Q86TB3 (ALPK2_HUMAN) Reviewed, UniProtKB/Swiss-Prot

Names and origin

Protein names

Recommended name:
Alpha-protein kinase 2
EC=2.7.11.-

Alternative name(s):
Heart alpha-protein kinase

Gene names

Name:	ALPK2
Synonyms:	HAK

Organism

Homo sapiens (Human) [Reference proteome]

Taxonomic identifier

9606 [NCBI]

Taxonomic lineage

cellular organisms › Eukaryota › Opisthokonta › Metazoa › Eumetazoa › Bilateria › Deuterostomia › Chordata › Craniata › Vertebrata › Gnathostomata › Teleostomi › Euteleostomi › Sarcopterygii › Tetrapoda › Amniota › Mammalia › Theria › Eutheria › Euarchontoglires › Primates › Haplorrhini › Simiiformes › Catarrhini › Hominoidea › Hominidae › Homininae › Homo

Protein attributes

Sequence length	2170 AA.
Sequence status	Complete.
Protein existence	Evidence at transcript level

General annotation (Comments)

Function	Kinase that recognizes phosphorylation sites in which the surrounding peptides have an alpha-helical conformation.
Sequence similarities	Belongs to the protein kinase superfamily. Alpha-type protein kinase family. ALPK subfamily. Contains 1 alpha-type protein kinase domain. Contains 2 Ig-like (immunoglobulin-like) domains.
Sequence caution	The sequence AAK95952.1 differs from that shown. Reason: Erroneous initiation. Translation N-terminally extended. The sequence AAK95952.1 differs from that shown. Reason: Aberrant splicing. The sequence BAC03812.1 differs from that shown. Reason: Erroneous initiation. Translation N-terminally extended. The sequence BAC03812.1 differs from that shown. Reason: Aberrant splicing. The sequence BX647796 differs from that shown. Reason: Aberrant splicing. The sequence CAD89922.1 differs from that shown. Reason: Erroneous initiation. Translation N-terminally extended.

Ontologies

Keywords
Coding sequence diversity	Polymorphism
Domain	Immunoglobulin domain Repeat
Molecular function	Kinase Serine/threonine-protein kinase Transferase
PTM	Disulfide bond
Technical term	Complete proteome Reference proteome
Gene Ontology (GO)
Molecular_function	ATP binding Inferred from electronic annotation. Source: InterPro protein serine/threonine kinase activity Inferred from electronic annotation. Source: UniProtKB-KW
Complete GO annotation...

Sequence annotation (Features)

