SlideShare a Scribd company logo
Presented By:
Aqsa Ayoub
Kinnaird
College For
Women
Lahore
INJECTING
LIFESAVING OXYGEN
INTO A VEIN
 Patients unable to breathe
because of acute lung failure
or an obstructed airway need
another way to get oxygen to
their blood -- and fast -- to
avoid cardiac arrest and brain
injury.
INTRODUCTION
 A team led by researchers at boston children's
hospital has designed tiny, gas-filled microparticles
that can be injected directly into the bloodstream to
quickly oxygenate the blood.
2
 The scientist began investigating the idea of injectable
oxygen many years back , after caring for a little girl
who sustained a severe brain injury resulting from a
severe pneumonia that caused bleeding into her lungs
and severely low oxygen levels. Despite the team's best
efforts, she died before they could place her on a
heart-lung machine. Frustrated by this, he formed a
team to search for another way to deliver oxygen.
BACKGROUND
3
 In the studies reported in the
paper, they used a device called
a sonicator, which uses high-
intensity sound waves to mix the
oxygen and lipids together.
 The process traps oxygen gas
inside particles averaging 2 to 4
micrometers in size . The
resulting solution, with oxygen
gas making up 70 percent of the
volume, mixed efficiently with
human blood.
MICROPARTICLE FORMATION
4
 Lipidic oxygen-containing
microparticles (LOMs)
 They are composed of oxygen gas
pocketed in a layer of lipids, a
natural molecule that usually
stores energy or serves as a
component to cell membranes.
 Lipids can be waxes, some
vitamins, monoglycerides,
diglycerides, triglycerides,
phospholipids, or—as in this
case—fats.
WHAT THESE MICROPARTICLES ARE????
5
 The LOMs solutions are
portable and could stabilize
patients in emergency
situations, buying time for
paramedics, emergency
clinicians or intensive care
clinicians to more safely place
a breathing tube or perform
other life-saving therapies,
LOM’S SOLUTIONS
6
7
HOW THEY WORK…..
HOW THEY WORK………
8
 After intravenous injection,
LOM suspensions mixed with
venous blood, which was then
oxygenated
 The check the effect of LOMs to blood, they desaturated
human red blood cells using nitrogen gas and
maintained them at 37°C under continuous motion on
stir plate. LOMs were added added to the sample
results indicate that the oxygen content of the blood
increased by about 1 ml for each milliliter of O2 gas
(encapsulated by LOMs) that was added to the blood
sample.
9
EX VIVO ADMINISTRATION
 The LOMs solution was injected intravenously into
rabbits with low blood oxygen levels, which caused the
restoration of blood oxygen saturation within seconds
to near-normal levels.
 When the trachea was completely blocked – a more
dangerous “real world” scenario - these microparticles
kept the animals alive and reduced the incidence of
cardiac arrest and organ injury.
IN VIVO ADMINISRARTION
10
 It sounds like magic, but it was just the start of what,
after years of investigation, became this real life-
giving liquid in a bottle.
 This is what the future is about. And it's a beautiful one
indeed, one that is arriving earlier than we ever could
have expected.
CONCLUSION
11
 http://mediclopaedia.com/post/49449703562/oxygen-
microparticle-injections-the-microparticles
 http://nextbigfuture.com/2013_05_12_archive.html
 http://www.33rdsquare.com/2012/06/researchers-
develop-new-way-to-breath.html
REFERENCES
12
13
Thank you

More Related Content

Similar to Injecting lifesaving oxygen into a vein

Oxygen insufficency
Oxygen insufficencyOxygen insufficency
Oxygen insufficency
Mahesh Chand
 
What is Ozone Therapy?
What is Ozone Therapy?What is Ozone Therapy?
What is Ozone Therapy?
gloherbals
 
oxygen therapy.pptx
oxygen therapy.pptxoxygen therapy.pptx
oxygen therapy.pptx
SakshiSrivastava472771
 
