Our approach should be more broadly applicable to the biologicall

Our approach should be more broadly applicable to the biologically focused, rational Selleck Cyclosporin A and accelerated design of molecules for other TLR receptors. They could be useful for treating infectious, inflammatory and malignant diseases. (C) 2011 Elsevier Ltd. All rights reserved.”
“The Coffin-Lowry syndrome (CLS) is a rare but well-defined X-linked semidominant syndrome characterized by psychomotor and growth retardation, and progressive skeletal changes. CLS is caused by loss of function mutations in the Rps6ka3 gene encoding the ribosomal S6 kinase 2 (RSK2) protein. A distinctive paroxysmal disorder has been described in some CLS patients,

characterized by episodes of sudden falling, without apparent alteration of consciousness, usually induced by unexpected tactile or auditory stimuli. Duration of episodes is very short, usually lasting a few seconds. The appellation “Stimulus-induced drop episodes” (SIDEs) was proposed for these non-epileptic events in CLS patients. SIDEs are clinically heterogeneous; with some patients exhibiting cataplexy-like events characterized by sudden hypotonia and collapse, and others hyperekplexia-like drug discovery episodes with a startle response. The pathophysiology of SIDEs is not well understood. (c) 2012 Elsevier Masson SAS. All rights reserved.”
“Viral hepatitis ranks as the fifth cause of morbidity for infectious diseases in Cuba. Epidemics are observed frequently

in the population, the hepatitis A virus being the selleck screening library main agent responsible for such epidemics. Previous reports also confirmed the circulation of the hepatitis E virus. From 1998 to 2003, 258 serum samples were collected by the Reference Laboratory on Viral Hepatitis during 33 outbreaks of acute viral hepatitis as well as from 39 sporadic clinical cases. Sera were tested for anti-HAV and anti-HEV IgM

by EIA. Overall of the 33 outbreaks studied sera from 12 (36.4%) were positive for anti-HAV IgM only, from 7 (21.2%) were positive for anti-HEV IgM only, and from 14 (42.4%) were positive for antibodies to both viruses. Individually of the 258 sera collected, 137 (53.1%) were positives for anti-HAV IgM, 20 (7.8%) were positives for anti-HEV IgM, 33 (12.8%) were positives for both markers and 68 (26.4%) were negative to both. Of the clinical cases, 4 (10.3%) were positives for anti-HAV IgM, 13 (33.3%) were positives for anti-HEV IgM and 5 (12.8%) were positives for both markers. Seventeen (43.6%) sera were negatives for all viral hepatitis markers available (A-E). A high positivity for HEV was found in outbreaks tested with the kit produced by CIGB. In particular HEV seems to infect individuals of all ages. The results demonstrate the co-circulation of and co-infection with two enterically transmitted viruses; however a higher positivity was observed for anti-HAV than to anti-HEV (53.1%vs. 7.8%) in outbreaks. J. Med. Virol. 80:798-802, 2008. (C) 2008 Wiley-Liss, Inc.

“Early palliative intervention in advanced cancer patients

“Early palliative intervention in advanced cancer patients with metastatic

non-small-cell-lung cancer has been shown to improve survival time. Possibly, palliative intervention at the time of outpatient care further improves patient survival selleck products time.\n\nWe performed a comparative study of late and early referrals of patients with advanced cancer to clarify the appropriate time for palliative intervention and the improvement in survival time.\n\nTwo hundred and one cancer patients, all since deceased, who were treated in our department over a period of 4 years were divided into two groups: patients who experienced outpatient services for 7 days (late referral group, 64 patients) and Selleck AZD8931 those who experienced outpatient services for 7 days (early referral group, 137 patients). Survival time, duration of chemotherapy and post-progression survival were retrospectively analyzed through examination of medical records.\n\nSurvival time of the early referral group was longer than that of the late referral group in all the cases (19.0 vs. 6.5 months, P 0.001). Survival time in advanced non-small-cell lung cancer was 3.5 and 14.0 months (P 0.010) and 16.5 and 20.9 months (P 0.039) in advanced colorectal

cancer, respectively. There was no significant difference in gastric cancer (P 0.310). Post-progression survival in each group was 0.7 and 2.7 months (P 0.018) in non-small-cell lung cancer.\n\nThe results of this study suggested that early outpatient referral and palliative intervention leads to improvement of the outcome

