Therefore, we addressed in the present study the role of autoanti

Therefore, we addressed in the present study the role of autoantibodies to BP230 in experimental bullous pemphigoid. Rabbit polyclonal antibodies generated against epitopes of the C-terminal fragment of murine BP230 bound to the basement membrane and activated the complement system ex vivo. Affinity-purified antibodies were subsequently subcutaneously transferred into neonatal and adult BALB/c mice. In vivo, we observed a dose-dependent binding of transferred antibodies in the murine skin; however, there was no complement activation and these mice showed no clinical or histological signs of inflammatory disease, in contrast to mice receiving anti-BP180

antibodies. We further conducted ex vivo experiments and demonstrated that rabbit IgG anti-BP230-specific antibodies, in contrast to antibodies from bullous pemphigoid patients or rabbit IgG anti-BP180 antibodies Histone Methyltransf inhibitor used as positive controls, did not activate human granulocytes to induce dermal epidermal separation in skin cryosections. Our present findings demonstrate

C59 that antibodies against BP230 are non-pathogenic in experimental models of bullous pemphigoid and suggest that proper activation of the complement and granulocytes represent prerequisites for conferring bullous pemphigoid autoantibodies their tissue destructive potential. (C) 2014 Published by Elsevier Inc. on behalf of American Society for Histocompatibility and Immunogenetics.”
“Objectives: PRT062607 order The practice of ‘suicide audit’ refers to the systematic collection of local data on suicides in order to learn lessons and inform suicide prevention plans. Little

is known about the utility of this activity. The aim of this study was to ascertain from Directors of Public Health in England how they were conducting suicide audit and what resources they were investing in it; how the findings were being used, and how the process might be improved. Study design: E-mail survey. Methods: A questionnaire was sent to all 153 Primary Care Trusts (PCTs) in England prior to their dissolution in 2013. Simple descriptive statistics were performed in an Excel database. Results: Responses were received from 49% of PCTs, of which 83% were conducting a regular audit of deaths by suicide. Many had worked hard to overcome procedural obstacles and were investing huge amounts of time and effort in collecting data, but it is not clear that the findings were being translated effectively into action. With few exceptions, PCTs were unable to demonstrate that the findings of local audits had influenced their suicide prevention plans. Conclusions: In the light of fresh calls for the practice of suicide audit to be made mandatory in England, these results are worrying.

05) The results expand the knowledge on use of medications among

05). The results expand the knowledge on use of medications among elderly Brazilians, emphasizing the need to improve pharmaceutical care focused on this subgroup of the population.”
“Background aims. Donor-derived vertebral bone marrow (BM) has been proposed to promote chimerism in solid organ transplantation with cadaveric organs. Reports of successful weaning

from immunosuppression in patients receiving directed donor transplants in combination with donor BM or blood cells and novel peri-transplant immunosuppression has renewed interest in implementing similar protocols with cadaveric organs. Methods. We performed six pre-clinical full-scale separations to adapt vertebral BM preparations to a good manufacturing practice (GMP) environment. Vertebral bodies L4-T8 were transported to a class 10 000 clean room, cleaned of soft LY2835219 clinical trial tissue, divided and crushed in a prototype bone grinder. Bone

fragments were irrigated with medium containing saline, albumin, DNAse and gentamicin, and strained through stainless steel sieves. Additional cells were eluted after two rounds of agitation using a prototype BM tumbler. Results. The majority of recovered cells (70.9 +/- 14.1%, mean +/- SD) were eluted directly from the crushed bone, whereas PD-1/PD-L1 Inhibitor 3 nmr 22.3% and 5.9% were eluted after the first and second rounds of tumbling, respectively. Cells were pooled and filtered (500, 200 mu m) using a BM collection kit. Larger lumbar vertebrae yielded about 1.6 times the cells of thoracic vertebrae. The average product yielded 5.2 +/- 1.2 x 10(10) total cells, 6.2 +/- 2.2 x 10(8) of which were CD45(+) CD34(+). Viability was 96.6 +/- 1.9% and 99.1 +/- 0.8%, respectively. Multicolor flow cytometry revealed distinct populations of CD34(+) CD90(+) CD117(dim) hematopoietic stem cells (15.5 +/- 7.5% of the CD34(+) cells) and