CABG may become a history
CABG may become a historyCABG may become a history
CABG may become a history
Ali Alwan
 
Oxygenation.ppt
Oxygenation.pptOxygenation.ppt
Oxygenation.ppt
formanite2
 
oxygenation in nursing.pdf
oxygenation in nursing.pdfoxygenation in nursing.pdf
oxygenation in nursing.pdf
sushmita chakraborty
 
Oxygenation
OxygenationOxygenation
Oxygenation
Jays George
 
Jicama Cores Lab Report
Jicama Cores Lab ReportJicama Cores Lab Report
Jicama Cores Lab Report
Mary Stevenson
 
oxygenation in nursing.pptx
oxygenation in nursing.pptxoxygenation in nursing.pptx
oxygenation in nursing.pptx
sushmita chakraborty
 
Effect Of Hypoxia On Ceramide
Effect Of Hypoxia On CeramideEffect Of Hypoxia On Ceramide
Effect Of Hypoxia On Ceramide
Heather Dionne
 
Nanobots
NanobotsNanobots
Nanobots
omkar manav
 
Oxygenation, respiratory function and cardiovascular system
Oxygenation, respiratory function and cardiovascular systemOxygenation, respiratory function and cardiovascular system
Oxygenation, respiratory function and cardiovascular system
Neeru Maher
 
Nasal drug delivery system
Nasal drug delivery systemNasal drug delivery system
Nasal drug delivery system
Sagar Savale
 
oxygen therapy
oxygen therapyoxygen therapy
oxygen therapy
sanu thomas
 
Oxygen therapy
Oxygen therapyOxygen therapy
Oxygen therapy
Joel PD
 
Non-invasive Transdermal Delivery of Medical Carbon Dioxide with D`OXYVA® Boo...
Non-invasive Transdermal Delivery of Medical Carbon Dioxide with D`OXYVA® Boo...Non-invasive Transdermal Delivery of Medical Carbon Dioxide with D`OXYVA® Boo...
Non-invasive Transdermal Delivery of Medical Carbon Dioxide with D`OXYVA® Boo...
Circularity
 
Oxygenation
OxygenationOxygenation
Oxygenation
Shiva Nagu
 
Hydrogen Stick English
Hydrogen Stick EnglishHydrogen Stick English
Hydrogen Stick English
Sook Yen Wong
 
histology of respiratory system upper and lower
histology of respiratory system  upper and lowerhistology of respiratory system  upper and lower
histology of respiratory system upper and lower
Mohamed Alashram
 
Recent Advances in Naturopathy.pptx
Recent Advances in Naturopathy.pptxRecent Advances in Naturopathy.pptx
Recent Advances in Naturopathy.pptx
DeviSneha1
 

Similar to Injecting lifesaving oxygen into a vein (20)

Oxygen insufficency
Oxygen insufficencyOxygen insufficency
Oxygen insufficency
 
What is Ozone Therapy?
What is Ozone Therapy?What is Ozone Therapy?
What is Ozone Therapy?
 
oxygen therapy.pptx
oxygen therapy.pptxoxygen therapy.pptx
oxygen therapy.pptx
 
CABG may become a history
CABG may become a historyCABG may become a history
CABG may become a history
 
Oxygenation.ppt
Oxygenation.pptOxygenation.ppt
Oxygenation.ppt
 
oxygenation in nursing.pdf
oxygenation in nursing.pdfoxygenation in nursing.pdf
oxygenation in nursing.pdf
 
Oxygenation
OxygenationOxygenation
Oxygenation
 
Jicama Cores Lab Report
Jicama Cores Lab ReportJicama Cores Lab Report
Jicama Cores Lab Report
 
oxygenation in nursing.pptx
oxygenation in nursing.pptxoxygenation in nursing.pptx
oxygenation in nursing.pptx
 
Effect Of Hypoxia On Ceramide
Effect Of Hypoxia On CeramideEffect Of Hypoxia On Ceramide
Effect Of Hypoxia On Ceramide
 
