(C) 2011 American Institute of Physics [doi:10 1063/1 3602120]“<

(C) 2011 American Institute of Physics. [doi:10.1063/1.3602120]“
“Report of the personal experience at repairing urogenital fistulae comparing the etiology, management, and outcomes in a developed and underdeveloped countries.

Fifty-three patients with urogenital fistulae were surgically repaired at two different countries. Twenty-nine of those were treated in Istanbul, Turkey during last 10

years period and the other 24 patients were operated in Maradi, Niger in August 2007. Detailed information on obstetric history and previous surgical procedures were questioned in all of the patients. selleck chemicals llc Specific evaluation included instillation of dye in the bladder to locate the site of the fistula and intravenous urography were applied to patients with suspected urogenital fistula to confirm the fistula tract. The site, number and the size of fistula, as well as the pliability of tissues was assessed before the operation. The position of patients for surgery and the route of repair were individualized according to the appropriate access to the fistulae. Patients were reviewed 4-10 weeks after surgery to determine the end results of click here the operations.

Over all, obstetric complications (47%) were the most common cause of urogenital fistulae. Gynecologic surgeries were responsible for 41%

of the cases. Although obstetric causes were prominent at patients in Niger, gynecological surgery was the main cause in Turkey. The most common type of fistulae was vesicovaginal. With regard to surgical approach to urogenital fistulae; the transabdominal approach was chosen in 12 (22.6%) of

patients and transvaginal repair was performed in 41 (77.4%) of patients; 94.34% of the patients were completely dry after the first attempt.

A high percentage of patients with genital fistulae can be rendered dry and continent by assessment of these conditions; meticulous attention must be applied for the absence learn more of inflammation and infection at the fistula site before the operation. Surgical team must be experienced at both abdominal and vaginal repair. Broad-spectrum antibiotics and continuous bladder drainage must be applied to all patients for at least 2 weeks. Interposition flaps must be used in complex cases.”
“Synthesis and physicochemical properties of the new glycidyl methacrylate, styrene, and bis[4(2-hydroxy-3-methacryloyloxypropoxy) phenyl] sulfide terpolymers of different crosslinking degrees are presented. The terpolymers were obtained in the form of regular microspheres by suspension polymerization. The epoxy group content, thermal properties (DSC, thermogravimetric analysis), and swelling characteristic of the functional microspheres were examined. In addition, a selected terpolymer was modified in the epoxide ring opening reaction with diethylenetriamine. (C) 2011 Wiley Periodicals, Inc. J Appl Polym Sci 123: 59-65, 2012″
“The photoluminescence of Pr doped (Bi0.5Na0.

In HHP1::GUS transgenic mutants, GUS activity was found to be mai

In HHP1::GUS transgenic mutants, GUS activity was found to be mainly expressed

in the roots, vasculature, stomata, hydathodes, adhesion zones, and connection sites between septa and seeds, regions in which the regulation of turgor pressure is crucial. By measuring transpiration rate and stomatal closure, it was shown that the guard cells in the hhp1-1 mutant had a decreased sensitivity to drought and ABA stress compared with the WT or the c-hhp1-1 mutant, a complementation mutant of HHP1 expressing the HHP1 gene. The N-terminal fragment (amino acids 1-96) of HHP1 was found to interact with the transcription factor inducer of CBF expression-1 (ICE1) in yeast two-hybrid and bimolecular fluorescence complementation (BiFC) studies. The hhp1-1 mutant grown in soil showed hypersensitivity

to cold stress with limited mTOR inhibitor watering. The expression of two ICE1-regulated www.selleckchem.com/products/R406.html genes (CBF3 and MYB15) and several other cold stress-responsive genes (RD29A, KIN1, COR15A, and COR47) was less sensitive to cold stress in the hhp1-1 mutant than in the WT. These data suggest that HHP1 may function in the cross-talk between cold and osmotic signalling.”
“Introduction and hypothesis Laparoscopic sacrocolpopexy (LSC) was first described almost 20 years ago. This technique aims to provide the outcomes of the gold standard abdominal approach while offering the benefits of minimally invasive surgery. However, the widespread diffusion of LSC in the management of pelvic organ prolapse THZ1 (POP) is hampered by its presumed length and technical difficulties due to the inherent need for laparoscopic suturing skills.

