In a review of 8 case-control studies, the mean level of 25-hydroxyvitamin D, was 22.8 +/-

14.1 ng/mL in 555 AS patients versus 26.6 +/- 12.5 ng/mL in 557 healthy controls. When compared with a 2-sample t test, vitamin D this website levels were significantly higher in healthy controls (p smaller than 0.01). We conclude that patients with AS appear to have lower vitamin D levels versus healthy controls; however, the cause is unclear. Existing studies do not demonstrate a consistent link 4 between vitamin D levels and disease activity in AS. Further studies are in need to determine if a causative link exists between vitamin D deficiency and AS. (C) 2014 Sociedade Brasileira de Reumatologia. Published by Elsevier Editora Ltda. All rights reserved.”
“Background: Pay for performance schemes are increasingly being implemented in low income countries to improve health service coverage and quality. This paper describes the context within which a pay for performance programme was introduced in Tanzania and discusses the potential for pay for performance to address health system constraints to meeting targets. click here Method: 40 in-depth interviews and four

focus group discussions were undertaken with health workers, and regional, district and facility managers. Data was collected on work environment characteristics and staff attitudes towards work in the first phase of the implementation of the pilot. A survey of 75 facilities and 101 health workers were carried out to examine facility resourcing, and health worker employment conditions and job satisfaction. Results: Five contextual DAPT ic50 factors which affect the implementation of P4P were identified by health workers: salary and employment benefits; resource availability, including staff, medicines and functioning equipment; supervision; facility access to utilities; and community preferences. The results suggest that it is important to consider contextual issues when implementing pay for performance schemes in low income settings. It highlights the importance of basic infrastructures

being in place, a minimum number of staff with appropriate education and skills as well as sufficient resources before implementing pay for performance. Conclusion: Health professionals working within a pay for performance scheme in Tanzania were concerned about challenges related to shortages of resources, limited supplies and unfavourable community preferences. The P4P scheme may provide the incentive and means to address certain constraints, in so far as they are within the control of providers and managers, however, other constraints will be harder to address.”
“The ability to rapidly and accurately recognize visual stimuli represents a significant computational challenge. Yet, despite such complexity, the primate brain manages this task effortlessly.

The statistically significant differences were found at the locus EGF: sows with BB genotype showed higher number of piglets born alive (NBA) and higher number of alive piglets on 21st day (N21) (P < 0.01 and P < 0.05) when compared to the other genotypes. At the LIF1 locus sows of AA genotype had higher number of NBA (P < 0.01) when compared to BB genotype, and at the LIF3 sows of BB had Danusertib concentration better results for this trait when compared to AA and AB genotype (P < 0.01 and P < 0.05). In our study, we obtained also statistically significant results for 3 association between AREG gene and

reproductive traits. In parities 2 to 4, statistically significant differences were observed between sows of A1A1 and A1A2 genotype of the AREG gene for NBA (P < 0.05) and between AA and BB genotypes of the LIF1 gene for NBA and N21 (P < 0.01 and P < 0.05). (C)

2013 Elsevier B.V. All rights reserved.”
“Ventricular assist devices are frequently used to bridge pediatric patients to cardiac transplantation; however, experience in single ventricle patients with aortopulmonary shunts remains limited. This case report addresses the challenge of balancing pulmonary and systemic circulation with a focus on the role of continuous versus pulsatile ventricular assist device support.”
“Objective: To develop recommendations for child unintentional injury prevention by comparing New Zealand’s child unintentional injury mortality and injury prevention policies with those of European countries. learn more Methods: Unintentional child injury death rates based on external cause of injury were calculated and ranked. NZ’s score for each of the 12 domains https://www.selleckchem.com/products/xmu-mp-1.html (based on external causes of injury) from the New Zealand Child and Adolescent Report Card was compared to European scoring. Policy priorities are identified by domains where mortality makes up a high proportion of overall child unintentional injury mortality (high burden of injury) and where report card score for that domain

is low in comparison to other countries (under-utilisation of effective interventions). Results: Death as a motor vehicle occupant accounts for 49% of all child unintentional injury deaths, followed by pedestrian (10%) and drowning deaths (8%). The overall score for the 12 policy domains of the NZ Report Card ranks NZ as 15(th) among the 25 European countries. There are important policy and legislative actions which NZ has not implemented. Conclusions: A number of evidence-based injury prevention policy and legislative actions are available that could target areas of greatest childhood injury mortality in NZ. Implications: A set of injury prevention policy and legislation priorities are presented which, if implemented, would result in a significant reduction in the injury mortality and morbidity rates of NZ children.”
“Traditional colorimetric protein assays such as Biuret, Lowry, and modified Lowry (U-1988) are unsuitable for colored biological samples.