CD45(-) Bafilomycin A1 CD73(+) CD105(+) mesenchymal stromal cells (0.04 +/- 0.04% of the total cells). Conclusions. This procedure can be used to prepare clinical-grade cells suitable for use in human allotransplantation in a GMP environment.”
“The cytopathologic diagnosis of basaloid squamous cell carcinoma can be problematic as there are several components of the differential diagnosis that share common cytomorphologic features. In this study, we report the fine-needle aspiration (FNA) findings of 16 basaloid squamous cell carcinoma cases and compare those cases to 16 cases of small cell carcinoma. To our knowledge, this is the largest series of basaloid squamous cell carcinoma FNA cases ever reported. The following cytomorphologic features were compared for both tumors: cohesive tissue fragments, single cells, adenoid cystic-like features (cribriform pseudoglandular lumina with hyaline materials), necrosis, nuclear size, nuclear molding, nucleoli, cytoplasm, and the presence of single keratinized cells.

Anatomic-functional correlations in high myopic foveoschisis are

Anatomic-functional correlations in high myopic foveoschisis are not yet well clarified. Posterior pole retinal detachment and macular hole are the most serious complications. (C) 2013 Elsevier Masson SAS. All rights reserved.”
“Background: Escherichia coli O25b-B2-ST131 are considered virulent extra-intestinal pathogens ON-01910 Cell Cycle inhibitor causing serious clinical complications such as urinary tract infection and bacteraemia. Our main objectives in this study were to characterise

the multi-drug resistant (MDR) isolates of this lineage in Kuwait, and to demonstrate whether reduced susceptibility is spread clonally. Results: A subset of 83 (10%) non-duplicate and non-selective E. coli O25b-B2-ST131 out of 832 MDR E. coli was identified and collected. Minimum inhibitory concentrations of the isolates were determined and pulsed-field gel electrophoresis was used for typing. The majority (95.2%) of the 83 E. coli O25b-B2-ST131 harboured at least one bla gene with blaC(TX-M-15)

check details being the most prevalent. bla(CTX-M-2) was present in one isolate. Also one isolate harboured bla(CTX-M-56), qnrB1 and bla(CMY-2) genes and carried IncF1 plasmids of about 97 kb and160 kb. qnrB and qnrS were found in 8 other bla(CTX-M-15) containing isolates. The bla(NDM), bla(IMP), bla(VIM) and qnrA were not detected, however, the bla(OXA-48) was present in two (2.4%). Conclusions: The majority of isolates harbouring qnr genes demonstrated relatedness ( bigger than = 85%) by PFGE. However, the diversity in PFGE profiles for the other MDR isolates

reflected the changes in population genetics of E. coli O25b-B2-ST131. We identified for the first time the appearance of bla(CTX-M-2) in the Middle East and bla(CTX-M-56) outside the Latin American countries. The isolate harbouring bla(CTX-M-56) also contained qnrB1 and bla(CMY-2) genes and carried IncF1 plasmids. The appearance of a highly virulent E. coli O25b-ST131 that is resistant to penicillins, most cephalosproins, beta-lactamase inhibitors as well as fluoroquinolones is a cause for concern.”
“Purpose: Adequate levels of physical activity are essential for health, but participation in sports and recreational physical activities is associated with an increased risk of injury. The present study quantifies the impact of sports- and recreation-related injuries (SRIs) for middle and high DMXAA school-aged Kentucky children. Methods: The study describes unintentional injuries in 2010-2012 Kentucky emergency department (ED) administrative records for patients age 10-18 years. SRIs were identified based on external codes of injuries, according to the International Classification of Diseases, Ninth Revision, Clinical Modification. Results: A total of 163,252 ED visits by 10- to 18-year olds occurred during the study period, of which 31,898 (20%) were related to participation in physical activity. Males accounted for 70% of the SRIs.