Nanobots
NanobotsNanobots
Nanobots
 
Oxygenation, respiratory function and cardiovascular system
Oxygenation, respiratory function and cardiovascular systemOxygenation, respiratory function and cardiovascular system
Oxygenation, respiratory function and cardiovascular system
 
Nasal drug delivery system
Nasal drug delivery systemNasal drug delivery system
Nasal drug delivery system
 
oxygen therapy
oxygen therapyoxygen therapy
oxygen therapy
 
Oxygen therapy
Oxygen therapyOxygen therapy
Oxygen therapy
 
Non-invasive Transdermal Delivery of Medical Carbon Dioxide with D`OXYVA® Boo...
Non-invasive Transdermal Delivery of Medical Carbon Dioxide with D`OXYVA® Boo...Non-invasive Transdermal Delivery of Medical Carbon Dioxide with D`OXYVA® Boo...
Non-invasive Transdermal Delivery of Medical Carbon Dioxide with D`OXYVA® Boo...
 
Oxygenation
OxygenationOxygenation
Oxygenation
 
Hydrogen Stick English
Hydrogen Stick EnglishHydrogen Stick English
Hydrogen Stick English
 
histology of respiratory system upper and lower
histology of respiratory system  upper and lowerhistology of respiratory system  upper and lower
histology of respiratory system upper and lower
 
Recent Advances in Naturopathy.pptx
Recent Advances in Naturopathy.pptxRecent Advances in Naturopathy.pptx
Recent Advances in Naturopathy.pptx
 

More from aqsa ayoub

Biologicals
BiologicalsBiologicals
Biologicals
aqsa ayoub
 
Lymphatic system
Lymphatic systemLymphatic system
Lymphatic system
aqsa ayoub
 
Mass spectroscopy
Mass spectroscopyMass spectroscopy
Mass spectroscopy
aqsa ayoub
 
Nmr spectroscopy
Nmr spectroscopyNmr spectroscopy
Nmr spectroscopy
aqsa ayoub
 
Mitochondial disorders
Mitochondial disordersMitochondial disorders
Mitochondial disorders
aqsa ayoub
 
Genetic fingerprinting
Genetic fingerprintingGenetic fingerprinting
Genetic fingerprinting
aqsa ayoub
 

More from aqsa ayoub (6)

Biologicals
BiologicalsBiologicals
Biologicals
 
Lymphatic system
Lymphatic systemLymphatic system
Lymphatic system
 
Mass spectroscopy
Mass spectroscopyMass spectroscopy
Mass spectroscopy
 
Nmr spectroscopy
Nmr spectroscopyNmr spectroscopy
Nmr spectroscopy
 
Mitochondial disorders
Mitochondial disordersMitochondial disorders
Mitochondial disorders
 
Genetic fingerprinting
Genetic fingerprintingGenetic fingerprinting
Genetic fingerprinting
 

Recently uploaded

Complementary feeding in infant IAP PROTOCOLS
Complementary feeding in infant IAP PROTOCOLSComplementary feeding in infant IAP PROTOCOLS
Complementary feeding in infant IAP PROTOCOLS
chiranthgowda16
 
Acute Gout Care & Urate Lowering Therapy .pdf
Acute Gout Care & Urate Lowering Therapy .pdfAcute Gout Care & Urate Lowering Therapy .pdf
Acute Gout Care & Urate Lowering Therapy .pdf
Jim Jacob Roy
 
Muscles of Mastication by Dr. Rabia Inam Gandapore.pptx
Muscles of Mastication by Dr. Rabia Inam Gandapore.pptxMuscles of Mastication by Dr. Rabia Inam Gandapore.pptx
Muscles of Mastication by Dr. Rabia Inam Gandapore.pptx
Dr. Rabia Inam Gandapore
 
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
Holistified Wellness
 
Abortion PG Seminar Power point presentation
Abortion PG Seminar Power point presentationAbortion PG Seminar Power point presentation
Abortion PG Seminar Power point presentation
AksshayaRajanbabu
 
