Attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and sleep disorders were detected at a higher rate in patients with adenotonsillar hypertrophy. It also was established that in the comparison of the severity of psychiatric symptoms determined by ECI-4, symptom severity of ADHD, ODD, anxiety disorders, and sleep disorders was higher in the adenotonsillar hypertrophy group than in the control group. In the evaluation of the SDQ parent form, it was determined that attention deficit, hyperactivity, behavioral, and peer relations problems occurred more frequently in the adenotonsillar hypertrophy group.

Conclusions:

In addition to oral respiration, snoring, and disordered breathing during sleep, adenotonsillar hypertrophy may also associated with psychiatric disorders and symptoms. (C) 2013 Elsevier Ireland Ltd. All rights Vorinostat inhibitor reserved.”
“OBJECTIVE: To develop detailed, explicit criteria for determining the appropriateness of admission for patients with exacerbations of chronic obstructive pulmonary disease (COPD).

DESIGN: Using a modified Delphi process, a panel of seven pneumologists

and five emergency department (ED) physicians was assembled to establish the appropriateness of hospital admission for 896 distinct theoretical scenarios. To assess the reliability of the criteria, a second national panel of five pneumologists and five ED physicians was assembled. We examined the influence of all variables SRT1720 on the first panel score using linear regression models. The explicit criteria developed were summarised by classification and regression tree analysis.

RESULTS: The appropriateness of the hospitalisation scenarios increased with the severity of COPD. The kappa of agreement between the two panels was 0.79. Predictors of appropriate hospitalisation were severity of current COPD exacerbation, response to previous treatment and expected adherence to treatment. The panel results were synthesised and presented in three LCL161 cell line decision trees. Misclassification error in the decision trees, as compared with the panel’s

original ratings, was 6.1%.

CONCLUSIONS: These explicit criteria can be used to help determine the appropriateness of admission for patients with exacerbations of COPD.”
“Compared with the general population, dialysis patients are at higher risk of acquiring mycobacterial infections. The aim of the present article is to review case reports and studies published since the report by Talwani and Horvath (2000) and to discuss the main problems that arise in daily practice. After a comprehensive review of the literature, cumulative data about peritoneal dialysis and peritoneal tuberculosis from reports of 98 patients in 21 papers were analyzed.

The clinical and laboratory findings of peritoneal tuberculosis are nonspecific. Diagnosis requires a high index of suspicion.

The “”blur artifact”" induced at operated level was also more pronounced in the 3 Tesla MR.

The artifact induced by the Discover(A (R)) titanium disc prosthesis in both 1.5 and 3 Tesla MR, makes interpretation

of the spinal cord impossible and visualization of the root canals difficult at operated level. Adjusting the MR sequences to produce the least amount of artifact is important.”
“This study aims to evaluate the therapeutic action of administration of Nigella sativa (NS) and Peganum harmala AG-881 molecular weight (PH) oils in diabetes and hepatic toxicity. Results show that treatment of diabetic rats with NS oil or PH oil ameliorate hyperglycaemia induced stress oxidative and hepatic dysfunction in diabetic rats. Administration of NS or PH oil to diabetic rats caused an anti-diabetic and antioxidant activities by the decrease in plasmatic glucose level this website and increase in hepatic superoxide

dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPX) activities, reduced glutathione (GSH) and glycogen contents compared to untreated diabetic rats. Besides, A’S and PH oils protect the hepatic function observed by decrease of triglyceride (TG), total cholesterol (TCh), and increase of high density lipoprotein-cholesterol (HDL-Ch) levels in serum and hepatic tissues. Moreover, a diminution in the bilirubin, transaminase glutanic pyruvic (TGP), and transaminase pyruvic oxaloacetic (TPO) contents in serum SU5402 datasheet and the thiobarbituric acid-reactive substances levels (TBARs) in hepatic tissues are also detected.”
“Objectives: To determine the impact of an educational program on the prevention of central venous catheter-related infections in a Brazilian Pediatric Intensive Care Unit. Patients and Methods: All patients admitted to the unit between February 2004 and May 2005 were included in the cohort study in a longitudinal assessment. An educational program was developed based on the Centers for Disease Control and Prevention recommendations for prevention of catheter-associated infections and was adapted to local conditions