Methods In this article, we highlight the current status of LSC based on a historical overview and in the paradigm of an interrelationship between the three different approaches to POP correction.

Results The enormous changes over the past 15 years have contributed to a better understanding of the pathologies and their treatment, which has enabled us to refine LSC, to simplify it, and to make it much more reproducible.

Conclusions In the future, we will need more prospective studies

to compare LSC with vaginal reconstructive surgery.”
“A MgO underlayer with (100) preferential orientation formed on a thin Fe seed layer is used to attain L1(0) ordered phase 2 nm-thick FePt films with (001) orientation. The Fe[1 nm]/Pt[1 nm] bilayer can be grown epitaxially on the MgO underlayer with (100) aligned texture and the bilayer transformed into (001)-textured L1(0)-FePt films after annealing at 600 degrees C. FePt films 2 nm thick with (001) preferential orientations can be prepared on a thick MgO underlayer with (100) orientation. Since the thinness of Fe and Pt layers enhances an inter-diffusion process between the layers, the crystallization and ordering temperature of FePt decreases from 550 degrees C to 500 degrees C. (C) 2011 American Institute of Physics. [doi:10.1063/1.

A response surface methodology was employed to evaluate the effec

A response surface methodology was employed to evaluate the effects of 4 independent variables (temperature, pH, solvent to sample ratio, and time) on the TPC. The optimum extraction conditions were as follows: liquid to solid ratio 20, pH 6.3, extraction temperature 35A degrees C, and extraction time 35 min. Under the above-mentioned conditions, the experimental TPC was 11.7 mg gallic acid equivalent/g dry matter. EC50 of the UAE extract at optimal conditions was found at 30.6 +/- 0.6 mg/L level and total flavonoids

(TF) were obtained at 12.6 +/- 0.2 mg/10 check details g sample. Also, the results of HPLC analysis showed that gallic acid and p-coumaric acid were the predominant phenolic compounds in the plant.”
“The results of the experimental study GSK1904529A clinical trial and computer simulation of the resonance spectra of a single crystal of the iron-manganese sulfide FexMn1-xS (0 <= x <= 0.29) are presented. The resonance properties of the concentrated solid solutions are explained by the formation of a homogeneous FexMn1-xS matrix with randomly distributed superparamagnetic iron nanoparticles. The mean diameter (< D > = 6.19 nm at T=250 K) and the axial first-order anisotropy constant (K-1 = 4.08 erg/cm(3) at T=250 K) of the ferromagnetic particles are determined. The volume fraction of the iron phase is estimated. (C) 2009 American

Institute of Physics. [doi:10.1063/1.3234402]“
“The drying characteristics of red pepper were examined in convection dryer at a temperature range of 55-70A degrees C with a constant air velocity of 2 m/s. The red peppers were pre-treated with ethyl oleate and citric acid solutions before drying process. Drying process continued until sample moisture fell down to 0.12 kg water/kg d.m. It was observed that drying, rehydration, and color characteristics were significantly influenced by air temperature and pretreatments.

Moisture transfer from red peppers was described by applying the Fick’s diffusion model, and the effective moisture diffusivity was calculated. The effective moisture diffusivity ranged from 5.72×10(-10) to 1.75×10(-9) m(2)/s for the studied temperature range. The values of activation energy (E (a)) were 50.27, 49.21, and 48.45 kJ/mol for control, pre-treated with citric acid, and ethyl oleate, respectively. EPZ5676 Drying data was fitted to 4 drying models, and the best models were logarithmic and Page.”
“Ferredoxins are proteins that participate in photosynthesis and in other processes that require reducing equivalents, such as the reduction of nitrogen or fatty acid desaturation. Two classes of ferredoxins have been described in plants: light-regulated photosynthetic ferredoxins and heterotrophic ferredoxins whose activity is not influenced by light. Genes encoding the two forms of ferredoxin have been cloned and characterized in developing sunflower cotyledons.