in patients with advanced non-small-cell lung cancer and colorectal cancer. A prospective comparative study is warranted.”
“Background: Intraclass correlation coefficients (ICCs) are used in a wide range of applications. Kinase Inhibitor Library datasheet However, most commonly used estimators for the ICC are known to be subject to bias.\n\nMethods: Using second order Taylor series expansion, we propose a new bias-corrected estimator for one type of intraclass correlation coefficient, for the ICC that arises in the context of the balanced one-way random effects model. A simulation study is performed to assess the performance of the proposed estimator. Data have been generated under normal as well as non-normal scenarios.\n\nResults: Our simulation results show that the new estimator has reduced bias compared to the least square estimator which is often referred to as the conventional or analytical estimator. The results also show marked bias reduction both in normal and non-normal data scenarios. In particular, our estimator outperforms the analytical estimator in a non-normal setting producing estimates that are very close to the true ICC values.

Conclusions: Information on indications and dosages were usua

\n\nConclusions: Information on indications and dosages were usually provided by pharmaceutical

representatives in Australia and Malaysia. However, risk and harmful effects of medicines were often missing in their presentations. Effective control of medicines information provided by pharmaceutical representatives is needed.”
“AIM: Our study focuses on the approach, management and treatment of patients with polythelia and supernumerary breast and the target is the search for a treatment algorithm for these diseases.\n\nMATERIAL OF STUDY: We considered at 18 patients treated from 2006 to 2011 for breast congenital anomalies in excess. 14 surgical procedures were performed, 8 for supernumerary nipple excision (1 case associated with Poland Syndrome) and 6 for accessory breast ablation. All patients were aged between 15 and 34 years and belonged to both sexes.\n\nRESULTS: The breast tissue it was detected fibrocystic learn more mastopathy in 5 cases of polimastia. In the remaining cases the nipples and mammary tissues were normal. After a median follow-up from one to five years, we obtained in all cases not only an excellent aesthetic result but also a psychological.\n\nDISCUSSION: The supernumerary breast tissue is not just a cosmetic problem, it is also subject to the same pathological lesions that are observed in a normal breast. In view

of thepotential malignant transformation of anomalous breast incidentally, early SIS3 and accurate diagnosis is required as well as its monitoring over time.\n\nCONCLUSIONS. We therefore believe that surgical approach is always necessary in cases of polimastia, while considering options in the treatment of polythelia, where it becomes crucial if aesthetic and/or psychologically problems in the patient coexist.”
“Neurons have highly polarized arrangements of microtubules, KPT-8602 datasheet but

it is incompletely understood how microtubule polarity is controlled in either axons or dendrites. To explore whether microtubule nucleation by gamma-tubulin might contribute to polarity, we analyzed neuronal microtubules in Drosophila containing gain-or loss-of-function alleles of gamma-tubulin. Both increased and decreased activity of gamma-tubulin, the core microtubule nucleation protein, altered microtubule polarity in axons and dendrites, suggesting a close link between regulation of nucleation and polarity. To test whether nucleation might locally regulate polarity in axons and dendrites, we examined the distribution of gamma-tubulin. Consistent with local nucleation, tagged and endogenous gamma-tubulins were found in specific positions in dendrites and axons. Because the Golgi complex can house nucleation sites, we explored whether microtubule nucleation might occur at dendritic Golgi outposts. However, distinct Golgi outposts were not present in all dendrites that required regulated nucleation for polarity.

7months (95%CI 34 1-62 3) and 39%, respectively The most common

7months (95%CI 34.1-62.3) and 39%, respectively. The most common first regimen for treatment after relapse was lenalidomide or thalidomide. In conclusion, our study indicates that patients with AL amyloidosis fare well post-transplant relapse/progression. Additionally, it provides a yardstick to design clinical trials to determine best treatment options.”
“Some signals vary

greatly, whereas others are remarkably similar across distantly related species. Here, we ask how the suite of receivers and information communicated correlates with signal evolution by comparing 2 different signals across the same set of species. Within the Old World leaf warblers (Phylloscopidae), each species utters 2 acoustically distinct alarm calls. The first, termed a “general” call, is used in interactions with conspecifics as a well as during confrontations with predators and nest-parasitic

