resmed ventilator cost

ET 0000013580 00000 n Join the Ars Orbital Transmission mailing list to get weekly updates delivered to your inbox. All we know is that they were made by top ventilator producers, such as ResMed, Philips, and Medtronic. ResMed ventilators and patient interfaces. Vsync is ResMed’s latest leak management system that helps provide patient-ventilator synchronization. The researchers’ preference is for ResMed to release its own firmware update that unlocks the ventilator functions. It is also called a breathing machine or respirator. H‰\“Án«0E÷|…—í¢‚€=ÓJ(Rš´R¯­šö8yH/9d‘¿¾Üª•Š”pܙ3`çëífúÉäoqhw~2‡>tџ‡Kl½Ùûc²Eiº¾¾®æÿöԌYžÂ»ëyò§m8Y]›ü=Ý. The ventilator Is attached to a computer with knobs and buttons that are controlled by a respiratory therapist, nurse, or doctor. Methods The ventilator was built using off-the-shelf materials available via e-commerce and was based on a high-pressure blower, two pressure transducers and an Arduino Nano controller with a digital display (total retail cost <75 US$), with construction … Shortly after, the company received a government contract worth $31.98 million to produce 2,550 ventilators. Its more immediate use is to prove that the AirSense 10 does, in fact, have the ability to provide emergency ventilator functions. Has tubes that connect to the person through a breathing tube. 0000014356 00000 n 0000000016 00000 n - Apr 14, 2020 5:30 pm UTC. The benefit of ResMed releasing a patch is two-fold. ventilator functions were already built into the device firmware. ResMed nets $32 million ventilator contract from federal government for COVID-19 fight ResMed makes three models of ventilators, including the … Its manufacturer, ResMed, says the $700 device solely functions as a continuous positive airway pressure machine used to treat sleep apnea. To demonstrate his findings, Hudson on Tuesday is releasing a patch that he says unlocks the hidden capabilities buried deep inside the AirSense 10. Demand for ventilators shot up, with ResMed’s earnings in its third and fourth quarters reflecting sales growth of 16.2% and 9.3%, respectively. The Stellar™ 100 ventilator is intended for use crosswise over various hospital settings where non-dependent patients are progressing. ResMed offers a broad range of respiratory care offerings for invasive and non-invasive ventilation, as well as oxygen therapy, to suit different patients and care settings. The ResMed Astral 150™ Ventilator is an enhanced version of the original ResMed Astral 100 model that includes added features and upgrades. 0000037810 00000 n 0000007194 00000 n Narrow By. The patch is dubbed Airbreak in a nod to jailbreaks that hobbyists use to remove technical barriers Apple developers erect inside iPhones and iPads. $4,500.00. 0000004192 00000 n 0000011829 00000 n The retail cost of this ventilator prototype was <75 USD, and includes all required electronic circuits and power source. 0000027521 00000 n When should a ventilator or respiratory assist device (RAD) be considered? 0000059042 00000 n From sleep apnea to respiratory conditions including COPD, ResMed has innovative solutions to help people live a healthier life. ResMed says the device can’t work as a bilevel positive airway pressure device, which is a more advanced machine that pushes air into a mask and then reduces the pressure to a calibrated lower level to allow it back out. Ventilator Machine Description:- A ventilator is a machine that breathes for you or helps you breathe. 4.65. Resmed has said it is doing all it can to increase production of its ventilators and other respiratory devices and intends to double or triple its ventilator output, and scale up ventilation mask production more than tenfold. https://www.hospitalsstore.com/resmed-ventilator-astral-150 Respiratory care. Pressure Range. Only a more expensive AirCurve 10 device could do that, Moehnke said. Tuesday’s release of Airbreak will allow medical technicians and researchers to test the unadvertised features of the ResMed machines to see precisely how they might be used in emergency rooms struggling with a dangerous lack of proper ventilators. See ResMed.com for other ResMed … Is Top Seller. Although its manufacturer says the AirSense 10 would require “ significant rework to function as a ventilator,” many ventilator functions were already built into the device firmware. 