Conclusions: This study shows that the SN abnormality observed by TCS

is a specific feature, which can be helpful in the process of PD diagnosing.”
“The activation-induced cytidine deaminase (AID; also known as AICDA) enzyme is required for somatic hypermutation and class switch recombination at the immunoglobulin locus(1). In germinal-centre B cells, AID is highly expressed, and has an inherent mutator activity that helps generate antibody diversity(2). However, AID may also regulate gene expression epigenetically by directly deaminating 4 5-methylcytosine in concert with base-excision repair to exchange cytosine(3). This pathway promotes gene demethylation, thereby removing epigenetic memory. For example, AID promotes active demethylation of the genome in primordial germ cells(4). GS-7977 However, different studies have suggested either a requirement(5)

or a lack of function(6) for AID in promoting pluripotency in somatic nuclei after fusion with embryonic stem cells. Here we tested directly whether AID regulates epigenetic memory by comparing the relative ability of cells lacking AID to reprogram from a differentiated murine cell type to an induced pluripotent stem cell. We show that Aid-null cells are transiently hyper-responsive to the reprogramming process. Although they initiate expression of pluripotency genes, they fail to stabilize in the pluripotent state. The genome of Aid-null cells remains hypermethylated in reprogramming cells, and hypermethylated genes associated with pluripotency fail to be stably upregulated, including many MYC target Apoptosis Compound Library genes. Recent studies identified a late step of reprogramming associated with methylation status(7), and implicated a secondary

set of pluripotency network components(8). AID regulates this late step, removing epigenetic memory to stabilize the pluripotent state.”
“Here, DZNeP molecular weight we present LNCipedia (http://www.lncipedia.org), a novel database for human long non-coding RNA (lncRNA) transcripts and genes. LncRNAs constitute a large and diverse class of non-coding RNA genes. Although several lncRNAs have been functionally annotated, the majority remains to be characterized. Different high-throughput methods to identify new lncRNAs (including RNA sequencing and annotation of chromatin-state maps) have been applied in various studies resulting in multiple unrelated lncRNA data sets. LNCipedia offers 21 488 annotated human lncRNA transcripts obtained from different sources. In addition to basic transcript information and gene structure, several statistics are determined for each entry in the database, such as secondary structure information, protein coding potential and microRNA binding sites. Our analyses suggest that, much like microRNAs, many lncRNAs have a significant secondary structure, in-line with their presumed association with proteins or protein complexes.

In Europe, A. j. japonicus has been detected in Switzerland, Belgium, Slovenia, and Germany, where it has become a resident species. Here, we describe the recent spread and genetic structure of A. j. japonicus populations in Germany. By monitoring the species in Baden-Wurttemberg in 2011 and 2012, we

observed a considerable enlargement of the infested area from 54 municipalities in 2011 to 124 municipalities in 2012. To elucidate the colonization of Europe by A. j. japonicus, seven microsatellite loci were 432 studied in 106 individuals sampled in Germany and Switzerland in 2012. The same markers were genotyped in 31 North American and 26 Japanese specimens. Population genetic analyses indicated that A. j. japonicus in Baden-Wurttemberg and North Rhine-Westphalia represented two genetically distinct populations with FST-values of 0.073-0.152, suggesting that they originated from two independent introduction events in the past. These PI3K inhibitor results are of particular interest in light

of vectorial variability for the transmission of viruses and other pathogens in Europe.”
“We report the sequence of the Halobacterium salinarum strain R1 chromosome and its four megaplasmids. Our set of protein-coding genes is supported by extensive proteomic and sequence homology data. The structures of the plasmids, which show three large-scale duplications (adding up to 100 kb), were unequivocally confirmed by cosmid analysis. The chromosome of strain R1 is completely colinear and virtually identical to that of strain NRC-1. Correlation of the plasmid sequences revealed Entinostat concentration 2 10 kb of sequence that occurs only in strain R1. The remaining 350 kb shows virtual sequence identity in the two strains. Nevertheless, the number and overall structure of the plasmids are largely incompatible. Also,