The characteristic histopathologic findings for chronic eczema ar

The characteristic histopathologic findings for chronic eczema are variable. However, periadnexal mucin deposition is not known as a feature of chronic eczema. Objective: To evaluate the presence of periadnexal mucin deposition in chronic eczematous dermatitis. Methods: We analyzed the skin biopsy specimens from 36 patients who were pathologically diagnosed with chronic eczematous dermatitis. Alcian blue, colloidal iron, and periodic acid-Schiff stains were used to evaluate the mucin deposition

in histologic sections. Two dermatologists and two dermatopathologists evaluated the degree of mucin deposition using a 4-point scale. Results: Various amounts of mucin deposition were observed in the periadnexal area of patients who were diagnosed with chronic eczema. Mucin deposition was more visible after staining with mucin-specific stains. Evaluation this website of the staining analysis scores revealed that the staining intensities were significantly higher in patients Selleckchem CYT387 with chronic eczema than age- and site-matched controls (normal, acute

to subacute eczema, and psoriasis vulgaris). Conclusion: Periadnexal mucin (secondary mucinoses) may be an additional finding of chronic eczematous dermatitis.”
“The aim of this study was to ascertain whether there is any evidence of stigma related to the use of antidepressants. Using the PubMed and MEDLINE databases, we searched for the terms stigma, antidepressants, and depression. A protocol was developed to extract information selleck inhibitor from the papers, which were identified and explored further. Thirty-two papers were identified. We found

that the stigma against depression differs from stigma against the use of antidepressants. Stigma against depression does not impact on therapeutic adherence to antidepressant use. Stigma related to antidepressant use appears to be linked with perceived emotional weakness, severity of illness, an inability to deal with problems, and a lack of belief in the therapeutic efficacy of antidepressants. Stigma against medication can be a useful target for interventions, just like the stigma related to depression. However, clinicians must be careful in avoiding the medicalization of symptoms.”
“Recently the American Heart Association has reported that favorable effects of soy protein on blood lipids were characteristic only for high amounts of soy protein and not observed for an intake less than 30 g/d. However. the period of the studies with the smaller amount was 4-6 wk and we thought a longer study was necessary for the conclusion. The death rate by heart disease is very high in Russia; therefore, we have done this study in Russian subjects with hyperlipidemia. Prior to the study we tried to find a favorable method for subjects to take 30 g protein a day from soybean protein isolate (SPI) or skimmed curd protein (SMP) and decided to use Russian style cookies. Thirty subjects with hyperlipidemia were recruited; however.

034) and OS (P = 0 0069) In this retrospective analysis, diffuse

034) and OS (P = 0.0069). In this retrospective analysis, diffuse immunohistochemical reactivity for myogenin in RMS correlates with decreased RFI and OS, independent of histologic subtype, translocation status, tumor site, or stage.”
“The 60S ribosomal protein L22 (GenBank accession no. EF990190)

was cloned from Culex pipiens pallens. An open reading frame (ORF) of 447 bps was found to encode a putative 148 amino acids protein which shares 90% and 80% identity with RPL22 VX-680 genes from Aedes aegypti and Anopheles gambiae respectively. Real-time quantitative PCR analysis demonstrated that the transcription level of RPL22 in deltamethrin-resistant strain was 2.57 folds higher than in deltamethrin-susceptible strain of Cx pipiens; pallens. Overexpression of RPL22 in C6/36 cells showed that the deltamethrin-resistance was decreased in C6/36-RPL22 cell compared to the control. The mRNA level of cytochrome P450

6A1 (CYP6A1, GenBank accession no. FJ423553) showed that CYP6A1 was down-regulated in the C6/36 transfected with RPL22 (C6/36-RPL22) cells, suggesting that CYP6A1 was repressed by RPL22. Our study provides the first evidence that RPL22 may play some role in the regulation of deltamethrin-resistance in Cx pipiens pallens. (C) 2009 Published by BVD-523 Elsevier Inc.”
“Objectives: To describe (1) the importance of understanding quality measurement and improvement and (2) the development and potential uses of the Educating Pharmacy Students and Pharmacists to Improve Quality (EPIQ) program.\n\nPractice description: The EPIQ program is applicable to all pharmacy practice settings.\n\nPractice innovation: EPIQ was developed as a quality improvement education resource, for use by pharmacy faculty and other professionals, to teach student pharmacists, pharmacists, and other stakeholders about measuring, reporting, and improving quality in pharmacy practice.\n\nResults:

The EPIQ program contains 17 sessions that have been packaged in five modules addressing (1) the status of quality improvement and reporting in the U. S. health care system, (2) quality improvement see more concepts, (3) quality measurement, (4) quality-based interventions and incentives, and (5) application of quality improvement to the pharmacy practice setting. Each standalone module can be used in a variety of orders and are not sequential in nature. Individual pharmacists may choose one or more modules to meet individual continuing education (CE) requirements, and employers (pharmacists) may mix and match modules to develop employee training programs. Pharmacy associations and other CE providers have also used the modules to develop live CE and certificate programs. A sample of the EPIQ program and how it can be used by pharmacists is provided in this article.