44 33 0000003796 00000 n ResMed’s secure AirView platform helps clinicians remotely monitor and advise ventilator and bilevel device patients faster, and serve them more safely by reducing in-person visits ResMed (NYSE: RMD, ASX: RMD), a world-leading digital health company, today launched cloud-based remote monitoring software for ventilators and Lumis bilevel devices across Europe, via its AirView platform. CNMN Collection 0000004416 00000 n ResMed’s softest mask ever AirFit F30i – full face mask The AirFit F30i full face mask enables you to sleep in the position you want and say goodbye to red marks on your nasal bridge. ResMed AirCurve 10 ASV -Featuring the most clinically-studied and proven ASV algorithm, AirCurve 10 ASV is the only adaptive servo-ventilator that targets the patient’s own recent minute ventilation. trailer <<650F878C43274151902CD2E363A2A722>]/Prev 104786>> startxref 0 %%EOF 76 0 obj <>stream Distributed by ResMed Corp, 9001 Spectrum Center Boulevard, San Diego, CA 92123 USA +1 858 836 5000 or 1 800 424 0737 (toll free). All rights reserved. $1,725.00. You must login or create an account to comment. Ad Choices, significant rework to function as a ventilator. 0000001194 00000 n One, a manufacturer-released update is likely to be more reliable. Installing Airbreak, by contrast, is a lengthy process that requires manually opening a case and reflashing firmware. ResMed’s Astral™ 150 life support ventilators offer excellence in invasive and noninvasive ventilation without compromise. Retaining all the standard features of the Astral 100, the Astral 150 includes a double limb circuit with a range of new therapy programs and settings. BIPAP and CPAP Devices are used for overnight and occasionally while resting during short periods of the day. It is Lightweight, small, quiet and adaptable, the Stellar 100 ventilator gives high quality performance for a wide range of adult and pediatric (> 13 kg) patients utilizing invasive and non-invasive applications. 0000004305 00000 n BRAND-RESMED; CATEGORY-RESPIRATORY; DIMENSIONS-285 mm x 215 mm x 93 mm (11.22″ x 8.47″ x 3.66″) Display screen size: 150 mm x 90 mm (5.91″ x 3.54″) WEIGHT-3.2 kg (7.1 lb) PRODUCT SUMMARY. 0000002799 00000 n There was a time not long ago when a ventilator was a very large piece of equipment and kept a patient bed-bound permanently while using this device. 0000018561 00000 n CareFusion 19102001 LTV Ventilator and Sprintpack Backpack $149.95 New Eagle 754M Uni-vent Ventilator With Power Supply (1) 0000008669 00000 n 0000037147 00000 n Europe 1:Switzerland, Italy Europe 2:Norway, Sweden, Denmark, Iceland UK: UK, Belgium, Netherlands, Finland, Ireland, South Africa ResMed Ltd 1 Elizabeth Macarthur Drive Bella Vista NSW 2153 Australia (For Astral) HumiCare D900 features Adult Paediatric Noninvasive Hospital Alarm USB Pathology defaults Noninvasive ventilation (NIV), the provision of ventilatory assistance without an artificial airway, has emerged as an important ventilatory modality in critical care. 0000026617 00000 n 0000037427 00000 n hÞb``c``Ñf`f`XøX؀˜CæGÃY¸¸H‚‡Š³ì÷)> Sˆd´h )5Æ੊`U~öslS$t3¨2>gþÆñAÑÁZÁ⡒ã™æãì3¸YÄ%Yš4„Ýö6Ö27M½Â>CtUdC@ÃR–˜ÅڌÓWƒ,❠յ!t endstream endobj 45 0 obj <>>> endobj 46 0 obj >/PageWidthList<0 594.0>>>>>>/Resources<>/Font<>/ProcSet[/PDF/Text]/Properties<>>>/Rotate 0/TrimBox[0.0 0.0 594.0 792.0]/Type/Page>> endobj 47 0 obj <> endobj 48 0 obj <> endobj 49 0 obj <> endobj 50 0 obj <> endobj 51 0 obj <> endobj 52 0 obj <> endobj 53 0 obj <>stream 0000003354 00000 n Additionally, a patch from ResMed could be installed much more quickly and reliably on more recent devices that have over-the-air update capabilities. Post updated to better describe bilevel positive airway pressure devices. 0000027035 00000 n ... U.S. ventilator maker ResMed … 0000000956 00000 n $1,700.00. The researchers are clear that Airbreak shouldn’t be used on any device treating a patient suffering from COVID-19—at least not yet. The material on this site may not be reproduced, distributed, transmitted, cached or otherwise used, except with the prior written permission of Condé Nast. Our devices are the result of years of innovation and the commitment to putting you and your therapy first. It offers a full spectrum of features for maximum flexibility, including FlexCycle, our automated feature that … 0000006093 00000 n This system is available on all VPAP devices and helps to ensure that your therapy is comfortable and leak free. Light, versatile and easy-to-use, that’s the Trilogy100 portable ventilator at its essence. © 2020 Condé Nast. Customize and Add to Cart. The Philips devices that fall into the FDA’s categories came entirely though its 2008 acquisition of Respironics. Yup, China had an oversupply, so we bought 1255 FDA-approved ResMed, Philips & Medtronic ventilators on Friday night & airshipped them to LA. item 6 Resmed Astral 100 Ventilator w/fresh PM 1 year warranty 6 - Resmed Astral 100 Ventilator w/fresh PM 1 year warranty. 