“
“Nearly half of very preterm (VP) and extremely preterm (EP) infants suffers from minor disabilities, The paper overviews the literature dealing with motor problems other than cerebral palsy (CP) during infancy and preschool age. The term “”minor motor problems”" indicates a wide spectrum of motor disorders other than CP;”"minor”"does selleckchem not mean “”minimal”", as a relevant proportion of the preterm infants will develop academic and behavioural problems at school age. Early onset disorders consist of abnormal general movements (GMs), transient

dystonia and postural instability; these conditions usually fade during the first months. They were underestimated in the past; recently, qualitative assessment of GMs using Prechtl’s method has become a major item of the neurological examination. Late onset disorders include developmental coordination disorder (DCD) and/or minor neurological dysfunction (MND): both terms cover partly overlapping problems. Simple MND (MND-1) and complex MND (MND-2) can be identified and MND-2 gives a higher risk for learning and

behavioural disorders. A relationship between the quality of GMs and MND in childhood has been recently described. The Touwen infant neurological examination (TINE) can reliably detect neurological signs of MND even in infancy. However, the prognostic value of these disorders requires further investigations.”
“The prolonged residence of drug formulation in the nasal cavity is of utmost importance for intranasal drug delivery. The objective of VX-809 supplier the present investigation was to develop a mucoadhesive in situ gel with reduced nasal mucocilliary selleck clearance in order to improve the bioavailability of the antiemetic drug, metoclopramide hydrochloride. The in situ gelation upon contact with nasal

mucosa was conferred via the use of the thermogelling Pluronic flake 127 (18%). Mucoadhesion was modulated via the use of hydroxy propyl methyl cellulose (HPMC), sodium carboxy methyl cellulose (Na CMC) and sodium alginate (Na-alginate) whereas drug release was modified by varying concentrations of polyethylene glycol 6000 (PEG 6000). The results revealed that the different mucoadhesives increased the gel viscosity but reduced its sol gel transition temperatures. The increase in viscosity was highest in formulations with Na-alginate and lowest in formulations with HPMC. PEG 6000 significantly decreased mucoadhesive strength of formula containing 0.3% HPMC (776.6 +/- 19.55 to 713.6 +/- 5.03), 0.2% Na CMC (656 +/- 11.13 to 575 +/- 9.07) and 0.2% Na-alginate (659 +/- 11.13 to 6183 +/- 9.45) whereas the gelation temperature increased by 3 to 4 degrees C. 100% of drug diffusion was found at four hours for formulation F5, F9, and F12. Formulation F5 showed maximum permeability (0.00949 +/- 0.00021 mg.cm/min) than other formulation containing PEG6000.

“
“The use of fluorochromes in bone research is a widely accepted technique that dates back to the 1950s. Several pioneers, such as Harold Frost, have thoroughly investigated the potential of fluorochrome use for the study on bone formation and bone remodeling dynamics. Since the development of bone tissue engineering, a renewed interest in the benefits of fluorochrome use was perceived. Fluorochrome use in animal models makes it possible to determine the onset time and location of osteogenesis, which are the fundamental parameters in bone tissue engineering studies. There is, however, a lack of standardized procedures

for using this technique. In addition, many types of fluorochromes exist and one could be confused upon selecting the appropriate type, the appropriate concentration, the route of administration, and methods LY3023414 price MI-503 of visualization. All these variables can potentially affect the outcome during fluorescence microscopy. This work aims at providing the bone tissue engineering researcher with an overview of the history, working mechanism, and the potential pitfalls in the use of fluorochromes in animal studies. Experiments using some of the more frequently used fluorochromes are explained and illustrated.”
“This paper studies the Rayleigh-Plateau instability for co-flowing immiscible aqueous polymer solutions

in a microfluidic channel. Careful vibration-free experiments with controlled actuation of the flow allowed direct measurement of the growth BAY 63-2521 inhibitor rate of this instability. Experiments for the well-known

