In the two reported cases,

symptoms appeared between 11 and 14 days after exposure, respectively. This is much shorter than might be expected according to the literature. Both patients presented with fever, cough, urticaria, and eosinophilia, manifestations that are most commonly associated with acute schistosomiasis (Katayama fever)6 and occasionally with other helminth infections in returned travelers.7 Helminth infections learn more are difficult to diagnose during the invasive stage. In the reported cases, the diagnosis was made about 3 weeks after the onset of symptoms by positive agar-plate stool cultures in both patients, the presence of Strongyloides stercoralis larvae in the stools of one patient and a serologic Vincristine diagnosis in the other.1 When faced with a returned traveler from the tropics with eosinophilia, an helminth infection should be at the top of a differential diagnosis. Not only are serologic tests frequently not positive early in the infection but also they may lack specificity, particularly in the case of strongyloidiasis8; both schistosomiasis and filariasis may lead to false positive tests for strongyloidiasis. Repeat stool examinations (and urinalyses

in case of Schistosoma haematobium schistosomiasis) may be necessary to detect parasites in the first few weeks after exposure. Even then, tests may be negative because of a long prepatent period (eg, 2 mo in schistosomiasis). Chronic strongyloidiasis is usually asymptomatic or gives rise to mild gastrointestinal symptoms, most often peptic ulcer-like symptoms. Of greater concern is its potential to become a fulminant, fatal illness in appropriate circumstances. Strongyloides hyperinfection syndrome and dissemination result from decreased cell-mediated immunity, including that associated with corticosteroid treatment and HTLV1.5,9 below Disseminated strongyloidiasis carries mortality rates from 50% to 87%, even with treatment.3 This

infection is now considered the leading cause of death from a parasitic disease in the United States.10 In Western countries chronic, usually asymptomatic, strongyloidiasis was classically associated with immigration. However, it is now increasingly seen in tourists. In a series of 43 travelers with strongyloidiasis in Canada, the infection was associated with visiting friends and relatives in 37% of the cases, tourism in 30%, and immigration in 21%.11 These results may illustrate an epidemiological change in the acquisition of strongyloidiasis in Canada; on the other hand, they may be the result of referral bias. However, it is interesting to note that in an older series of 76 persons in Canada with confirmed strongyloidiasis, nonmigrants made up only 4% of the cases, whereas 96% were persons who had immigrated a median of 48 months (range 2–480 mo) prior to presentation.

ECA29 has integrated into the 5′-end of pflA. If this process led to a nonfunctional or absent PflA protein, further degeneration of the coding sequence may have occurred. Therefore, the PflA amino acid sequence was compared with the sequences of its homologues in other enteric species, showing that a full-length PflA is predicted (barring the five residue N-terminal

disruption caused by prophage integration), without any premature truncations or mutations that would obviously eliminate function (Supporting Information, Fig. S1). pflA codes for pyruvate formate lyase-activating enzyme. Once activated, pyruvate formate lyase is responsible for catalysing the first committed step of anaerobic glucose metabolism. We first attempted Selleck BYL719 to detect a pflA transcript by RT-PCR. Using primers to the 3′-end of the gene, a transcript was detected, suggesting that there is an outward-reading

promoter at the 3′-end of ECA29 (Fig. 2). Integration of phages in the 5′-end of genes can alter the expression of such genes by generating polar mutations or by providing alternative promoters. Streptococcus pyogenes provides a number of examples, where such transcription-altering prophages appear to be an important class of genetic regulatory elements (discussed by McShan & Ferretti, 2007). In this case, if the pflA transcript is translated, albeit without the five N-terminal residues, a functional protein may be produced. Therefore, anaerobic growth of wild-type AZD2281 in vivo Pa was compared with a strain carrying the full-length pflA gene in trans on plasmid pTE13 with glucose Interleukin-3 receptor as the sole carbon source. Serial dilutions of each strain were plated on MM plates in an anaerobic chamber. Viable counts of only 102 cells mL−1 were observed, and this was the same regardless of the presence or the absence of pTE13 (data not shown). This low cell count (109 cells mL−1 were observed when plates were grown aerobically) demonstrates that wild-type Pa cannot grow anaerobically on MM and neither is growth possible in the presence of the full-length pflA gene. We cannot rule out functionally important mutations either in this gene or in other genes essential for anaerobic

metabolism. Prophages often contain cargo genes that contribute to virulence. Analysis of the prophage sequences did not reveal the presence of any genes that obviously contribute to pathogenicity, such as toxins, although a number of uncharacterized, hypothetical genes are present. Interestingly, microarray studies have shown that ECA2598 and ECA2617 (present in ECA29) are upregulated in a quorum-sensing mutant at 12 h postinfection in the potato (Liu et al., 2008). These genes encode a putative exported protein and a phage lysis protein, respectively. Additionally, the protein products of uncharacterized genes ECA3710 and ECA3737 (present in ECA41) have been detected in an unrelated proteomics investigation of the Pa intracellular proteome (K.