	Feature key	Position(s)	Length	Description	Graphical view	Feature identifier
Molecule processing
	Chain	1 – 2170	2170	Alpha-protein kinase 2		PRO_0000260030
Regions
	Domain	10 – 114	105	Ig-like 1
	Domain	1786 – 1874	89	Ig-like 2
	Domain	1901 – 2133	233	Alpha-type protein kinase
	Compositional bias	1644 – 1649	6	Poly-Ser
Amino acid modifications
	Disulfide bond	33 ↔ 98		By similarity
	Disulfide bond	1808 ↔ 1858		By similarity
Natural variations
	Natural variant	2	1	K → T. Corresponds to variant rs6566987 [ dbSNP | Ensembl ].		VAR_054914
	Natural variant	136	1	R → S. Corresponds to variant rs9944810 [ dbSNP | Ensembl ].		VAR_054915
	Natural variant	719	1	H → Q. Ref.1 Ref.3 Ref.4 Corresponds to variant rs12103986 [ dbSNP | Ensembl ].		VAR_054916
	Natural variant	810	1	G → S. Ref.1 Ref.3 Ref.4 Corresponds to variant rs3809970 [ dbSNP | Ensembl ].		VAR_054917
	Natural variant	825	1	R → T. Ref.1 Ref.3 Ref.4 Corresponds to variant rs3809972 [ dbSNP | Ensembl ].		VAR_054918
	Natural variant	829	1	K → N. Corresponds to variant rs3809973 [ dbSNP | Ensembl ].		VAR_054919
	Natural variant	884	1	S → L. Corresponds to variant rs3809974 [ dbSNP | Ensembl ].		VAR_054920
	Natural variant	891	1	T → I. Ref.1 Ref.3 Ref.4 Corresponds to variant rs3826593 [ dbSNP | Ensembl ].		VAR_054921
	Natural variant	916	1	N → K. Ref.1 Ref.3 Ref.4 Corresponds to variant rs4940404 [ dbSNP | Ensembl ].		VAR_054922
	Natural variant	942	1	E → K in an ovarian undifferentiated carcinoma sample; somatic mutation. Ref.5		VAR_045591
	Natural variant	977	1	S → T. Corresponds to variant rs3809975 [ dbSNP | Ensembl ].		VAR_054923
	Natural variant	1057	1	L → V. Ref.1 Ref.3 Ref.4 Corresponds to variant rs3809976 [ dbSNP | Ensembl ].		VAR_054924
	Natural variant	1063	1	G → V. Corresponds to variant rs34347938 [ dbSNP | Ensembl ].		VAR_062168
	Natural variant	1134	1	K → N. Corresponds to variant rs35791514 [ dbSNP | Ensembl ].		VAR_054925
	Natural variant	1174	1	H → P. Ref.1 Ref.3 Ref.4 Corresponds to variant rs3809977 [ dbSNP | Ensembl ].		VAR_054926
	Natural variant	1296	1	L → V. Corresponds to variant rs3809976 [ dbSNP | Ensembl ].		VAR_045593
	Natural variant	1449	1	P → S. Ref.1 Ref.3 Ref.4 Corresponds to variant rs3809982 [ dbSNP | Ensembl ].		VAR_054927
	Natural variant	1476	1	K → T in a melanoma metastatic sample; somatic mutation. Ref.5		VAR_045594
	Natural variant	1551	1	A → S. Ref.1 Corresponds to variant rs3809983 [ dbSNP | Ensembl ].		VAR_054928
	Natural variant	1579	1	Q → R. Corresponds to variant rs33910491 [ dbSNP | Ensembl ].		VAR_054929
	Natural variant	1729	1	K → E. Corresponds to variant rs34409558 [ dbSNP | Ensembl ].		VAR_054930
	Natural variant	1730	1	K → E. Corresponds to variant rs17065127 [ dbSNP | Ensembl ].		VAR_054931
	Natural variant	1767	1	H → Y. Corresponds to variant rs7234999 [ dbSNP | Ensembl ].		VAR_054932
	Natural variant	1884	1	R → C. Corresponds to variant rs33969768 [ dbSNP | Ensembl ].		VAR_057742
	Natural variant	1969	1	E → K. Corresponds to variant rs17065127 [ dbSNP | Ensembl ].		VAR_045595
	Natural variant	2157	1	I → V. Ref.1 Ref.3 Corresponds to variant rs7240666 [ dbSNP | Ensembl ].		VAR_054933
Experimental info
	Sequence conflict	550	1	N → S in BX647796. Ref.1
	Sequence conflict	829	1	K → S in CAD89922. Ref.1
	Sequence conflict	912	1	A → T in BX647796. Ref.1
	Sequence conflict	959	1	G → E in BAC03812. Ref.4
	Sequence conflict	1067	1	K → E in CAD89922. Ref.1
	Sequence conflict	1165	1	E → G in CAD89922. Ref.1
	Sequence conflict	1217	1	I → T in BAC03812. Ref.4
	Sequence conflict	1402	1	S → P in BX647796. Ref.1
	Sequence conflict	1428	1	Q → R in BAC03812. Ref.4
	Sequence conflict	1443	1	H → R in BX647796. Ref.1
	Sequence conflict	1784	1	R → S in BX647639. Ref.1
	Sequence conflict	1814	1	H → R in BX647796. Ref.1
	Sequence conflict	1939	1	M → V in CAD89922. Ref.1
	Sequence conflict	2042	1	I → V in CAD89922. Ref.1
	Sequence conflict	2092	1	G → D in BX647796. Ref.1