aqueous two phase system (ATPS, or aqueous biphasic systems) of dextran and polyethylene glycol solutions exhibited a growth rate of 1 s(-1), which was more than an order of magnitude slower than an analogous experiment with two immiscible Newtonian fluids with viscosities and interfacial tension that closely matched the ATPS experiment. Viscoelastic effects and adhesion to the walls were ruled out as explanations for the observed behavior. The results are remarkable because all current theory suggests that such dilute polymer solutions should break up faster, not slower, than the analogous Newtonian case. Microfluidic uses of aqueous two phase systems include separation of labile biomolecules but have hitherto be limited because of the difficulty in making droplets. The results of this work teach how to design devices for biological microfluidic ATPS platforms. (C) 2012 American Institute of Physics. [http://dx.doi.org.elibrary.einstein.yu.edu/10.1063/1.3700117]“
“Neurons in the midline and intralaminar thalamic nuclei are components of an interconnected brainstem, limbic and prefrontal cortex neural network that is engaged during arousal, vigilance, motivated and addictive behaviors, and stress.

Methods. Motor-evoked potentials following transcranial magnetic stimulation, and compound muscle action potentials and F-waves following electrical stimulation in the ulnar and tibial nerves were measured from the abductor digiti

minimi (ADM) and abductor hallucis (AH) muscles in 20 patients with CTM, 92 patients with compressive cervical myelopathy (CCM), and 18 control subjects. The CMCT detected from the ADM (CMCT-ADM), the AH (CMCT-AH), and the CMCT-ADM/AH selleck chemical ratio (CMCT-ADM/CMCT-AH) were calculated.

Results. The CMCT-AHs in patients with CTM were significantly longer than in control subjects, although there were no significant differences in the CMCT-ADMs. In contrast, both the CMCT-ADMs and CMCT-AHs in the CCM group were significantly longer than those of the control group. The CMCT-ADM/AH ratios in the CTM group were significantly lower than those of the other groups. Among the CTM and CCM groups, when the cutoff point of the CMCT-ADM/AH ratio was set at equal to or lower than 0.52, i.e., the mean CMCT-ADM/AH ratio in the control group, the odds ratio for CTM was 68.4 (95% confidence interval: 8.62-543; P < 0.001).

Conclusion. Our data showed a significant

pattern of CMCT parameters and low CMCT-ADM/AH ratios in patients with CTM. The measurement of CMCT is valuable as a noninvasive Pfizer Licensed Compound Library clinical trial technique for screening patients with CTM or CCM before magnetic resonance imaging.”
“Neurodegenerative conditions such as Alzheimer’s disease, Parkinson’s disease, and hemorrhagic stroke are associated with increased levels of non-transferrin-bound iron (NTBI) in the brain, which can promote Fenton chemistry. While all types of brain cells can take up NTBI, their efficiency of accumulation and capacity to withstand iron-mediated toxicity has not been directly compared. PF-04929113 in vivo The present study assessed NTBI accumulation in cultures enriched in neurons, astrocytes, or microglia after exposure to ferric

ammonium citrate (FAC). Microglia were found to be the most efficient in accumulating iron, followed by astrocytes, and then neurons. Exposure to 100 mu M FAC for 24 h increased the specific iron content of cultured neurons, astrocytes, and microglial cells by 30-, 80-, and 100-fold, respectively. All cell types accumulated iron against the concentration gradient, resulting in intracellular iron concentrations that were several orders of magnitude higher than the extracellular iron concentrations. Accumulation of these large amounts of iron did not affect the viability of the cell cultures, indicating a high resistance to iron-mediated toxicity. These findings show that neurons, astrocytes and microglia cultured from neonatal mice all have the capacity to accumulate and safely store large quantities of iron, but that glial cells do this more efficiently than neurons.

In parallel, relevant genomic DNA samples from the family were also analyzed by SNP microarray.

After applying a ‘unique informative allele’ selection algorithm to the data, this array-based assay reconfirmed the initial diagnosis in all samples.

We describe selleck inhibitor a PGD method that is both accurate and feasible during the time-frame required for embryo transfer. This strategy greatly reduces the time for pre-case haplotype preparation.”
“Public concern on mental health has noticeably increased given the high prevalence of neuropsychiatric disorders. Cognition and emotionality are the most affected functions in neuropsychiatric disorders, i.e., anxiety

disorders, depression, and schizophrenia. In this review, most relevant literature on the role of the endocannabinoid (eCB) system in neuropsychiatric disorders will be presented. Evidence from clinical and animal studies is provided for the participation of CB1 and CB2 receptors (CB1R