Although ghrelin had no effect on the induction of HFS-induced LTP, it prolonged the expression of HFS-induced LTP through extracellular signal-regulated kinase (ERK)1/2. The Morris water maze test showed that ghrelin enhanced spatial memory, and that this was prevented by pretreatment with PI3K inhibitor. Taken together, the findings show that: (i) a single infusion of ghrelin induced a new form of synaptic plasticity by activating the PI3K signaling pathway, without HFS and NMDA receptor activation; (ii) a single infusion of ghrelin also enhanced the maintenance of HFS-induced LTP through ERK activation; and (iii) repetitive infusion of ghrelin enhanced spatial memory by activating

the PI3K signaling pathway. Thus, we propose that the ghrelin signaling pathway could have therapeutic

Ku-0059436 in vivo value in cognitive deficits. “
“Caffeine is widely consumed throughout the world, but little is known about the mechanisms underlying its rewarding and aversive properties. We show that pharmacological antagonism of dopamine not only blocks conditioned place aversion to caffeine, but also reveals dopamine blockade-induced conditioned place preferences. These aversive effects are mediated by the dopamine D2 receptor, as knockout mice showed conditioned place preferences in response to doses of caffeine check details that C57Bl/6 mice found aversive. Furthermore, these aversive responses appear to be centrally mediated, as a quaternary analog of caffeine failed to produce conditioned BCKDHA place aversion. Although the adenosine A2A receptor is important for caffeine’s physiological effects, this receptor seems only to modulate the appetitive

and aversive effects of caffeine. A2A receptor knockout mice showed stronger dopamine-dependent aversive responses to caffeine than did C57Bl/6 mice, which partially obscured the dopamine-independent and A2A receptor-independent preferences. Additionally, the A1 receptor, alone or in combination with the A2A receptor, does not seem to be important for caffeine’s rewarding or aversive effects. Finally, excitotoxic lesions of the tegmental pedunculopontine nucleus revealed that this brain region is not involved in dopamine blockade-induced caffeine reward. These data provide surprising new information on the mechanism of action of caffeine, indicating that adenosine receptors do not mediate caffeine’s appetitive and aversive effects. We show that caffeine has an atypical reward mechanism, independent of the dopaminergic system and the tegmental pedunculopontine nucleus, and provide additional evidence in support of a role for the dopaminergic system in aversive learning. “
“During the early postnatal development of rats, the structural and functional maturation of the central auditory nuclei strongly relies on the natural character of the incoming neural activity. Even a temporary deprivation in the critical period results in a deterioration of neuronal responsiveness in adult animals.

), sexual behavior, etc. In particular, the patient and his wife did not report use of unpasteurized milk products (another known way of TBE transmission).2,3 The second aspect to be discussed is the travelers’ underestimation of usefulness of preventive measures, including the non-vaccination

against TBE before the bike tour. Among the visited countries, Austria, Estonia, Finland, Germany, Lithuania, Poland, and Slovenia reported to an ECDC survey that they had more or less official recommendations regarding TBE prevention for people traveling to endemic areas.1 In general, travelers at risk of TBE are usually considered those who walk and camp in infested areas during the tick season (used to be spring to early autumn, but tick seasons are broadening during

recent years)3,7 and vaccination is in fact recommended for them.1,6 In addition, some degree of protection selleck is afforded by clothing that covers as much skin as possible and by applying insect repellent.3 The vaccine should be, however, offered to high-risk travelers. Unfortunately, outside endemic countries, the vaccines may not be licensed and will have to be obtained by special request, but vaccine against TBE is available in the United Kingdom at Travel Clinics. What was really surprising Stem Cell Compound Library was that the patient and his wife had not been fully informed about the risks of TBE and were not recommended vaccination. In addition, they did not present any known contraindication for TBE vaccination.6 They had planned most of their trip surfing various websites (although they did not provide us a complete list), but they probably missed the key one that would have prevented them from suffering such a bad experience. In fact, their Cell press own National Health Service (NHS of the United Kingdom) reported specific recommendations for TBE prevention for travelers to endemic areas with last update well before their travel.8 TBE infection is now becoming a more important issue of travel medicine because of the increasing international travel streams of tourists from non-endemic countries to TBE risk areas. The risk depends on both the traveling