These children may be transferred to centers of specialist pediat

These children may be transferred to centers of specialist pediatric cardiac anesthesia to be benefited from experience obtained there.”
“This systematic narrative review of randomised controlled trials (RCTs) identifies and evaluates the efficacy of behaviour-change techniques explicitly aimed at walking in individuals with

intermittent claudication. An electronic database search was conducted up to December 2012. RCTs were included comparing interventions incorporating behaviour-change techniques with usual care, walking advice or exercise therapy for increasing walking in people with intermittent claudication. Studies were evaluated using the Cochrane Collaboration risk of bias tool. The primary outcome variable was maximal walking ability at least 3 months after the

start of an intervention. Secondary outcome variables included pain-free walking ability, self-report walking ability and daily walking www.selleckchem.com/products/ly333531.html activity. A total of 3,575 records were retrieved. Of these, six RCTs met the inclusion criteria. As a result of substantial heterogeneity between studies, no meta-analysis was conducted. Overall, 11 behaviour-change techniques were identified; barrier identification with problem solving, self-monitoring NSC23766 ic50 and feedback on performance were most frequently reported. There was limited high-quality evidence and findings were inconclusive regarding the utility of behaviour-change techniques for improving walking in people with intermittent claudication. Rigorous, fully powered trials SCH727965 datasheet are required that control for exercise dosage and supervision in order to isolate the effect of behaviour-change techniques alongside exercise therapy. (C) 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.”
“Background: Ore workers are conventionally monitored for

exposure by measuring the uranium in their urine, but specific biomarkers of kidney damage still remain to be discovered. A recent toxicogenomics study allowed us to focus on osteopontin (OSTP) normally excreted in human urine and linked to mineral metabolism.

Objectives: We examined the association between osteopontin and uranium exposure both in vitro, in a human kidney cell model, and in the urine of exposed individuals.

Methods: OSTP was measured in supernatants of uranium-exposed HK2 cells to establish a dose-response curve and a time course experiment. Its role was studied through a gene extinction experiment. Uranium and OSTP were then monitored in the urine of exposed nuclear fuel industry workers and a chronically exposed population. These levels were compared with those found in a non-exposed population.

Results: The study of HK2 cells indicated that OSTP secretion decreased after uranium exposure in a concentration and time dependent manner, but its suppression does not affect cell sensitivity to uranium.

Much more is known about optimizing rehabilitation of the engraft

Much more is known about optimizing rehabilitation of the engrafted intestine in the first 12 months after transplant, but it is also becoming apparent that there are some long-term health issues to consider.

Recent findings

The key issues in rehabilitation of ITx are the immunogenic nature of the intestinal graft, which means a higher risk of rejection and necessitates relatively high levels of immune suppression that promotes infections, including Epstein-Barr virus-driven lymphoma, viral gastroenteritis and renal impairment;

and those related to the specifics of an intestinal allograft (nutritional supports chylous ascites, growth, food allergy, fat soluble vitamin deficiencies, metabolic bone disease). In this article, recent publications about approaches for establishing nutrition and methods for monitoring JAK inhibitor the health of the ITx patient are reviewed.


ITx appears

to be cost-effective compared PF-02341066 chemical structure with parenteral nutrition, but lTx recipients continue to be vulnerable to infections, nutritional deficiencies and rejection over the long-term and, therefore, require support from and involvement of a multidisciplinary team for patients to become safely integrated with their local community.”
“Voltage-dependent sodium channels (VDSCs) are crucial for pain generation. Here, to develop a new behavioral index of pain induced by spinal VDSC activation, we examined whether intrathecal veratridine injection produced nociceptive behavior. Intrathecal injection of the VDSC opener veratridine in mice dose-dependently induced nociceptive responses, with response times subsequently reduced by administration GW786034 molecular weight of morphine

or pregabalin. Systemic administration of lidocaine and mexiletine, but not amitriptyline, also decreased this response time. Taken together, these results demonstrated that response time of nociceptive behavior induced by intrathecal veratridine injection is a quantitative index of pain triggered by spinal VDSC activation.”
“Study design A retrospective review of a case series.

Objectives Giant thoracic disc herniations remain a surgical challenge and historically have been associated with significant complications. While neurological outcomes have improved with the abandonment of decompressive laminectomy, the attempt to minimize surgical complications and associated morbidities continues through less-invasive approaches. With the current study, we describe a surgical technique to treat giant thoracic disc herniations while minimizing approach-related morbidity.

Methods Demographic and radiographic data; clinical outcome and perioperative complications were retrospectively analysed for patients with single-level giant thoracic disc herniations who underwent mini-thoracotomy and selective microsurgical anterior spinal cord decompression without instrumented fusion.

