Angiopoietin-like

protein 2 (ANGPTL2) maintains tissue homeostasis by promoting adaptive inflammation and subsequent tissue reconstruction, whereas excess ANGPTL2 activation induced by prolonged stress promotes breakdown of tissue homeostasis due to chronic inflammation and irreversible tissue remodeling, promoting development of various metabolic diseases. Thus, it is important to define how ANGPTL2 signaling is regulated in order to understand mechanisms underlying disease development. Here, we focus on ANGPTL2 learn more function in physiology and pathophysiology.”
“Objectives. To determine, by means of static fracture testing the effect of the tooth preparation design and the elastic modulus of the cement on the structural integrity of the cemented machined ceramic crown-tooth complex. Methods. Human maxillary extracted premolar teeth were prepared for all-ceramic crowns using two preparation designs; a standard preparation in accordance with established protocols and a novel design with a flat occlusal design. All-ceramic feldspathic (Vita MK II) crowns were milled for all the preparations using a CAD/CAM system (CEREC-3). The machined allceramic crowns were resin bonded to the tooth structure using one of three cements with different elastic moduli: Super-Bond C&B, Rely X Unicem and Panavia F 2.0. The specimens

were subjected Napabucasin solubility dmso to compressive force through a 4 mm diameter steel ball at a crosshead speed of 1 mm/min using a universal test machine (Loyds Instrument Model LRX.). The load at the fracture point was recorded for each specimen in Newtons (N). These values were compared to a control group of unprepared/unrestored teeth. Results. There was

a significant difference between the control group, with higher fracture strength, and the cemented samples regardless of the occlusal design and the type of resin cement. There was no significant difference in mean fracture load between the two designs of occlusal preparation using Super-Bond C&B. For the Rely X Unicem ZD1839 Protein Tyrosine Kinase inhibitor and Panavia F 2.0 cements, the proposed preparation design with a flat occlusal morphology provides a system with increased fracture strength. Significance. The proposed novel flat design showed less dependency on the resin cement selection in relation to the fracture strength of the restored tooth. The choice of the cement resin, with respect to its modulus of elasticity, is more important in the anatomic design than in the flat design. (C) 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.”
“Chromosome segment substitution lines (CSSLs) provide ideal materials for quantitative trait loci (QTLs) mapping and genetic dissection of complex traits. In this study, we developed a set of CSSL population consisting of 175 lines, which were derived between the recipient Guangluai 4′ and the donor Nipponbare’.

\n\nMethods: From 2000 to 2004, the relationship between daily changes in PM10, PM2.5, SO2, NO2, CO, and ozone levels and daily total mortality and mortality due to respiratory and heart diseases were assessed using Generalized Additive Poisson models controlled for potential confounders. The lag effect (up to five days) as well as the concurrent and previous day averages and distributed lag models were all estimated. Single and two pollutant models were also constructed.\n\nResults: Daily levels of PM10, PM2.5, NO2, and SO2

were found to be associated with an increase in respiratory mortality in Santa Cruz de Tenerife and with increased heart disease mortality in Las Palmas de Gran Canaria, thus indicating an association between daily ozone levels and mortality from heart diseases. The effects spread over five successive days. SO2 was the GNS-1480 order only air selleck kinase inhibitor pollutant significantly related with total mortality (lag 0).\n\nConclusions: There is a short-term association between current exposure levels to air pollution and mortality (total as well as that due specifically to heart and respiratory diseases) in both cities. Risk coefficients were higher for respiratory and cardiovascular mortality, showing a delayed effect over several days.”
“Crohn’s Disease is a chronic,

idiopathic, transmural inflammatory disease affecting predominantly distal ileum, the common presentation include stricture and fistula formation. Free perforation in the peritoneal cavity is rare. To study the presentation and management of Crohn’s perforation. A retrospective study of 9 cases of perforative peritonitis later diagnosed due to Crohn’s disease on histopathological examination. Among the 9 patients, 8 were males and 1 was female. The ages of the patients ranged from 30 to 58 years, with mean age of 41.8 years. 6 patients were in the age group of 30-45 years. 8 patients were not known to be suffering from Crohn’s. Resection followed by anastomosis was done in 4 cases including the case of known Crohn’s, while resection