Sequences

	Sequence		Length	Mass (Da)
	Q86TB3 [UniParc]. Last modified April 14, 2009. Version 3. Checksum: 5C257153F091B08E	FASTA	2,170	237,013
	10 20 30 40 50 60 MKDSEGPQRP PLCFLSTLLS QKVPEKSDAV LRCIISGQPK PEVTWYKNGQ AIDGSGIISN 70 80 90 100 110 120 YEFFENQYIH VLHLSCCTKN DAAVYQISAK NSFGMICCSA SVEVECSSEN PQLSPNLEDD 130 140 150 160 170 180 RDRGWKHETG THEEERANQI DEKEHPYKEE ESISPGTPRS ADSSPSKSNH SLSLQSLGNL 190 200 210 220 230 240 DISVSSSENP LGVKGTRHTG EAYDPSNTEE IANGLLFLNS SHIYEKQDRC CHKTVHSMAS 250 260 270 280 290 300 KFTDGDLNND GPHDEGLRSS QQNPKVQKYI SFSLPLSEAT AHIYPGDSAV ANKQPSPQLS 310 320 330 340 350 360 SEDSDSDYEL CPEITLTYTE EFSDDDLEYL ECSDVMTDYS NAVWQRNLLG TEHVFLLESD 370 380 390 400 410 420 DEEMEFGEHC LGGCEHFLSG MGCGSRVSGD AGPMVATAGF CGHHSQPQEV GVRSSRVSKH 430 440 450 460 470 480 GPSSPQTGMT LILGPHQDGT SSVTEQGRYK LPTAPEAAEN DYPGIQGETR DSHQAREEFA 490 500 510 520 530 540 SDNLLNMDES VRETEMKLLS GESENSGMSQ CWETAADKRV GGKDLWSKRG SRKSARVRQP 550 560 570 580 590 600 GMKGNPKKPN ANLRESTTEG TLHLCSAKES AEPPLTQSDK RETSHTTAAA TGRSSHADAR 610 620 630 640 650 660 ECAISTQAEQ EAKTLQTSTD SVSKEGNTNC KGEGMQVNTL FETSQVPDWS DPPQVQVQET 670 680 690 700 710 720 VRETISCSQM PAFSEPAGEE SPFTGTTTIS FSNLGGVHKE NASLAQHSEV KPCTCGPQHE 730 740 750 760 770 780 EKQDRDGNIP DNFREDLKYE QSISEANDET MSPGVFSRHL PKDARADFRE PVAVSVASPE 790 800 810 820 830 840 PTDTALTLEN VCDEPRDREA VCAMECFEAG DQGTCFDTID SLVGRPVDKY SPQEICSVDT 850 860 870 880 890 900 ELAEGQNKVS DLCSSNDKTL EVFFQTQVSE TSVSTCKSSK DGNSVMSPLF TSTFTLNISH 910 920 930 940 950 960 TASEGATGEN LAKVENSTYP LASTVHAGQE QPSPSNSGGL DETQLLSSEN NPLVQFKEGG 970 980 990 1000 1010 1020 DKSPSPSAAD TTATPASYSS IVSFPWEKPT TLTANNECFQ ATRETEDTST VTIATEVHPA 1030 1040 1050 1060 1070 1080 KYLAVSIPED KHAGGTEERF PRASHEKVSQ FPSQVQLDHI LSGATIKSTK ELLCRAPSVP 1090 1100 1110 1120 1130 1140 GVPHHVLQLP EGEGFCSNSP LQVDNLSGDK SQTVDRADFR SYEENFQERG SETKQGVQQQ 1150 1160 1170 1180 1190 1200 SLSQQGSLSA PDFQQSLPTT SAAQEERNLV PTAHSPASSR EGAGQRSGWG TRVSVVAETA 1210 1220 1230 1240 1250 1260 GEEDSQALSN VPSLSDILLE ESKEYRPGNW EAGNKLKIIT LEASASEIWP PRQLTNSESK 1270 1280 1290 1300 1310 1320 ASDGGLIIPD KVWAVPDSLK ADAVVPELAP SEIAALAHSP EDAESALADS RESHKGEEPT 1330 1340 1350 1360 1370 1380 ISVHWRSLSS RGFSQPRLLE SSVDPVDEKE LSVTDSLSAA SETGGKENVN NVSQDQEEKQ 1390 1400 1410 1420 1430 1440 LKMDHTAFFK KFLTCPKILE SSVDPIDEIS VIEYTRAGKP EPSETTPQGA REGGQSNDGN 1450 1460 1470 1480 1490 1500 MGHEAEIQPA ILQVPCLQGT ILSENRISRS QEGSMKQEAE QIQPEEAKTA IWQVLQPSEG 1510 1520 1530 1540 1550 1560 GERIPSGCSI GQIQESSDGS LGEAEQSKKD KAELISPTSP LSSCLPIMTH ASLGVDTHNS 1570 1580 1590 1600 1610 1620 TGQIHDVPEN DIVEPRKRQY VFPVSQKRGT IENERGKPLP SSPDLTRFPC TSSPEGNVTD 1630 1640 1650 1660 1670 1680 FLISHKMEEP KIEVLQIGET KPPSSSSSSA KTLAFISGER ELEKAPKLLQ DPCQKGTLGC 1690 1700 1710 1720 1730 1740 AKKSREREKS LEARAGKSPG TLTAVTGSEE VKRKPEAPGS GHLAEGVKKK ILSRVAALRL 1750 1760 1770 1780 1790 1800 KLEEKENIRK NSAFLKKMPK LETSLSHTEE KQDPKKPSCK REGRAPVLLK KIQAEMFPEH 1810 1820 1830 1840 1850 1860 SGNVKLSCQF AEIHEDSTIC WTKDSKSIAQ VQRSAGDNST VSFAIVQASP KDQGLYYCCI 1870 1880 1890 1900 1910 1920 KNSYGKVTAE FNLTAEVLKQ LSSRQDTKGC EEIEFSQLIF KEDFLHDSYF GGRLRGQIAT 1930 1940 1950 1960 1970 1980 EELHFGEGVH RKAFRSTVMH GLMPVFKPGH ACVLKVHNAI AYGTRNNDEL IQRNYKLAAQ 1990 2000 2010 2020 2030 2040 ECYVQNTARY YAKIYAAEAQ PLEGFGEVPE IIPIFLIHRP ENNIPYATVE EELIGEFVKY 2050 2060 2070 2080 2090 2100 SIRDGKEINF LRRESEAGQK CCTFQHWVYQ KTSGCLLVTD MQGVGMKLTD VGIATLAKGY 2110 2120 2130 2140 2150 2160 KGFKGNCSMT FIDQFKALHQ CNKYCKMLGL KSLQNNNQKQ KQPSIGKSKV QTNSMTIKKA 2170 GPETPGEKKT

