Integrated care changed the patient distribution, allowing the cardiologist to focus on serious pathologies while cardiovascular risk factors and stable patients were monitored in primary care. In ischemic heart disease,

improvement was observed in cholesterol management and blood pressure control; optimal medical treatment was more frequently prescribed and ventricular function evaluated more often. In heart failure, beta-blockers SCH 900776 molecular weight treatment increased and functional class was assessed more often. In atrial fibrillation, an increase in anticoagulation prescription and echocardiography evaluation was observed. Satisfaction parameters improved with integrated care. The use of resources was not increased.

Conclusions: Using our integration model, follow-up and chronic treatment of patients with ischemic heart disease, heart failure, and atrial fibrillation were improved. Monitoring of chronic patients was redistributed between primary care

and cardiology, and family physicians’ satisfaction levels improved. There was no increase in use of resources. (C) 2011 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S. L. All rights reserved.”
“The aim of the present review is to provide an update of the epidemiological evidence of the effects of air pollution on Selleck STI571 neuropsychological development and impairment, as well as of the evidence on individual susceptibility to these effects. Animal studies have shown deposition of ultrafine particles containing

metals in olfactory bulb and frontal cortical and subcortical areas, and overexpression of inflammatory responses, white matter lesions and vascular pathology in these areas that could be the basis for functional and structural brain effects. Several observational studies in the general population have observed cognitive deficits and behavioural impairment in children and the elderly. These effects, however, are not conclusive given the limited number of studies, their small size and their methodological constraints.”
“We assessed knowledge and perceptions of epilepsy held by Korean adolescents in the general population, and selleck compound investigated factors important in adolescents’ perceptions of stigma with respect to epilepsy. Surveys were distributed to students at 22 schools. A total of 1377 students participated. Fewer than half of all students (45.1%) reported hearing or reading about epilepsy. Overall, students showed a general lack of familiarity with and knowledge of epilepsy. Stigma perception scores were significantly higher in boys than in girls (P<0.05) and in middle school than in high school (P<0.05) students. We also found that stigma perception scores were significantly correlated with both younger age (r=-0.074, P=0.006) and lower knowledge scores (r=-0.404, P=0.000). Linear regression analysis showed that stigma-related perception was associated with lower knowledge scores (P<0.001) and middle school (P<0.05).

39 weeks, P < 0.01), and higher median maternal HIV viral load at the start of prenatal care (15,411 vs. 2209 copies/mL, P = 0.02). CMV-infected infants were more likely to be born to mothers who were diagnosed with HIV during the pregnancy

or at delivery (P = 0.03).

Conclusions: The prevalence of congenital CMV infection among HIV-exposed newborns was 3%. Screening of these infants for CMV would allow identification of infants Fer-1 who are at risk for delayed onset of hearing loss and other neurodevelopmental impairment.”
“We have investigated a new micro drug jet injector using laser pulse energy. An infrared laser beam of high energy (similar to 3 J/pulse) is focused inside a driving fluid in a small chamber. The pulse then induces various energy releasing processes, and generates fast microjets through a micronozzle. The elastic membrane of this system plays an important role in transferring mechanical pressure and protecting drug from heat release. In this paper, we offer

the sequential images of microjet generation taken by a high speed camera as an evidence of the multiple injections via single pulse. Furthermore, we test the proposed system to penetrate soft animal tissues in order to evaluate its feasibility as an advanced transdermal drug delivery method. (C) 2011 American Institute of Physics. [doi:10.1063/1.3584813]“
“Atypical patterns of metastatic spread from colorectal primary tumors are often misdiagnosed, with potential implications for the clinical outcome. Selleck MLN2238 Metastatic diffusion to the splanchnocranium is extremely rare in colorectal cancer. A histological proof of diagnosis is rarely obtained and therapeutic management is a challenge. We describe the case of a 46-year-old patient who

presented with a radiologically proven sphenoid wing metastasis. The patient presented with left-sided exophthalmos while receiving systemic chemotherapy for relapsed high-risk colorectal cancer. A left sphenoid wing metastasis was proven by a head computed tomography scan. A metastatic spread to the sino-nasal tract is regarded as a poor prognosis determinant in colorectal cancer and presents a unique set of diagnostic and therapeutic challenges. The compression of noble structures such as the optic nerve holds serious implications in terms of quality of life but PCI-34051 there is insufficient evidence clarifying whether radiotherapy or surgery represent the best option for these patients, leaving the therapeutic plan to be decided case by case.”
“Background: Live oral rotavirus vaccines have been less immunogenic and efficacious among children in poor developing countries compared with middle income and industrialized countries for reasons that are not yet completely understood. We assessed whether the neutralizing activity of breast milk could lower the titer of vaccine virus and explain this difference in vitro.