Surprisingly, it was found that more carriers were trapped in the

Surprisingly, it was found that more carriers were trapped in the Au devices than in the Cu devices even though the pentacene film and dielectric layers were essentially identical. We propose that carrier trapping

in the long channel of the Au devices is indirectly caused by the deep see more trap states at the pentacene-dielectric interface in the contact region generated by Au penetration. In addition, ambipolar injection and transport were observed in an LCC with an Al contact and a PMMA buffer layer between pentacene and SiO2. (c) 2011 American Institute of Physics. [doi: 10.1063/1.3638706]“
“The aim of the study was to evaluate the subjective outcome between 1 and 5 years after tension-free vaginal tape (TVT) operation and the need for follow-up.

A prospective questionnaire study was performed including questions about incontinence, urinary tract infection, emptying problems, the wish for a clinical control and the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF).

One hundred seventy-three patients were included. There were more patients

selleck chemicals llc with subjective recurrent stress incontinence over the years, but ICIQ-SF was unchanged. There was no rise in patients reporting urge incontinence over the years. Only 11.4% of the patients wished for a clinical control at some time.

The TVT operation showed a slight degree of subjective deterioration between 1 and 5 years check details after the operation; however, the ICIQ-SF was unchanged. There seems to be no need for long-term follow-up at the operating department.”
“The adverse effects of regimes in cancer treatment have forced us to change to new targeted therapy options. Understanding these side effects, which can lead to discontinuation of the new therapy strategies, will allow the clinical management of these side effects and result in continuing therapies with effective medications.

Bevacizumab, which is an IgG1 antibody against vascular endothelial growth factor, has side effects such as proteinuria, hypertension, venous and arterial thromboembolic events, and hemorrhage. This is the first reported case of dural sinus vein thrombosis, during the treatment with bevacizumab.”
“This contribution presents an analytical formulation for the electromagnetic response of grids of ferromagnetic microwires, where the electromagnetic fields produced by the structure are found by means of the local field method. In addition, a circuit analogy is introduced for a better understanding of the grid response, where a single ferromagnetic microwire is modeled as an impedance-loaded wire, and the transmission-line approach is used for the whole grid. Moreover, the homogenization of the structure is considered to provide more physical insight into internal polarizations of the grid.

026) The DD genotype and the D allele were more frequent in the

026). The DD genotype and the D allele were more frequent in the subgroup of T2DM patients with multivessel CAD (p=0.01) than in individuals with single vessel stenosis.

Conclusions: These findings reveal a significant relationship between

ACE gene I/D polymorphism, multivessel CAD and also the occurrence of MI in T2DM individuals with significant coronary stenoses in our population.”

Electroporation therapy is a new cancer treatment modality in which a locally applied electrical field enhances cell membrane permeability, allowing greater intracellular accumulation of a chemotherapeutic agent.


To evaluate the efficacy of electroporation therapy in treating basal cell and squamous cell carcinomas of the skin.


Six patients with selleck skin cancer of the head and neck SC79 solubility dmso were treated using electroporation therapy

with intratumorally injected bleomycin. Orbital growth, facial nerve proximity, or proximity to cartilage of the external meatus complicated four of these tumors. The intention was curative. The follow-up period was 24 months and included biopsies after 8 weeks.


In four of the six patients, one treatment was enough to eradicate the tumor. In one patient, the tumor persisted even after a second treatment with electroporation therapy. A septal cartilage perforation was the only major complication. The cosmetic results were very satisfactory. One additional recurrence was recorded 6 months after the follow-up period


Electroporation therapy

is a promising new cancer treatment that should be further evaluated as an alternative to surgery, especially in complicated skin cancer.

Genetronics, Inc. provided financial support for this study and has paid Dr. L. Lofgren an honorarium for work at investigator meetings.”
“Introduction: The purpose of this study was to investigate whether the effects of renin-angiotensin system inhibitors (RASIs) after encircling ipsilateral pulmonary veins AZD5153 purchase isolation (EIPVsI) for atrial fibrillation (AF) differed between patients with non-dilated and dilated left atria.