Histololgy of Female Reproductive System.pptx
Histololgy of Female Reproductive System.pptxHistololgy of Female Reproductive System.pptx
Histololgy of Female Reproductive System.pptx
AyeshaZaid1
 
CHEMOTHERAPY_RDP_CHAPTER 3_ANTIFUNGAL AGENT.pdf
CHEMOTHERAPY_RDP_CHAPTER 3_ANTIFUNGAL AGENT.pdfCHEMOTHERAPY_RDP_CHAPTER 3_ANTIFUNGAL AGENT.pdf
CHEMOTHERAPY_RDP_CHAPTER 3_ANTIFUNGAL AGENT.pdf
rishi2789
 
Osteoporosis - Definition , Evaluation and Management .pdf
Osteoporosis - Definition , Evaluation and Management .pdfOsteoporosis - Definition , Evaluation and Management .pdf
Osteoporosis - Definition , Evaluation and Management .pdf
Jim Jacob Roy
 
Physical demands in sports - WCSPT Oslo 2024
Physical demands in sports - WCSPT Oslo 2024Physical demands in sports - WCSPT Oslo 2024
Physical demands in sports - WCSPT Oslo 2024
Torstein Dalen-Lorentsen
 
Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...
Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...
Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...
Kosmoderma Academy Of Aesthetic Medicine
 
Adhd Medication Shortage Uk - trinexpharmacy.com
Adhd Medication Shortage Uk - trinexpharmacy.comAdhd Medication Shortage Uk - trinexpharmacy.com
Adhd Medication Shortage Uk - trinexpharmacy.com
reignlana06
 
CHEMOTHERAPY_RDP_CHAPTER 2 _LEPROSY.pdf1
CHEMOTHERAPY_RDP_CHAPTER 2 _LEPROSY.pdf1CHEMOTHERAPY_RDP_CHAPTER 2 _LEPROSY.pdf1
CHEMOTHERAPY_RDP_CHAPTER 2 _LEPROSY.pdf1
rishi2789
 
Pharmacology of 5-hydroxytryptamine and Antagonist
Pharmacology of 5-hydroxytryptamine and AntagonistPharmacology of 5-hydroxytryptamine and Antagonist
Pharmacology of 5-hydroxytryptamine and Antagonist
Dr. Nikhilkumar Sakle
 
share - Lions, tigers, AI and health misinformation, oh my!.pptx
share - Lions, tigers, AI and health misinformation, oh my!.pptxshare - Lions, tigers, AI and health misinformation, oh my!.pptx
share - Lions, tigers, AI and health misinformation, oh my!.pptx
Tina Purnat
 
Cardiac Assessment for B.sc Nursing Student.pdf
Cardiac Assessment for B.sc Nursing Student.pdfCardiac Assessment for B.sc Nursing Student.pdf
Cardiac Assessment for B.sc Nursing Student.pdf
shivalingatalekar1
 
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptxVestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Dr. Rabia Inam Gandapore
 
Top Travel Vaccinations in Manchester
Top Travel Vaccinations in ManchesterTop Travel Vaccinations in Manchester
Top Travel Vaccinations in Manchester
NX Healthcare
 
CBL Seminar 2024_Preliminary Program.pdf
CBL Seminar 2024_Preliminary Program.pdfCBL Seminar 2024_Preliminary Program.pdf
CBL Seminar 2024_Preliminary Program.pdf
suvadeepdas911
 
pathology MCQS introduction to pathology general pathology
pathology MCQS introduction to pathology general pathologypathology MCQS introduction to pathology general pathology
pathology MCQS introduction to pathology general pathology
ZayedKhan38
 
CHEMOTHERAPY_RDP_CHAPTER 1_ANTI TB DRUGS.pdf
CHEMOTHERAPY_RDP_CHAPTER 1_ANTI TB DRUGS.pdfCHEMOTHERAPY_RDP_CHAPTER 1_ANTI TB DRUGS.pdf
CHEMOTHERAPY_RDP_CHAPTER 1_ANTI TB DRUGS.pdf
rishi2789
 