20% of the protein sequences differ despite the near identity at the DNA sequence Torin 2 level. Finally, we report genome-wide mobility data for insertion sequences from which we conclude that strains R1 and NRC-1 originate from the same natural isolate. This exemplifies evolution in the laboratory. (c) 2008 Elsevier Inc. All rights reserved.”
“The aim of this study was to characterize the physicochemical properties of bacterial cellulose (BC) membranes functionalized with osteogenic growth peptide (OGP) and its C-terminal pentapeptide OGP[10-14], and to evaluate in vitro osteoinductive potential in early osteogenesis, besides, to evaluate cytotoxic, genotoxic and/or mutagenic effects. Peptide incorporation into the BC membranes did not change the morphology of BC nanofibers and BC crystallinity pattern. The characterization was complemented by Raman scattering, swelling ratio and mechanical tests. In vitro assays demonstrated no cytotoxic, genotoxic or mutagenic effects for any of the studied BC membranes. Culture with osteogenic cells revealed no difference in cell morphology among all the membranes tested.

But in the oxymatrine and mesalazine groups, looser stool and bloody purulent stool reduced after treatment. And the colonic wall in the model group was thickened and the colon length shortened. The colon mucosa Selleck S3I-201 was congested in multiple areas with edema, erosion, superficial or linear ulcer and scar formation, while the intestinal mucosa injury reduced in the mesalazine and oxymatrine groups (P<0.01). In colonic mucosa and in spleen lymphocytes, compared with the normal control group, the expression of NF-kappa Bp65 were significantly increased (P<0.01) in the model group while the expressions of beta 2AR

and beta-arrestin2 were significantly decreased (P<0.01). Compared with the model group, the expression of NF-kappa Bp65 was significantly

decreased in the mesalazine group (P<0.01) and oxymatrine treatment group (P<0.01) while the expressions of beta 2AR and beta-arrestin2 were significantly increased (P<0.01). There were no statistically significant differences in the expression of beta 2AR, beta-arrestin2 and NF-kappa Bp65 between the mesalazine group and oxymatrine group (P>0.05). Conclusions: The beta 2AR-beta-arrestin2-NF-kappa B signal transduction pathway participated in the pathologic course of ulcerative colitis. Oxymatrine attenuated ulcerative colitis through regulating the beta 2AR-beta-arrestin2-NF-kappa B signal transduction pathway.”
“Functional follicular ovarian cysts are frequently reported in girls with peripheral precocious puberty (PP). These cysts are usually PR-171 nmr self-limiting and resolve spontaneously. Several drugs like antiestrogens (tamoxifen)

and new aromatase inhibitors are seldom used for treatment. Here we report a P505-15 chemical structure girl with peripheral PP who presented with unilateral enlargement of the ovary and a recurrent autonomous ovarian cyst. No skin pigmentation or bone anomaly was noted. The patient was successfully treated with anastrozole, a highly selective aromatase inhibitor. No adverse reaction was noted. Anastrozole is a safe and tolerable drug especially used to suppress estrogen action.”
“The radio frequency (RF) and high frequency performance of the flip chip interconnects with anisotropic conductive film (ACF) and non-conductive film (NCF) was investigated and compared by measuring the scattering parameters (S-parameters) of the flip chip modules. Low cost electroless-Ni immersion-Au (ENIG) plating was employed to form the bumps for the adhesive bonding. To compare the accurate intrinsic RF performance of the ACF and NCF interconnect without lossy effect of chip and substrate, a de-embedding modeling algorithm was employed. The effects of two chip materials (Si and GaAs), the height of ENIG bumps, and the metal pattern gap between the signal line and ground plane in the coplanar waveguide (CPW) on the RF performance of the flip chip module were also investigated.