and resources after an initial observational phase. Incidence of catheter-associated infections was measured by means of on-site surveillance. Results: One hundred eighteen nosocomial infections occurred in 253 patients (46.6 infections per 100 admissions) and in 2,954 patient-days (39.9 infections per 1,000 patient-days). The incidence-density of catheter infections was 31.1 episodes per 1.000 venous central catheter-days before interventions, and 16.5 episodes per 1,000 venous central catheter-days afterwards (relative risk 0.53 [95% CI 0.28-1.01]). Corresponding rates for exit-site catheter infections were 8.0 and 2.5 episodes per 1,000 venous central catheter-days [0.32 (0.07-1.49)], and the rates for bloodstream infections were 23.1 and 13.9 episodes per 1,000 venous central catheter-days, before and after interventions [0.61 (0.32-1.14)].

“
“The study was planned as a pilot study to investigate two common polymorphisms in the MTHFR gene c.677C > T and c.1298A > C and their association with enhanced risk of colorectal cancer (CRC) in a sample of Egyptian individuals. Venous blood samples were withdrawn from 35 cases of CRC and 68 healthy controls. Specimens from colonic and rectal carcinoma tissues in addition to cancer free tissues were obtained from

all cases. Frequencies of MTHFR677T and 1298C alleles were SBE-β-CD supplier significantly higher among cases of CRC tumor tissues (50% and 56%, respectively) than germ line alleles in CRC patients (33% and 41%, respectively) and healthy controls (21% and 35%, respectively). Frequencies of heterozygous and homoyzgous polymorphisms of MTHFR at positions 677 and 1298 in carcinoma tissues were always the highest. At position 677, TT and CT genotype frequencies were 17% and 66% with an odds ratio OR of 11 [95% confidence interval CI 2.39-50.59] and OR 8.34 [95% CI 2.97-23.92], respectively, in carcinoma

tissues. While in the germ line of patients the genotype frequencies of 677TT and CT were 6% and 54% with OR 1.57 [95% CI 0.26-9.51] and 2.99 [95% CI 1.25-7.12], respectively, compared to controls (6% and 29%, respectively). The combined genotype MTHFR 1298CC + AC frequencies were 86% with OR 3.71 [95% CI 1.28-10.78] in carcinoma tissues, 69% with OR 1.35 [95% CI 0.57-3.21] in germ line of patients and 62% in controls. The combined genotype 677CT plus any of the following genotypes

1298AA, AC or CC enhanced risk of CRC, when comparing germ line TPCA-1 NF-��B inhibitor DNA polymorphism of patients BTSA1 versus peripheral blood DNA of control subjects with OR 4.5 [95% CI 0.94-21.56], OR 3.12 [95% CI 0.79-12.36] and OR 18 [95% CI 1.56-207.5], respectively, suggesting strong genetic predisposition of certain Egyptian population to CRC. These results suggested that at least one C to T polymorphism at 677MTHFR gene is required to significantly increase the risk for CRC development. Further large scale studies are required to confirm the present findings.”
“Dengue fever is becoming a great public health problem leading to significant morbidity and mortality, particularly in developing countries. In the past few years, various neurological complications have been reported globally. Dengue encephalitis as a clinical presentation of dengue fever is now gaining recognition in the scientific community. It is characterized by fever, headache, reduced consciousness, and generalized seizures. Epilepsia partialis continua, a type of focal status epilepticus, is caused by multiple clinical disorders, including viral encephalitis. We describe a young woman who manifested epilepsia partialis continua caused by dengue encephalitis. (C) 2010 Elsevier Inc. All rights reserved.

“
“Objective: To characterize the metabolic phenotype of 2 cases of normal weight young women who developed

type 2 diabetes (T2D), severe insulin resistance (insulin requirement >200 units/day), marked hypertriglyceridemia (>2000 mg/dL), and hepatic steatosis beginning 9 years after undergoing total body irradiation (TBI) and bone marrow transplantation for childhood cancer.

Methods: Fasting plasma glucose, insulin, free fatty acids (FFAs), leptin, adiponectin, resistin, TNF alpha, and IL-6 were measured in each case and in 8 healthy women; Case 1 was also assessed after initiating pioglitazone. Coding regions and splice junctions of PPARG, LMNA, and AKT2 were sequenced check details in Case 1 and of PPARG in Case 2 to evaluate for familial partial lipodystrophies. Genotyping of APOE was performed in Case 1 to rule out type III hyperlipoproteinemia.

