Here, we used this assay in orthotopic

xenografts of huma

Here, we used this assay in orthotopic

xenografts of human MDA-MB-231 breast cancer cells to isolate selectively the migratory cell subpopulation of the primary tumor for gene-expression profiling. In this way, we derived a gene signature specific to breast cancer migration and invasion, which we call the Human Invasion Signature (HIS).\n\nResults: Unsupervised analysis of the HIS shows that the most significant upregulated gene networks in the migratory breast tumor cells include genes regulating embryonic and tissue development, cellular movement, and DNA replication and repair. We confirmed that genes involved in these functions are upregulated in the migratory tumor cells with independent biological repeats. GSK1904529A Protein Tyrosine Kinase inhibitor We also demonstrate that specific genes are functionally required for in vivo invasion and hematogenous dissemination in MDA-MB-231, as well as in patient-derived breast tumors. Finally, we used statistical analysis to show that the signature can significantly predict risk of breast cancer metastasis in large patient cohorts, independent of well-established prognostic parameters.\n\nConclusions: Our data provide novel insights into, and reveal previously unknown mediators of, the metastatic steps of invasion and dissemination MAPK Inhibitor Library order in human breast tumors in vivo. Because migration and invasion are the early steps of metastatic progression, the novel markers Staurosporine nmr that

we identified here might become valuable prognostic tools or therapeutic targets in breast cancer.”
“Alzheimer’s disease (AD) and

semantic dementia (SD) are characterized by different patterns of global and temporal lobe atrophy which can be studied using magnetic resonance imaging (MRI). Manual delineation of regions of interest is time-consuming FreeSurfer is a freely available automated technique which has a facility it) label cortical and subcortical brain regions automatically. As with all automated techniques comparison with existing methods is important. Eight temporal lobe structures in each hemisphere were delineated using FreeSurfer and compared with manual segmentations in 10 control, 10 AD, and 10 SD Subjects. The reproducibility errors for the manual segmentations ranged from 3% to 6% Differences in protocols between the two methods led to differences in absolute volumes with the greatest differences between methods found bilaterally in the hippocampus, entorhinal cortex and fusiform gyrus (p<0.005). However. good correlations between the methods were found for most regions. with the highest correlations shown for the venticles, whole brain and left medial-inferior temporal gyrus (r>0.9), followed by the bilateral amygdala and hippocampus. left superior temporal gyros, right medial-inferior temporal gyrus and left temporal lobe (r>0.8) Overlap ratios differed between methods bilaterally in the amygdala, superior temporal gyrus.

Patients (n = 18) showed a tendency towards a better suppression

Patients (n = 18) showed a tendency towards a better suppression of symptoms after STN-DBS (Unified Parkinson`s Disease Rating Scale motor score with medication decreased from 24.1 +/- 16.1 to 15.4 +/- 7.45; p = 0.002) while medication was strongly reduced (61 % reduction of levodopa equivalent units; p Alvespimycin price < 0.0001). No changes of striatal [I-123]FP-CIT binding and an increase

of [I-123] IBZM binding up to 16 % (p < 0.05) between pre-surgery and follow-up investigations were noticed. These data show that clinical improvement and reduction of dopaminergic drugs in patients with advanced PD undergoing bilateral STN-DBS are paralleled by stable DAT and recovery of striatal D2R availability 12 months after surgery.”
“Methods: plasma activities of AChE and BuChE were measured pre- and postoperatively in consecutive patients >= 60 years old undergoing

elective total hip replacement surgery. In addition to a comprehensive clinical and demographic baseline evaluation, venous blood samples were collected from each STI571 in vivo subject in the morning of hospital admission’s day and in the morning of the first postoperative day. Delirium was screened daily with confusion assessment method (confirmed with diagnostic and statistical manual of mental disorders (DSM-IV)-TR).\n\nResults: preoperatively, plasma esterase activity was significantly lower in patients who developed delirium compared with the remaining subjects. Following surgery BuChE activity was lower in the delirium group but this difference disappeared after controlling for preoperative values. Plasma cholinesterase activity correlated positively with calcium and haemoglobin and negatively with total bilirubin and international normalised ratio.\n\nConclusion: plasma cholinesterase activity can be