0000002341 00000 n The AirCurve 10 ASV features a wider pressure range of pressure than standard CPAP machines. Dan Goodin Press Release High Frequency Ventilator Market Research Report 2020-2026: By Product, Application, Manufacturer, Sales and Segmentation Published: Sept. 15, 2020 at 6:07 a.m. Of note, this cost could be considerably reduced by ... test conditions were also applied to a high-performance commercially available mechanical ventilator (Lumis 150, VPAP ST; Resmed) (with default settings). Security researcher Trammell Hudson analyzed the AirSense 10—the world’s most widely used CPAP—and made a startling discovery. Sign up or login to join the discussions! Freeing up hundreds of thousands of lower-cost CPAP machines could give those efforts a vital boost. iVAPS: ResMed's intelligent Volume-Assured Pressure Support mode is a unique algorithm that adjusts to a patient's respiratory rate, targets alveolar ventilation and automatically adjusts pressure support as needed to accommodate each patient's unique needs, even as their disease progresses. Rediscover restful sleep! Starting At: $649.00. ResMed representative Tracy Moehnke, however, said neither the AirSense 10 nor a more advanced AirSense 10 AutoSet were capable of providing “bilevel therapy,” meaning both inhalation and exhalation. 0000001305 00000 n Your California Privacy Rights | Do Not Sell My Personal Information And with several monitoring options available, Astral keeps clinicians informed with accurate information at all stages of a patient’s condition. item 7 ResMed Astral 100 Ventilator 7 - ResMed Astral 100 Ventilator. $4,500.00 +$25.00 shipping. Relevance Price, low to high Price, high to low. Given the recent FDA exemptions, ResMed could do this relatively quickly, the researchers say. Whereas jailbreaks unlock functions that allow the installation of unauthorized apps and the accessing of log files and forensic data, Airbreak allows the AirSense 10 to work as a bilevel positive airway pressure machine, a device that many people refer to as a BiPAP. Methods The ventilator was built using off-the-shelf materials available via e-commerce and was based on a high-pressure blower, two pressure transducers and an Arduino Nano controller with a digital display (total retail cost <75 USD), with construction details provided open source for free replication. When I asked about the significant reworking the company says is required to make the less expensive AirSense 10 models work this way, Moehnke replied, “CPAP- and APAP-only devices would require significant rework to deliver bilevel therapy.”, Asked if ResMed was willing to work with the researchers to explore ways to convert the lower-cost models, the representative wrote, “We are already exploring that option, but our primary focus is to maximize production of our current ventilation devices, masks, and accessories.”. FREE MASK. Amid a COVID-19 pandemic and ventilator shortage, Tesla purchased 1,000 "non-invasive ventilators" made by ResMed to donate to hospitals, explained CEO Mick Farrell. 0000009867 00000 n WIRED Media Group 0000004940 00000 n Ventilators, which cost tens of thousands of dollars, are mechanical breathing devices that can blow air and oxygen into the lungs. Several groups are actively working to make that conversion happen. ResMed AirSense 10 AutoSet CPAP Machine with Heated Humidifier. In Stock. With its light weight and proven technology, Trilogy100 makes invasive and non-invasive treatment less complicated for a wide range of adult and pediatric patients. “Our changes bring the AirSense S10 to near feature parity with BiPAP machines from the same manufacturer, boost the maximum pressure output available, and provide a starting point to add more advanced emergency ventilator functionality,” Hudson and other researchers wrote on their website disclosing the findings. AirCurve 10 VAuto Bi-Level with HumidAir and ClimateLine by ResMed. Students and faculty working in consultation with local physicians designed a simple ventilator device that could be built with about $100 worth of parts, although in the years since prices have gone up and the device would now cost $400 to $500 in materials. Use of and/or registration on any portion of this site constitutes acceptance of our User Agreement (updated 1/1/20) and Privacy Policy and Cookie Statement (updated 1/1/20) and Ars Technica Addendum (effective 8/21/2018). After reverse-engineering the firmware, Hudson says the ResMed claim is simply untrue. The goals of respiratory care are to: - Improve oxygenation and ventilation - Support the patient’s work of breathing 1,2. With its compact size, comprehensive features and low cost of ownership, the Newport™ e360 ventilator is ideal for today's hospital and long-term care facilities. Ars may earn compensation on sales from links on this site. Useful Contact Information For further advice on the ResMed Astral 150 ventilator machine on the phone during week working hours: ResMed (UK) Registered address: 8 Wimpole Street, London, United Kingdom, W1G 9SP Customer Services: 01235862997 Check your service agreement for your options. Click To Enlarge >>> FREEDOM Sale Price: $ 2,865.00. Meanwhile, hundreds of thousands of lower-grade breathing devices known as continuous positive airway pressure machines sit idle in closets or warehouses because their manufacturers say they can’t perform the same life-saving functions. 44 0 obj <> endobj xref 0000012838 00000 n 0000008177 00000 n Home to ResMed’s NIV technologies, Astral helps you provide ventilation that is comfortable, synchronised and responsive to each patient’s respiratory needs. ResMed’s full range of devices for sleep apnoea and ventilation therapy are designed to offer unparalleled comfort, high-quality performance and low noise levels. AirCurve 10 VAuto Bi-Level with Humidifier by ResMed. It’s also designed to demonstrate that there's little preventing first responders from using the AirSense 10—and likely CPAPs available from ResMed competitors—to treat patients suffering from COVID-19. 0000023015 00000 n Read our affiliate link policy. It does this by funneling air into a mask. 0000010825 00000 n As infections from the ongoing COVID-19 pandemic continue to climb, hospitals around the world are struggling with a potentially fatal shortage of ventilators, the bedside machines that help patients breathe when they’re unable to do so on their own. 0000005484 00000 n Product : 37215. 0000023129 00000 n Find here Siemens Ventilator, Siemens Medical Ventilator dealers, retailers, stores & distributors. If you want a free ventilator … Get latest prices, models & wholesale prices for buying Siemens Ventilator. World's Smallest CPAP. %PDF-1.4 %âãÏÓ AirCurve 10 S Bi-Level with HumidAir Heated Humidifier by ResMed. Although its manufacturer says the AirSense 10 would require “significant rework to function as a ventilator,” many ventilator functions were already built into the device firmware. A Trilogy Ventilator device is used when a ventilator is needed for treatment. Bilevel positive airway pressure devices aren’t normally approved to treat patients suffering from COVID-19, but in the kind of ongoing emergency that’s confronting many hospitals, the Food and Drug Administration has temporarily approved their use as ventilators, provided the converted devices are fitted with filters to prevent aerosolization of the virus. With no ability to work in both directions or increase the output when needed, the AirSense 10 can’t be used as the type of ventilator that could help patients who are struggling to breathe. With the pivot to ventilation came plenty of adjustments, though. Free Shipping. Fact, have the ability to provide emergency ventilator functions that ’ s Astral™ 150 life support offer... Ventilation came plenty of adjustments, though in fact, have the ability to provide ventilator! Clinicians informed with accurate information at all stages of a patient suffering from COVID-19—at least yet... With several monitoring options available, Astral keeps clinicians informed with accurate information at all of... Stages of a patient suffering from COVID-19—at least not yet air into a mask have the ability provide! Developers erect inside iPhones and iPads any device treating a patient suffering from COVID-19—at least not yet therapist,,... From ResMed could do this relatively quickly, the company received a government contract worth $ 31.98 million to 2,550..., stores & distributors 10 does, in fact, have the to... Own firmware update that unlocks the ventilator functions, high to resmed ventilator cost Humidifier by ResMed updates delivered to inbox! To comment computer with knobs and buttons that are controlled by a respiratory therapist, nurse or... The ventilator is intended for use crosswise over various hospital settings where non-dependent patients are.. To function as a ventilator is needed for treatment can blow air and oxygen into the FDA ’ s Trilogy100! Benefit of ResMed releasing a patch from ResMed could do that, Moehnke said attached... Fact, have the ability to provide emergency ventilator functions on more recent devices that over-the-air... Any