and CB2R) in the above mentioned neuropsychiatric disorders. CBRs are crucial in some of the emotional and cognitive impairments reported, although more research is required to understand the specific role of the eCB system in neuropsychiatric disorders. Cannabidiol (CBD), the main non-psychotropic component of the Cannabis sativa plant, has shown therapeutic potential in several neuropsychiatric disorders. Although further studies are needed, recent studies indicate that CBD therapeutic effects may partially depend on facilitation of eCB-mediated neurotransmission. Last but not least, this

review includes recent findings Copanlisib mw on the role of the eCB system in eating disorders. A deregulation of the eCB system has been proposed to be in the bases of several neuropsychiatric disorders, including eating disorders. Cannabis consumption has been related to the appearance of psychotic symptoms and schizophrenia. In contrast, the pharmacological manipulation of this eCB system has been proposed as a potential strategy for the treatment of anxiety disorders, depression, and anorexia nervosa. In conclusion, the eCB system plays a critical role in psychiatry; however, detrimental consequences of manipulating this endogenous system cannot be underestimated CH5424802 over the potential and promising perspectives of its therapeutic manipulation.”
“New functionalization procedure was developed for C- and N-vinyltetrazoles based on Heck reaction. Applying this method diverse (E)-styryl- and (E)-distyryltetrazoles were obtained for the first time in 76-85% yields. C-Vinyltetrazoles are more reactive in Heck cross-coupling than N-vinyltetrazoles. The arylation of 1-vinyltetrazole along Heck reaction proceeds with a C-H-activation and leads to the formation of 5-phenyl-1-[2-(E)-phenylethenyl]tetrazole.”
“Purpose: This study evaluates the safety and efficacy of intravesical ropivacaine as part of a mulitimodal approach to the provision of analgesia after robot-assisted radical prostatectomy (RARP).

In this region of operation, selleck kinase inhibitor the voltage levels corresponding to

logic “”1″” and logic “”0″” are not V(dd) and Gnd, respectively. We model the incomplete voltage swing and show that the minimum supply voltage for a CMOS inverter (with pull-up and pull-down devices as ideal conventional metal oxide semiconductor field effect transistors) is, indeed, 2kT/q ln 2. The novelty of this approach lies in the fact that it gives an explicit mathematical relationship between the supply voltage and a measure of distinguishability of the binary states defined in terms of the expected voltage swing. The analysis shows that the minimum supply voltage corresponds to the state when the two states become completely indistinguishable. Further, we obtain a relationship between the switching energy and robustness of CMOS inverters and interconnects, valid for the entire range of supply voltages. This analysis FGFR inhibitor also shows that a minimum supply voltage of 2kT/q ln 2 may not correspond to the fundamental energy dissipation of kT ln 2. (C) 2009 American Institute of Physics. [DOI: 10.1063/1.3123763]“
“Purpose: The role of MAP kinases in the activation of AP-1 (c-Jun, c-Fos) and NF-kappa B p65 engaged in the regulation of iNOS expression in human neutrophils (PMNs)

exposed to N-nitrosodimethylamine (NDMA) was analyzed in the study.

Material and Methods: The study included a group of 20 healthy individuals. Isolated human PMN were incubated in the presence of NDMA. Selective MAP kinases inhibitors were used.

The expression of proteins in the cytoplasmic and nuclear fractions was assessed using Western blot method.

Results: The results show that NDMA intensifies iNOS, c-Jun, NF-kappa B p65 and I kappa B-alpha expression in the analyzed PMNs. The blocking of the p38 pathway led to lower iNOS expression, and higher expression of c-Jun and c-Fos in the cytoplasmic fraction, and also lower c-Jun expression in the nuclear fraction of PMNs exposed to NDMA. A decrease in iNOS expression in the cytoplasmic fraction, and also c-Jun in both fractions of the examined cells, was observed as a result of JNK pathway inhibition. The blocking of the ERK5 pathway led to higher iNOS, c-Jun and c-Fos expression in the cytoplasmic fraction, and higher c-Jun expression Cilengitide purchase in the nuclear fraction of PMNs exposed to NDMA. The study also demonstrated that blocking of the p38 and JNK pathways resulted in higher expression of NF-kappa B p65 and I kappa B-alpha in the cytoplasmic fraction and their lower expression in the nuclear fraction of these cells.