a useful candidate biomarker to identify subjects at greater risk of developing postoperative delirium.”
“Introduction Diagnostic evaluation of the musculoskeletal system has traditionally been based on medical history, physical examination, and x-rays (techniques that provide limited information), and more recently on computerized axial tomography and magnetic resonance imaging (both very expensive). Ultrasound, a non-invasive and less expensive method, has become an indispensable tool for diagnosing overuse sports injuries. The Imaging Department AG-014699 mouse at the Cuban Sports Medicine Institute (abbreviated in Spanish as IMD) developed a preventive ultrasound diagnostic imaging method and has applied it for the last 15 years as part of the IMD’s medical management of high-performance athletes.\n\nObjectives Identify normal ultrasound patterns for knee structures and extensor mechanism alignment, and perform ultrasound imaging of the knee on asymptomatic, high-performance athletes to detect alterations and endogenous predisposing factors to overuse sports injuries as a basis for adopting preventive action.

The results are presented in the form of a reciprocal mass fracti

The results are presented in the form of a reciprocal mass fraction ternary diagram and the

energies used to derive a parameterised function g(a(3)), where a(3) = m(3)(-1)/(m(1)(-1) + m(2)(-1) + m(3)(-1)) is the reciprocal mass of the uniquely charged particle. It is found that ACY-738 price the function is not minimal at a(3) = 0 which corresponds to infinity H- nor is it minimal at the positronium negative ion (Ps(-)) the system with the least absolute energetic gain by association with a third particle; the function g(a(3)) is minimal at m(1)/m(3) = 0.49, and a possible physical interpretation in terms Autophagy inhibitor of the transition from atomic-like to molecular-like

is provided. (C) 2013 AIP Publishing LLC.”
“ObjectivesTo determine whether the postoperative administration of tryptophan would be beneficial for elderly adults undergoing surgery who are at risk of developing postoperative delirium. DesignRandomized, double-blind, placebo-controlled trial. SettingDenver Veterans Affairs Medical Center. ParticipantsIndividuals aged 60 and older undergoing major elective operations requiring a postoperative intensive care unit (ICU) admission (n=325). InterventionL-tryptophan, 1g orally three times a day or placebo was started after surgery and continued for up to 3days postoperatively. MeasurementsDelirium and its motor subtypes were measured using the Confusion Assessment Method-Intensive Care Unit (CAM-ICU) and the Richmond Agitation and Sedation Scale. The primary outcome for between-group comparison was the incidence of excitatory (mixed and hyperactive)

postoperative delirium. The secondary outcomes for comparison were the incidence and duration of overall Adriamycin order postoperative delirium. ResultsThe overall incidence of postoperative delirium was 39% (95% confidence interval=34-44%) (n=116). Seventeen percent of participants in the tryptophan group and 9% in the placebo group had excitatory delirium (P=.18), and the duration of excitatory delirium was 3.31.7days for tryptophan and 3.1 +/- 1.9days for placebo (P=.74). Forty percent of participants in the tryptophan group and 37% in the placebo group had overall delirium (P=.60), and the duration of overall delirium was 2.9 +/- 1.8days for tryptophan and 2.4 +/- 1.6days for placebo (P=.17). ConclusionPostoperative tryptophan supplementation in older adults undergoing major elective operations requiring postoperative ICU admission did not reduce the incidence or duration of postoperative excitatory delirium or overall delirium.

Participants from groups

in which HIV has a higher preval

Participants from groups

in which HIV has a higher prevalence felt HIV testing required consideration that may not be possible during acute hospital admission. However, there was concern that screening would still be targeted at groups in which HIV prevalence is higher, based on clinicians’ judgement of patients’ behaviours, sexuality, or ethnicity. Conclusion The opt-out method of testing for HIV must be routinely offered to all who are eligible, to increase test uptake and to prevent communities feeling targeted. Any pressure to test is likely to be poorly received. Inaccurate concerns about medical records being shared with financial services are a disincentive to test. Primary care should be an active setting for opt-out HIV testing.”
“To highlight different transcriptional behaviors GSK2879552 of the phytoplasma in the plant and animal host, expression of 14 genes of “Candidatus Phytoplasma asteris,” chrysanthemum yellows strain, was investigated selleck chemical at different times following the infection of a plant host (Arabidopsis thaliana) and two insect vector species (Macrosteles quadripunctulatus and Euscelidius variegatus). Target genes were selected among those encoding antigenic membrane proteins, membrane transporters, secreted proteins, and general enzymes. Transcripts were detected for