follwed by end illeostomy with mucous fistula was done in remaining cases. Resected specimens were sent for histopathological this website examination in all cases. Though Crohn’s perforation is rare it should be kept in mind when dealing with single or multiple perforation of the small intestine even in the developing countries. Though the number of cases in our series are too few to come to a conclusion, we found that illeostomy sems a prudent alternative to traditional resection anastomosis.”
“Neuroendocrine, metabolic and autonomic nervous system dysfunctions are prevalent among patients with Huntington’s disease (HD) and may underlie symptoms such as depression, weight loss and autonomic failure.

The recent discovery of TA loci in obligatory intracellular species of the Rickettsia genus has prompted new research to establish whether they work as stress response elements or as addiction systems that might be toxic for the host cell. VapBC2 is a TA locus from R. felis, a pathogen responsible for flea-borne spotted fever in humans. The VapC2 toxin is a PIN-domain protein, whereas the antitoxin, VapB2, belongs to the family of swapped-hairpin beta-barrel DNA-binding proteins. We have used a combination of biophysical and structural methods to characterize this new toxin/antitoxin

pair. Our results show how VapB2 can block the VapC2 toxin. They provide a first structural description of the interaction between a swapped-hairpin beta-barrel protein and DNA. Finally, these results Selleckchem CBL0137 suggest how the VapC2/VapB2

molar ratio can control the self-regulation of the TA locus transcription.”
“The inhibitory effect of ultrasound on barnacle AR-13324 (Amphibalanus amphitrite) cyprid was investigated under three excitation frequencies (23, 63, and 102 kHz). The linear regression models were built to study the effect of ultrasound pressure and exposure time on the cyprid settlement. The negative slopes of the linear regression lines indicate reduced settlement behavior with increased exposure time and acoustic pressure. The excitation frequency of 23 kHz was found to be the most effective on settlement inhibition,

with 63 and 102 kHz exhibiting similar but weaker response. Separately, ultrasonic cavitation was investigated and confirmed in the filtered seawater (FSW) and partially degassed filtered seawater (PDFSW) via the acoustic spectrum analysis. The cavitation energy was found to be double in FSW than in PDFSW at 23 kHz with the acoustic pressure of 20 kPa. The much higher settlement click here reduction and stronger cavitation in FSW at 23 kHz suggest that cavitation is a possible if not most likely mechanism for the cyprid inhibition. The cavitation induced force may lead to physical damage to the cyprids which subsequently will result in much higher mortality. The cavitation effect was proven to be stronger at 23 kHz than the other two frequencies with the same acoustic energy, which might explain the enhanced efficiency on settlement reduction at this frequency. (C) 2011 Elsevier B.V. All rights reserved.”
“The present study investigated the effects of chronic pre-exposure to methamphetamine on sexual motivation and performance in male Japanese quail. Quail were pre-exposed to methamphetamine (1.0 or 3.0 mg/kg ip) or saline (ip) once daily for 10 days and locomotor activity was measured. After a 10 day washout period, sexual motivation was measured in a straight-arm runway with visual access to a female at one end.

Up to now, classical visuomotor rotation paradigms have been performed on the horizontal plane, where the reaching motor plan Selleckchem Acalabrutinib in general requires the same kinematics (i.e., straight path and symmetric velocity profile). To overcome this limitation, we considered vertical and horizontal movement directions requiring specific velocity profiles. This way, a change in the motor plan due to the visuomotor conflict

would be measurable in terms of a modification in the velocity profile of the reaching movement. Ten subjects performed horizontal and vertical reaching movements while observing a rotated visual feedback of their motion. We found that adaptation to a visuomotor rotation produces a significant change in the motor plan, i.e., changes to the symmetry of velocity profiles. This suggests that the find more central nervous system takes into account the visual information to plan a future motion, even if this causes the adoption of nonoptimal motor plans