Treating analyses as sensitivity analyses when one or more of the answers are negative can be misleading and confuse the interpretation of studies. The value of these questions is illustrated with several examples.

Summary:

By removing unreasonable analyses that might have been performed, these questions will lead to relevant sensitivity analyses, which help to assess the robustness of trial results.”
“Increasing Selleck Nutlin 3a evidence shows that migraine, typically considered as an episodic disease, is a chronic and, in some patients, progressive disorder. Among neuromodulators used for migraine prevention, topiramate has a high level of evidence-based efficacy. Through its wide range of mechanisms of action topiramate increases the activation threshold resulting in neuronal stabilization and thereby reducing cortical neurons hyperexcitability, which is believed to be an important electrophysiological feature underlying the pathogenesis of epilepsy and

migraine. Recent studies show that migraineurs have subclinical structural brain changes PCI-34051 nmr and persistent alteration of pain perception, in some cases correlated with the duration of the disease and the frequency of attacks that might play a role in the transformation of episodic migraine to chronic forms. An early and prolonged preventive treatment might reduce the risk of such transformation. Recent evidence suggests that topiramate, by reducing migraine frequency and use of acute medication, may prevent the negative progression of migraine. Furthermore, two recently completed Pexidartinib ic50 multicenter, randomised, placebo-controlled trials have shown that treatment with topiramate 100 mg/day is effective

and well tolerated in patients already progressed to chronic migraine and difficult to treat conditions associated with medication-overuse. Topiramate seems to be a preventive treatment, which might be able to act at different levels of the migraine cycle: reduction of frequency in episodic migraine, prevention, and treatment of chronic migraine.”
“BACKGROUND: Efficient conversion of glucose/xylose mixtures from lignocellulose is necessary for commercially viable ethanol production. Oxygen and carbon sources are of paramount importance for ethanol yield. The aim of this work was to evaluate different glucose/xylose mixtures for ethanol production using S. cerevisiae ITV-01 (wild type yeast) and P. stipitis NRRL Y-7124 and the effect of supplying oxygen in separate and co-culture processes.

Activity of SOD was elevated in T-cell ALL and acute myelomonocytic leukemia however; no significant difference in the activity of GR and TAS was noted. Levels of antioxidant were reduced insignificantly in patients who achieved complete remission.”
“Introduction: Anti-VEGF treatment has proven effective in recurrent ovarian cancer. However, the

identification of the patients most likely to respond is still pending. It is well known that the angiogenesis is regulated by several other pro-angiogenic proteins, e. g. the platelet – derived growth factor (PDGF) system and the fibroblast growth factor (FGF) system. These other signaling pathways may remain active or become upregulated during anti-VEGF treatment.

The aim of the present study was to investigate if potential changes of PDGF-BB, PDGF-AA, and FGF2 before and during bevacizumab treatment Nutlin-3 solubility dmso had predictive value for early progression

or survival. Furthermore, we wanted to investigate the importance of serum VEGF in the same cohort.

Methods: This study included 106 patients with chemotherapy-resistant epithelial ovarian cancer who were GM6001 cell line treated with single agent bevacizumab as part of a biomarker protocol. Patients were evaluated for response by the Response Evaluation Criteria In Solid Tumors (RECIST) and/or Gynecologic Cancer Intergroup (GCIG) CA125 criteria. Serum samples were collected Selleck QNZ at baseline and prior to each treatment. FGF2, PDGF-BB, PDGF-AA were quantified simultaneously using the Luminex system, and VEGF-A was

measured by ELISA. Eighty-eight baseline samples were avaliable for FGF2, PDGF-BB, PDGF-AA analysis, and 93 baseline samples for VEGF.

