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hiren can you talk about your approach to ph- patients and how that whole area is evolving yeah absolutely I mean as Ryan mentioned earlier one of our best prognosticators for outcome is the age of the patient and we really have to take that into account when we decide how weamp;#39;re gonna treat someone for the under age forty group I think itamp;#39;s very well-established now that we should try if at all possible to use a pediatric inspired regimen and hopefully itamp;#39;s gonna be on a clinical trial the first consideration for a patient of any age should be a clinical trial we havenamp;#39;t yet established a gold standard but if you donamp;#39;t have a clinical trial open for youamp;#39;re a young adult up to age 40 um you should be using anyway aya protocol an example would be the inner group 100 403 study that is showed very compelling outcomes in patients up to age 39 there are other similar pediatric inspired regimens that can be utilized in this setting or intensific