all analyzed genes in the three hosts; in particular, those encoding the antigenic membrane protein Amp, elements of the mechanosensitive channel, and two of the four secreted proteins (SAP54 and TENGU) were highly accumulated, suggesting that they play important roles in phytoplasma physiology during the infection cycle. Most transcripts were present at higher abundance in the plant host than in the insect hosts. Generally, transcript levels of the selected genes decreased significantly during infection of A. thaliana and M. quadripunctulatus

but were more constant in E. variegatus. Such decreases may be explained by the fact that only a fraction of the phytoplasma population was transcribing, while the remaining part was aging to a stationary phase. This strategy might improve long-term survival, thereby increasing the likelihood that the pathogen may be acquired by a vector and/or inoculated to a healthy plant.”
“The URMC-099 chemical structure classic gold standard for detecting amyloid deposits is Congo red stained bright field and polarized microscopy (CRPM). A prior study showed that Congo red fluorescence (CRF) microscopy had increased sensitivity compared with traditional CRPM when analyzing fat pad specimens. The purpose of the current study was to determine the sensitivity of CRF for evaluating Congo red stained bone marrow biopsy specimens, and to compare these results with those of CRPM We compared the CRPM and the CRF analyses of 33 trephine bone marrow biopsy specimens with clinical or morphologic suspicion of amyloid deposits. These results were verified against immunohistochemical staining with anti amyloid P antibody.

Conclusions ET-1 plays a role in progression of atheroscleros

\n\nConclusions ET-1 plays a role in progression of atherosclerosis and AAA formation by decreasing high-density lipoprotein, and increasing oxidative stress, inflammatory cell infiltration, and matrix metalloproteinase-2 in perivascular fat, vascular wall, and atherosclerotic lesions.”
“Conventional and molecular techniques were applied to detect and characterize drug resistance of mycobacteria in the sputum samples

of clinically confirmed tuberculosis. The sensitivities of mycobacterium detection by ZN staining, culture, multiplex PCR, and restriction fragment length polymorphism (RFLP) were 27.7%, 19.9%, 92.9%, and 95.7%, respectively, but all were 100% AZD7762 manufacturer specific. The conventional and multiple-allele-specific PCR (MAS-PCR) methods enabled establishment of the drug resistance in 19.3% and 86.9% cases, respectively. We Staurosporine price demonstrated that molecular techniques have potential in the accurate diagnosis of tuberculosis.”
“To obtain

microorganisms for the microbial conversion of ginsenosides in red ginseng powder (RGP). Lactobacillus species (M1-M4 and P1-P4) were isolated from commercial ginseng products. Strain M1 was determined to be L. plantarum by 16S rRNA sequencing. Red ginseng powder (RGP) fermented by L plantarum M1 had a high total content of ginsenosides (142.4 mg/g) as compared to the control (121.8 mg/g). In particular, the ginsenoside metabolites Rg3, Rg5, Rk1, Compound K (CK), Rh1, and Rg2 showed a high level in the fermented RGP (65.5 mg/g) compared to the control (32.7 mg/g). During fermentation for 7 days, total sugar content decreased from 8.55 mg/g to 4 mg/g, uronic acid content reached its maximum (53.43 mu g/g) at 3 days, and total ginsenoside content increased to 176.8 mg/g at 4 days. In addition, ginsenoside metabolites increased from 38.0 mg/g to 83.4 mg/g at 4 days of fermentation.

Using everted instestinal sacs of rats, the fermented red ginseng showed a high transport level (10.3 mg of polyphenols/g sac) compared to non-fermented red ginseng (6.67 mg of polyphenols/g sac) after 1 h. These results confirm that fermentation with L plantarum M1 is very useful for preparing minor ginsenoside metabolites while being safe for foods. (C) 2010 Elsevier Ltd. All rights reserved.”
“AIM: Selleckchem ERK inhibitor To test the effect of the dephytinization of three different commercial infant cereals on iron, calcium, and zinc bioavailability by estimating the uptake, retention, and transport by Caco-2 cells.\n\nMETHODS: Both dephytinized (by adding an exogenous phytase) and non-dephytinized infant cereals were digested using an in vitro digestion protocol adapted to the gastrointestinal conditions of infants younger than 6 mo. Mineral cell retention, transport, and uptake from infant cereals were measured using the soluble fraction of the simulated digestion and the Caco-2 cells.\n\nRESULTS: Dephytinization of infarct cereals significantly increased (P < 0.05) the cell uptake efficiency (from 0.66%-6.05% to 3.93%-13%), retention (from 6.