Results: High baseline serum VEGF was related to poor overall survival. Furthermore, high serum PDGF-BB and FGF2 was of prognostic significance. None of the markers showed predictive value, neither at baseline level nor during the treatment.”
“The diagnostic and pathological relevance of anti-desmoglein autoantibodies in common forms of pemphigus has been well established, and T cells have been shown to play a role in the onset and progression of these diseases. The role of superantigens in provoking polyclonal activation of T cells with many different fine specificities, possibly including autoreactive T cells and T-cell mediated autoantibody response, is unknown. Further, abnormal T-cell function may lead to opportunistic infections particularly with Candida. The response of T cells of pemphigus patients to recall antigens of these opportunists is not clear. The aim of this study was to investigate the in vitro response of T lymphocytes from pemphigus patients to common bacterial superantigens such as streptococcal pyrogenic exotoxin A and staphylococcal enterotoxin B, and recall antigens such as Candida antigen.

Continued study into these noninvasive techniques is warranted.”
“Knowledge of the molecular basis of plant resistance to pathogens in species other than Arabidopsis is limited. The function

of Fa WRKY1, the first WRKY gene isolated from strawberry (Fragariaxananassa), an important agronomical fruit crop, has been investigated here. Fa WRKY1 encodes a IIc WRKY transcription factor and is up-regulated in strawberry following Colletotrichum acutatum infection, treatments with elicitors, and wounding. Its Arabidopsis sequence homologue, At WRKY75, has been described as playing a role in regulating phosphate starvation responses. However, using T-DNA insertion mutants, a role for the At WRKY75 and Fa WRKY1 in the activation of basal and R-mediated resistance

in Arabidopsis is demonstrated. At wrky75 mutants are more susceptible to virulent and avirulent Autophagy phosphorylation isolates of Pseudomonas syringae. Overexpression of Fa WRKY1 in At wrky75 mutant and wild type reverts the enhanced susceptible phenotype of the mutant, and even increases resistance to avirulent strains of P. syringae. The resistance phenotype is uncoupled to PATHOGENESIS-RELATED (PR) gene expression, but it is associated with a strong oxidative burst and glutathione-S-transferase (GST) induction. Taken together, these results indicate that At WRKY75 and Fa WRKY1 act as positive regulators of defence during compatible and incompatible interactions in Arabidopsis and, very likely, Fa WRKY1 is an important element mediating defence responses to C. acutatum in strawberry. Moreover, these results provide evidence that Arabidopsis selleck inhibitor can be a useful model for functional studies in Rosacea species like strawberry.”
“The relaxation of lattice-mismatched strain by deep postetching was systematically investigated for InGaN/GaN www.selleckchem.com/products/3-deazaneplanocin-a-dznep.html multiple quantum wells (MQWs). A planar heterojunction wafer, which included an In(0.21)Ga(0.79)N (3.2 nm)/GaN (14.8 nm) MQW, was etched by inductively coupled plasma dry etching, to fabricate high-density nanopillar, nanostripe, and nanohole arrays. The etching depth was 570 nm

for all nanostructures. The diameter of the nanopillars was varied from 50 to 300 nm, then the mesa stripe width of the nanostripes and the diameter of the nanoholes were varied from 100 nm to 440 nm and 50 nm to 310 nm, respectively. The effect of strain relaxation on various optical properties was investigated. For example, in an array of nanopillars with diameter 130 nm and interval 250 nm, a large blueshift in the photoluminescence (PL) emission peak from 510 nm (as-grown) to 459 nm occurred at room temperature (RT). PL internal quantum efficiency (defined by the ratio of PL integral intensity at 300 K to that at 4.2 K) was enhanced from 34% (as-grown) to 60%, and the PL decay time at 4.2 K was reduced from 22 ns (as-grown) to 4.2 ns.

The macroscopic properties of nanocomposites were found to be strongly dependent on their components, concentrations, dispersion, and resulted morphological structures. (C) 2009 Wiley Periodicals, Inc. HDAC assay J Appl Polym Sci 115: 2734-2746, 2010″
“Malignant melanoma is a cancer of the skin arising in the melanocytes. We present a mathematical model of melanoma invasion into healthy tissue with an immune response. We use this model as a framework with which to investigate primary tumor invasion and treatment by surgical excision. We observe that the presence of immune cells can destroy tumors, hold them to minimal expansion, or, through the production of

angiogenic factors, induce tumorigenic expansion. We also find that the tumor-immune system dynamic is critically important in determining the likelihood and extent of tumor regrowth following resection. We find that small metastatic lesions distal to the primary tumor mass can be held to a minimal size via the immune interaction with the larger primary tumor. Numerical experiments further suggest that metastatic disease is optimally suppressed by immune activation when the primary tumor is moderately, rather than minimally, metastatic. Furthermore, satellite lesions can become aggressively tumorigenic upon removal of the primary tumor and its associated immune tissue. This can lead to recurrence where total cancer mass increases more quickly than in primary tumor invasion, representing a