Results: Both cases had elevated plasma levels of insulin, leptin, resistin, and IL-6, high-normal to elevated TNF alpha, and low to low-normal adiponectin in keeping with post-receptor insulin resistance and adipose tissue inflammation. Case 1 experienced a biochemical response to pioglitazone. No causative mutations for partial lipodystrophies or type III hyperlipoproteinemia were identified.

Conclusion: Though metabolic derangements have previously been reported in association with TBI, few cases

have described insulin resistance and hypertriglyceridemia as severe as that seen in our patients. We speculate that early KU-57788 childhood TBI may impede adipose tissue development leading to metabolic complications from an attenuated ability of adipose tissue to accommodate caloric excess, and propose that this extreme metabolic syndrome be evaluated for as a late complication of TBI. (Endocr Pract. 2013; 19: 51-58)”
“Robust embryonic stem cell (ESC) lines from livestock species have been difficult to derive and maintain, and unlike mouse ESC, have not contributed to our ability to understand directed

differentiation in vitro. Nor have such cells yet provided a simpler means than pronuclear injection to manipulate the genomes of agriculturally important species, such as cattle, sheep and pigs. Induced pluripotent stem cells (iPSC) generated by reprogramming somatic cells, such as fibroblasts, with a set of stemness genes, most usually but not exclusively POU5F1, SOX2, KLF4 see more and c-MYC, offer an alternative to ESC in these regards, as they exhibit a pluripotent phenotype resembling that of ESC, yet are readily generated in the laboratory. Accordingly, such cells, in association with cloning technologies, may be useful for introducing complex genetic changes into livestock, although this potential has yet to be demonstrated. Porcine iPSC may be especially valuable because the pig is a prime biomedical model for tissue transplantation. In general, iPSC from livestock, like those from humans, are of the epiblast type and depend upon FGF2 and activin/nodal signalling systems to maintain their pluripotency and growth.

RESULTS: The prevalence of asthma in the study group was 4.9%. In a multivariate model, significant association was found with sex (male predominance) and exposure to dust in the house. Place of residence, farm dwelling, household pets (cats or dogs), smokers in the family, type of cooking fuel used and the use of firewood without chimneys did not show any significant association.

CONCLUSION: In the present study, the prevalence of questionnaire-diagnosed asthma in the study group was 4.9%. Of the total number of schoolchildren with asthma, 17 (58.6%) were detected who had not been diagnosed previously. One third of the children with asthma had visited emergency

departments in the last 12 months, indicative of poor asthma control. Another third suffered limitation of activity at home and or at school, which could indicate poor quality of life.”
“As a principle ingredient in omija-eui, the physicochemical properties of mung bean starch Selleck PXD101 BMN 673 (MBS) paste were investigated and compared

to those of rice and corn starch. The amylose and the protein content of MBS were higher than those of rice or corn starch while the total sugar content and the swelling power of MBS were lower. In addition, the clarity of MBS paste was higher than either rice or coni starch paste. Regarding pasting properties, the peak viscosity and cool paste viscosity of MBS were higher than those of either rice or corn starch. During the freeze-thaw cycle, MBS exhibited higher degree of syneresis than corn and rice starch, which decreased with high starch concentration and heating temperature. The paste properties and freeze-thaw stability of MBS showed a potential for improving the quality of omija-eui.”
“SETTING: Tuberculosis (TB) hospital in Beijing, China.

OBJECTIVE: To describe perspectives of patients and physicians regarding the incorporation of smoking cessation interventions as part of TB treatment.

DESIGN: Seven focus groups were conducted with 39 patients and 17 physicians.

RESULTS: Patients were more receptive to physicians’

advice to quit ARN-509 order smoking due to increased concerns about their health after becoming ill with TB. However, patients indicated that they might start smoking again after they recovered from TB. Patients’ attempts to quit smoking may have been inhibited by exposure to smoking at the TB facility. Physicians had low levels of knowledge regarding the effect of smoking on TB. Many doctors, particularly those who smoked, did not view smoking cessation as an integral part of TB treatment.

