This paper examines the effects of China's foreign direct investment (FDI) on the carbon emissions of its domestic economy and the Belt and Road countries (BRCs). Total inward FDI into China as a host country shows a pollution reducing effect in the western and eastern regions while that in the central region remains unchanged. But China's outward FDI particularly from its eastern region reduces pollution in China. This suggests that China could be exporting carbon emissions via its FDI in the BRCs. https://www.selleckchem.com/products/AR-42-HDAC-42.html on BRCs' pollution from China's FDI is however different depending on the country's level of development. China's FDI was found to have no effect on high and upper middle income BRCs; a decreasing effect on low income BRCs; and an increasing effect on lower middle income BRCs. Evidence shows that China needs to consider a mix of policies to manage its inward and outward FDI to ensure its move to a low carbon economy benefits its own regional development and the BRCs by not contributing to increased carbon emissions.In the context of tremendously promoting bioenergy utilization, regional suitability for industrial development of biomass power generation is a critical factor when deploying region-specific strategies. An integrated framework is developed incorporating resource potential, development demands and development conditions to evaluate the suitability for regional industrial development of power generation utilizing agricultural bioresources. Twelve indicators reflecting local resource, environmental and socioeconomic features are used to measure the suitability of 31 provincial regions in China. An improved matter-element extension model combined with the entropy weight method is adopted to attain holistic and hierarchical suitability ranks. The results reveal that the distribution of holistic suitability ranks among regions is imbalanced with the eastern regions presenting more advantages compared with the western regions. Three regions belonging to Rank I (optimum) are Henan, Shandong and Xinjiang. Hainan, Tibet, Qinghai are classified into Rank V (unsuited). Moreover, there are great differences in the limiting factors of the suitability among regions. #link# Resource potential is a limiting factor for Beijing, Shanghai, Fujian, Hainan and Guizhou; Development demands refrain Fujian, Guangxi and Yunnan; Tianjin and Ningxia are limited by development conditions. Tibet and Qinghai have the worst performance on each criterion. The results and region-targeted policy recommendations can provide insights for bioenergy utilization development in accordance with local conditions closely.Weighting scheme definition represents an important step in assessment of adaptive capacity to climate change with indicator approach since it defines the trade-offs among indicators or components and can be source of uncertainty. This study aims to assess smallholder farmers' adaptive capacity to climate change by using a mixed weighting scheme that reflect farmers' perceived importance of adaptive capacity components to inform policy makers. To achieve that objective, the sustainable livelihood framework was adopted and indicator approach was used for the assessment. The mixed weighting scheme were defined by using both equal weights and experts judgement methods during the assessment process. The mixed weighting scheme index is compared to the case where equal weights are applied in the assessment process and an uncertainty analysis was performed on relative standard deviation through a Monte Carlo simulation. Primary Data were collected from 450 farmers in two communities in northern Benin with a structured questionnaire and through focus groups discussion. The results show that smallholder farmers in both communities do not have the same perceived importance of adaptive capacity components. The index scores show that farmers have in majority low adaptive capacity. When weighted product aggregation method is used, there is more uncertainty related to the index computed with the mixed weighting scheme, but it leads to the same characterisation when compared with the index computed with the equal weights. It is recommended that mixed weighting scheme should be preferred for the assessment of adaptive capacity and weighted product aggregation method should be used.Huntington's disease (HD) is a neurodegenerative disease characterized by prominent loss of neurons in the striatum and cortex. Traditionally research in HD has focused on brain changes as they cause progressive motor dysfunction, cognitive decline and psychiatric disorders. The discovery that huntingtin protein (HTT) and its mutated form (mHTT) are expressed not only in the brain but also in different organs and tissues paved the way for the hypothesis that HD might affect regions beyond the central nervous system (CNS). Besides pathological deposition of mHTT, other mechanisms, including inflammation, seem to underlie HD pathogenesis and progression. Altered inflammation can be evidenced even before the onset of classical symptoms of HD. Herein, we will discuss current pre-clinical and clinical evidence on immune/inflammatory changes in peripheral organs during HD development and progression. The understanding of the impact of inflammation on peripheral organs may open new venues for the development of novel therapeutic targets in HD.Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system (CNS) commonly complicated by cognitive impairment. Unfortunately, no medical therapy has been proved to improve cognitive problems in these patients. This meta-analysis investigated the effectiveness of different categories of drugs on the minimal assessment of cognitive function in MS (MACFIMS)-related tasks outcome in MS patients. To this end, a systematic evaluation was conducted using PubMed, Google Scholar, and Scopus databases. Among a total of 128 publications, 31 studies met our inclusion criteria, and 22 included in the meta-analysis. We found that symbol digit modalities test (SDMT), paced auditory serial addition test (PASAT), controlled oral word association test (COWAT), and California verbal learning test (CVLT) were the most frequently reported tasks in included studies. The frequently reported drugs were classified into five main groups of acetylcholine esterase inhibitors, CNS stimulants, fampridine, herbal remedies, and miscellaneous.