Children were more likely than adults to undergo surgery (44% vs

Children were more likely than adults to undergo surgery (44% vs. 29% of trauma patients). To maximize hospital surge capacity, minor procedures were performed in the wards under sedation, and patients were discharged after an average of 1.4 days, with subsequent follow-up in the clinic.\n\nCONCLUSION: Children constitute a high percentage of patients in a developing country. The epidemiology of pediatric injuries following an earthquake differs significantly from that encountered in everyday practice and compared with that in adults. Children sustain a significantly higher percentage of femoral fractures and are more likely to PP2 require surgery. The shift to nontraumatic

reasons for admission occurred earlier in the pediatric population than in adults. Organizations providing post-earthquake relief are usually geared toward adult populations and will require supplementation PD-1 assay of both manpower and equipment specifically suited for treatment of pediatric patients. Early deployment teams should be adequately staffed with adult and pediatric orthopedists. (J Trauma Acute Care Surg. 2013;74: 617-621. Copyright (C) 2013 by Lippincott Williams & Wilkins)”
“Terrestrial laser scanning (TLS) data allow spatially explicit (x, y, z) laser return intensities to be recorded throughout a plant canopy, which could considerably improve our understanding of how physiological

processes vary in three-dimensional space. However, the utility of TLS data for the quantification of plant physiological properties remains largely unexplored. Here, we test whether the laser return intensity of green (532-nm) TLS correlates with changes in the de-epoxidation state of the xanthophyll cycle and photoprotective non-photochemical quenching (NPQ), and compare the ability of TLS to quantify these parameters with the passively measured photochemical reflectance index (PRI). We exposed leaves from five plant species to increasing light

intensities to induce NPQ and de-epoxidation of violaxanthin (V) to antheraxanthin (A) and zeaxanthin (Z). At each light intensity, the green laser return intensity (GLRI), narrowband spectral reflectance, chlorophyll fluorescence emission and xanthophyll cycle pigment composition were recorded. Strong relationships between both predictor BKM120 nmr variables (GLRI, PRI) and both explanatory variables (NPQ, xanthophyll cycle de-epoxidation) were observed. GLRI holds promise to provide detailed (mm) information about plant physiological status to improve our understanding of the patterns and mechanisms driving foliar photoprotection. We discuss the potential for scaling these laboratory data to three-dimensional canopy space.”
“We report the results of an attempt to identify the supposed remains of a famous World War I (WWI) Italian soldier who was killed in battle along the Italian front in 1915.

Both c-Myc and PHB1 directly interact with Nrf2 but c-Myc lowers

Both c-Myc and PHB1 directly interact with Nrf2 but c-Myc lowers Nrf2 binding to ARE while PHB1 enhances it. Innovation: This Panobinostat research buy is the first work that shows how activation of this circuit in cholestatic liver injury

inhibits GCL expression. Conclusions: LCA feeding and BDL activate c-Myc-miR27a/b-PHB1 circuit, with the consequence of inhibiting Nrf2 expression and ARE binding, resulting in decreased reduced glutathione synthesis and antioxidant capacity. Antioxid. Redox Signal. 22, 259-274.”
“Purpose: To establish a first-order derivative ultraviolet spectrophotometric (FODUS) method with good reproducibility for the determination of levan, a D-fructofuranosyl polymer with a beta-(2-6) backbone and beta-(2-1) branching. Methods: Levan was isolated from fermentation broth by alcohol precipitation and ultrafiltration. Factors influencing the determination of the ultraviolet (UV) spectrophotometric method was compared with a single-factor analysis. The UV spectra of levan reaction solutions in the absorbance range of 200 – 400 nm were obtained. An orthogonal experimental design was applied to optimize the sulfuric acid hydrolysis conditions in the spectrophotometric

determination. FODUS method was validated by analyzing its linearity, reproducibility, stability and recovery. Results: Factors influencing absorbance for the determination were confirmed and two regression AZD9291 equations were established. UV absorbance at 320 nm AC220 manufacturer of sulfuric acid-hydrolyzed sample was stable for 5 h. The FODUS method developed had a good reproducibility (RSD = 2.1 %, n = 5), linearity (ranging from 1.6 mu g/mL to 12.8 mu g/mL), R-2 = 0.9996) and recovery (95.90 %, RSD = 1.7 %, n = 3). Conclusion: The developed FODUS method is convenient, efficient and robust for the determination of microbial levan.