Materials and methods: We retrospectively studied 292 consecutive patients (mean age=61+/-11 years, 75% males) who underwent successful EIPVsI for paroxysmal or persistent AF. RASIs’ effects were compared between the patients with a non-dilated left atrium of <40 mm (n=178) and dilated left atrium of >= 40 mm (n=114).

Results: During a mean follow-up period of 18.9+/-12.7 months, AF recurred in 38 (21.4%) and 45 (39.5%) patients with non-dilated and dilated left atria, respectively. A multivariate Cox proportional analysis revealed that treatment with RASIs (hazard ratio (HR) 0.30, 95% confidence interval (CI) = 0.13-0.66, p=0.003), the duration of AF (HR 1.08/year, 95% CI=1.01-1.16, p=0.03), a history of hypertension (HR 2.86, 95% CI=1.21-6.85, p=0.02) and the left ventricular ejection fraction (HR 0.54/10%., 95% CI=0.34-0.87, p=0.

044), higher frequency of male gender, and a non significant high

044), higher frequency of male gender, and a non significant higher value of VO(2)max (P = 0.099). The CA-IMT was similar. Only better aerobic capacity was associated with lower frequency of high C-reactive protein when adjusted to diabetes and gender in a logistic regression model. In conclusion, aerobic capacity was associated with inflammatory state, in CKD patients, independently of diabetes presence.”
“Background: Angiopoietins are essential angiogenic mediators. Since inflammatory bowel

disease (IBD) involves inflammation, ulceration and regeneration of the intestinal mucosa, the angiopoietin system has been proposed as a factor to maintain pathological angiogenesis during the development of the IBD.

Aim: this website To review the potential role of angiopoietins in the inflammation driven by CDK inhibitor drugs angiogenesis during the course of the IBD.

Methods: Publications were identified by PubMed searches using the following key words: angiopoietin; Tie-2 receptor; angiogenesis; inflammatory bowel disease and inflammation, in various combinations.

Results: Angiopoietin-1 acts as a regulator of blood vessel maturation and has anti-inflammatory properties, whereas angiopoietin-2 marks the onset of angiogenesis and is required for normal formation of lymph vessels. Both angiopoietins make use of their angiogenic

regulatory effects via the angiopoietin tyrosine-kinase receptor (Tie-2). While angiogenesis has been shown to promote and sustain many events of inflammation, the involvement of the angiopoietin system in IBD has been reported in few studies. It is not clear whether the angiopoietins role in the development of intestinal inflammation is due to an imbalance in the levels of these proteins or this system

exerts its pro-angiogenic properties through a different mechanism during the close-loop relationship between angiogenesis and inflammation.

Conclusions: Angiopoietins have key functions in the angiogenic process, and their abnormal activation might depend on their surrounding inflamed environment. The determination of these angiogenic factors in serum and tissue could be useful for monitoring IBD progression. (C) 2013 The Authors. Published by Elsevier B.V. on behalf of European Crohn’s and Colitis Organisation. All rights reserved.”
“BACKGROUND: Cardiomyocyte apoptosis PR-171 in vivo takes place at an early stage after myocardial infarction (MI). Therapy with mesenchymal stem cells (MSCs) is reported to reduce apoptosis.

OBJECTIVES: To determine whether anoxic preconditioning (AP) could enhance the antiapoptotic effect of MSCs.

METHODS: Cultured cardiomyocytes were created With Dulbecco’s modified Eagle’s medium (as a control), MSCs or AP-MSCs, and were exposed to hypoxia/reoxygenation. Apoptotic cardiomyocytes were stained with Annexin V fluorescein isothiocyanate (BioVision, USA), visualized by fluorescence microscopy and analyzed by flow cytometry.

Animals-4,620 horses on 500 farms

Procedures-A questi

Animals-4,620 horses on 500 farms.

Procedures-A questionnaire was structured and mailed to farm owners or managers to obtain information related to diagnosis of anhidrosis in horses and exposure factors associated with this condition. The frequency of investigated farm- and animal-level factors was compared between farms and horses affected and not affected with anhidrosis, respectively.

Results-The prevalence of anhidrosis was 11% at the farm level and 2% at the animal level. The odds of anhidrosis were 2.13 and 4.40 times

as high in farms located in central and southern Florida, respectively, compared with odds for farms in northern Florida. The odds of anhidrosis were 5.26 and 15.40 times OSI-906 in vitro as high in show and riding instruction operations, respectively, compared with odds for ranch operations. At the animal level, breed (Thoroughbreds and warmblood horses), foaling place (western or midwestern region of the United States), and family history of anhidrosis were significantly associated with anhidrosis.