3-Methyladenine supplier clinically more dangerous disease state. These results are in line with clinical case studies involving resection of a primary melanoma followed by recurrence

in local metastases.”
“We have investigated the effects of temperature on the photoluminescence (PL) characteristics of excitons in ordinary stacked quantum dots (QDs) and QD chains in which QDs are interconnected along the growth direction. While the temperature dependence of the PL intensity of both samples is similar, that of the PL decay time is different. In addition, the PL decay times of both samples monitored at 150 K clearly depend on the detection energy. This result is attributed to lateral QD coupling. From these results, in ordinary stacked QDs, the exciton transfer owing to the lateral coupling is the only cause of the increase in the PL decay time. selleck chemical On the other hand, in QD chains, the interconnection along the chain direction as well as the lateral coupling is considered to cause the change in the PL characteristics and induce the extremely long exciton lifetime. (C) 2010 American Institute of Physics. [doi: 10.1063/1.3366711]“
“A pilot study was implemented in the Veneto Region of Italy, aimed at classifying dairy farms which produce milk to be commercialised unpasteurised on the basis of their risk of faecal contamination of milk, which is directly correlated to the probability of a foodborne pathogen, if present in the herd and eliminated through faecal excretion, to contaminate the raw product.

The Sb desinsertion reaction from SbxCoSb3-x follows a first order kinetics, with a transition enthalpy of approximately 21 kJ/mol and an activation energy of 83 kJ/mol. (C) 2011 American Institute of Physics. [doi:10.1063/1.3626045]“
“The chemically modified analogs, the demethylated HIF pathway analogs 4-6, the tetrahydro analogs 7-9 and the hexahydro analogs 10-12, of curcumin (1), demethoxycurcumin

(2) and bisdemethoxycurcumin (3) were evaluated for their inhibitory activity on lipopolysaccharide activated nitric oxide (NO) production in HAPI microglial cells. Di-O-demethylcurcumin (5) and O-demethyldemethoxycurcumin (6) are the two most potent compounds that inhibited NO production. The analogs 5 and 6 were twofold and almost twofold more active than the TPX-0005 parent

curcuminoids 1 and 2, respectively. Moreover, the mRNA expression level of inducible NO synthase was inhibited by these two compounds. The strong neuroprotective activity of analogs 5 and 6 provide potential alternative compounds to be developed as therapeutics for neurological disorders associated with activated microglia.”
“Charge carrier transport in disordered organic semiconductors, performed in electronic devices such as optoelectronic and photovoltaic ones, is usually affected by an exponential distribution of localized states in the band-gap (traps) under space-charge limited current. In this paper, we provide a full analysis for the trap-controlled transport of the single-carrier device in the frequency

domain. Trap-limited mobility is interpreted in terms of the classical multiple-trapping picture with one transport state and the trapping-detrapping dynamics of the exponential density of traps. This allows us to provide a suitable explanation of the usual experimental features of the mobility dependence on voltage as along with the capacitance spectra. (C) 2011 American Institute of Physics. [doi: 10.1063/1.3622615]“
“Many natural products from plants have been identified to exert anticancer activity. It might be expected to be a challenge to look at the Saudi plants in order to discover new sources for new molecules which may have anticancer activity. The methanolic extracts of forty species HSP inhibitor of plants traditionally used in Saudi Arabia for the treatment of a variety of diseases were tested in vitro for their potential anticancer activity on different human cancer cell lines. The cytotoxic activity of the methanolic extracts of the tested plants were determined using three human cancer cell lines, namely, breast cancer (MCF7), hepatocellular carcinoma (HEPG2), and cervix cancer (HELA) cells. In addition, human normal melanocyte (HFB4) was used as normal nonmalignant cells. Sulforhodamine B colorimetric assay was used to evaluate the in vitro cytotoxic activity of the different extracts. The growth inhibition of 50% (IC50) for each extract was calculated from the optical density of treated and untreated cells.