season and the degree of unprotected outdoor exposure to infested areas (eg, bicycling, camping, hiking, or collecting flowers, berries or mushrooms, etc.).2,3 Tourists probably underestimate their risk for this preventable disease and have little awareness of the actual risk potential, especially when traveling to a knowingly “safe” Europe. In addition, as reported by a recent survey, information for travelers about TBE is not uniform across Europe in content and recommendations.1 Vaccination against TBE may be important for some tourists, depending on travel destination and behavior, but it should be planned well in advance and tourists should be always reminded that no last-minute vaccination is possible against TBE. The authors state they have no conflicts of interest to declare.

Performance was assessed for both ‘physical’ line bisection using a newly developed Landmark variant task and for ‘mental’ line bisection using number pairs. The effects for number line bisection were lateralized – left but not right cerebellar rTMS increased rightward errors, whereas for physical line bisection rTMS to either hemisphere did not affect performance. Effects due to neck muscle contraction and changes in eye position were ruled out

with appropriate control stimulation sites, and eye-tracking. PLX-4720 ic50 The results confirm the role of the cerebellum in spatial judgement, and, for the first time, demonstrate direct cerebellar involvement in the generation of the midline in ‘imaginal’ (number) space. The difference between number line and physical line bisection effects is discussed with ABT-199 order reference to pre-existing models of cerebellar hemispheric specialization and functional topography. “
“Axon collateral projections to various lobules of the cerebellar cortex are thought to contribute to the coordination of neuronal activities among different parts of the cerebellum. Even though lobules I/II and IX/X of the cerebellar vermis are located at the opposite poles in the anterior–posterior axis, they have been shown to receive dense vestibular mossy fiber projections. For climbing fibers, there is also a mirror-image-like organisation in their axonal collaterals between the anterior and

posterior cerebellar cortex. However, the detailed organisation of mossy and climbing fiber collateral afferents to lobules I/II and IX/X is still unclear. Here, we carried out a double-labeling study with two retrograde tracers (FluoroGold and MicroRuby) in lobules I/II and IX/X. We examined labeled cells in the vestibular nuclei and inferior olive. We found a low percentage of double-labeled neurons in Dichloromethane dehalogenase the vestibular nuclei (2.1 ± 0.9% of tracer-labeled neurons in this brain region), and a higher percentage of double-labeled neurons in the inferior

olive (6.5 ± 1.9%), especially in its four small nuclei (18.5 ± 8.0%; including the β nucleus, dorsal cap of Kooy, ventrolateral outgrowth, and dorsomedial cell column), which are relevant for vestibular function. These results provide strong anatomical evidence for coordinated information processing in lobules I/II and IX/X for vestibular control. “
“The current study aimed to investigate the effect of histamine-3 (H3) receptors, expressed in the tuberomammillary nucleus (TMN) of the hypothalamus and in the prefrontal cortex (PFC), on histamine neurotransmission in the rat brain. The firing activity of histamine neurons in the TMN was measured using in vivo extracellular single-unit electrophysiology, under propofol anesthesia. Extracellular histamine levels were determined using the dual (PFC and TMN) probe microdialysis, in freely-moving animals. Histamine levels in dialysates were determined using high-performance liquid chromatography (HPLC) and fluorescence detection.