Conclusion: Our data indicate the role of MAP kinases p38 and JNK in the activation of c-Jun and NF-kappa B p65 transcription factors engaged in the regulation of iNOS expression in human neutrophils exposed to NDMA. However ERK5 kinase is not involved in the regulation of iNOS and NO production by those cells.

(C) 2013 Elsevier B.V. All rights reserved.”
“Contents The aim of this study was to evaluate the influence of different physiological phases on serum total proteins and their fractions of ten Comisana ewes housed in Mediterranean area. From each animal, blood samples were collected at different physiological phases: late pregnancy, post-partum, early, mid-, end lactation and dry period. On all samples serum total proteins were determined by the biuret method, and albumin, a-globulins, beta 1-globulins, beta

2-globulins and ?-globulins concentrations were assessed using an automated system. One-way repeated measures analysis of variance was applied to determine the significant effect of different physiological phases on the parameters studied. During the late pregnancy and post-partum, total proteins, beta 1-

and beta 2-globulins and ?-globulins showed the highest values. Starting from post-partum, find more a-globulins increased to reach their check details peaks in mid-lactation. Early lactation was characterized by low ?-globulins values. The increase in serum albumin concentration and the drop in some globulin fractions determined the significant increase in albumin/globulin ratio. The obtained results contributed to improve the knowledge on electrophoretic profile during the different physiological phases in ewes, confirming that pregnancy and lactation periods affect the protein metabolism. Particularly, serum protein fractions pattern could give information about dehydration,

plasma volume expansion and hepatic function, which occur during the different physiological phases. Dynamics of the protein profile from pregnancy to dry period which are provided by our results, could be considered as guidelines for the management strategies to guarantee the nutritional needs of these animals during the different physiological phases and to avoid a decline of productive performance and consequently an economic loss.”
“Background and objective: COPD is associated signaling pathway with impaired health-related quality of life (HRQL) and cardiac autonomic dysfunction. Data describing the association between these factors in patients with COPD are mostly lacking. The objective of this study was to evaluate whether there is an association between cardiac autonomic dysfunction and HRQL in COPD.

Methods: We studied 60 patients with COPD (37 women, mean (SD) age 65.20 (7.73) years, FEV(1)% pred. 46.58 (18.53) %) and measured HRQL, as assessed by the Chronic Respiratory Disease Questionnaire, and cardiac autonomic dysfunction, as assessed by heart rate variability (HRV). Analysis of HRV was performed using a Holter-ECG device during a recording period of 5 min. To evaluate a possible association between these factors, univariate and multivariate analyses were used.

The frequencies of IL-21-secreting CD4(+) T cells were higher in HB-ACLF (both P < 0.001) and

S-CHB (P = 0.002 and 0.001) as compared to M-CHB patients and controls. Serum IL-21 levels were highest (P < 0.001) in HB-ACLF and positively associated with high MELD score (P = 0.001) and mortality (P = 0.038). Recovery from HB-ACLF was associated with reduced serum IL-21 levels (P = 0.003) and lower CD4(+)IL-21(+) T-cell frequency Sapanisertib price (P = 0.006). The secretions of IL-1 beta (P < 0.001), IL-6 (P < 0.001), IL-10 (P < 0.001), IFN-gamma (P = 0.001) and TNF-alpha (P = 0.042) from PBMC were significantly increased with rhIL-21 stimulation. In summary, IL-21 has a causal role in the development of severe liver mTOR inhibitor inflammation, which is upregulated in HB-ACLF and associated with severity of liver disease.”
“Purpose: To investigate in vivo severity and topographic distribution of brain white matter (WM) fiber bundle atrophy in patients with Friedreich ataxia, a condition characterized by an uneven involvement of brain WM, and to correlate such findings with the clinical status of the patients.

Materials and Methods: The study was conducted with institutional review board approval. Written informed consent was obtained from each participant. Sixteen patients with Friedreich

ataxia and 15 healthy control subjects were studied by using a 1.5-T magnetic resonance (MR) imager and 3-mm-thick diffusion-tensor images with 15 noncollinear directions. The size of WM fiber bundles was examined at a voxel level by using a recently developed method, which relies on production of anisotropy maps and nonlinear registration. Data were analyzed by using statistical parametric

mapping software and an analysis of covariance model adjusted for age and sex.