Palm oil was used as the oil phase of the microemulsion. Experimental results indicate that the optimum triglyceride microemulsion was achieved when equal mass of palm oil and the aqueous phase containing 3 wt% sodium chloride, 1 wt% alkyl polyglycosides, 3 wt% glyceryl monooleate, and 93 wt% de-ionized water were mixed. The formulated composition of the aqueous phase was able to form translucent Winsor Type I microemulsion with palm oil at ambient conditions. The measured interfacial tension between the optimum microemulsion and the model oil, which is n-octane in this study, was 0.0002 mN/m. The maximum tertiary oil recovery of 71.8% was achieved

selleck inhibitor after the injection of the optimum microemulsion formulation to a sand pack. The significant increase in total oil recovery (87%) suggests the effectiveness of the triglyceride microemulsion formulation for enhanced oil recovery. Its capability in recovering additional oil (4.3% of the trapped oil after water flooding)

compared to a typical polymer in tertiary oil recovery indicates the efficiency of the optimum triglyceride microemulsion formulation. (C) 2012 Elsevier B.V. All rights reserved.”
“A methodologically chemorational approach HCS assay to the design of PGB structures was demonstrated using a PGB type misoprostol analog as an example.”
“Transformations of diepoxy derivatives of terpinolene under conditions of homogeneous and heterogeneous acid catalysis were studied. Qualitative and quantitative compositions of the reaction mixtures were found to depend on the acidity of the medium and mutual orientation of the epoxide rings in the p-menthane skeleton. The experimental data were compared with the results of computer simulation of the most probable transformation pathways in terms of molecular mechanics and quantum-chemical methods.”
“It is no secret that during microemulsion flooding, the oil entrapped in rock GDC-0973 purchase pores can be easily removed when a new Winsor Type III microemulsion is

formed in situ. Formulation of an efficient microemulsion in tertiary oil recovery requires good understanding of its phase behavior. This paper presents the phase behavior study of a triglyceride microemulsion before and after n-octane solubilization in formulating an efficient triglyceride microemulsion. The effects of solubilized oil as co-oil, salinity, surfactant concentration and co-surfactant concentration on the phase behavior of a triglyceride microemulsion were investigated. The optimized aqueous phase composition of the triglyceride microemulsion was adjusted at 1 wt% alkyl polyglycosides, 3 wt% glyceryl monooleate, 3 wt% sodium chloride, and 93 wt% de-ionized water.

(Obstet Gynecol 2011;117:883-5) DOI: 10.1097/AOG.0b013e3182107d47″
“2-(1-Alkoxyvinyl)-1,3-thiazolidines reacted with H2O or D2O in the presence of 105 mol % of p-toluenesulfonic acid or trifluoroacetic acid (20 degrees C, 1 h) to give 2-acetyl-1,3-thiazolidine in quantitative yield. 2-(1-Alkoxyvinyl)-3,5-diphenylimidazolidines underwent hydrolysis in the presence of 20 mol % of an acid (20 degrees C, 24 h) at the vinyloxy group with high regioselectivity yielding 2-acetylimidazolidines. Hydrolysis of 2-(1-alkoxyvinyl)-3-phenyl-1,3-oxazolidines

in the presence of 10 mol % of p-toluenesulfonic acid (20 degrees C, 5 days) takes two pathways, one of which selleck involves the endocyclic C-O bond with ring opening and the other involves the vinyloxy group to produce 2-acetyl-3-phenyl-1,3-oxazolidine. Unlike phenyl-substituted 1,3-thiazolidines and imidazolidines, hydrolysis of their 3-methyl-and 3,5-dimethyl-substituted analogs in acid medium occurs mainly via ring opening. The observed hydrolysis pathways were interpreted in terms of B3PW91/6-311G(d,p) quantum-chemical calculations.”
“Objective: To describe the experience with parathyroid fine-needle aspiration (FNA) and parathyroid hormone (PTH) washout at Mayo Clinic Rochester, Rochester, Minnesota.