CONCLUSION: Despite the presence of a ‘teachable moment’, TB patients experience significant barriers to quitting smoking. Patient education in TB treatment programs should address the specific effects of smoking on TB and the general health benefits of cessation. Smoke-free policies should be strictly enforced in TB facilities.

g., serotonin syndrome) or signs of lactate acidosis. Two patients died from uncontrolled vancomycin-resistant Enterococcus faecium sepsis with septic shock and one due to uncontrolled methicillin-resistant Staphylococcus aureus pneumonia. These deaths were considered to be unrelated to linezolid treatment, and linezolid was regarded as the optimal treatment choice in these patients. A

subgroup analysis of patients treated for >14 days revealed no statistically significant differences when compared with patients on shorter treatment. In particular, no cases of thrombocytopenia occurred during longer treatment. In conclusion, linezolid is a safe and effective treatment for adult liver transplant patients with gram-positive infections.”
“Hematoma puncture LY2606368 and subsequent clot lysis with recombinant tissue plasminogen activator (rtPA) emerged as an alternative therapy for spontaneous intracerebral hemorrhage (ICH) and is associated with delayed edema possibly counteracting selleck inhibitor the beneficial effects of hematoma volume reduction. We hypothesized that immediate reversal of rtPA activity after clot lysis and hematoma drainage diminishes edema formation. To

test this hypothesis, we administered plasminogen activator inhibitor (PAI)-1 after rtPA lysis of experimentally induced ICH. A right frontal ICH was placed through a twist drill burr hole and autologous blood injection. Following creation Caspase inhibitor in vivo of the frontal ICH, pigs received no further treatment (n=5), lysis with rtPA (n=7), or lysis with rtPA followed by administration of PAI-1 (n=6). Hematoma and edema volumes were assessed with magnetic resonance imaging on days 0, 4, and 10. The rtPA significantly reduced hematoma volume and contributed to edema on day 10 after experimentally induced ICH. Administration of PAI-1 attenuated the rtPA-induced edema volume on day 10, but the hematoma volume reduction was less pronounced. In

conclusion, PAI-1 attenuated delayed cerebral edema after rtPA lysis of experimental ICH but also reduced the lytic activity of rtPA. The combination of rtPA clot lysis with PAI-1 might have the potential to further improve the effect of the lytic therapy of ICH, but additional studies to define the optimum time point for PAI-1 administration are required.”
“Background: Warfarin-associated intracerebral hemorrhage (WAICH) is expected to increase in prevalence as the population ages. We sought to evaluate national trends, characteristics, and in-hospital outcomes among intracerebral hemorrhage (ICH) patients taking warfarin at baseline. Methods: We reviewed the Nationwide Inpatient Sample to identify all admissions with primary diagnosis of ICH by International Classification of Diseases, Ninth Revision code (431) from 2005 to 2008. We identified premor-bid warfarin use by the V code (V58.93) and calculated the proportion of WAICH among all ICH patients in each year.

Growth factor treatment and molecular therapies could be less problematic. The biological solutions for NP and AF replacement are still more fiction than fact. However, tissue engineering just scratched the tip of the iceberg, more satisfying solutions are yet to be added to the biomedical pipeline.”
“The aim of the study was to determine the effect of the type of birth, the sex of the kids, the duration of the birth (categorized as short, medium, or long), and the level of maternal care (categorized as low, medium, or

high) on the behavioral variables of kids during the first hour after birth. selleck products The parturitions of 78 primiparous goats of Murciano-Granadina breed (46 single-birth and 32 twin-birth) along with the behavior of the kids (44 males and 66 females) during the first hour of life were studied. Birth weight and duration of parturition were greater in single-birth kids (2.94 kg and 60.5 min, respectively) than in twin-birth kids (2.27 kg and 43.2 min, respectively). Birth weight and duration of parturition was greater in males (2.74 kg and 54.61 min) than in females (2.43 kg and 47.70 min). All the kids attempted to stand during the first hour of life,

but only 83% attempted to suckle with 65% succeeding. Single-birth kids attempted to stand earlier than twin-birth kids (7.05 vs. 9.08 min), although they achieved this later (16.87 vs. 13.21 min). Compared with twin-birth kids, single-birth kids attempted to suckle later (22.45 vs. 34.76 GDC-0068 ic50 min, respectively) and achieved it later (25.69 vs. 37.32 min). In the single-birth kids the duration of the first suckling was shorter (16.11 vs. 22.26 s), although total suckling time was greater (5.86 min) than in the twin-birth kids. Males tried to stand sooner than females (7.41 vs. 8.78 min), but took longer (16.12 vs. 13.81 min). The sex factor had no significant effect on suckling-related