Results: Compared with control subjects, patients with Friedreich ataxia had WM atrophy in (a) the central portion of the medulla oblongata, (b) the dorsal upper pons, SBE-β-CD in vitro (c) the superior cerebellar peduncles, (d) the central portion of the midbrain, (e) the medial portion of the right cerebral peduncle, (f) the peridentate region, bilaterally, and (g) the optic chiasm. The severity of the neurologic deficits correlated significantly with atrophy of the peridentate WM, bilaterally, and that of the superior cerebellar peduncle decussation.

Conclusion: Findings of this study show that it is feasible to obtain in vivo atrophy estimates of specific brain WM fiber bundles in patients with Friedreich ataxia and that such estimates correlate with patients’ clinical status. This approach has the potential to provide new information that is likely to improve the understanding of the pathophysiology of inherited ataxias. (c) RSNA, 2010″
“Molecular dynamics simulation is carried out to investigate structural modifications of single-walled carbon nanotubes by electron irradiation.

Results: Thirty-seven studies were included, the majority focused on etanercept. Seven RCTs were identified, including one each for etanercept, infliximab, adalimumab, abatacept, and anakinra, and one each looking at etanercept or infliximab as first-line therapies. There was strong evidence to support the efficacy and safety of biologics over the short-term, but a lack of long-term data for treatments AZD9291 order other than etanercept. Several high-quality patient registries confirmed the efficacy and safety of etanercept over the long-term.

Conclusions:

Current evidence shows that a short-term improvement in treatment response is achieved when patients with polyarticular JIA with an inadequate response to conventional treatment are treated with biologics. Long-term effectiveness data, however, are

sparse leaving many questions regarding switches between biologics, handling patients that achieve disease remission, and long-term safety. Study designs other than RCTs may be important in understanding the role of biologics in JIA over the long-term. (C) 2013 Elsevier Inc. All rights reserved. Semin Arthritis Rheum 42:597-618″
“We present the surface and interfacial chemical analysis of sputter deposited TiNi thin films over Si (100) substrates using Rutherford backscattering NCT-501 spectrometry (RBS), secondary ionization mass spectrometry (SIMS), and grazing incidence x-ray diffraction analysis. Upon annealing to high temperatures, significant diffusion of Ni into the Si substrate was observed. The analysis of the RBS and SIMS spectra confirm the net movement of the film species into the substrate. Further, we discuss the formation mechanism and the composition distribution surrounding the TiNi/Si Erismodegib interface that proves conducive for the nucleation and growth of the detected nickel silicide compound.”
“Aim:

To evaluate the sexual functioning of breast cancer patients post mastectomy and its association with their quality of life, the personal characteristics of women and their partners, breast reconstruction, cancer staging and adjuvant therapies.

Methods: A cross-sectional study was carried out in a University hospital located in the SouthEast of Brazil. A total of 100 women were included in the study. The parameters evaluated were sexual functioning, which was assessed based on the Sexual Quotient Female Version (SQ-F), quality of life (QoL), evaluated by the Medical Outcomes Study 36-item Short Form (SF-36), cancer staging, breast reconstruction, adjuvant therapies and the personal characteristics of patients (age, years of study and years of marriage) and their partners (age, years of study).

Results: The majority (40.48%) of women had an unfavorable to regular SQ-F score. A significant positive correlation (p < 0.05) was found between the SQ-F score and years of education (p = 0.03), and the following SF-36 domains: functional capacity (p = 0.03), vitality (p = 0.06), emotional limitations (p = 0.00) and mental health (p = 0.03).

CONCLUSIONS: The prevalences of abnormal CXRs and TB were respectively 2.6- and 8.9-fold higher among asymptomatic PLWH screened for the trial than in the pilot. A cost-effectiveness analysis is needed to determine whether the benefits of symptom screening alone are offset by the risk of inducing INH resistance by excluding CXRs during screening.”
“Luteolin is a flavonoid in many fruits and vegetables. Although luteolin has important biological functions, including antioxidant, anti-inflammatory, antimicrobial, and neuroprotective activities,

little is known about the functions of luteolin in the olfactory system. Various odorants can be detected and distinguished by using several molecular processes, including the binding of odorants to odorant receptors, activation of adenylyl cyclase (AC), changes of cyclic adenosine monophosphate (cAMP) and Ca2+ buy Pevonedistat levels in olfactory sensory neurons, as well as changes in membrane potentials and the transmission of electric signals to the brain. Because AC-cAMP signal selleck chemicals llc transduction plays a pivotal role in the olfactory