INTRODUCTION Policy directions in the health sector are based on research which provides insight into implemented actions and helps to formulate improvement recommendations for health. In Cameroon, an innovative experience of anthropological research on newborn health was followed by a process of appropriating findings by the Ministry of Public Health aiming at improving the quality of care. We suggest reporting this Cameroonian experience of interdisciplinary collaboration and involved research. METHOD Coinciding with the anthropological study on newborn care in hospital maternities and at home conducted by researchers in the field of anthropology from December 2016 to June 2017, a process of appropriating findings was carried out. https://www.selleckchem.com/products/Cyclopamine.html This article accurately describes this process both at the peripheral level, during "reflexive returns" in investigated maternity hospitals, and at the central level within the framework of work conducted by the study's steering committee. It reports on the changes that have taken place as a result of the study both at the level of health structures and at the level of national policies and strategies with a view to improving the quality of newborns care. RESULTS The output of this process is twofold. At the peripheral level, activities of "reflexive returns" led to in situ changes of some harmful practices detrimental to the survival of the newborn, such as inappropriate use of the cradle in the birth room and lack of knowledge relative to the fight against hypothermia through the practice of skin-to-skin contact. At central level, changes concerned communication and strengthening policies and strategies of newborn care. CONCLUSION The contribution of anthropology in the production evidence-based data is of paramount importance for the implementation of strategies to improve the quality of neonatal care. It opens up new perspectives for the sustainable improvement of the quality of care for newborns.INTRODUCTION In Sub-Saharan Africa, despite the establishment of many health care programs, neonatal mortality rates remain extremely high. From a medical point of view, the main causes are obstetric, along with diarrhea and pneumonia. Understanding how these risks and pathogenic situations are constructed cannot be achieved without observing, analyzing, and understanding the underlying gestures and meaning systems. METHOD Rather than describing obvious inequalities in the access to health care, our study aimed at questioning the different actors' operational capacities and at considering what is actually possible to improve in the most common healthcare situations. More specifically, how are births, neonatal care, and popular practices carried out in the first days of the lives of these newborns? In five countries of West Africa, a "multi-sited" anthropological study was carried out to observe the first weeks of newborns. This study not only allowed for the methodical identification of care interactions at aed dialogues with families which will enable the indispensable follow-up care for the newborns and ensure adapted preventive care and coherence in the care provided by the healthcare structures, the families, and the collectivities.INTRODUCTION Driven by international programs specifically targeting neonatal survival, a set of recommended care practices is being promoted in West Africa. Using data from a multi-centered anthropological study, we enquire as to how local practices integrate the recommendations disseminated by these programs. METHOD The surveys were conducted in rural localities in five countries  Benin, Burkina Faso, Mali, Mauritania, and Togo. In every site, the investigations combined ethnography of newborn care and in-depth interviews in maternity homes and homes. RESULTS The care of newborns is based on a set of local social representations and logics, where medical recommendations are integrated heterogeneously. In maternity wards, health professionals face difficulties in implementing recommended practices, and make various conciliations when faced with local material and social constraints. In private homes, the "messages" promoting life-saving care for newborns punctuate conversations, but lead to various interpretations and variations in care. DISCUSSION The irregular integration of medical recommendations in neonatal care is analyzed around three areas the divergence of intentions around the birth, the dissonances between the recommended care and the local conceptions of the newborn, the influence of intra-family power relations. Considering the complexity of the changes in neonatal care, we argue for the implementation of programs that respect local cultures, and for health professionals to skillfully accommodate conflicting constraints.INTRODUCTION The WHO and UNICEF have declared exclusive breast-feeding one of the essential tools in the fight against neonatal mortality. Both international bodies finalized a 40-hour training program to provide counseling in feeding, to teach a body of care-givers to bring qualified assistance to the breast-feeding mothers and to help them to overcome their difficulties. However, in the field and in maternities such as those where the study took place (Boucle du Mouhoun region in the northwest of Burkina Faso), although technical recommendations are generally adopted and respected, exclusive breastfeeding makes it difficult for mothers to find their way. The aim of this study is to examine the blockages existing at the maternity ward and in families which prevent the practice of exclusive breastfeeding from becoming widespread. A qualitative approach was used through open interviews with various socio-professional medical categories and community members. METHOD Fourteen observations were made in the families. Twenty-four observations were made on the care of the newborn at home. Thirty-eight interviews with health and administrative staff and nine interviews with healers using traditional knowledge were also conducted. RESULTS The results show that exclusive breastfeeding is complicated to implement particularly in rural areas because of the use of medicinal plants in the form of washing and gavage. Moreover, the information is not given to mothers of families at the appropriate time. CONCLUSION In conclusion, we suggest that maternities be thought out and designed in partnership with the health workers who use them.