cuckoos. ABT-737 concentration The second, termed a “rasp” call, is primarily used in the presence of nest-parasitic cuckoos. The rasp call precedes aggressive attacks on cuckoos and attracts surrounding heterospecifics that are also potential hosts. The general call attracts a wide Selleck Lapatinib range of species threatened by predators, including those that are not cuckoo hosts. Acoustic features of general calls evolve bigger than 5x faster than rasp calls. We argue that rasp calls show strong stasis because they have a restricted function as aggressive antiparasite signals, whereas multiple contexts and receivers have promoted divergence in general

calls. These results support the idea that variation in the suite of receivers is a powerful force affecting signal evolution.”
“The aims were to evaluate the cognitive performance and clinical diagnosis in patients (<75 years) seeking help for subjective www.selleckchem.com/products/acy-738.html memory complaints, to determine the prevalence of certain psychiatric symptoms and to conduct follow-up examinations. At baseline 41% showed normal cognitive performance ( subjective memory impairment; SMI), 37% fulfilled criteria for mild cognitive impairment (MCI) and 22% were classified as dementia. There were significant associations between the three groups and experiences of psychosocial stress and feelings of anxiety. The proportion of psychosocial stress was significantly higher in SMI vs. MCI and SMI vs. dementia. Feelings of anxiety were significantly higher in SMI vs. MCI. At the 3-year follow-up, 88% of the SMI patients remained stable SMI and 60% of the MCI patients remained stable. There was a significant reduction of psychosocial stress and moderate reduction of feelings of anxiety among the SMI patients. The findings indicate that the risk of patients with SMI developing dementia is small within a 3-year span.

“The ability to resist the urge to eat requires the proper

“The ability to resist the urge to eat requires the proper functioning of neuronal circuits involved in top-down control to oppose the conditioned responses that predict reward from eating the food and the desire to eat the food. Imaging studies show that obese subjects might have impairments in dopaminergic pathways that regulate neuronal systems

associated with reward sensitivity, conditioning and control. It is known that the neuropeptides that regulate energy balance (homeostatic processes) through Selleck MAPK inhibitor the hypothalamus also modulate the activity of dopamine cells and their projections into regions involved in the rewarding processes underlying food intake. It is postulated that this could also be a mechanism by which this website overeating and the resultant resistance to homoeostatic signals impairs the function of circuits involved

in reward sensitivity, conditioning and cognitive control.”
“OBJECTIVES: Published data on the natural history of low-grade dysplasia (LGD) in Barrett’s esophagus (BE) are inconsistent and difficult to interpret. We investigated the natural history of LGD in a large community-based cohort of BE patients after reviewing the original histological diagnosis by an expert panel of pathologists.\n\nMETHODS: Histopathology reports of all patients diagnosed with LGD between 2000 and 2006 in six non-university hospitals were SNS-032 reviewed by two expert pathologists. This panel diagnosis was subsequently compared with the histological outcome during prospective endoscopic follow-up.\n\nRESULTS: A diagnosis of LGD was made in 147 patients. After pathology review, 85% of the patients were downstaged to non-dysplastic BE (NDBE) or to indefinite for dysplasia. In only 15% of the patients was the initial diagnosis LGD. Endoscopic follow-up was carried out in 83.6% of patients, with a mean follow-up of 51.1 months. For patients with a consensus diagnosis of LGD, the cumulative risk of progressing to high-grade dysplasia

or carcinoma (HGD or Ca) was 85.0% in 109.1 months compared with 4.6% in 107.4 months for patients downstaged to NDBE (P < 0.0001). The incidence rate of HGD or Ca was 13.4% per patient per year for patients in whom the diagnosis of LGD was confirmed. For patients downstaged to NDBE, the corresponding incidence rate was 0.49%.\n\nCONCLUSIONS: LGD in BE is an overdiagnosed and yet underestimated entity in general practice. Patients diagnosed with LGD should undergo an expert pathology review to purify this group. In case the diagnosis of LGD is confirmed, patients should undergo strict endoscopic follow-up or should be considered for endoscopic ablation therapy.”
“The discovery of upregulated glycogen synthase kinase-3 (GSK-3) in various pathological conditions has led to the development of a host of chemically diverse small molecule GSK-3 inhibitors, such as BIP-135.