References

	« Hide 'large scale' referencesShow 'large scale' references »
[1]	"The full-ORF clone resource of the German cDNA consortium." Bechtel S., Rosenfelder H., Duda A., Schmidt C.P., Ernst U., Wellenreuther R., Mehrle A., Schuster C., Bahr A., Bloecker H., Heubner D., Hoerlein A., Michel G., Wedler H., Koehrer K., Ottenwaelder B., Poustka A., Wiemann S., Schupp I. BMC Genomics 8:399-399(2007) [PubMed] [Europe PMC] [Abstract] Cited for: NUCLEOTIDE SEQUENCE [LARGE SCALE MRNA], VARIANTS GLN-719; SER-810; THR-825; ILE-891; LYS-916; VAL-1057; PRO-1174; SER-1449; SER-1551 AND VAL-2157. Tissue: Skeletal muscle.
[2]	"DNA sequence and analysis of human chromosome 18." Nusbaum C., Zody M.C., Borowsky M.L., Kamal M., Kodira C.D., Taylor T.D., Whittaker C.A., Chang J.L., Cuomo C.A., Dewar K., FitzGerald M.G., Yang X., Abouelleil A., Allen N.R., Anderson S., Bloom T., Bugalter B., Butler J. , Cook A., DeCaprio D., Engels R., Garber M., Gnirke A., Hafez N., Hall J.L., Norman C.H., Itoh T., Jaffe D.B., Kuroki Y., Lehoczky J., Lui A., Macdonald P., Mauceli E., Mikkelsen T.S., Naylor J.W., Nicol R., Nguyen C., Noguchi H., O'Leary S.B., Piqani B., Smith C.L., Talamas J.A., Topham K., Totoki Y., Toyoda A., Wain H.M., Young S.K., Zeng Q., Zimmer A.R., Fujiyama A., Hattori M., Birren B.W., Sakaki Y., Lander E.S. Nature 437:551-555(2005) [PubMed] [Europe PMC] [Abstract] Cited for: NUCLEOTIDE SEQUENCE [LARGE SCALE GENOMIC DNA].
[3]	"Complete sequencing and characterization of 21,243 full-length human cDNAs." Ota T., Suzuki Y., Nishikawa T., Otsuki T., Sugiyama T., Irie R., Wakamatsu A., Hayashi K., Sato H., Nagai K., Kimura K., Makita H., Sekine M., Obayashi M., Nishi T., Shibahara T., Tanaka T., Ishii S. , Yamamoto J., Saito K., Kawai Y., Isono Y., Nakamura Y., Nagahari K., Murakami K., Yasuda T., Iwayanagi T., Wagatsuma M., Shiratori A., Sudo H., Hosoiri T., Kaku Y., Kodaira H., Kondo H., Sugawara M., Takahashi M., Kanda K., Yokoi T., Furuya T., Kikkawa E., Omura Y., Abe K., Kamihara K., Katsuta N., Sato K., Tanikawa M., Yamazaki M., Ninomiya K., Ishibashi T., Yamashita H., Murakawa K., Fujimori K., Tanai H., Kimata M., Watanabe M., Hiraoka S., Chiba Y., Ishida S., Ono Y., Takiguchi S., Watanabe S., Yosida M., Hotuta T., Kusano J., Kanehori K., Takahashi-Fujii A., Hara H., Tanase T.