The method provides a valuable approach for the determination of polysaccharides.”
“In a companion article to this study,1 the successful programming of a JAWSII dendritic cell (DC) line’s antigen uptake and processing was demonstrated based on pre-treatment of DCs with a specific cocktail’ of select chemokines. Chemokine pre-treatment modulated cytokine production before and after DC maturation [by lipopolysaccharide (LPS)]. After DC maturation, it induced an antigen uptake and processing capacity at levels 36% and 82% higher than in immature DCs, respectively. Such programming proffers a potential new approach to enhance vaccine efficiency. Unfortunately, simply enhancing antigen uptake does not guarantee the desired activation and proliferation of lymphocytes, e.g. CD4+ T cells.

Methods: Vocationally strained patients (n = 800) aged betwee

\n\nMethods: Vocationally strained patients (n = 800) aged between 18 and 59 years with private internet access are recruited in psychosomatic, orthopedic and cardiovascular rehabilitation clinics in Germany. During inpatient rehabilitation, participants in stress management group training are cluster-randomized ACY-738 mw to the intervention or control group. The intervention group (n = 400) is offered an internet-based aftercare with weekly writing tasks

and therapeutic feedback, a patient forum, a self-test and relaxation exercises. The control group (n = 400) obtains regular e-mail reminders with links to publicly accessible information about stress management and coping. Assessments are conducted at the beginning of inpatient rehabilitation, the end of inpatient rehabilitation, the end of aftercare, and 9 months later. The primary outcome is a risk score for premature pension, measured by a screening questionnaire at follow-up. Secondary outcome measures include level of vocational stress, physical and mental health, and work capacity at follow-up.\n\nDiscussion: We expect the intervention 3-MA clinical trial group

to stabilize the improvements achieved during inpatient rehabilitation concerning stress management and coping, resulting in an improved vocational reintegration. The study protocol demonstrates the features of internet-based aftercare in rehabilitation.”
“The US FDA has issued safety alerts and required manufacturers of leukotriene-modifying agents (LTMAs), including montelukast, zafirlukast and zileuton, to include suicide and neuropsychiatric events as a precaution in the drug label. This paper reviews the existing evidence on the potential association between the LTMAs and suicidal

behaviour. We conducted a literature search of MEDLINE, EMBASE and International Pharmaceutical Abstracts from 1995 to 2010 (inclusive) to identify pertinent studies and reports. We also examined data obtained from the FDA adverse event reporting system. To date, there are no well conducted, comparative, observational studies of this association, and BMS-754807 the safety alerts are based primarily on case reports. While the FDA safety alerts apply to all three LTMAs, montelukast (known by its trade name Singulair) is by far the most widely used of these drugs and most of the reports to date regarding suicide pertain to montelukast. From 1998 to 2009 there were 838 suicide-related adverse events associated with leukotrienes reported to the FDA, of which all but five involved montelukast. Nearly all cases were reported in 2008 and 2009 (96.1%) after the FDA warnings. LTMAs are approved for use in asthma and allergic rhinitis, and are effective drugs. Both of these diseases are also associated with suicide, making confirmation of the association more difficult.

Results: Mediation analyses showed that changes in cycling, s

\n\nResults: Mediation analyses showed that changes in cycling, sports and total physical activity behaviour induced by the environmentally tailored intervention were mediated by changes in environmental perceptions. Changes in environmental perceptions did not mediate the effect this website of the basic tailored intervention

on behaviour. Compared with the basic tailored intervention, the environmentally tailored intervention significantly improved cycling behaviour (t = 30.2). Additionally, the tailored letters of the environmentally tailored intervention were better appreciated and used, although these differences did not mediate the intervention effect.\n\nDiscussion: This study gave some first indications of the relevance of environmental perceptions as a determinant of changing physical activity behaviours and the potential effectiveness of providing environmental SN-38 purchase information as an intervention strategy aimed at enhancing physical activity behaviour among older adults.”
“Improving osseointegration of extensively used titanium (Ti) implants still remains a main theme in implantology.