On the cycle we assume that any string of n neighbouring players

On the cycle we assume that any string of n neighbouring players interacts. We study fixation probabilities of stochastic evolutionary dynamics. We derive analytical results on the cycle both for linear and exponential fitness for any intensity of selection, and compare those to results for the well-mixed population. As particular examples we study multi-player public goods games, stag hunt games and snowdrift games. (C) 2011 Elsevier Ltd. All rights reserved.”
“Motivation: Most experimental evidence on kinetic click here parameters is buried in the literature, whose manual searching is

complex, time consuming and partial. These shortcomings become particularly acute in systems biology, where these parameters need to be integrated into detailed, genome-scale, metabolic models. These problems PLX3397 in vivo are addressed by KiPar, a dedicated information retrieval system designed to facilitate access to the literature relevant for kinetic modelling of a given metabolic pathway in yeast. Searching for kinetic data in the context of an individual pathway offers modularity as a way of tackling the complexity of developing

a full metabolic model. It is also suitable for large-scale mining, since multiple reactions and their kinetic parameters can be specified in a single search request, rather than one reaction at a time, which is unsuitable given the size of genome-scale models.\n\nResults: We developed an integrative approach, combining public data and software resources for the rapid development of large-scale text mining tools targeting complex biological information. The user supplies input in the form of identifiers

used in relevant data resources to refer to the concepts of interest, e. g. EC numbers, GO and SBO identifiers. By doing so, the user is freed from EPZ-6438 cell line providing any other knowledge or terminology concerned with these concepts and their relations, since they are retrieved from these and cross-referenced resources automatically. The terminology acquired is used to index the literature by mapping concepts to their synonyms, and then to textual documents mentioning them. The indexing results and the previously acquired knowledge about relations between concepts are used to formulate complex search queries aiming at documents relevant to the user’s information needs. The conceptual approach is demonstrated in the implementation of KiPar. Evaluation reveals that KiPar performs better than a Boolean search. The precision achieved for abstracts (60%) and full-text articles (48%) is considerably better than the baseline precision (44% and 24%, respectively). The baseline recall is improved by 36% for abstracts and by 100% for full text. It appears that full-text articles are a much richer source of information on kinetic data than are their abstracts.

Methods: Twenty-three family caregivers of patients with head and

Methods: Twenty-three family caregivers of patients with head and neck cancer completed the Neuropsychiatric Inventory Questionnaire and participated in a semistructured interview. Results: All caregivers reported that patients experienced at least 1 neuropsychiatric symptom (mean, 7.5; range, 1-12). The most frequently reported symptoms were trouble with appetite and eating (95.7%), altered nighttime behaviors (82.6%), depression/dysphoria (78.3%), decreased alertness (69.6%), inattention (60.9%), apathy/indifference (56.5%), anxiety (56.5%), irritability/lability (52.5%), agitation/aggression

(52.2%), and slowed behavior (43.5%). The mean severity rating for 9 symptoms was moderate to severe. Most symptoms caused mild to moderate levels of caregiver distress. Qualitative data indicated that neuropsychiatric see more symptoms JNJ-26481585 research buy negatively affected patients, their caregivers, and other family members. Patients required more caregiver support resulting in increased caregiver burden and distress. Conclusions: Neuropsychiatric symptoms are common and troubling in patients with head and neck cancer during treatment. Further investigation of their effects on patients and family caregivers is needed. Implications for Practice: Clinicians should monitor for and treat neuropsychiatric symptoms throughout treatment

and provide caregiver and patient education and support.”
“Recent studies show that ion channels/transporters play important roles in fundamental cellular functions that would be involved in the cancer process. We Belnacasan cost review the evidence for their expression and functioning in human gastric cancer (GC), and evaluate the potential of cellular physiological approach in clinical management. Various types of ion channels, such as voltage-gated K+ channels, intracellular Cl-channels and transient receptor potential channels have been found to express in GC cells and tissues, and to control cell cycles. With regard to water