Methods: We retrospectively reviewed

all parathyroid FNA procedures performed at Mayo Clinic Rochester between January 2000 and December 2007. Clinical, biochemical, STI571 chemical structure and imaging information, parathyroid FNA procedure, and cytology, surgical, and pathology reports were reviewed, Pitavastatin and descriptive statistics, sensitivity, specificity, and positive predictive values are presented.

Results: During the study period, 75 parathyroid FNAs were performed on 74 patients. Cytology results were available for 74 of 75 procedures, with only 31% interpreted as parathyroid cells. PTH washout was performed in 67 patients (91%). Parathyroid FNA with PTH washout had a

sensitivity of 84%, specificity of 100%, positive predictive value of 100%, and accuracy of 84%. At the time of surgical treatment, 2 patients were noted to have an inflammatory response from the parathyroid FNA biopsy, I had a parathyroid abscess, and 2 had a hematoma. In 3 of these 5 patients, the necessary conversion of a minimally invasive surgical procedure to the standard surgical approach prolonged the surgical time.

Conclusion: Parathyroid FNA with PTH washout had a superior performance in comparison with parathyroid scanning or ultrasonography alone. The main limitations of parathyroid FNA with PTH washout are (1) the need for initial identification of a potential parathyroid adenoma by ultrasonography and (2) the number of false-negative results. Parathyroid FNA resulted in complications affecting the surgical procedure in 3 patients. (Endocr Pract. 2012; 18:441-449)”
“Streptomyces sp. CSWu2 was newly isolated and identified from Korean soil.

(C) 2011 American

NU7441 chemical structure Institute of Physics. [doi:10.1063/1.3553390]“
“Ethylene-octene copolymer (EOC) was crosslinked by dicumyl peroxide (DCP) at various temperatures (150-200 degrees C). Six concentrations of DCP in range 0.2-0.7 wt % were investigated. cross-linking was studied by rubber process analyzer (RPA) and by differential scanning calorimetry (DSC). From RPA data analysis real part modulus s`, tan delta, and reaction rate were investigated as a function of peroxide content and temperature. The highest s`(max) and the lowest tan d were found for 0.7% of DCP at 150 degrees C. Chain scission was analyzed by slope analysis of conversion ratio, X in times after reaching the maximum. GDC-0941 mw Less susceptible to chain scission are temperatures in range 150-170 degrees C and peroxide levels 0.2-0.5%. Heat of reaction was analyzed by DSC at various heating rates (5-40 degrees C min(-1)). It was found to be exothermic. By projection to zero heating rate, the reaction was found to start at 128 degrees C

with the maximum at 168 degrees C. (c) 2011 Wiley Periodicals, Inc. J Appl Polym Sci 121: 521-530, 2011″
“Background: Human enterovirus 71 (HEV71) causes outbreaks of life-threatening diseases throughout the world. The genesis of these severe diseases is unknown.

Methods: During an outbreak of HEV71 infection, we investigated risk factors for critical illness. We developed a modified pediatric index of mortality (mPIM) incorporating heart rate, temperature, white blood cell count, respiratory rate, chest infiltrates, skin color, reflexes, responsiveness, and mobility. We calculated the mPIM for 103 patients (22 deaths) using complete scoring criteria in the medical record. In a case-control study, we compared cases (mPIM >= 10 or death) with controls (mPIM =

0-9) by drugs received within 96 hours after onset of fever, initial temperature, age, and nutritional anthropometry.

Results: About 66% (68/103) of the patients with an mPIM score (28 cases and 40 controls) had data on initial exposures. About 50% of the 28 cases and 18% of the 40 controls received an injection to treat fever during the first 96 hours after onset (Odds ratio [OR] = 7.0, 95% confidence interval [CI]: 1.8-28). Injections containing GSK2879552 concentration exclusively glucocorticoids (OR = 4.8, 95% CI: 1.2-21) or pyrazolones (OR = 4.1, 95% CI: 0.91-19, P = 0.047) were risk factors for severe HEV71 infection. About 25% of cases and 5% of controls received both drugs parenterally while 7% of cases and 30% of controls received neither (OR = 21, 95% CI: 1.8-305). Conversely, cases and controls had identical average initial temperature, and did not differ significantly by age, sex, nutritional measurements, use of other drugs, or timeliness of medical care received.

Conclusion: Fever treatment with glucocorticoids and/or pyrazolones is a risk factor for life-threatening HEV71 infection.