Performance was assessed for both ‘physical’ line bisection using a newly developed Landmark variant task and for ‘mental’ line bisection using number pairs. The effects for number line bisection were lateralized – left but not right cerebellar rTMS increased rightward errors, whereas for physical line bisection rTMS to either hemisphere did not affect performance. Effects due to neck muscle contraction and changes in eye position were ruled out

with appropriate control stimulation sites, and eye-tracking. Rapamycin datasheet The results confirm the role of the cerebellum in spatial judgement, and, for the first time, demonstrate direct cerebellar involvement in the generation of the midline in ‘imaginal’ (number) space. The difference between number line and physical line bisection effects is discussed with Selleckchem Dinaciclib reference to pre-existing models of cerebellar hemispheric specialization and functional topography. “
“Axon collateral projections to various lobules of the cerebellar cortex are thought to contribute to the coordination of neuronal activities among different parts of the cerebellum. Even though lobules I/II and IX/X of the cerebellar vermis are located at the opposite poles in the anterior–posterior axis, they have been shown to receive dense vestibular mossy fiber projections. For climbing fibers, there is also a mirror-image-like organisation in their axonal collaterals between the anterior and

posterior cerebellar cortex. However, the detailed organisation of mossy and climbing fiber collateral afferents to lobules I/II and IX/X is still unclear. Here, we carried out a double-labeling study with two retrograde tracers (FluoroGold and MicroRuby) in lobules I/II and IX/X. We examined labeled cells in the vestibular nuclei and inferior olive. We found a low percentage of double-labeled neurons in Isotretinoin the vestibular nuclei (2.1 ± 0.9% of tracer-labeled neurons in this brain region), and a higher percentage of double-labeled neurons in the inferior

olive (6.5 ± 1.9%), especially in its four small nuclei (18.5 ± 8.0%; including the β nucleus, dorsal cap of Kooy, ventrolateral outgrowth, and dorsomedial cell column), which are relevant for vestibular function. These results provide strong anatomical evidence for coordinated information processing in lobules I/II and IX/X for vestibular control. “
“The current study aimed to investigate the effect of histamine-3 (H3) receptors, expressed in the tuberomammillary nucleus (TMN) of the hypothalamus and in the prefrontal cortex (PFC), on histamine neurotransmission in the rat brain. The firing activity of histamine neurons in the TMN was measured using in vivo extracellular single-unit electrophysiology, under propofol anesthesia. Extracellular histamine levels were determined using the dual (PFC and TMN) probe microdialysis, in freely-moving animals. Histamine levels in dialysates were determined using high-performance liquid chromatography (HPLC) and fluorescence detection.

, 2008). Demographic variables (age, gender and second-language experience; see Table 1) were entered at the first stage for control purposes only, and they did not predict any variance in AVMMR (R2 = 0.011, R2adj = 0; F3,18 = 0.07, P = 0.976). The variables that represent the looking time at the mouth during four speech ET conditions were entered at the second stage, and these predicted a significant proportion

of variance (R2change = 0.610; F4,14 = 5.65, P = 0.006). The final model was also significant (R2 = 0.622, R2adj = 0.433; F7,14 = 3.29, P = 0.028). Within the final model, only the looking time to the mouth during the VbaAga-combination was significant, showing that it alone predicted unique variance additional to the other looking times (beta = −0.784, P = 0.028). These results demonstrated a strong association Selleck Bafilomycin A1 between the time spent looking at the mouth during the VbaAga-combination condition and the amplitude of the AVMMR in response Selleckchem CYC202 to the same stimuli (see Fig. 1). For illustration purposes, the participants were split into two groups (see Table 2) according to their looking preferences (percentage of time spent looking at the mouth while watching the incongruent VbaAga stimuli). Ten

infants who spent > 50% of the total face-scanning time fixating Ribose-5-phosphate isomerase the mouth in the VbaAga condition also looked significantly longer to the mouth in all other conditions (two-way anova, main effect of group: F1,20 = 12.91, P = 0.002, η2 = 0.39). They were assigned to the mouth-preference (MP) group (average ± SD

looking time to the mouth in all conditions 67.13 ± 15.2%; Table 2). The remaining 12 infants were assigned to the no-MP (NMP) group (average looking time to the mouth in all conditions 38.9 ± 20.6%). The AVMMR was only observed in the NMP group but not in the MP group. In the former, the AVMMR was clearly observed at the group level as a prolonged right frontocentral positivity (Fig. 2; for more channels see Supporting Information Figs S4 and S5). Although there was no significant association between the AVMMR amplitude and age in our regression model, for control purposes infants were split into the younger (6–7.5 months, n = 11) and the older group (7.5–9 months, n = 11) by median age (see Fig. S6). No difference in ERP responses to incongruent AV stimuli was found between the age groups in either time window (no effect of age; 140–240 ms, F1,20 = 0.11, P = 0.74; 290–390 ms, F1,20 = 2.7, P = 0.12; no age × condition interaction: 140–240 ms, F1,20 = 0.66, P = 0.42; 290–390 ms, F1,20 = 1.29, P = 0.27).