Recently uploaded (20)

Complementary feeding in infant IAP PROTOCOLS
Complementary feeding in infant IAP PROTOCOLSComplementary feeding in infant IAP PROTOCOLS
Complementary feeding in infant IAP PROTOCOLS
 
Acute Gout Care & Urate Lowering Therapy .pdf
Acute Gout Care & Urate Lowering Therapy .pdfAcute Gout Care & Urate Lowering Therapy .pdf
Acute Gout Care & Urate Lowering Therapy .pdf
 
Muscles of Mastication by Dr. Rabia Inam Gandapore.pptx
Muscles of Mastication by Dr. Rabia Inam Gandapore.pptxMuscles of Mastication by Dr. Rabia Inam Gandapore.pptx
Muscles of Mastication by Dr. Rabia Inam Gandapore.pptx
 
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
 
Abortion PG Seminar Power point presentation
Abortion PG Seminar Power point presentationAbortion PG Seminar Power point presentation
Abortion PG Seminar Power point presentation
 
Histololgy of Female Reproductive System.pptx
Histololgy of Female Reproductive System.pptxHistololgy of Female Reproductive System.pptx
Histololgy of Female Reproductive System.pptx
 
CHEMOTHERAPY_RDP_CHAPTER 3_ANTIFUNGAL AGENT.pdf
CHEMOTHERAPY_RDP_CHAPTER 3_ANTIFUNGAL AGENT.pdfCHEMOTHERAPY_RDP_CHAPTER 3_ANTIFUNGAL AGENT.pdf
CHEMOTHERAPY_RDP_CHAPTER 3_ANTIFUNGAL AGENT.pdf
 
Osteoporosis - Definition , Evaluation and Management .pdf
Osteoporosis - Definition , Evaluation and Management .pdfOsteoporosis - Definition , Evaluation and Management .pdf
Osteoporosis - Definition , Evaluation and Management .pdf
 
Physical demands in sports - WCSPT Oslo 2024
Physical demands in sports - WCSPT Oslo 2024Physical demands in sports - WCSPT Oslo 2024
Physical demands in sports - WCSPT Oslo 2024
 
Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...
Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...
Cosmetology and Trichology Courses at Kosmoderma Academy PRP (Hair), DR Growt...
 
Adhd Medication Shortage Uk - trinexpharmacy.com
Adhd Medication Shortage Uk - trinexpharmacy.comAdhd Medication Shortage Uk - trinexpharmacy.com
Adhd Medication Shortage Uk - trinexpharmacy.com
 
CHEMOTHERAPY_RDP_CHAPTER 2 _LEPROSY.pdf1
CHEMOTHERAPY_RDP_CHAPTER 2 _LEPROSY.pdf1CHEMOTHERAPY_RDP_CHAPTER 2 _LEPROSY.pdf1
CHEMOTHERAPY_RDP_CHAPTER 2 _LEPROSY.pdf1
 
Pharmacology of 5-hydroxytryptamine and Antagonist
Pharmacology of 5-hydroxytryptamine and AntagonistPharmacology of 5-hydroxytryptamine and Antagonist
Pharmacology of 5-hydroxytryptamine and Antagonist
 
share - Lions, tigers, AI and health misinformation, oh my!.pptx
share - Lions, tigers, AI and health misinformation, oh my!.pptxshare - Lions, tigers, AI and health misinformation, oh my!.pptx
share - Lions, tigers, AI and health misinformation, oh my!.pptx
 
Cardiac Assessment for B.sc Nursing Student.pdf
Cardiac Assessment for B.sc Nursing Student.pdfCardiac Assessment for B.sc Nursing Student.pdf
Cardiac Assessment for B.sc Nursing Student.pdf
 
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptxVestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
 