-O., Nomura Y., Togiya S., Komai F., Hara R., Takeuchi K., Arita M., Imose N., Musashino K., Yuuki H., Oshima A., Sasaki N., Aotsuka S., Yoshikawa Y., Matsunawa H., Ichihara T., Shiohata N., Sano S., Moriya S., Momiyama H., Satoh N., Takami S., Terashima Y., Suzuki O., Nakagawa S., Senoh A., Mizoguchi H., Goto Y., Shimizu F., Wakebe H., Hishigaki H., Watanabe T., Sugiyama A., Takemoto M., Kawakami B., Yamazaki M., Watanabe K., Kumagai A., Itakura S., Fukuzumi Y., Fujimori Y., Komiyama M., Tashiro H., Tanigami A., Fujiwara T., Ono T., Yamada K., Fujii Y., Ozaki K., Hirao M., Ohmori Y., Kawabata A., Hikiji T., Kobatake N., Inagaki H., Ikema Y., Okamoto S., Okitani R., Kawakami T., Noguchi S., Itoh T., Shigeta K., Senba T., Matsumura K., Nakajima Y., Mizuno T., Morinaga M., Sasaki M., Togashi T., Oyama M., Hata H., Watanabe M., Komatsu T., Mizushima-Sugano J., Satoh T., Shirai Y., Takahashi Y., Nakagawa K., Okumura K., Nagase T., Nomura N., Kikuchi H., Masuho Y., Yamashita R., Nakai K., Yada T., Nakamura Y., Ohara O., Isogai T., Sugano S. Nat. Genet. 36:40-45(2004) [PubMed] [Europe PMC] [Abstract] Cited for: NUCLEOTIDE SEQUENCE [LARGE SCALE MRNA] OF 552-1770, VARIANTS GLN-719; SER-810; THR-825; ILE-891; LYS-916; VAL-1057; PRO-1174; SER-1449 AND VAL-2157. Tissue: Heart and Teratocarcinoma.
[4]	"Alpha-kinases: a new class of protein kinases with a novel catalytic domain." Ryazanov A.G., Pavur K.S., Dorovkov M.V. Curr. Biol. 9:R43-R45(1999) [PubMed] [Europe PMC] [Abstract] Cited for: NUCLEOTIDE SEQUENCE [MRNA] OF 569-2170, VARIANTS GLN-719; SER-810; THR-825; ILE-891; LYS-916; VAL-1057; PRO-1174 AND SER-1449.
[5]	"Patterns of somatic mutation in human cancer genomes." Greenman C., Stephens P., Smith R., Dalgliesh G.L., Hunter C., Bignell G., Davies H., Teague J., Butler A., Stevens C., Edkins S., O'Meara S., Vastrik I., Schmidt E.E., Avis T., Barthorpe S., Bhamra G., Buck G. , Choudhury B., Clements J., Cole J., Dicks E., Forbes S., Gray K., Halliday K., Harrison R., Hills K., Hinton J., Jenkinson A., Jones D., Menzies A., Mironenko T., Perry J., Raine K., Richardson D., Shepherd R., Small A., Tofts C., Varian J., Webb T., West S., Widaa S., Yates A., Cahill D.P., Louis D.N., Goldstraw P., Nicholson A.G., Brasseur F., Looijenga L., Weber B.L., Chiew Y.-E., DeFazio A., Greaves M.F., Green A.R., Campbell P., Birney E., Easton D.F., Chenevix-Trench G., Tan M.-H., Khoo S.K., Teh B.T., Yuen S.T., Leung S.Y., Wooster R., Futreal P.A., Stratton M.R. Nature 446:153-158(2007) [PubMed] [Europe PMC] [Abstract] Cited for: VARIANTS [LARGE SCALE ANALYSIS] LYS-942 AND THR-1476.
+	Additional computationally mapped references.