In this article, we describe our experience with myoglobinuric AKI in these border crossers. Records from all patients in the custody of the border

selleck products patrol from 1 June 2010 to 30 June 2011, who had AKI defined by the Acute Kidney Injury Network (AKIN) criteria and a CK > 1000 IU/L, were reviewed. The age, gender, temperature, days in the desert, initial serum creatinine, CK on presentation, need for dialysis, length of hospital stay, and serum creatinine at discharge were recorded and analyzed. Forty-two patients developed myoglobinuric AKI with a mean age of 32.5 years. Among them, 38 were males and four females. There was a mean of 4.2 days in the desert. Seven had stage 1 AKI, 10 stage 2, and 25 stage 3.5 patients required hemodialysis. Only one patient had a temperature SB273005 >100.6 degrees F on arrival. CKs ranged between 1101 and 447,966 IU/L. Mean length of stay was 4 days. Two patients were discharged on hemodialysis and eight were discharged with serum creatinine levels of >1.3 mg/dL. This is the largest series of myoglobinuric AKI reported

in border crossers. The kidney injury is presumably due to the excessive heat combined with volume depletion. We have coined the term “border crossers’ nephropathy” for this disorder. This is a serious problem that has both political and economic consequences on both sides of the border.”
“Both automated and auscultatory blood pressure (BP) devices have their

strengths and accuracy limitations. Hybrid devices, such as the Nissei DM-3000, are mercury free and provide both automated and auscultatory measurement modes. The aim of this study was to validate all measurement modes of the Nissei DM-3000 device according to the European Society of Hypertension (ESH) protocol, as well as CA4P to develop and validate a ‘blinded’ auscultatory measurement mode. Different measurement modes were developed and evaluated in separate studies. Nine sequential same-arm BP measurements were taken alternating between simultaneous mercury sphygmomanometer readings and the device. The latter seven measurements were analysed according to the requirements of the ESH protocol. All measurement modes of the device passed the ESH protocol. The blinded mode achieved the best results with a mean difference +/- s.d. of -0.1 +/- 2.6 and 0.04 +/- 2.4 mm Hg for systolic BP (SBP) and diastolic BP (DBP), respectively. The most accurate auscultatory measurement results were obtained with a deflation rate of 2.5 mm Hg s(-1) achieving a mean difference +/- s.d. of -0.6 +/- 4.4 (for SBP) and -1.4 +/- 2.8 mm Hg (for DBP). The automated mode achieved a mean difference +/- s.d. of -0.8 +/- 6.0 (SBP) and 0.8 +/- 4.8 mm Hg (DBP). The Nissei DM-3000 device is a suitable replacement for the mercury sphygmomanometer. Journal of Human Hypertension (2010) 24, 609-616; doi:10.1038/jhh.2009.

Farmer knowledge exchanges about the experiment have been investigated using a mix of quantitative and qualitative methods. Network surveys identified who the farmers contacted for knowledge before the study began and who they had talked to about the experiment by 18 months later. Open-ended interviews collected farmer statements about their most valuable contacts and these statements have been thematically analysed. The network analysis shows that farmers talked about the experiment with 192 people, most of whom were fellow farmers. Farmers with densely tied and occupationally homogeneous contacts grew their networks more than did farmers with contacts that are loosely tied and

diverse. Thematic analysis reveals three general principles: farmers value knowledge delivered by persons rather than roles, privilege farming experience, and develop knowledge with Vorinostat mouse empiricist rather than rationalist techniques. Taken together, these findings suggest that farmers deliberate about science in intensive and durable networks

that have significant implications for theorizing agricultural innovation. The paper thus concludes by considering the findings’ significance for current efforts to rethink agricultural extension.”
“Struma ovarii is an uncommon ovarian teratoma comprised predominantly of mature thyroid tissue. The combination of pseudo-Meigs’ syndrome, and elevation of CA 125 to the struma ovarii is a rare condition that can mimic ovarian malignancy. We reported a case of selleck benign struma ovarii, presenting with the clinical features of advanced ovarian carcinoma: complex pelvic mass, gross ascites, bilateral pleural effusion and markedly elevated serum CA 125 levels. The patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Ascites and pleural effusion were not evident and the CA 125 levels returned to normal following surgical excision. A systematic review of reported cases of coexistent benign struma ovarii, pseudo-Meigs’ syndrome and elevated serum CA 125 was performed. Struma ovarii accompanied by pseudo-Meigs’ syndrome and elevated serum CA 125 should be considered in the differential diagnosis of ovarian epithelial cancer.”
“Obestatin,