Recently, grafting biomolecules onto a Ti surface has attracted more attention due to their direct participation in the osseointegration process around the implant. Semaphorin 3A (Sema3A) is a new proven osteoprotection molecule and is considered to be a promising therapeutic agent in bone diseases, but how to immobilize the protein onto a Ti surface to acquire a long-term effect is poorly defined. In our study, we tried to use chitosan to wrap Sema3A (CS/Sema) and connect to the microarc oxidized Ti surface via silane glutaraldehyde coupling. The microarc oxidization could formulate

porous topography on a Ti surface, and the covalently bonded coating was homogeneously covered on the ridges between the pores without significant Elafibranor solubility dmso influence on the original topography. A burst release of Sema3A was observed in the first few days in phosphate-buffered saline and could be maintained for. 2 weeks. Coating in phosphate-buffered saline containing lysozyme was similar, but the release rate was much more rapid. The coating did not significantly affect cellular adhesion, viability, or cytoskeleton arrangement, but the osteogenic-related gene expression was dramatically increased and calcium deposition was also abundantly detected. In conclusion, covalent bonding of CS/Sema could strongly improve osteogenic differentiation of osteoblasts and might be applied for Ti implant surface biofunctionalization.”
“Growth restriction and retarded bone age are common findings in children with chronic kidney disease (CKD). We compared the automated BoneXpert (TM) method with the manual assessment of an X-ray of the non-dominant hand.

“The aim of this research was the selection of spermatozoa

“The aim of this research was the selection of spermatozoa parameters related to boar fertility performance and their combination into an in vitro index. A first set (data set 1) of 36 Pietrain boars with 138 ejaculates from two seasons with 5083 LY2090314 single-sire inseminations from 34 farms was used to determine correlations between in vitro sperm quality parameters and fertility performance. 2970 ejaculates representing a second set (data set 2) served calculation of seasonal and age effects on semen quality. Morphological spermatozoa parameters were estimated manually with a phase contrast microscope on the day of semen collection, whereas mitochondrial activity and viability were analyzed by double-staining with rhodamine123/propidium

iodide on day 2 of semen storage using flow cytometry. Sperm motility was tested on day 7 by thermoresistance (TRT) after 30 min (TRT1) and 300 min (TRT2) incubation at 38 degrees C using computer-assisted semen analysis (CASA).\n\nCorrelations revealed four independent sperm quality parameters qualifying as relevant predictors of boar fertility: (i) percentage of spermatozoa with proximal cytoplasmic droplets, (ii) percentage of spermatozoa with active mitochondria, (iii) beat cross frequency

of progressively motile spermatozoa in TRT1, and (iv) oscillation measure of the actual path of progressively motile spermatozoa in TRT2. There were no significant effects of sperm concentration, ejaculate volume, and total number of sperm cells MK-2206 concentration per ejaculate on litter size (LS) and on pregnancy rate (PR). Our findings suggest the usefulness of sperm quality parameters based on adjusted range of methods and enable the construction of an in BAY 80-6946 mouse vitro index as a means to predicting boar fertility. (C) 2013 Elsevier B.V. All rights reserved.”
“Introduction Various functional residual capacity (FRC) repeatability criteria have

been proposed for lung clearance index (LCI) measurement by multiple breath washout (MBW). Adult guidelines recommend three technically acceptable tests with FRC values within 10%, whilst preschool guidelines recommend two such tests. Feasibility of and need for recommendations in children is unclear. Methods Retrospective analysis of MBW data was undertaken in healthy control (n=90) and cystic fibrosis (CF) subjects (n=108) encompassing infancy, pre-school and school age ranges. Feasibility of FRC repeatability recommendations was investigated in those with three technically acceptable tests. Validity of mean LCI from the first two tests alone (vs. all three) was investigated by comparing mean data and sensitivity to detect abnormal peripheral airway function in CF. Results LCI coefficient of variation (CoV) was related to FRC CoV (P<0.001) and disease category (P=0.002). Application of adult repeatability criteria decreased LCI CoV (4.7 vs. 8.5%, P<0.001), but had poor feasibility beyond infancy (62/150, 41%). Preschool recommendations increased feasibility but only to 70% overall.