Cross-references

Sequence databases
EMBL GenBank DDBJ	AL832018 mRNA. Translation: CAD89922.1. Different initiation. BX647796 mRNA. No translation available. BX647639 mRNA. No translation available. AK092133 mRNA. Translation: BAC03812.1. Sequence problems. AY044450 mRNA. Translation: AAK95952.1. Sequence problems.
IPI	IPI00646010. IPI00792557.
RefSeq	NP_443179.3. NM_052947.3.
UniGene	Hs.628152.
3D structure databases
HSSP	HSSP built from PDB template 1IAJ based on UniProtKB Q923J1.
ProteinModelPortal	Q86TB3.
ModBase	Search...
PTM databases
PhosphoSite	Q86TB3.
Polymorphism databases
DMDM	226694196.
Proteomic databases
PaxDb	Q86TB3.
PRIDE	Q86TB3.
Protocols and materials databases
DNASU	115701.
StructuralBiologyKnowledgebase	Search...
Genome annotation databases
Ensembl	ENST00000361673; ENSP00000354991; ENSG00000198796.
GeneID	115701.
KEGG	hsa:115701.
UCSC	uc002lhj.4. human.
Organism-specific databases
CTD	115701.
GeneCards	GC18M056148.
H-InvDB	HIX0014477.
HGNC	HGNC:20565. ALPK2.
HPA	HPA027377. HPA027976. HPA028084. HPA029801.
neXtProt	NX_Q86TB3.
PharmGKB	PA134916108.
GenAtlas	Search...
Phylogenomic databases
eggNOG	NOG148552.
HOGENOM	HOG000033907.
HOVERGEN	HBG100440.
InParanoid	Q86TB3.
KO	K08868.
OMA	YLPQEIC.
OrthoDB	EOG4SXNBK.
Gene expression databases
Bgee	Q86TB3.
CleanEx	HS_ALPK2.
Genevestigator	Q86TB3.
GermOnline	ENSG00000198796. Homo sapiens.
Family and domain databases
Gene3D	2.60.40.10. 2 hits.
InterPro	IPR007110. Ig-like_dom. IPR013783. Ig-like_fold. IPR013098. Ig_I-set. IPR003599. Ig_sub. IPR003598. Ig_sub2. IPR011009. Kinase-like_dom. IPR004166. MHCK_EF2_kinase. [Graphical view]
Pfam	PF02816. Alpha_kinase. 1 hit. PF07679. I-set. 2 hits. [Graphical view]
SMART	SM00811. Alpha_kinase. 1 hit. SM00409. IG. 1 hit. SM00408. IGc2. 1 hit. [Graphical view]
SUPFAM	SSF56112. Kinase_like. 1 hit.
PROSITE	PS51158. ALPHA_KINASE. 1 hit. PS50835. IG_LIKE. 2 hits. [Graphical view]
ProtoNet	Search...
Other
GenomeRNAi	115701.
NextBio	79646.

Entry information

Entry name

ALPK2_HUMAN

Accession

Primary (citable) accession number: Q86TB3
Secondary accession number(s): Q6ZUX0, Q8NAT5, Q96L95

Entry history

Integrated into UniProtKB/Swiss-Prot:	November 28, 2006
Last sequence update:	April 14, 2009
Last modified:	May 1, 2013
This is version 81 of the entry and version 3 of the sequence. [Complete history]

Entry status

Reviewed (UniProtKB/Swiss-Prot)

Annotation program

Chordata Protein Annotation Program

Disclaimer

Any medical or genetic information present in this entry is provided for research, educational and informational purposes only. It is not in any way intended to be used as a substitute for professional medical advice, diagnosis, treatment or care.