encoded by the same gene as ghrelin, was first described as a physiological opponent of ghrelin. We investigated fasting plasma ghrelin and obestatin levels Quisinostat purchase and ratio of ghrelin to obestatin in humans with untreated mild-to-moderate hypertension and humans with normal blood pressure. We found that the plasma concentration of ghrelin and the ratio of ghrelin to obestatin were significantly lower in hypertension group compared with control group (236.3 +/- 12.3 pg/ml vs 381.4 +/- 25.6 pg/ml, P<0.01: 0.89 +/- 0.06 vs 1.2 +/- 0.06, P<0.01). The plasma concentration of obestatin was lower in hypertension group compared with control group, but the difference between the two groups was not significant (276.2 +/- 15.1 pg/ml vs 325.4 +/- 25.8 pg/ml, P>0.05).

A hybrid imaging agent targeting the av beta 3 integrin111In-MSAP-RGD (MSAP=multifunctional single-attachment-point reagent), which contains a targeting moiety, a pentetic acid (DTPA) chelate, and a cyanine INCB028050 ic50 dyewas evaluated for its potential value in combined lesion detection and interventional molecular imaging in a 4T1 mouse breast cancer model. SPECT/CT and fluorescence imaging were used to visualize the tumor in vivo. Tracer distribution was evaluated ex vivo down to the microscopic level. The properties of 111In-MSAP-RGD were compared with those of 111In-DTPA-RGD. Biodistribution studies revealed a prolonged retention and increased tumor accumulation of 111In-MSAP-RGD

relative to 111In-DTPA-RGD. With 111In-MSAP-RGD, identical features could be visualized preoperatively (SPECT/CT) and intraoperatively (fluorescence imaging). As well as the primary tumor, 111In-MSAP-RGD also enabled detection and accurate excision of distant metastases in the head and neck region of the mice. Therefore, the hybrid RGD derivative 111In-MSAP-RGD shows potential in preoperative planning and fluorescence-based surgical

intervention.”
“There are no data indicating a clear relationship between the clinical effect of risperidone and plasma drug concentration. In this study, 51 patients with acutely exacerbated schizophrenia received 6 mg risperidone/day for 4 weeks. A clinical evaluation using the Brief Psychiatric Rating Scale (BPRS) and Emricasan Udvalg for Klinicke Undersogelser (UKU) side effect rating scale were performed at baseline and each week. Significant (P < 0.05) correlations were found between plasma concentrations of risperidone and improved total Acalabrutinib in vitro BPRS scores, positive and cognitive symptoms. Plasma

concentrations of the active moiety were significantly (P < 0.05) correlated with improved total BPRS scores. Improved score and percent improvement in anxiety-depression subscale were significantly (P < 0.01) correlated with plasma concentrations of the active moiety. The sum of total UKU side effect scores from 1 to 4 weeks was significantly correlated with plasma concentration of both risperidone (rs = 0.319, P < 0.05) and active moiety (rs = 0.373, P < 0.01). The sum of the psychic subgroup scores was significantly correlated with plasma concentrations of active moiety (rs = 0.318, P < 0.05). Results suggest that plasma drug concentrations are, to some extent, associated with improved scores in some psychopathological schizophrenic symptoms and sedative side effects. These findings should be replicated with a larger patient sample.”
“QRS Fragmentation and the Risk of Sudden Cardiac Death in MADIT II. Background: QRS fragmentation (fQRS) has been reported as a useful ECG parameter in predicting mortality in high-risk postinfarction patients. Its prognostic value for sudden cardiac death (SCD) and ventricular arrhythmias in ischemic cardiomyopathy (ICM) remains unknown.

“
“N-myc downstream-regulated gene 1 (NDRG1) is an intracellular protein that is induced under a wide variety of stress and cell growth-regulatory conditions. NDRG1 is up-regulated by cell differentiation signals in various cancer cell lines and suppresses tumor metastasis. Despite its specific role in the molecular cause of Charcot-Marie-Tooth type 4D disease, there has been more interest in the gene as a marker of tumor progression and enhancer of cellular differentiation. Because it is strongly up-regulated under hypoxic conditions, and this condition is prevalent in solid tumors, its regulation is somewhat complex, governed by hypoxia-inducible factor 1 alpha (HIF-1 alpha)- and p53-dependent pathways,