variables. Compared with medium-and long-duration-birth kids, short-duration-birth kids attempted to suckle earlier, (29.34, 34.23, and 12.82 min, respectively), achieved suckling earlier (31.75, 37.00, and 16.70 AZD9291 min, respectively), and suckled longer at first attempt (0.32, 0.17, and 0.45 min, respectively). Total suckling time was longer in long-duration-birth kids than in medium-and short-duration birth (9.07, 2.63, and 3.86 min, respectively). These results suggest that heavier kids suffer more during birth and are slower to achieve suckling; however, they appear to recover quickly because the total suckling time observed during the first hour was greater.”
“Hypertension is associated with an increased risk of cognitive decline, which is generally regarded as a consequence of advanced cerebral atherosclerosis. Many hypertensive patients, however, suffer from cognitive decline long before they have any signs of cerebrovascular disease.

Preoperative evaluation Volasertib mw included the Categories of Auditory Performance (CAP) score, Korean Version

of the Ling’s Stage (K-Ling), Sequenced Language Scale for Infants (SELSI), Bailey Scales of Infant Development II assessment, Social Maturity Scale test, and grading of CP severity using severity level and Gross Motor Function Classification System for CP (GMFCS). To measure the outcome, the CAP scores, K-Ling, and SELSI were performed at 3, 6, 12, and 24 months after implantation.

Results: Four CP children with outstanding performances showed comparable achievement with matched control recipients. These patients had less severe motor disabilities (mild-moderate severity, GMFCS level 1-3), better social quotient, and better cognitive abilities. Although the others showed poor language abilities and hardly produced meaningful speech, their CAP scores reached 1 or 2 in 24 months after implantation.

Conclusions: Deaf children with CP could have various ranges of benefits up to the levels of normal peers whose only disability was hearing loss, when CI was performed within a critical Z-DEVD-FMK period. Especially, children with mild or moderate CP had a favorable outcome after CI, equivalent to that of normal peers. (C) 2013 Elsevier Ireland Ltd. All rights reserved.”
“Background: Understanding the

causes of failure and the types of revision total hip arthroplasty performed is essential for guiding research, selleck products implant design, clinical decision-making, and health-care policy. The purpose of the present study was to evaluate the mechanisms of failure and the types of revision total hip arthroplasty procedures performed

in the United States with use of newly implemented ICD-9-CM (international Classification of Diseases, Ninth Revision, Clinical Modification) diagnosis and procedure codes related specifically to revision total hip arthroplasty in a large, nationally representative population.

Methods: The Healthcare Cost and Utilization Project Nationwide Inpatient Sample database was used to analyze clinical, demographic, and economic data from 51,345 revision total hip arthroplasty procedures performed between October 1, 2005, and December 31, 2006. The prevalence of revision procedures was calculated for population subgroups in the United States that were stratified according to age, sex, diagnosis, census region, primary payer class, and type of hospital. The cause of failure, the average length of stay, and total charges were also determined for each type of revision arthroplasty procedure.

Results: The most common type of revision total hip arthroplasty procedure performed was all-component revision (41.1%), and the most common causes of revision were instability/dislocation (22.5%), mechanical loosening (19.7%), and infection (14.8%).

Conclusion: Although the experiences of endocrinologists who provided H1N1 vaccine were generally positive, many did not offer the vaccine and indicated

that they are hesitant about providing vaccine during a future influenza pandemic. Approaches to increase their participation in future pandemics in an effort to reach persons at high risk for influenza and its complications, such as those with diabetes, should be further explored. (Endocr Pract. 2012;18:464-471)”
“OBJECTIVE: To compare the immediate results of patients undergoing either two-channel single-port laparoscopic-assisted vaginal hysterectomy or conventional multiport laparoscopic-assisted vaginal hysterectomy.