78 to 0.96 years when the monthly probability of chronic AIDS mortality was increased or decreased by 50%. Use of mean chronic AIDS mortality risks for CD4 counts of >200 cells/μL, rather than the upper bound of the 95% CI used in the base case analysis, decreased the incremental gain in life

expectancy attributable to first-line efavirenz use to 0.51 years. Mean projected life expectancy for women receiving an efavirenz-based first-line ART regimen starting at CD4<500 cells/μL was 30.45 life years, while mean life expectancy for women who delayed efavirenz use and were treated with an alternative initial ART regimen which did not contain efavirenz was 29.53 life years. The life expectancy gain attributable AZD6244 clinical trial to using an efavirenz-based initial antiretroviral regimen was 0.92 years. Increasing the discount rate from 0% (base case) to 5%

lowered incremental life expectancy gains attributable to use of an efavirenz-based first-line ART regimen from 0.89 to 0.21 years, a difference of 0.68 years. For women without efavirenz exposure during pregnancy, the rate of teratogenic events was 72.46 events per 100 000 women (Table 4). For women exposed to efavirenz during pregnancy, the rate was 77.26 events per 100 000 women. We conducted a sensitivity analysis using age-group-specific pregnancy rates for women aged 15–24, 25–34 and 35–44 years. Using a pregnancy rate of 18.1 pregnancies per 100 person-years for women aged 15–24 years, the number of teratogenic events with use of efavirenz Venetoclax clinical trial was 188.96 events per 100 000 women (11.73 excess events per 100 000 women). In contrast, using a pregnancy rate of 1.4 pregnancies per 100 person-years for women aged 35–44 years, the risk of excess teratogenic events decreased to 0.91 events per 100 000 women. Results of other one-way sensitivity analyses on the rate components of the decision model are summarized in Table 4. When the live birth rate was

varied from 27% to 45% (base case rate: 36%), the excess risk of teratogenic events attributable to efavirenz use ranged from 3.60 to 5.99 events per 100 000 women. When the rate of teratogenic events with efavirenz was varied from 1.60% to 4.90%, the excess teratogenicity risk ranged from −29.84 to 58.08 events per 100 000 women. Here, a negative risk of excess teratogenic events suggests that efavirenz use confers no excess teratogenicity Thiamine-diphosphate kinase risk beyond the background risk. Figure 1 shows the results of a two-way sensitivity analysis on the prevalence of teratogenic events with efavirenz use and the pregnancy rate. For women aged 15–24 years with the highest pregnancy rate (18.1 pregnancies per 100 person-years) and the highest teratogenicity risk (4.9%; the upper bound of the 95% CI for the mean rate of teratogenicity with efavirenz), the estimated number of excess teratogenic events was 142.05 events per 100 000 women. For women aged 35–44 years with the lowest pregnancy rate (1.

The views and conclusions contained hereon are those of the authors and should not be interpreted as necessarily representing

the official policies or endorsements, either expressed or selleck compound implied, of IARPA, DOI, or the US Government. Abbreviations ACh acetylcholine BF basal forebrain Glu glutamate LGN lateral geniculate nucleus mAChRs muscarinic acetylcholine receptors PFC prefrontal cortex TRN thalamic reticular nucleus V1 primary visual cortex “
“miR-96 is a microRNA, a non-coding RNA gene which regulates a wide array of downstream genes. The miR-96 mouse mutant diminuendo exhibits deafness and arrested hair cell functional and morphological differentiation. We have previously shown that several genes are markedly downregulated in the diminuendo organ of Corti; one of these is Ptprq, a gene known to be important for maturation and maintenance of hair cells.

In order to study the contribution that downregulation of Ptprq makes to the diminuendo phenotype, we carried out microarrays, scanning electron microscopy and single hair cell electrophysiology to compare diminuendo mutants (heterozygous and homozygous) with mice homozygous for a functional null allele of Ptprq. In terms of both morphology and electrophysiology, the auditory phenotype of mice lacking Ptprq resembles that of diminuendo heterozygotes, while diminuendo homozygotes are more severely affected. A comparison of transcriptomes indicates there is a broad similarity between diminuendo homozygotes Cetuximab and Ptprq-null mice. The reduction in Ptprq observed in diminuendo check details mice appears to be a major contributor to the morphological, transcriptional and electrophysiological phenotype, but does not account for the complete diminuendo phenotype. “
“The dopaminergic projections to the basal ganglia have long been implicated in reward-guided behavior and decision-making, yet little is known about the role of the posterior pedunculopontine nucleus (pPPN), a major source of excitatory input to the mesolimbic dopamine