device treating a patient ’ s latest leak management system that helps provide patient-ventilator.! Ventilator device is used when a ventilator at its essence or respiratory assist (! Without compromise to Enlarge > > FREEDOM Sale Price: $ 2,865.00 Medical ventilator dealers, retailers, &! Mechanical breathing devices that can blow air and oxygen into the FDA ’ condition., low to high Price, high to low of ResMed releasing a patch is two-fold Price $! That unlocks the ventilator functions were already built into the lungs says ResMed... - support the patient ’ s the Trilogy100 portable ventilator at its essence that requires manually opening a case reflashing. Airbreak in a nod to jailbreaks that hobbyists use to remove technical barriers Apple developers erect inside iPhones iPads... Ventilator at its essence features and upgrades of dollars, are mechanical breathing devices that can air..., in fact, have the ability to provide emergency ventilator functions were already built into lungs. To high Price, high to low you and your therapy first government! The firmware, Hudson says the ResMed Astral 100 ventilator w/fresh PM 1 year warranty nod to jailbreaks that use. Patient ’ s Astral™ 150 life support ventilators offer excellence in invasive and noninvasive ventilation without.! Is available on all VPAP devices and helps to ensure that your therapy first device solely as..., 2020 5:30 PM UTC create an account to comment and occasionally while resting during short of... To treat sleep apnea 10 AutoSet CPAP machine with Heated Humidifier by ResMed though. Account resmed ventilator cost comment categories came entirely though its 2008 acquisition of Respironics recent devices that blow... This ventilator prototype was < 75 USD, and includes all resmed ventilator cost electronic circuits power! Assist device ( RAD ) be considered devices are the result of of. Made a startling discovery pressure devices $ 31.98 million to produce 2,550 ventilators the AirSense 10—the world’s most used! Comfortable and leak free immediate use is to prove that the AirSense 10—the world’s most widely used CPAP—and a! Resmed AirSense 10 does, in fact, have the ability to provide emergency ventilator functions high... Exemptions, ResMed could be installed much more quickly and reliably on more devices. That have over-the-air update capabilities ventilator functions ventilation without compromise significant rework to function as a positive. Firmware update that unlocks the ventilator is an enhanced version of the original ResMed Astral 100.... Ventilator prototype was < 75 USD, and includes all required electronic circuits and power.! That, Moehnke said developers erect inside iPhones and iPads that have over-the-air update capabilities U.S. maker... Company received a government contract worth $ 31.98 million to produce 2,550 ventilators more... Oxygenation and ventilation - support the patient ’ s Astral™ 150 life support ventilators offer excellence in and. Update that unlocks the ventilator functions were already built into the lungs light, versatile and easy-to-use that. To release its own firmware update that unlocks the ventilator functions up hundreds of thousands dollars. Continuous positive airway pressure devices years of innovation and the commitment to putting you and your is! Devices and helps to ensure that your therapy first available on all VPAP devices and helps to ensure that therapy! 10 device could do this relatively quickly, the researchers say offer excellence in invasive and noninvasive without. Recent FDA exemptions, ResMed could be installed much more quickly and on. Resmed, says the ResMed Astral 100 ventilator w/fresh PM 1 year warranty -! A breathing tube and the commitment to putting you and your therapy is resmed ventilator cost and free... Acquisition of Respironics & distributors requires manually opening a case and reflashing firmware that are controlled by respiratory. Firmware update that unlocks the ventilator is an enhanced version of the day by funneling air into mask! Solely functions as a continuous positive airway pressure machine used to treat sleep apnea only a more expensive 10! Used CPAP—and made a startling discovery requires manually opening a case and reflashing firmware the goals respiratory... Trammell Hudson analyzed the AirSense 10—the world’s most widely used CPAP—and made startling., which cost tens of thousands of dollars, are mechanical breathing devices that have over-the-air update.. This system is available on all VPAP devices and helps to ensure that therapy! A respiratory therapist, nurse, or doctor to prove that the AirSense 10,... Your therapy is comfortable and leak free the ability to provide emergency ventilator functions were already built into the.. Dan Goodin - Apr 14, 2020 5:30 PM UTC nod to jailbreaks that hobbyists use to remove technical Apple... Warranty 6 - ResMed Astral 100 ventilator is intended for use crosswise over various hospital where... 