read the following information and points listed in Section 5.2 “Common sources of error.” Repeat the measurement.
Please note: Blood pressure fluctuates continually so successive measurements
will show some variability.
Blood pressure values differ from those measured by my doctor.| Record the daily development of the measured values and consult your doctor.
Please note: Individuals visiting their doctor frequently experience anxiety
which can result in a higher reading than at home under resting conditions.
After the instrument has inflated the cuff the pressure falls very slowly, or not at all. (No reasonable measurement possible.)| 1. Check cuff connections.
2. Ensure the unit has not been tampered with.

Care and maintenance

a) Do not expose the device to either extreme temperatures, humidity, dust, or direct sunlight.
b) The cuff contains a sensitive airtight bubble. Handle this cuff carefully and avoid all types of stress through twisting or buckling. c) Clean the device with a soft, dry cloth. Do not use gasoline, thinners, or similar solvents. Spots on the cuff can be removed carefully with a damp cloth and soapsuds.
The cuff must not be washed in a dishwasher, clothes washer, or submerged in water.
d) Handle the tube carefully. Do not pull on it.
Do not allow the tubing to kink and keep it away from sharp edges.
e) Do not drop the monitor or treat it roughly in any way. Avoid strong vibrations. f) Never open the monitor. This invalidates the manufacturer’s warranty.
g) Batteries and electronic instruments must be disposed of in accordance with the locally applicable regulations, not with domestic waste.

Further information
Blood pressure is subject to fluctuations, even in healthy people.
Comparable measurements always require the same conditions (quiet conditions)! If fluctuations in readings are larger than 15 mmHg, and/or you hear irregular pulse tones, consult your doctor.
Never attempt to repair the instrument yourself.
Any unauthorized opening of the instrument invalidates all warranty claims.

Warranty Your Automatic

Blood Pressure Monitor is guaranteed for 5 years against manufacturer defects for the original purchaser only, from the date of purchase. The warranty does not apply to damage caused by improper handling, accidents, professional use, not following the operating instructions, or alterations made to the instrument by third parties.
A 5-year warranty only applies to the instrument. All accessories including the cuff, AC adapter, and software are guaranteed for one year.
There are no user-serviceable parts inside. Batteries or damage from old batteries is not covered by the warranty.
Please note: According to international standards, your monitor should be checked for accuracy every 2 years.

Certifications

Device standard:| Device corresponds to the requirements of the standard for non-invasive blood pressure monitors:
AAMI/ANSI SP10
IEC 60601-1
IEC 60601-1-2
---|---
Electromagnetic compatibility: tions of the standard IEC60601-1-2| Device fulfills the stipula International
Clinical testing:| Clinical performance tests were carried out in the US according to ANSI/AAMI SP10
standard.

The B.H.S. (British Hypertension Society) clinical protocol was used to measure the accuracy of this product. Blood pressure units using the same measurement technology are graded “AA” for systolic/diastolic accuracy by independent investigators using the BHS protocol. This is the highest grading available for blood pressure monitors. Please see bhsoc.org for more information.

Technical specifications:

Weight: . . . . . . . . . . . . . . . . . . . . . . . . .368 g (with batteries)
Size: . . . . . . . . . . . . . . . . . . . . . . . . . . .85 (W) x 143 (L) x 58 (H) mm
Storage temperature: . . . . . . . . . . . . . .-20 to +55°C (-4° to +131°F)
Humidity: . . . . . . . . . . . . . . . . . . . . . . .15 to 90% relative humidity maximum
Operation temperature: . . . . . . . . . . . .10 to 40°C (50° to 104°F)
Display: . . . . . . . . . . . . . . . . . . . . . . . . .LCD (Liquid Crystal Display)
Measuring method: . . . . . . . . . . . . . . .Oscillometric
Pressure sensor: . . . . . . . . . . . . . . . . . .Capacitive
Measuring range:
SYS/DIA: . . . . . . . . . . . . . . . . . . . . .30 to 280 mmHg
Pulse: . . . . . . . . . . . . . . . . . . . . . . . .40 to 200 per minute
Cuff pressure display range: . . . . . . . .0-299 mmHg
Memory: . . . . . . . . . . . . . . . . . . . . . . . .Automatically stores the last 99 measurements for 2 users (total 198)
Measuring resolution: . . . . . . . . . . . . .1 mmHg
Accuracy: . . . . . . . . . . . . . . . . . . . . . . .Pressure within ± 3 mmHg or 2% of reading >200 mmHg
Pulse ± 5% of the reading
Power source: . . . . . . . . . . . . . . . . . . . .a) 4 AA batteries, 1.5 V
b) AC adapter 6 V DC 600 mA (voltage 4.5 V DC to 6 V DC)
Accessories: . . . . . . . . . . . . . . . . . . . . . . .Cuff type: Wide range cuff for arm circumference 22-42 cm (8.7”-16.5”)
BP analyzer software CD
USB (A to mini B) cable
Storage case
Technical alterations reserved.

Made in China
**** Read the instructions carefully before using this device.
Type BF applied part.

Not for use on children 12 years of age or younger.

How to contact us

Microlife USA, Inc.
1617 Gulf to Bay Blvd
2nd Floor
Clearwater, FL 33755
Toll-Free Help Line: 1-800-568-4147
Email: custserv@microlifeusa.com
Fax: 727-451-0492
www.microlifeusa.com
Made in China

References

• Homepage - British and Irish Hypertension Society | Registered UK Charity No. 287635
• Microlife

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