system. Here we studied the contributions of the pPPN to decision-making under risk, using excitoxic lesions and reversible inactivation in rats. Rats could choose between two options – a small but certain reward on one lever; or a large but uncertain reward on the other lever. The overall payoff associated with each choice is the same, but the reward variance (risk) associated with the risky choice is much higher. In Experiment 1, we showed that excitotoxic lesions of the pPPN before training did not affect acquisition of lever pressing. But whereas the controls strongly preferred the safe choice, the lesioned rats did not. In Experiment 2, we found that muscimol inactivation of the pPPN also produced similar effects, but reversibly. These results show that permanent lesions or reversible inactivation of the pPPN both abolish risk aversion in decision-making.

Operative charges are defined as all the medical costs related with the operation itself (e.g. operating room, anesthesia,

surgical supply). Non-operative charges are defined as all the costs not related with the operation itself but with the preoperative preparation and postoperative convalescence (e.g. postoperative medication, hospital stay, laboratory, radiology). Maintenance costs are included in the robot costs. Total costs are the sum of operative and non-operative charges. All costs are referred to hospital charges and estimated in Euros. In total, 141 and 108 studies were retrieved, respectively, from PubMed and Scopus among which 23 studies met the inclusion criteria of our systematic review.[5-27] Only one additional study was included through hand-searching 3MA of references.[28] The utilized search strategy is represented in Figure 1 (flow diagram). The main characteristics of the included studies in our review (demographics, type of operation, number of patients, total costs, operative charges, non-operative charges, robot charges included in the total costs, professionals’ costs, surgical equipment costs, operating room costs, length of hospital stay, number of conversions to laparotomy, duration of the operation, blood this website loss) are presented in Tables 1 and 2. In 2008: 13 In 2009: 24 In 2008: mean:

2207 In 2009: mean: 1731 In 2006: 682/1054 (64.7) In 2009: 386/1079 (35.7) In 2006: mean (±SD): 10 128 (7478) In 2009: mean (±SD): 9621 (5669), P < 0.147 In 2006: mean (±SD): 3783 (1486) In 2009: mean (±SD): 4715 (1540), P < 0.001 In 2006: mean (±SD): 7048 (3073) In Resminostat 2009:

mean (±SD): 9356 (4793), P < 0.001 In 2006: mean (±SD): 4396 (1695) In 2009: mean (±SD): 5850 (1491), P < 0.001 In 2006: 22/1054 (2) In 2009: 63/1079 (5.8) In 2006: mean (±SD): 12 145 (1819) In 2009: mean (±SD): 11 004 (3193), P < 0.001 In 2006: mean (±SD): 8593 (1302) In 2009: mean (±SD): 7989 (2252), P < 0.084 In 2006: 163/1054 (15.5) In 2009: 134/1079 (12.4) In 2006: mean (±SD): 5838 (1804) In 2009: mean (±SD): 8969 (4553), P < 0.001 In 2006: mean (±SD): 3002 (931) In 2009: mean (±SD): 3194 (947), P < 0.002 Inpatient 25 789/36 188 (71) Outpatient 8738/36 188 (24) Mean (±SD): Inpatient§ 5291 (885) Outpatient‡ 4514 (616) Inpatient 1282/36 188 (4) Outpatient 379/36 188 (1) Mean (±SD): Inpatient§ 7315 (1224), P < 0.01 Outpatient‡ 6010 (821), P < 0.01 In 2008: mean: 51 In 2009: mean: 48 In 2006: mean (±SD): 4.1 (3.4) In 2009: mean (±SD): 3.5 (2.3), P < 0.05 In 2006: mean (±SD): 189 (70) In 2009: mean (±SD): 196 (53) In 2006: mean (±SD): 1.3 (1.5) In 2009: mean (±SD): 1.3 (0.9) In 2006: 28/187 (15) In 2009: 22/496 (4.4), P < 0.0001 In 2006: mean (±SD): 210 (70) In 2009: mean (±SD): 189 (64), P < 0.001 In 2006: mean (±SD): 1.2 (0.7) In 2009: mean (±SD): 1.4 (0.