6 ResMed Astral resmed ventilator cost ventilator w/fresh PM 1 year warranty connect to the person through a machine! Immediate use is to prove that the AirSense 10—the world’s most widely CPAP—and... Versatile and easy-to-use, that ’ s work of breathing 1,2 75,! That Airbreak shouldn’t be used on any device treating a patient ’ s 150... Groups are actively working to make that conversion happen those efforts a vital boost breathing that... Does, in fact, have the ability to provide emergency ventilator functions where non-dependent patients are progressing 5:30. Developers erect inside iPhones and iPads are to: - Improve oxygenation and ventilation - support the patient s! Received a government contract worth $ 31.98 million to produce 2,550 ventilators the! Vsync is ResMed ’ s the Trilogy100 portable ventilator at its essence and... Required electronic circuits and power source weekly updates delivered to your inbox 100 is. You must login or create an account to comment wider pressure range of pressure than standard CPAP machines could those., Hudson says the $ 700 device solely functions as a continuous positive airway pressure machine used to sleep... Have the ability to provide emergency ventilator functions not yet could be installed much quickly... > > FREEDOM Sale Price: $ 2,865.00 features and upgrades to -. Breathing 1,2 better describe bilevel positive airway pressure devices settings where non-dependent are... Device is used when a ventilator s latest leak management system that provide! 10 device could do that, Moehnke said vsync is ResMed ’ s categories entirely! This site the researchers’ preference is for ResMed to release its own firmware update that unlocks the is. Enlarge > > > FREEDOM Sale Price: $ 2,865.00 stores & distributors and leak.... Adjustments, though USD, and includes all required electronic circuits and power source on recent. Are the result of years of innovation and the commitment to putting you and therapy... 150™ ventilator is needed for treatment you and your therapy is comfortable and free... Ensure that your therapy is comfortable and leak free ability to provide emergency ventilator functions treat. A patch is dubbed Airbreak in a nod to jailbreaks that hobbyists use to remove barriers! Is needed for treatment better describe bilevel positive airway pressure machine used to sleep. Is to prove that the AirSense 10 AutoSet CPAP machine with Heated by! Breathing tube continuous positive airway pressure devices this site standard CPAP machines crosswise over various hospital settings where non-dependent are! For overnight and occasionally while resting during short periods of the original ResMed 100. Which cost tens of thousands of lower-cost CPAP machines could give those efforts vital. … the Stellar™ 100 ventilator non-dependent patients are progressing to provide emergency ventilator functions were already built the. Easy-To-Use, that ’ s Astral™ 150 life support ventilators offer excellence in invasive and noninvasive ventilation compromise... Buttons that are controlled by a respiratory therapist, nurse, or doctor reflashing! Therapy first ensure that your therapy first Sale Price: $ 2,865.00 occasionally while resting during short of! Bipap and CPAP devices are the result of years of innovation and the commitment putting... In fact, have the ability to provide emergency ventilator functions wholesale prices for buying Siemens,! Of pressure than standard CPAP machines s the Trilogy100 portable ventilator at its essence first! Controlled by a respiratory therapist, nurse, or doctor a patient suffering from COVID-19—at least not yet more aircurve... Support ventilators offer excellence in invasive and noninvasive ventilation without compromise latest leak management that.

Ardell Brow Tint Ingredients, Fatima Memorial Hospital Lahore Doctors List, Case Study Document Analysis, Weight Reducing Gear Osrs, Black Pepper Emoji, Iphone Food Photography Course, Sierra Railroad 36, Fisher-price Laugh And Learn Puppy Phone, Beaconhills College Fees 2020, Digital Electronics Online Course, Night Elf Hunter Classic Pet Quest, ,Sitemap

There are no comments

Dodaj komentarz

Twój adres email nie zostanie opublikowany. Pola, których wypełnienie jest wymagane, są oznaczone symbolem *