interscience wiley com) DOI 10:1002/jbt 20252″
“Vinnik E, I

interscience.wiley.com). DOI 10:1002/jbt.20252″
“Vinnik E, Itskov PM, Balaban E. beta- And gamma-band EEG power predicts illusory auditory continuity perception. J Neurophysiol 108: 2717-2724, 2012. First published July 5, 2012; doi:10.1152/jn.00196.2012.-Because acoustic landscapes are complex and rapidly changing, auditory PARP assay systems have evolved mechanisms that permit rapid detection of novel sounds, sound source segregation, and perceptual restoration of sounds obscured by noise. Perceptual restoration is particularly important in noisy environments because it allows organisms to track sounds over time even when they are masked. The continuity

illusion is a striking example of perceptual restoration with sounds perceived as intact even when parts of selleck screening library them have been replaced by gaps and rendered inaudible by being masked by an extraneous sound. The mechanisms of auditory filling-in are complex

and are currently not well-understood. The present study used the high temporal resolution of EEG to examine brain activity related to continuity illusion perception. Masking noise loudness was adjusted individually for each subject so that physically identical sounds on some trials elicited a continuity illusion ( failure to detect a gap in a sound) and on other trials resulted in correct gap detection. This design ensured that any measurable differences in brain activity would be due to perceptual differences rather than physical differences among stimuli. We found that baseline activity recorded immediately before presentation of the stimulus significantly predicted the occurrence of the continuity illusion in 10 out of 14 participants based on power differences in gamma-band EEG (34-80 Hz). Across all participants, power in the beta and gamma (12-to 80-Hz range) was informative about the subsequent perceptual

decision. These data suggest that a subject’s baseline brain state influences the strength of continuity illusions.”
“A series of shape-memory polyurethanes AZD1480 in vivo based on poly(E-caprolactone) diol were prepared with novel hydroxyl-terminated hyperbranched polyurethanes as crosslinkers and were characterized by Fourier transform infrared spectroscopy, H-1-NMR, gel permeation chromatography, differential scanning calorimetry, scanning electron microscopy, wide-angle X-ray diffraction, dynamic mechanical analysis, tensile testing, and shape-memory testing. The molecular weight of the soluble polymers ranged from 5.1 x 10(4) to 29.0 x 10(4) g/mol. The differential scanning calorimetry and wide-angle X-ray diffraction data indicated that when the crystallinities of the crosslinked polymers were compared to that of linear polyurethane, this parameter was improved when the crosslinker was in low quantity. The storage modulus ratios obtained from the dynamic mechanical analyses data of the crosslinked polymers were also high compared to that of the linear polyurethane.

29, median of 2) Sixty-nine patients (46 6%) matched the TLICS r

29, median of 2). Sixty-nine patients (46.6%) matched the TLICS recommendation; all discordant patients (53.4%) were treated for stable burst fractures (TLICS=2). No neurological complications occurred in either group. CONCLUSIONS: The TLICS recommendation matched treatment in 307/310 patients (99%) in the conservative group. However, in the surgical group, 53.4% of patients did not match TLICS recommendations, all were burst fractures without neurological injury (TLICS=2). The TLICS system can be used to effectively classify thoracolumbar injuries and guide conservative MK-2206 cost treatment. Inconsistencies, however, remain in the treatment thoracolumbar burst fractures. (C) 2013

Elsevier Inc. All rights reserved.”
“Purpose. To evaluate the effect of laser peripheral iridotomy (LPI) on biometric parameters including central anterior chamber depth (CACD) in primary angle closure suspect eyes.

Methods. Eyes classified as primary angle closure suspect were enrolled in this interventional case series. Biometry with Lenstar (Haag-Streit AG, Koeniz, Switzerland) was performed before LPI and 6 weeks afterward. Central anterior chamber depth, Selleck GS-9973 lens thickness, axial length, and central corneal thickness were measured before and after the intervention. Results. Forty eyes of 40 patients with mean age of 56.5 +/- 5.5 years were studied. Mean central anterior chamber depth was 2.07 +/- 0.21 mm before and 2.08 +/- 0.19 mm after LPI (p = 0.8). There was no significant change in lens thickness, axial length, and central corneal thickness after LPI. Conclusions. Central anterior chamber depth “measured by Lenstar” does not change after LPI in primary angle closure suspect eyes.”
“Although most carabids are primarily carnivorous, some carabid species are omnivorous, with mainly granivorous feeding habits check details during the larval and/or adult stages (granivorous carabids). This feeding habit has been established based on laboratory and field experiments; however, our knowledge of the