Conclusions and Clinical Relevance-This study provides new information on the prevalence of and factors for anhidrosis in horses in Florida. Horses with a family history of anhidrosis should be examined by a veterinarian for diagnosis of this condition before they are exposed to exercise in a hot and humid climate. (J Am Vet Med Assoc 2010;236:1091-1097)”
“Purpose of review

To provide an overview of the mechanisms

of autoimmunity associated with Birinapant primary immunodeficiencies.

Recent findings

Over the past several years, new concepts of the relationship between primary immunodeficiencies and autoimmunity have developed that promise to illuminate the mechanisms by which alterations in the same gene may alternately, or sometimes concomitantly, lead to increased susceptibility to infection and loss of self-tolerance. A common pathway in the process leading to autoimmunity involves gene defects that permit effector T-cell development in the absence of sufficient regulatory T-cell function. Conversely, MLN2238 gene defects that primarily

lead to autoimmunity may impair host defense by neutralizing key elements of immunity. The production of neutralizing antibodies against cytokines comprises a newly recognized mechanism in which autoimmunity may lead to immunodeficiency.


Autoimmunity has long been known to be a part of the presenting symptoms and clinical course of many primary immunodeficiencies. This review will provide an overview of the new concepts regarding the complex relationship between the genetic immune deficiencies and autoimmunity. The mechanisms by which immunodeficiency may lead to autoimmunity or, in some instances, by which autoimmunity produces immunodeficiency can provide important insights into the underlying pathogenic processes and ultimately better diagnosis and treatment for the patient.”
“Objective-To compare the effects of IV administration of isotonic (1.3%) and hypertonic (8.

Studies in the rat hippocampus have been shown that BDNF is capab

Studies in the rat hippocampus have been shown that BDNF is capable to rescue that late-phase of long-term potentiation as well as

the hippocampus-related LTM when protein synthesis was inhibited. Our previous studies on the insular cortex (IC), a region of the temporal cortex implicated in the acquisition and storage of conditioned taste aversion (CTA), have demonstrated that intracortical delivery of BDNF reverses that deficit in CTA memory caused by the inhibition of IC protein synthesis due to anisomycin administration during early acquisition. In this work, we first analyze whether CTA memory storage is protein synthesis-dependent in different time analyze whether CTA memory storage is protein synthesis-dependent in different time windows. We observed that CTA memory became sensible to protein synthesis inhibition 5 and 7h after acqisition. Then, we explore that effect of BDNF delivery (2 mu g/2 mu l check details per side) in the IC during those late protein synthesis-dependent phases. Our results show that BDNF reverses the

CTA memory deficit produced by protein synthesis inhibition in both phases. These AZD9291 in vivo findings support the notion that recurrent rounds of consolidation-like events take place in the neocortex for maintencance of CTA memory trace and that BDNF is and essential component of these processes.”
“OBJECTIVES: The objective of this study was to evaluate the association between different types of child maltreatment and the presence of psychiatric disorders in highly vulnerable children and adolescents served selleck by a multidisciplinary program.

METHODS: In total, 351 patients with a mean age of 12.47, of whom 68.7% were male and 82.1% lived in shelters, underwent psychiatric evaluations based on the Kiddie-Sads-Present and Lifetime Version. Two different methods were used to evaluate maltreatment: medical records were reviewed to identify previous diagnoses related to socioeconomic and psychosocial circumstances, and the Childhood Trauma Questionnaire was used to

obtain a structured history of trauma. Bivariate associations were evaluated between psychiatric disorders and evidence of each type and the frequency of abuse.

RESULTS: The most frequent psychiatric diagnoses were substance use disorders, affective disorders and specific disorders of early childhood, whereas 13.67% of the sample had no psychiatric diagnosis. All patients suffered neglect, and 58.4% experienced physical or sexual abuse. The presence of a history of multiple traumas was only associated with a diagnosis of substance use disorder. Mental retardation showed a strong positive association with reported physical abuse and emotional neglect. However, a negative correlation was found when we analyzed the presence of a history of multiple traumas and mental retardation.