Top Travel Vaccinations in Manchester
Top Travel Vaccinations in ManchesterTop Travel Vaccinations in Manchester
Top Travel Vaccinations in Manchester
 
CBL Seminar 2024_Preliminary Program.pdf
CBL Seminar 2024_Preliminary Program.pdfCBL Seminar 2024_Preliminary Program.pdf
CBL Seminar 2024_Preliminary Program.pdf
 
pathology MCQS introduction to pathology general pathology
pathology MCQS introduction to pathology general pathologypathology MCQS introduction to pathology general pathology
pathology MCQS introduction to pathology general pathology
 
CHEMOTHERAPY_RDP_CHAPTER 1_ANTI TB DRUGS.pdf
CHEMOTHERAPY_RDP_CHAPTER 1_ANTI TB DRUGS.pdfCHEMOTHERAPY_RDP_CHAPTER 1_ANTI TB DRUGS.pdf
CHEMOTHERAPY_RDP_CHAPTER 1_ANTI TB DRUGS.pdf
 

Injecting lifesaving oxygen into a vein

  • 1. Presented By: Aqsa Ayoub Kinnaird College For Women Lahore INJECTING LIFESAVING OXYGEN INTO A VEIN
  • 2.  Patients unable to breathe because of acute lung failure or an obstructed airway need another way to get oxygen to their blood -- and fast -- to avoid cardiac arrest and brain injury. INTRODUCTION  A team led by researchers at boston children's hospital has designed tiny, gas-filled microparticles that can be injected directly into the bloodstream to quickly oxygenate the blood. 2
  • 3.  The scientist began investigating the idea of injectable oxygen many years back , after caring for a little girl who sustained a severe brain injury resulting from a severe pneumonia that caused bleeding into her lungs and severely low oxygen levels. Despite the team's best efforts, she died before they could place her on a heart-lung machine. Frustrated by this, he formed a team to search for another way to deliver oxygen. BACKGROUND 3
  • 4.  In the studies reported in the paper, they used a device called a sonicator, which uses high- intensity sound waves to mix the oxygen and lipids together.  The process traps oxygen gas inside particles averaging 2 to 4 micrometers in size . The resulting solution, with oxygen gas making up 70 percent of the volume, mixed efficiently with human blood. MICROPARTICLE FORMATION 4
  • 5.  Lipidic oxygen-containing microparticles (LOMs)  They are composed of oxygen gas pocketed in a layer of lipids, a natural molecule that usually stores energy or serves as a component to cell membranes.  Lipids can be waxes, some vitamins, monoglycerides, diglycerides, triglycerides, phospholipids, or—as in this case—fats. WHAT THESE MICROPARTICLES ARE???? 5
  • 6.  The LOMs solutions are portable and could stabilize patients in emergency situations, buying time for paramedics, emergency clinicians or intensive care clinicians to more safely place a breathing tube or perform other life-saving therapies, LOM’S SOLUTIONS 6
  • 8. HOW THEY WORK……… 8  After intravenous injection, LOM suspensions mixed with venous blood, which was then oxygenated
  • 9.  The check the effect of LOMs to blood, they desaturated human red blood cells using nitrogen gas and maintained them at 37°C under continuous motion on stir plate. LOMs were added added to the sample results indicate that the oxygen content of the blood increased by about 1 ml for each milliliter of O2 gas (encapsulated by LOMs) that was added to the blood sample. 9 EX VIVO ADMINISTRATION
  • 10.  The LOMs solution was injected intravenously into rabbits with low blood oxygen levels, which caused the restoration of blood oxygen saturation within seconds to near-normal levels.  When the trachea was completely blocked – a more dangerous “real world” scenario - these microparticles kept the animals alive and reduced the incidence of cardiac arrest and organ injury. IN VIVO ADMINISRARTION 10
  • 11.  It sounds like magic, but it was just the start of what, after years of investigation, became this real life- giving liquid in a bottle.  This is what the future is about. And it's a beautiful one indeed, one that is arriving earlier than we ever could have expected. CONCLUSION 11