in terms of energy consumption. However, the influence of vision on arm movement planning is not fixed, but rather changes as a function of the visual orientation of the movement. Indeed, a clear influence on motion planning can be observed only when the movement is visually presented as oriented along the vertical direction. Thus vision contributes differently to the planning of arm pointing movements depending on motion orientation in space.”
“The electrical characteristics of low-temperature-processing Al2O3 films were studied. With an anodization SiO2 film as a buffer layer, Al2O3 dielectric was grown on it by oxidizing an ultra-thin aluminum film in nitric acid, followed by a surface DAC-ANO compensation. The significant development is, when the Al2O3 film fabrication of this experiment was repeated, which means one more same Al2O3 layer deposition, the sample demonstrated satisfactory electrical properties. (C) 2009 Elsevier B.V. All rights reserved.”
“Objective. To evaluate reliability of umbilical cord blood (UCB) for complete blood count (CBC) and blood cultures compared with the infant’s blood from peripheral site for group

B streptococcal (GBS) sepsis screening. Methods. A total of 200 neonates, at risk for GBS infection, were studied prospectively. Kinase Inhibitor Library After birth, UCB sample was obtained for CBC and blood cultures from umbilical vein. Peripheral arterial/venous blood was obtained from the neonate. Results. In 200 neonates, CBC counts were similar for clinical significance except for leukopenia (6% in UCB vs 1.2% in peripheral blood, P = .02). One UCB sample grew GBS and another grew microaerophilic streptococcus, a contaminant. A neonatal sample grew Escherichia coli, a pathogen and another neonatal sample grew Staphylococcus auricularis, a contaminant. Conclusion. CBC results were similar from UCB and the infant for the purpose of GBS screening. Contamination of UCB sample for culture is uncommon.

335).\n\nConclusion. Despite

some heterogeneity there is a possible indication of an association between RS and patients receiving interferons. [Int Angiol 2012;31:408-13]“
“Benzophenanthridine alkaloids (chelerythrine and sanguinarine) inhibited binding of [H-3]SR141716A to mouse brain membranes (IC(50)s: smaller than 1 mu M). Piperonyl butoxide and (S)-methoprene were less potent (IC(50)s: 21 and 63 mu M respectively). Benzophenanthridines and piperonyl butoxicle were more selective towards brain CB1 receptors versus spleen CB2 receptors. All compounds reduced B-max of [H-3]SR141716A binding to CB1 receptors, but only methoprene and piperonyl butoxide increased VX809 K-d (3-5-fold). Benzophenanthridines increased the K-d of [H-3]CP55940 binding (6-fold), but did not alter B-max. (S)methoprene increased the K-d of [H-3]CP55940 binding (by almost 4-fold) and reduced B-max by 60%. Piperonyl butoxicle lowered GSI-IX order the B-max of [H-3]CP55940 binding by 50%, but did not influence K-d. All compounds reduced [H-3]SR141716A and [H-3]CP55940 association with CBI receptors. Combined with a saturating concentration of SR141716A, only piperonyl butoxide and

(S)-methoprene increased dissociation of [H-3]SR141716A above that of SR141716A alone. Only piperonyl butoxicle increased dissociation of [H-3]CP55940 to a level greater than CP55940 alone. Binding results indicate predominantly allosteric components to the study compounds action. 4-Aminopyridine-(4-AP-) evoked release of L-glutamate from synaptosomes was partially inhibited by WIN55212-2, an effect completely neutralized by AM251, (s) methoprene and piperonyl butoxide. With WIN55212-2 present, benzophenanthridines enhanced 4-AP-evoked L-glutamaterelease above 4-AP alone. Modulatory patterns of L-glutamate release (with WIN-55212-2

present) align with previous antagonist/inverse agonist profiling based on [S-35]GTP gamma S binding. Although these compounds exhibit lower potencies compared to many classical CB1 receptor inhibitors, they may have potential to modify CB1-receptor-dependent behavioral/physiological outcomes in the PP2 concentration whole animal. (C) 2013 Elsevier B.V. All rights reserved”
“Background/purpose: Pressable all-ceramic materials are widely used in dentistry. Determining the effect of repeated firing on flexural strength will help to improve these materials so that they can remain resistant to fracture in restorative work. The aim of this study was to determine the change in the flexural strength of pressable all-ceramic materials after repeated firings, which may be unavoidable when color and shape corrections are necessary for use in dental restorations. Materials and methods: Forty disc specimens (15.5 mm x 2.1 mm) were prepared for each of four pressable ceramic materials (Empress 2, Finesse, Cergo, and Evopress) according to the manufacturers’ instructions.