One of the serious mental disorders where people interpret reality in an abnormal state is schizophrenia. A combination of extremely disordered thinking, delusion, and hallucination is caused due to schizophrenia, and the daily functions of a person are severely disturbed because of this disorder. A wide range of problems are caused due to schizophrenia such as disturbed thinking and behaviour. In the field of human neuroscience, the analysis of brain activity is quite an important research area. For general cognitive activity analysis, electroencephalography (EEG) signals are widely used as a low-resolution diagnosis tool. https://www.selleckchem.com/products/ykl5-124.html The EEG signals are a great boon to understand the abnormality of the brain disorders, especially schizophrenia. In this work, schizophrenia EEG signal classification is performed wherein, initially, features such as Detrend Fluctuation Analysis (DFA), Hurst Exponent, Recurrence Quantification Analysis (RQA), Sample Entropy, Fractal Dimension (FD), Kolmogorov Complexity, Hjorth exponent, Lempel Ziv Complexity (LZC), and Largest Lyapunov Exponent (LLE) are extracted initially. The extracted features are, then, optimized for selecting the best features through four types of optimization algorithms here such as Artificial Flora (AF) optimization, Glowworm Search (GS) optimization, Black Hole (BH) optimization, and Monkey Search (MS) optimization, and finally, it is classified through certain classifiers. The best results show that, for normal cases, a classification accuracy of 87.54% is obtained when BH optimization is utilized with Support Vector Machine-Radial Basis Function (SVM-RBF) kernel, and for schizophrenia cases, a classification accuracy of 92.17% is obtained when BH optimization is utilized with SVM-RBF kernel.Nature-inspired computing has attracted huge attention since its origin, especially in the field of multiobjective optimization. This paper proposes a disruption-based multiobjective equilibrium optimization algorithm (DMOEOA). A novel mutation operator named layered disruption method is integrated into the proposed algorithm with the aim of enhancing the exploration and exploitation abilities of DMOEOA. To demonstrate the advantages of the proposed algorithm, various benchmarks have been selected with five different multiobjective optimization algorithms. The test results indicate that DMOEOA does exhibit better performances in these problems with a better balance between convergence and distribution. In addition, the new proposed algorithm is applied to the structural optimization of an elastic truss with the other five existing multiobjective optimization algorithms. The obtained results demonstrate that DMOEOA is not only an algorithm with good performance for benchmark problems but is also expected to have a wide application in real-world engineering optimization problems.
Acute kidney injury (AKI) is a frequent complication of snakebite envenomation, which is still little known in sub-Saharan Africa. This study aims to describe the clinical, biological and ultrasonographic aspects of AKI following severe snakebite envenomation managed in the intensive care unit.

A prospective observational survey was performed in Benin over a period of 18 months. All patients suffering severe snakebite envenomation (SBE) were included. The diagnosis of AKI was made using the KDIGO criteria. Kidney ultrasound exam was performed in all patients to assess internal bleeding and morphological and structural abnormalities of the kidneys.