system, we evaluated the effects of luteolin on the AC-cAMP pathway that had been stimulated by the odorant eugenol. We demonstrated that eugenol caused an upregulation of the cAMP level and the phosphorylation of phosphokinase A (PKA, a downstream target of cAMP) in human embryonic kidney 293 (HEK293) cells expressing the murine eugenol receptor. This upregulation significantly decreased in the presence of luteolin, suggesting that luteolin inhibited the odorant-induced production of cAMP and affected ICG-001 the downstream phosphorylation of PKA.”
“SETTING: An antiretroviral treatment (ART) service in Gugulethu township, Cape Town, South Africa.

OBJECTIVE: To assess the inter-observer agreement when

using the chest radiographic reading and reporting system (CRRS) to detect radiographic abnormalities in patients with advanced human immunodeficiency virus (HIV) associated immunodeficiency being actively screened for tuberculosis (TB). Second, to assess the associated performance characteristics of radiology as routine screening test for detection of culture-confirmed pulmonary TB.

DESIGN: Radiographs from a study in which patients were actively screened for TB just before starting ART were independently reported by two CRRS-certified readers blinded to clinical status.

RESULTS: Good kappa statistic agreements between observers were found when reporting any radiological abnormality consistent with TB among all patients (n = 203, K = 0.63, 95%CI 0.52-0.73) and among those with culture-confirmed TB (n = 53, K = 0.61, 95%CI 0.40-0.83). However, in comparison with sputum culture, the sensitivity (0.68, 95%CI 0.54-0.79) and specificity (0.53, 95%CI 0.45-0.61) of radiology in this patient group were low.

Methods. A retrospective case-control study was performed at the Obstetrics and Gynecology Ultrasound unit of a tertiary referral medical center. Patient’s population included 32 bi-chorionic bi-amniotic twin pregnancies reduced to singleton and 35 non-reduced twin pregnancies. Thirty-six patients with singleton pregnancies comprised the second control group. Main outcome measures were rates of pregnancy complications, preterm delivery (both before 37 weeks of gestation and before 34 weeks of gestation), late abortions, intra-uterine PD0332991 growth retardation, cesarean section, mean birth weights, and mean gestational age at delivery.

Results. The reduced twin pregnancies group had similar rates

of total pregnancy complications, preterm deliveries, and cesarean section

as non-reduced Natural Product Library twins. Gestational age at delivery and mean birth weight were also similar to non-reduced twins and significantly different compared with singletons. Preterm delivery and late abortion incidences were significantly higher when reduction was beyond 15 weeks gestation.

Conclusions. Reduction of twin pregnancy to singleton does not change significantly pregnancy course and outcome. Favorable obstetrical and neonatal outcomes could be achieved by performing early, first trimester reductions.”
“Background: Increased injury rates have been associated with physical activity (PA). The differences in musculoskeletal injury (MSI) characteristics resulting from PA, versus those unrelated to PA, are unknown. We describe the pattern of PA and non-PA MSI incurred by community-dwelling women. Methods: Data were extracted from the Women’s Injury Study, a web-based observational study that tracked weekly PA behaviors and self-reported MSI of 909 community-dwelling women ages 20-83 years. The primary outcome was self-reported MSI that interrupted

daily activities 2 days and/or required treatment from a health care provider. Follow-up telephone reporting of MSIs allowed further description of injuries. Mixed effects logistic regression AZD0530 purchase was used to identify injury sites associated with PA, controlling for age, body mass index, previous injury, and use of alcohol. Results: Incidence of PA and non-PA MSIs were comparable; some differences in injury characteristics were evident across 83,241 person-weeks of reporting. Non-PA MSIs were more likely to come on suddenly (54% vs. 8%) and commonly involved head/jaw/neck injuries. Reported PA-related MSIs were less likely to require health care provider treatment (60% vs. 80%) and resulted in less missed days of work/school (11%) versus non-PA MSIs (17%). Compared to non-PA related injuries, PA-related injuries were more likely to involve the lower (odds ratio [OR]=3.10, p=0.002) or upper limbs (OR=2.54, p=0.01) and less likely to involve the head/jaw/neck (OR=0.21, p=0.002).