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

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

that have significant implications for theorizing agricultural innovation. The paper thus concludes by considering the findings’ significance for current efforts to rethink agricultural extension.”
“Struma ovarii is an uncommon ovarian teratoma comprised predominantly of mature thyroid tissue. The combination of pseudo-Meigs’ syndrome, and elevation of CA 125 to the struma ovarii is a rare condition that can mimic ovarian malignancy. We reported a case of ZD1839 benign struma ovarii, presenting with the clinical features of advanced ovarian carcinoma: complex pelvic mass, gross ascites, bilateral pleural effusion and markedly elevated serum CA 125 levels. The patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Ascites and pleural effusion were not evident and the CA 125 levels returned to normal following surgical excision. A systematic review of reported cases of coexistent benign struma ovarii, pseudo-Meigs’ syndrome and elevated serum CA 125 was performed. Struma ovarii accompanied by pseudo-Meigs’ syndrome and elevated serum CA 125 should be considered in the differential diagnosis of ovarian epithelial cancer.”
“Obestatin,

encoded by the same gene as ghrelin, was first described as a physiological opponent of ghrelin. We investigated fasting plasma ghrelin and obestatin levels AZD7762 and ratio of ghrelin to obestatin in humans with untreated mild-to-moderate hypertension and humans with normal blood pressure. We found that the plasma concentration of ghrelin and the ratio of ghrelin to obestatin were significantly lower in hypertension group compared with control group (236.3 +/- 12.3 pg/ml vs 381.4 +/- 25.6 pg/ml, P<0.01: 0.89 +/- 0.06 vs 1.2 +/- 0.06, P<0.01). The plasma concentration of obestatin was lower in hypertension group compared with control group, but the difference between the two groups was not significant (276.2 +/- 15.1 pg/ml vs 325.4 +/- 25.8 pg/ml, P>0.05).

“
“Optic nerve atrophy and hypoplasia can be primary disorders or can result from trans-synaptic degeneration arising from cerebral visual INCB28060 datasheet impairment (CVI). Here we report six individuals with CVI and/or optic nerve abnormalities, born after an uneventful pregnancy and delivery, who have either de novo heterozygous missense mutations in NR2F1, also known as COUP-TFI, or deletions encompassing NR2F1. All affected individuals show mild to moderate intellectual impairment.

NR2F1 encodes a nuclear receptor protein that regulates transcription. A reporter assay showed that missense mutations in the zinc-finger DNA-binding domain and the putative ligand-binding domain decrease NR2F1 transcriptional activity. These findings indicate that NR2F1 plays an important role in the neurodevelopment of the visual system and that its disruption can lead to optic atrophy with intellectual disability.”
“Extensive full-atomistic molecular dynamics simulations are performed

to study the self-organization of C-60-fullerene dyad molecules in water, namely phenyl-C-61-butyric acid methyl ester and fulleropyrrolidines, which have two elements of ordering, the hydrophobic fullerene cage and the hydrophilic/ionic group. While pristine fullerene or phenyl-C-61-butyric acid methyl ester forms spherical droplets in order to minimize the surface tension, the amphiphilic nature of charged solute molecules leads to the formation of supramolecular LY3023414 clinical trial assemblies having cylindrical MI-503 shape driven by charge repulsion

between the ionic groups located on the surface of the aggregates. We show that formation of non-spherical micelles is the geometrical consequence if the fullerene derivatives are considered as surfactants where the ionized groups are only hydrophilic unit. The agglomeration behavior of fullerenes is evaluated by determining sizes of the clusters, solvent accessible surface areas, and shape parameters. By changing the size of the counterions from chloride over iodide to perchlorate we find a thickening of the cylinder-like structures which can be explained by stronger condensation of larger ions and thus partial screening of the charge repulsion on the cluster surface. The reason for the size dependence of counterion condensation is the formation of a stronger hydration shell in case of small ions which in turn are repelled from the fullerene aggregates. Simulations are also in good agreement with the experimentally observed morphologies of decorated C-60-nanoparticles. (C) 2014 AIP Publishing LLC.”
“Herpes simplex virus (HSV) is a human pathogen that can cause severe diseases such as encephalitis, keratitis and neonatal herpes. Control of HSV infection may be achieved by using small interfering (si)RNAs. We have designed and enzymatically produced pools of siRNAs targeting HSV. In addition to the target-specific effects, such siRNAs may induce innate immunity responses that may contribute to antiviral effects.