METHODS:

Patients were randomly assigned to undergo selleck chemicals laparoscopic-assisted vaginal hysterectomy using the single-port (n=50) or conventional (n=50) approach. The outcome measures included blood loss, operative time, intraoperative and immediate postoperative complications, time to flatus passage after operation, and postoperative pain (assessed by the visual analog scale score and postoperative analgesics use).

RESULTS: The general CP-456773 manufacturer characteristics of the patients were similar in both groups. There were no statistically significant differences in operative time, estimated blood loss, time to first flatus, intraoperative and immediate postoperative complications, shoulder tip pain, or length of hospital stay between the two groups. However, postoperative pain was significantly less in the single-port group compared with the conventional group, as evidenced by lower mean scores on the visual analog scale (3.64 +/- 2.75 compared with 5.08

+/- 2.76 at 24 hours, P=.011 and 1.94 +/- 2.31 compared with 2.84 +/- 2.07 at 48 hours, P=.043) and less mean accumulated dose of postoperative analgesics (74.40 +/- 24.25 mg compared with 104.80 +/- 57.08 mg of meperidine, P=.001; 16 +/- 13.40 mg compared with 33.6 find more +/- 28.7 mg of tenoxicam, P <.001).

CONCLUSION: Transumbilical two-channel single-port laparoscopic-assisted vaginal hysterectomy significantly decreases postoperative pain and analgesic use.”
“Intermolecular coordination effects on the P-31 NMR spectra of molecular complexes of N-vinylimidazole and 1-allyl-3,5-dimethylpyrazole with phosphorus pentachloride were studied by theoretical and experimental methods. The formation of intermolecular dative N -> P bond was shown to be accompanied by upfield shift of the phosphorus resonance signal by more than 200 ppm. Appreciable contribution of relativistic effects to P-31 NMR chemical shifts was revealed; the spin-orbital contribution to P-31 shielding constant was estimated at >210 ppm.

Results from these case studies suggest that spatially variable patterns of snow or summer precipitation

associated with regional climate change across NE Asia will have significant impacts on watershed biogeochemical processes and surface water quality, in interactions with local topography, land use change, or acid deposition. (C) 2009 Elsevier Ltd. All rights reserved.”
“Surgical site infections (SSIs) are frequent complications in colorectal surgery and may lead to burst abdomen, incisional hernia, and increased perioperative costs. Plastic wound ring drapes (RD) were introduced some decades ago to protect the abdominal wound from bacteria and reduce SSIs. There have been no controlled trials examining the benefit of RD in laparoscopic colorectal surgery. The Reduction of wound infections in laparoscopic selleck inhibitor assisted colorectal resections

by plastic wound ring 3-deazaneplanocin A in vitro drapes (REDWIL) trial was thus designed to assess their effectiveness in preventing SSIs after elective laparoscopic colorectal resections.

REDWIL is a randomized controlled monocenter trial with two parallel groups (experimental group with RD and control group without RD). Patients undergoing elective laparoscopic colorectal resection were included. The primary endpoint was SSIs. Secondary outcomes were colonization of the abdominal wall with bacteria, reoperations/readmissions, early/late postoperative complications, and cost of hospital stay. The duration of follow-up was 6 months.

Between January 2008 and October 2010, 109 patients were randomly assigned to the experimental or control group (with or without RD). Forty-six patients in the RD group and 47 patients in the control group completed follow-up. SSIs developed in ten patients with RD (21.7 %) and six patients without RD (12.8 %) (p = 0.28). An intraoperative swab taken from the abdominal wall was positive in 66.7 % of patients with RD and 57.5 % without RD (p = 0.46). The number of species cultured within one swab was significantly higher in those without RD (p = 0.03).

The median total inpatient costs including emergency readmissions were 3,402 +/- 4,038 a,not sign in the buy Vorinostat RD group and 3,563 +/- 1,735 a,not sign in the control group (p = 0.869).

RD do not reduce the rate of SSIs in laparoscopic colorectal surgery. The inpatient costs are similar with and without RD.”
“Microcystins (MICs) are potent toxins produced worldwide by cyanobacteria during bloom events. Phosphatases inhibition is a well recognized effect of this kind of toxins as well as oxidative stress. However, it is not fully understood why and how MICs exposure can lead to an excessive formation of reactive oxygen species (ROS) that culminate in oxidative damage. Some evidences suggest a close connection between cellular hyperphosphorylation state and oxidative stress generation induced by MICs exposure.