channels, aquaporin 3 and 5 play an important role in the progression of GC. Regulators of intracellular pH, such as anion exchanger, sodium-hydrogen exchanger, vacuolar H+-ATPases and carbonic anhydrases are also involved in tumorigenesis of GC. Their pharmacological manipulation and gene silencing affect cellular behaviours, suggesting their potential as therapeutic targets for GC. Our studies indicate the intracellular Cl- concentration could act as a mediator of cellular signaling and control cell cycle progression in GC cells. Further, we demonstrate the cytocidal effects of hypotonic shock on GC cells, and indicate that the blockade of Cl(-)channels/transporters enhances these effects by inhibiting regulatory volume decrease. A deeper understanding of molecular mechanisms may lead to the discovery of these cellular physiological approaches as a novel therapeutic strategy for GC. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.

Based on the above results, our present study revealed that the d

Based on the above results, our present study revealed that the density and oxidative capacity of mitochondrial markedly increased during primary

adipocyte differentiation, and on the other hand, we suggested that mitochondria dysfunction might inhibit the differentiation process.”
“Pancreatitis is a known side effect of the once commonly used drug, sodium stibogluconate, for treatment of visceral leishmaniasis (VL). In India, miltefosine has recently been introduced as the first-line drug. Its side effects include loose motions, vomiting, and teratogenicity. We report here a case of a 41-year-old parasitologically confirmed male case of VL, who developed acute pancreatitis during treatment with miltefosine. On the 13th day of treatment,

he presented β-Nicotinamide in vivo with abdominal pain and vomiting. The biochemical, hematological, and radiological features were suggestive of acute pancreatitis. The patient was put on conservative treatment for pancreatitis at the specialized center but succumbed to renal failure and septicaemia.”
“Although quantitative computed tomography (QCT) is considered the gold standard for in vivo densitometry, dual-energy X-ray absorptiometry (DXA) scans assess larger bone regions and are more appropriate for pediatric longitudinal studies. Unfortunately, DXA does not yield specific bone architectural output. To address this issue in healthy, postmenarcheal girls, Sievanen’s distal radius formulae [1996] were applied to derive indices of bone Geometry, volumetric bone mineral density (vBMD), and strength from DXA data; results were selleckchem compared to peripheral quantitative computed tomography (pQCT) output. Contemporaneous scans were performed on the left, distal radii of 35 gymnasts, ex-gymnasts, and nongymnasts (aged 13.3-20.4 yr, mean 16.6 yr). For 4% and 33% regions, pQCT measured cross-sectional areas (CSAs) and vBMD; comparable DXA indices were generated at ultradistal and 1/3 regions. Index of structural strength in axial compression was calculated from 4% pQCT and DXA output for comparison; 33% pQCT strength-strain index was compared to 1/3 DXA section modulus.

Ion Channel Ligand Library cell line Sievanen DXA indices were significantly. positively correlated with pQCT output (R = +0.61 to +0.98; p < 0.0001). At the distal radius, in healthy postmenarcheal girls. Sievanen’s method yielded potentially useful DXA indices of diaphyseal cortical CSA and bone strength at both the diaphysis (section modulus) and the metaphysis (index of structural strength in axial compression).”
“Helicobacter cinaedi infection is recognized as an increasingly important emerging disease in humans. Although H. cinaedi-like strains have been isolated from a variety of animals, it is difficult to identify particular isolates due to their unusual phenotypic profiles and the limited number of biochemical tests for detecting helicobacters.

In this study, we examined the role of SCD1

In this study, we examined the role of SCD1 Tubastatin A manufacturer in autophagy using the tsc2(-/-) mouse embryonic fibroblasts (MEFs) possessing constitutively active MTORC1 as a cellular model. We found that mRNA and protein levels of SCD1 are significantly elevated in the tsc2(-/-) MEFs compared with Tsc2(+/+) MEFs, resulting in significant increases in levels of various lipid classes. Furthermore, inhibition of SCD1 activity

by either a chemical inhibitor or genetic knockdown resulted in an increase of autophagic flux only in the tsc2(-/-) MEFs. Induction of autophagy was independent of MTOR as MTORC1 activity was not suppressed by SCD1 inhibition. Loss of phosphorylation on AKT Ser473 was observed upon SCD1 inhibition and such AKT inactivation was due to disruption of lipid raft formation, without affecting the formation and activity of MTORC2. Increased nuclear translocation of FOXO1 was observed following AKT inactivation, leading to increased transcription of genes involved in the autophagic process. The tsc2(-/-) MEFs were also