This study reported the occurrence of a much wider spectrum of fungi, when compared with previous work. Also, it confirmed the variation of different isolates from the same species in terms of antifungal activity.”
“The aim of the present study was to understand the genetic stability of a master seed bank (MSB) and a working seed bank (WSB) of an adenovirus vector vaccine expressing the human papillomavirus (HPV) type 16 E6 and E7 fusion proteins

(Ad-HPV16E6E7). Microscopic examination and viral infectious efficacy were used Liproxstatin-1 concentration to measure the infectious titers of the Ad-HPV16E6E7 MSB and WSB. Polymerase chain reaction was used to analyze the stability of the Ad-HPV16E6E7 target gene insertion, while western blot analysis and immunofluorescence were used to assess the expression levels of the Ad-HPV16E6E7 target protein. A C57BL/6 mouse TC-1 tumor cell growth inhibition model was used to evaluate

the biological effect of Ad-HPV16E6E7 administration. The infectious titers of the Ad-HPV16E6E7 MSB and WSB were 6.31×10(9) IU/ml and 3.0×10(9) IU/ml, respectively. In addition, the expression levels of the inserted target genes and target proteins were found to be stable. In the mouse TC-1 tumor inhibition analysis, when the virus titers of the Ad-HPV16E6E7 MSB and WSB were 10(9) IU/ml, the tumor inhibition rate was 100%, which was significantly different when compared with the control group ((MSB)-M-2=20.00 and selleck compound (WSB)-W-2=20.00; P smaller than 0.01). Therefore, the Ad-HPV16E6E7 vaccine seed bank is genetically stable and meets the requirements for vaccine development.”
“Background: Three-drug combination therapy based on cisplatin/fluorouracil might improve treatment efficacy for metastatic esophageal squamous cell carcinoma (ESCC), but at the risk of increasing toxicity. The study sought to identify factors associated with outcomes of metastatic ESCC in patients who were treated with three-drug combinations. Patients and Methods:

One-hundred and thirteen patients with metastatic or recurrent ESCC who were treated with cisplatin/fluorouracil-based three-drug combination during 2000-2009 were https://www.selleckchem.com/products/wnt-c59-c59.html studied. The prognostic impact of clinicopathological characteristics were evaluated by Cox proportional hazard regression analyses. Results: The third chemotherapeutic agents comprised of paclitaxel, docetaxel, and methotrexate in 76 (67%), 13 (12%), and 24 (21%) of patients, respectively. The overall response rate was 41%. The median overall survival (OS) was 8.5 months. Results of the Cox proportional hazard regression models showed that age >= 65 years, Eastern Cooperative Oncology Group performance status of 0 and 1, lymph node-only metastasis and baseline white blood cell (WBC) count <= 10,000/mm(3) were significant prognostic factors for better OS.

6 to 0.5, unit B from 6.9 to 1.6, and unit C from 7.8 to 0.6. Secondary bloodstream infection rates remained unchanged throughout the observation period in units A and B; however, unit

C had a decrease in its rates over time.\n\nConclusions: We report the progressive reduction of central catheter-associated bloodstream infection rates after the stepwise implementation of chlorhexidine “scrub-the-hub” and daily baths in surgical intensive care units, suggesting effectiveness of these interventions. (Crit Care Med 2012; 40: 1464-1469)”
“Objective. Increased proximity to parkland is associated with physical activity (PA). This study explored the extent to which self-selection – the idea that active persons simply seek out neighborhoods more endowed with active resources – influences the relationship between park availability and Selonsertib PA.\n\nMethod. In August 2007, measures of AZD8931 cost parkland availability within 1 km, importance placed on living near parks, and park-based PA participation were assessed for 585 adults in Waterloo, Ontario.\n\nResults. Logistic regression revealed that (i) participants who placed greater importance on neighborhood open space were not more likely to live near more parkland; (ii) both park importance and park space availability were associated with increased, and relatively equal, odds of engaging in at least some