feeding ecology of these beetles in the field is limited owing to the lack of an appropriate methodology. In this study, we tested the utility of stable isotope analysis in investigations of the feeding ecology of granivorous carabids in the field, using two closely related syntopic species, Amara chalcites and Amara congrua. We addressed two issues concerning the feeding ecology of granivorous carabids: food niche differentiation between related syntopic species during the larval stage and the effect on adult body size of supplementing seeds with an animal diet during the larval stage. To investigate larval feeding habits, we analysed newly emerged adults, most somatic tissues of which are considered of larval origin. In the two populations examined, both delta 15N and delta 13C were significantly higher in A. chalcites than A. congrua, suggesting that the two species differentiate food niches, with A. chalcites larvae being more carnivorous than A. congrua larvae.

All other range of motion was full The mean QuickDASH score was

All other range of motion was full. The mean QuickDASH score was 11 (+/- 12), and the mean PRWE score was 19 (+/- 14). Average time to full activity was 5 months. There were no surgical complications of the procedure.

One patient complained of persistent ulnar-sided wrist pain 12 months after surgery and had an ulnar shortening osteotomy. Arthroscopy at the time of the osteotomy revealed that the TFCC was stable.\n\nConclusions At mean 1-year follow-up, 11 out of 12 patients achieved excellent subjective outcomes based on QuickDASH and PRWE questionnaires. Although range of motion and grip strength were slightly decreased compared to prior case series reports, the short-term results indicate that the FasT-Fix all-arthroscopic, all-inside technique is a safe and effective technique for repair of Palmer type 1B TFCC tears. (J Hand Surg 2011;36A:836-842. Copyright (C) 2011 by the American www.selleckchem.com/products/Vorinostat-saha.html Society for Surgery of the Hand. All rights reserved.)”

of gamma rays from buried and exposed radioactive materials poses health risks at radiologically contaminated sites. Covering the source material with a barrier of adequate thickness and physicochemical composition can reduce the intensity of transmitted gamma rays (gamma), thereby reducing such risks. Herein, the Geo-Radiological Barrier Gamma Attenuation Model (GRBGAM) is developed to quantify gamma attenuation by earthen covers. The model allows variation of barrier Combretastatin A4 clinical trial and radioactive source input parameters and comparison of emitted gamma intensities and attenuation ratios of PLX4032 price different barrier designs for virtually any radioactive isotope decay chain. The model calculates the activities

of successive amounts of decaying isotopes within a decay chain and temporally couples the results with an exponential absorption equation to estimate the exit intensity of gamma radiation from barriers. A Weibull function integrated into the absorption equation, scales temporal changes in barrier density (rho(‘)) during long service times. This model can be used to optimize georadiological (georad) barrier mix composition and thickness to increase gamma attenuation ratio to acceptable levels.”
“The present study was carried out in abandoned fields in central Cyprus. The main objective was to examine the impact of the regeneration environment on the establishment and survival of Pinus brutia seedlings. Sixty-four permanent plots of 16 m 2 were randomly established in two distinct sites. Four regeneration environments were recorded: (a) bare soil under the crown of a P. brutia tree, (b) soil under the canopy of a P. brutia tree and low shrubs, (c) bare soil in open areas, and (d) soil under the canopy of low shrubs in open areas. All P. brutia seedlings were classified in categories according to their regeneration environment. In all plots, the density of the P. brutia seedlings was measured in three different seasons (spring, summer, autumn).

CONCLUSIONS: Expression of activated LXR alpha blocks proliferati

CONCLUSIONS: Expression of activated LXR alpha blocks proliferation of human colorectal cancer cells and slows the growth of xenograft tumors in mice. It also reduces

intestinal tumor formation after administration of chemical carcinogens, and in Apc(min/+) mice. LXR agonists therefore might be developed as therapeutic treatments for colorectal cancer.”
“Aims Although several factors contribute to wound healing, bacterial infections and the presence of biofilm can significantly affect healing. Despite that this clearly indicates that therapies should address biofilm in wounds, only few wound care products have been evaluated for their antibiofilm effect. For this reason, Selleckchem Liproxstatin 1 we developed a rapid quantification approach to investigate