more susceptible to apoptosis induced by SCD1 inhibition and blockage of autophagy sensitized the cell death response. These results revealed a novel function of SCD1 on regulation of autophagy via lipogenesis and the lipid rafts-AKT-FOXO1 pathway.”
“In wheat, monocarpic senescence is a tightly regulated LY2835219 chemical structure process during which nitrogen (N) and micronutrients stored pre-anthesis are remobilized from vegetative tissues to the developing grains. Recently, a close connection between senescence and remobilization was shown through the map-based cloning of the GPC (grain find more protein content)

gene in wheat. GPC-B1 encodes a NAC transcription factor associated with earlier senescence and increased grain protein, iron and zinc content, and is deleted or non-functional in most commercial wheat varieties. In the current research, we identified ‘loss of function’ ethyl methanesulfonate mutants for the two GPC-B1 homoeologous genes; GPC-A1 and GPC-D1, in a hexaploid wheat mutant population. The single gpc-a1 and gpc-d1 mutants, the double gpc-1 mutant and control lines were grown under field conditions at four locations and were characterized for senescence, GPC, micronutrients and yield parameters. Our results show a significant delay in senescence in both the gpc-a1 and gpc-d1 single mutants and an even stronger effect in the gpc-1 double mutant in all the environments tested in this study. The accumulation of total N in the developing grains showed a similar increase in the control and gpc-1 plants until 25 days after anthesis (DAA) but at 41 and 60 DAA the control plants had higher grain N content than the gpc-1 mutants. At maturity, GPC in all mutants was significantly lower than in control plants while grain weight was unaffected.

This study aimed to examine whether polymorphisms in the SNCA gen

This study aimed to examine whether polymorphisms in the SNCA gene were associated with alcohol taste cue elicited responses in the brain, one such intermediate phenotype. Method: A total of 326 heavy drinkers who underwent

an alcohol taste task during functional magnetic resonance imaging (fMRI) also were genotyped. Analyses focused on two previously identified SNCA variants (rs2583985 and rs356168) as well as 27 other single nucleotide polymorphisms from the Illumina https://www.selleckchem.com/products/OSI-906.html Human1M BeadChip that were used in an exploratory analysis of the whole gene. Neurobiological phenotypes were defined as fMRI blood oxygenation level dependent (BOLD) responses to alcohol taste cue (vs. a control cue) in seven regions of interest known to be involved in cue processing and rich in dopaminergic axon terminals. Results: Polymorphisms in the SNCA gene were significantly correlated with BOLD activation. Specifically, the largest effect sizes and significance were seen for rs2583985 in paracingulate and caudate (focused analysis) and for rs1372522 in paracingulate (exploratory analysis). Activation in all regions of interest was correlated with alcohol-dependence severity. Conclusions: SNCA genotype was found to be associated with the degree of fMRI

Selleckchem FG-4592 BOLD response during exposure to the taste of alcohol versus a control taste. This study also further validates the use of this alcohol taste task as an intermediate phenotype for alcohol-dependence severity. (J. Stud. Alcohol Drugs, 74, 233-244,2013)”
“Objective

With the increasing use of biologics in patients with inflammatory bowel disease, the Hong Kong IBD Society developed a set of consensus statements intended to serve as local recommendations for clinicians about the appropriate use of biologics for treating inflammatory bowel disease.\n\nParticipants The consensus meeting was held on 9 July 2011 in Hong Kong. Draft consensus statements were developed by core members of the Hong Kong IBD Society, including local gastroenterologists and colorectal surgeons experienced in managing patients with inflammatory bowel disease.\n\nEvidence Published literature learn more and conference proceedings on the use of biologics in management of inflammatory bowel disease, and guidelines and consensus issued by different international and regional societies on recommendations for biologics in inflammatory bowel disease patients were reviewed.\n\nConsensus process Four core members of the consensus group drafted 19 consensus statements through the modified Delphi process. The statements were first circulated among a clinical expert panel of 15 members for review and comments, and were finalised at the consensus meeting through a voting session. A consensus statement was accepted if at least 80% of the participants voted “accepted completely” or “accepted with some reservation”.