park-based PA; and (iii) participants who placed a low importance on living near parks but had a higher amount of park space nearby were significantly more likely to engage in park-based PA than participants who also placed a low importance on parks but had less nearby park space.\n\nConclusion. The issue of self-selection does not solely account for the relationship frequently observed between park space availability and PA. Future prospective and intervention studies are needed to draw more definitive conclusions about causality. (c) 2010 Elsevier Inc. All Combretastatin A4 nmr rights

reserved.”
“Dermatoglyphics is the scientific study of fingerprints. Recently, interest has been developed in associating Dermatoglyphics with various diseases. Therefore, this study was undertaken to find the frequency of various fingerprint patterns in Type 2 diabetes mellitus (T2DM) with and without ischemic heart disease (IHD). This study also intended to find the frequency of finger print patterns in T2DM patients having the family history of cardiovascular disease. Twenty five T2DM male patients in the age group of 38-65 years were selected, of which 18 had ischemic heart disease (IHD) and 16 patients had the family history of cardiovascular events. The right hand fingerprints of patients were obtained on an A4 size paper. The papers were coded and analyzed for finger print patterns, based on IHD and family history after categorizing them into 4 groups. In T2DM patients, there was higher frequency of whorls than other patterns.

29, CI 1.17-1.41). Mean adjusted 12-month COPD-related total health care costs were lower for FSC ($2068, standard deviation [SD] $1190)

than for ipratropium ($2841, SD $1858) and tiotropium ($2408, SD $1511, both P < 0.05). Mean number of COPD-related hospitalizations, emergency department visits, and outpatient visits associated with an oral corticosteroid or antibiotic were also lower for FSC than for ipratropium and tiotropium (all P < 0.05).\n\nConclusions: In this retrospective “real-world” observational sample of COPD patients, initiating treatment with FSC was associated with significantly better clinical and economic outcomes compared with short-and long-acting anticholinergic therapy. Consistent with the goal of

preventing and click here reducing exacerbations advocated by global guidelines, the findings suggest that initiation of maintenance treatment with FSC may afford clinical benefits at a lower cost than anticholinergic treatment.”
“Stroke and cerebral hypoxia are among the main complications during cardiopulmonary bypass (CPB). The two main reasons for these complications are the cannula jet, due to altered flow conditions and the sandblast effect, and impaired cerebral autoregulation which often occurs in the elderly. The effect BMS-345541 supplier of autoregulation has so far mainly been modeled using lumped parameter modeling, while Computational Fluid Dynamics (CFD) has been applied to analyze flow conditions during CPB. In this study, we combine both modeling techniques to analyze the effect of lumped parameter modeling on blood flow during CPB. Additionally, cerebral autoregulation is implemented using the Baroreflex, which adapts the cerebrovascular

resistance and compliance based on the cerebral perfusion pressure. The results show that while a combination of CFD and lumped parameter modeling without autoregulation delivers feasible results for Duvelisib molecular weight physiological flow conditions, it overestimates the loss of cerebral blood flow during CPB. This is counteracted by the Baroreflex, which restores the cerebral blood flow to native levels. However, the cerebral blood flow during CPB is typically reduced by 10-20% in the clinic. This indicates that either the Baroreflex is not fully functional during CPB, or that the target value for the Baroreflex is not a full native cerebral blood flow, but the plateau phase of cerebral autoregulation, which starts at approximately 80% of native flow. (C) 2013 Elsevier Ltd. All rights reserved.”
“Background: Viral pathogens have not generally been regarded as important causes of severe hospital-acquired pneumonia (HAP), except in patients with hematologic malignancy or transplant recipients. We investigated the role and distribution of viruses in adult with severe HAP who required intensive care. Methods: From March 2010 to February 2012, adult patients with severe HAP required admission to the intensive care unit (ICU), 28-bed medical ICU in a tertiary care hospital, were prospectively enrolled.