Fifty-one cases of severe SBE were included. All patients presented inflammatory syndrome and showed abnormal WBCT whereas bleeding was found in 46 of them (90%). The median time to hospital presentation was three days. The majority of patients were male (M/F sex ratio = 1.55) and the median age was 26. Sixteen patients (31%) showed AKI according to the KDIGO fe-threatening factor.Population sequencing often requires collaboration across a distributed network of sequencing centers for the timely processing of thousands of samples. In such massive efforts, it is important that participating scientists can be confident that the accuracy of the sequence data produced is not affected by which center generates the data. A study was conducted across three established sequencing centers, located in Montreal, Toronto, and Vancouver, constituting Canada's Genomics Enterprise (www.cgen.ca). Whole genome sequencing was performed at each center, on three genomic DNA replicates from three well-characterized cell lines. Secondary analysis pipelines employed by each site were applied to sequence data from each of the sites, resulting in three datasets for each of four variables (cell line, replicate, sequencing center, and analysis pipeline), for a total of 81 datasets. These datasets were each assessed according to multiple quality metrics including concordance with benchmark variant truth sets to assess consistent quality across all three conditions for each variable. Three-way concordance analysis of variants across conditions for each variable was performed. Our results showed that the variant concordance between datasets differing only by sequencing center was similar to the concordance for datasets differing only by replicate, using the same analysis pipeline. We also showed that the statistically significant differences between datasets result from the analysis pipeline used, which can be unified and updated as new approaches become available. We conclude that genome sequencing projects can rely on the quality and reproducibility of aggregate data generated across a network of distributed sites.Nile tilapia (Oreochromis niloticus) is among the most important finfish in aquaculture, particularly in Asia. Numerous genetically improved strains of Nile tilapia have been developed and disseminated through formal and informal channels to hatcheries, many of which operate at a relatively small scale in developing countries. The primary objective of this study was to assess the extent to which molecular genetic tools can identify different and interrelated strains of Nile tilapia in Bangladesh and the Philippines, two globally significant producers. A tool was developed using a low-density panel of single-nucleotide polymorphisms (SNPs), genotyping-by-sequencing and discriminant analysis of principal components (DAPC). When applied to 2,057 samples from 205 hatcheries in Bangladesh and the Philippines, for hatcheries where the hatchery-identified strain was one of the sampled core populations used to develop the tool, hatchery-identified and DAPC-assigned hatchery-level strains were in agreement in 74.1% of cases in Bangladesh and 80.

13, confidence interval [CI] = 1.16-3.93), have poor relations with their teachers (AOR = 2.98, CI = 1.68-5.29), have used alcohol (AOR = 3.51, CI = 1.74-7.09) and are involved in cult and gangsterism (AOR = 9.14, CI = 2.55-32.75). Conclusion The rate of bullying perpetration by youth in Benin City, Nigeria, is significant and is comparable to global occurrence. The predictors of bullying in this study suggest that perpetrators are individuals who may benefit from rehabilitative measures. © 2020. The Authors.Background Comorbid psychiatric and substance use disorders are common and present several treatment challenges. Aim The aim of this study was to determine which patient and substance factors are associated with the completion of a substance rehabilitation programme in psychiatric inpatients. Setting The study was conducted at the Substance Rehabilitation Unit (SRU) at Weskoppies Hospital, a psychiatric training hospital in South Africa, which offers a 6-week programme at the hospital for psychiatric inpatients. Methods This descriptive, retrospective hospital-based study was carried out comparing completers and non-completers of the SRU programme with respect to patient and substance factors. All patients accepted into the SRU during 2013-2014 were included (n = 119). Data were collected over a year (2016-2017) from the clinical files, SRU referral forms, SRU attendance register, hospital computerised demographic records, nursing notes and administration files using a data collection sheet designed by the real comorbidity were not associated with completion. Conclusions This study has yielded several results in areas that have not yet been