the efficacy of wound care products on wounds infected with Staphylococcus spp. Methods and Results An in vitro chronic wound infection model was used in which a fluorescent Staph.aureus strain was used to allow the rapid quantification of the bacterial burden after treatment. A good correlation was observed between the fluorescence signal and the bacterial counts. When evaluated in HKI-272 this model, several commonly used wound dressings and wound care products inhibited biofilm formation resulting in a decrease between one and seven log CFU per biofilm compared with biofilm formed in the absence of products. In contrast, most dressings only moderately affected mature biofilms. Conclusion Our model allowed the rapid quantification of the bacterial burden after treatment. However, the efficacy of treatment varied between the different types of

dressings and/or wound care products. Significance and Impact of the Study Our model can be used to compare the efficacy of wound care products to inhibit biofilm formation and/or eradicate mature biofilms. In addition, the results indicate that treatment of infected wounds should be started as soon as possible and that novel products with more potent antibiofilm activity are needed.”
“Duez H, Staels B. Rev-erb-alpha: an integrator of circadian rhythms and metabolism. J Appl Physiol 107: 1972-1980, 2009. First published August 20, 2009; doi:10.1152/japplphysiol.00570.2009.-The endogenous circadian clock ensures daily PF-03084014 cell line rhythms in diverse behavioral and physiological processes, including locomotor activity and sleep/wake cycles, but also food intake patterns. Circadian rhythms are generated by an internal clock system, which synchronizes these daily variations to the day/night alternance. In addition, circadian oscillations may be reset by the time of food availability in peripheral metabolic organs. Circadian rhythms are seen in many metabolic pathways (glucose and lipid metabolism, etc.) and endocrine secretions (insulin, etc.). As a consequence, misalignment of the internal timing system vs.

(C) 2009 Elsevier B V All rights reserved “
“Foodborne dise

(C) 2009 Elsevier B.V. All rights reserved.”
“Foodborne diseases encompass a wide

spectrum of illnesses especially in developing countries. Aims: This study aimed to investigate food handlers’ knowledge, attitude and practices about food safety in four restaurants in Fayoum University and to assess the carrier rate of S aureus and Salmonella spp. also determination of the total viable count, and level of hand contamination with E. coli, other members of Enterobacteriaceae as well as other aerobic Gram-negative bacteria. Methods: A cross-sectional, descriptive, observational study was conducted among 209 Fayoum University food handlers serving four main kitchens at the University. The food handlers’ interviewed using a pre-tested questionnaire included three main topics regarding knowledge, attitude and practices of GSK126 chemical structure food safety. Data collectors observed food handlers’ to collect information on food preparation,

handling and the sanitary condition of the facilities. Microbiological samples were collected from 158 healthy food handlers including swabs from throat, each nostril, stool and urine samples followed by culturing on proper media, also determine of the total bacterial count and hand contamination click here by fingerprint culture technique. Results: About 90% of food handlers have good knowledge, between 30.1% and 55% found to have good practice. Carrier rate of S. aureus was 17.1%. The total viable bacterial count exceeds 300 CFU)/hand in 37.3%. Out of 158 food handlers, 57 (36.1%) of them had contaminated hand with S. aureus, 26 (16.5%) with Enterobacteriaceae and 6 (3.8%) with Pseudomonas Spp.. All stool and urine samples were negative for Salmonella spp. Conclusion: To achieve AR-13324 a good level of food safety, pre Employement investigations and training as well as continuous monitoring of food handlers should be implemented. [Rasha H. Bassyouni, Naglaa El-Sherbiny, Enas H. Hefzy, Ahmed-Ashraf Wegdan. Perception

of Food Safety and Prevalence of Staphylococcus aureus and Salmonella species Carriers among Fayoum University Food handlers. Life Sci J 2012;9(4):2934-2940]. (ISSN: 1097-8135). http://www.lifesciencesite.com. 429″
“Objective: Prevalence of binge eating has been shown to be as common in men as in women, yet few studies have included men. Men are especially underrepresented in treatment studies, raising the question of whether men who binge eat experience less distress or impairment than women. This study compared demographic and clinical correlates of binge eating in a large employee sample of men and women.\n\nMethod: Cross-sectional data from 21,743 men and 24,608 women who participated in a health risk self assessment screening were used.