as well as its namesake, neuroblastoma-derived myelocytomatosis, and probably many other factors, at the transcriptional and BTSA1 translational levels, and through mRNA stability. We survey the data for clues to theNDRG1 gene’s mechanism and for indications that the NDRG1 gene may be an efficient diagnostic tool and therapy in many types of cancers.”
“We Selleck JPH203 present a method to monitor a patient and the equipment in a radiotherapy

treatment room, by exploiting the information in the treatment plan, enriched with other elements such as visual, geometric, and “semantic” information. Using all these information items, and a generic model, a virtual environment of the scene is created, with maximum precision. The images resulting from video sequences with several cameras are also used to confront the filmed information on the scene selleck compound and its numerical representation. The method is based on the features of the scene elements, and on a fuzzy formalism. The feasibility of the method is being quantitatively evaluated in the absence of treatment, to be further exploited in a module for external control by video in real conditions.”
“BACKGROUND: The significance of circulating tumor cells (CTCs) in blood and of disseminated tumor cells (DTCs) in bone marrow (BM) in patients with early stage breast cancer is unclear. In this study, the authors investigated

the occurrence of CTCs and DTCs in women with early stage breast cancer and evaluated the correlation of their presence with other prognostic markers. METHODS: Blood and BM aspirations were collected at the time of primary breast surgery. CTCs were detected by using the Cell Search assay, and DTCs were detected by immunostaining BM aspirates for pancytokeratin. The presence of CTCs and DTCs was correlated with tumor classification (T1 vs T2), tumor histologic grade, estrogen receptor (ER) status, progesterone receptor (PR) status, human epidermal growth factor receptor 2 (HER2) status, and lymph node (LN) status. RESULTS: Of 92 patients who were included in the study, 49 had T1 tumors, and 43 had T2 tumors. CTCs were detected in 31% of patients, and DTCs were detected in 27% of patients.

We report here that peptides derived from the fifth domain of beta-2 glycoprotein I (beta(2)GPI), a human heparin binding plasma protein, have antibacterial activities against Gram-positive and Gram-negative bacteria. Streptococcus pyogenes, an important human pathogen that can survive and grow in human blood, has developed mechanisms to escape the attack by these peptides. Thus, protein H and M1 protein, two surface proteins of the highly pathogenic S. pyogenes AP1 strain, bind full-length beta(2)GPI and thereby prevent the processing of beta(2)GPI by proteases from polymorphonuclear Epigenetics inhibitor neutrophils (PMNs) into antibacterial peptides. In addition, protein H and

M1 protein, released from the bacterial cell wall by PMN-derived proteases, bind to, and inhibit the activity of, beta(2)GPI-derived

antibacterial peptides. Taken together, the data suggest that the interaction between the streptococcal proteins and beta(2)GPI or beta(2)GPI-derived peptides presents a novel mechanism to resist an antibacterial attack by beta(2)GPI-cleavage products.”
“Objectives To compare the safety and the efficacy of plasmakinetic bipolar resectoscope versus conventional monopolar in the transurethral resection of primary non-muscle invasive bladder cancer. Methods From January 2007 to December 2009, 132 patients underwent endoscopic resection for primary non-muscle invasive Staurosporine cost bladder cancer. They were randomly assigned to two groups: 67 patients underwent a transurethral resection of the bladder with bipolar plasmakinetic energy transurethral resection of the bladder and 65 were treated with conventional monopolar transurethral resection. Results The mean operative time was 27min for bipolar plasmakinetic energy transurethral resection of the bladder and 31min for monopolar transurethral resection of the bladder. click here No significant differences in the mean change of hemoglobin and serum sodium level were observed. Mean catheterization time was 1.3 days and 2.3 days for bipolar plasmakinetic energy transurethral resection of the bladder

and monopolar transurethral resection of the bladder, respectively. The mean hospital stay was shorter in the bipolar plasmakinetic energy transurethral resection of the bladder. Bladder perforation was reported in two cases for the monopolar transurethral resection of the bladder group and obturator nerve reflex occurred in a single case for both procedures. None of the patients experienced transurethral resection syndrome. The median time of bladder tumor recurrence after initial transurethral resection of the bladder was 12.4 months and 11.9 months for bipolar plasmakinetic energy transurethral resection of the bladder and monopolar transurethral resection of the bladder, respectively. No significant differences in the overall recurrence-free survival rate were observed comparing the two procedures.