well researched in South Africa. Risk factors for non-completion may include lower levels of education, being on a disability grant and using Nyaope or nicotine, but may vary in different settings. https://www.selleckchem.com/products/Pyroxamide(NSC-696085).html Future research should focus on identifying further factors that may affect completion of substance rehabilitation in psychiatric inpatients, the role of disability grants in patients with co-occurring disorders and the effect of Nyaope and nicotine use on treatment outcomes in this population. Effective and accessible interventions to assist vulnerable patients also need to be identified. © 2020. The Authors.An amniocele, or contained uterine rupture, is a phenomenon in which there is herniation of the amniotic sac through a uterine defect, secondary to various causes. It is associated with severe morbidity and mortality. This case presents the findings in a 36-year-old female at 29 weeks gestation who was initially managed as antepartum haemorrhage secondary to placenta previa, based on ultrasound. Upon further imaging, an amniocele was diagnosed. This case report illustrates the importance of early identification of this life-threatening condition. © 2020. The Authors.Background Fluoroscopic imaging in orthopaedic theatres is increasing, with added risk to the orthopaedic surgeon who is increasingly being exposed to ionising radiation. It is thus crucial for orthopaedic surgeons to have a working knowledge of radiation safety. In spite of these concerns, however, many orthopaedic surgeons do not receive standard training in radiation safety. Objectives The evaluation of orthopaedic surgeons' knowledge, awareness and everyday practices regarding radiation safety in an academic hospital. Methods A questionnaire with multiple-choice-type questions was developed by a panel of experts and used to conduct a descriptive study. The questionnaire had multiple dimensions, each evaluating orthopaedic knowledge, awareness and practices, respectively. The study population included orthopaedic surgeons rotating within the orthopaedic circuit of the University of Pretoria. Results Orthopaedic surgeons regularly make use of fluoroscopic imaging in theatre, with 34 (77%) participants indicating that they use fluoroscopy in more than half of all their procedures performed. Most participants have insufficient knowledge of radiation safety, with the majority failing to correctly answer basic questions on radiation safety. Forty (91%) participants do not wear personal dosimeters, in spite of 39 participants (89%) believing that they are vulnerable to adverse effects. Basic radiation protection devices are underutilised, with 32 (73%) participants indicating that they have not received adequate training in radiation safety. Conclusion The majority of orthopaedic surgeons regularly use fluoroscopic imaging in theatre yet lack in-depth knowledge and awareness regarding radiation safety associated with this imaging modality. Implementation of a radiation safety training programme is thus recommended. © 2020. The Authors.Background Thyroid nodules are common, the majority benign. The small risk of malignancy leads to excessive workup. Thyroid ultrasound is essential for risk stratification and management guidance. Without an organised reporting guideline, reports do not add significant value to referring clinicians. The American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) was developed to aid ultrasound reporting, lessen excessive biopsies and diagnose thyroid cancers. Objectives To standardise reporting of thyroid ultrasounds by utilising an organised reporting guideline based on ACR TI-RADS. Method Thyroid ultrasound reports generated by radiology registrars at an academic hospital were studied in two phases. In Phase 1, the reports were generated as free text, and in Phase 2, using a guideline based on ACR TI-RADS. The percentages of reports that described the maximum size, the five ACR TI-RADS features and a management recommendation were compared. Results A total of 130 reports were studied. Significant improvement was observed in the description of all five ACR TI-RADS categories (p less then 0.0001) from Phase 1 to Phase 2. Of all the reports, 89% included a management recommendation. Reports including an ACR TI-RADS-based recommendation increased from 48% to 75% (p less then 0.05). Recommendation for biopsy increased from 35.4% to 53.8% (p less then 0.05). Conclusion Introduction of an organised reporting guideline based on ACR TI-RADS, standardised reporting of thyroid ultrasounds by increasing description of thyroid nodule features and ensuring appropriate management recommendations. This, in future, will prevent underdiagnosis of thyroid cancer and unnecessary workup of benign nodules. © 2020. The Authors.

Over the past century, groundwater levels in California's San Joaquin Valley have dropped more than 30 m in some areas mostly due to excessive groundwater extraction used to irrigate agricultural lands and sustain a growing population. Between 2012 and 2015 California experienced the worst drought in its recorded history, depleting surface water supplies and further exacerbating groundwater depletion in the region. Due to a lack of groundwater regulation, exact quantities of extracted groundwater in California are unknown and hard to quantify. Recent adoption of the Sustainable Groundwater Management Act has intensified efforts to identify sustainable groundwater use. However, understanding sustainable use in a highly productive agricultural system with an extremely complex surface water allocation system, variable groundwater use, and spatially extensive and diverse irrigation practices is no easy task. Using an integrated hydrologic model coupled with a land surface model we evaluated how water management activities, specifically a suite of irrigation and groundwater pumping scenarios, impact surface water-groundwater fluxes and storage components, and how those activities and the relationships between them change during drought. Results showed that groundwater pumping volume had the most significant impact on long-term water storage changes. Comparison with total water storage anomaly (TWSA) estimates from NASA's Gravity Recover and Climate Experiment (GRACE) provided some insight as to which combinations of pumping and irrigation matched the GRACE TWSA estimates, lending credibility to these scenarios. Additionally, the majority of long-term water storage changes during the recent drought occurred in groundwater storage in the deeper subsurface. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.An optimal habitat-selecting organism should use a dispersal strategy that enables occupation of the habitat yielding greatest fitness. The strategy is complicated when habitat quality varies through time. Theory predicts that the long-term distribution of individuals will match mean habitat quality while undermatching current habitat quality. I tested the prediction with experiments on controlled populations of meadow voles occupying two pairs of field enclosures. I released equal numbers, and equal sexes, of voles in each enclosure, and varied resource abundance between enclosures by supplemental feeding. I measured the voles' response with giving-up densities (GUDs) in artificial foraging patches, and with live-trapping at the end of the experiment. The data were consistent with only one of four a priori dispersal models. Giving-up densities declined with resource supply because short-term supply had no effect on population density. GUDs were invariant to the time-course of the experiment because densities were proportional to each enclosure's long-term mean quality. Similar patterns in sex ratios and patterns of habitat occupation by juvenile voles born during the experiment reinforce the interpretation of time-averaged habitat matching. This study adds to the cumulating evidence that strategies of space use converge towards behavioral and evolutionary optima. This article is protected by copyright. All rights reserved.According to the American Psychiatric Association, eating disorders (EDs) are characterized by a persistent disturbance of eating or eating-related behaviors that result in altered consumption or absorption of food and that significantly impair physical health and/or psychosocial functioning. EDs are chronic psychiatric illnesses and are notoriously difficult to treat. The etiology of eating disorders is unknown and thought to be a complex interplay among biological predisposition, environmental and sociocultural factors, neurobiological influences, and psychological factors. Moreover, prevalence of eating disorders is increasing despite variation in prevalence estimates across studies. Nurses are well-positioned to implement appropriate screening for and comprehensive assessment of EDs as well as offer patient-centered treatment options including referrals when indicated. As the first in a two-part series, this article provides an overview of the clinical characteristics of EDs and key areas for assessment and diagnostic considerations. The follow-up article in this series will focus on pharmacological treatment strategies. [Journal of Psychosocial Nursing and Mental Health Services, 58(3), 7-13.]. Copyright 2020, SLACK Incorporated.RNA displays diverse functions in living cells. The presence of various chemical modifications of RNA mediated by enzymes is one of the factors that impart such functional diversity to RNA. Among more than 100 types of RNA modification, N1-methyladenosine (m1A) is found mainly in tRNA and rRNA of many living organisms, and is known to be deeply implicated in the topology or function of the two classes of RNA. In this commentary article, we would like to deal with the functional significance of m1A in RNA, and also to describe one methyltransferase installing m1A in a large subunit rRNA, whose orthologue in C. elegans was discovered recently and was reported in this journal. © The Author(s) 2020. Published by Oxford University Press on behalf of the Japanese Biochemical Society. All rights reserved.OBJECTIVES The aim of this study was to investigate the relationship between anthropometric characteristics and both geophagy and cognitive function of children. STUDY DESIGN The study prospectively followed singleton children whose mothers participated in the MiPPAD clinical trial in Allada, Benin, from birth to age 12 months. Anthropometric measurements were taken at birth and 9 and 12 months. https://www.selleckchem.com/products/OSI-906.html Wasting, stunting and underweight were defined as weight-for-length, length-for-age and weight-for-age Z-scores less than -2, respectively. Cognitive and motor functions were assessed using the Mullen Scales of Early Learning. Parent-reported geophageous habits of children were collected when the children were 12 months. Multiple linear and logistic regressions were used to analyse the data. RESULTS A total of 632 children (49.7% girls) were involved in the study. Stunting, wasting and underweight were observed in 14.1%, 13.6% and 17.7%, respectively, at 9 months and 17.3%, 12.7% and 17.2%, respectively, at 12 months.