10 mm (interquartile range [IQR], 1 29-2 37) and 4 13 (IQR, 3 11-

10 mm (interquartile range [IQR], 1.29-2.37) and 4.13 (IQR, 3.11-7.39) (p < 0.001).\n\nInattentional blindness was evident in both groups. Although more accurate, the AR group was less likely to identify significant unexpected findings clearly within view. Advanced navigational displays may increase precision, but strategies to mitigate attentional costs need further investigation to allow safe implementation.”
“Objective: To determine whether the routine use of preimplantation genetic screening (PGS) in “good prognosis” women improves in vitro fertilization (IVF) cycle outcome.\n\nDesign:

Randomized, controlled, prospective clinical study.\n\nSetting: Private infertility clinic.\n\nPatient(s): Infertile women predicted to have a good prognosis as defined by: age < 39 Liproxstatin-1 inhibitor years, normal ovarian reserve, body mass index < 30 kg/m(2), presence of ejaculated sperm, normal uterus, <= 2 previous failed IVF cycles.\n\nIntervention(s): Patients were randomized to the PGS group or the control group on day 3 after oocyte retrieval; 23 women underwent blastomere biopsy on day 3 after fertilization (PGS group), and 24 women underwent routine IVF (control group). All embryos were transferred on day 5 or 6 after fertilization.\n\nMain Outcome Measure(s): Pregnancy, implantation, multiple gestation, and live birth rates.\n\nResult(s): No statistically

significant differences were found between the PGS and control groups with respect to clinical pregnancy rate selleck products (52.4% versus 72.7%). However, the embryo implantation rate was statistically significantly lower for the PGS group (34.7% versus 62.3%) as were the live birth rate (28.6% versus 68.2%) and the multiple birth rate (9.1% versus 46.7%).\n\nConclusion(s): In a “good prognosis” population of women, PGS does not appear to improve pregnancy, implantation, or live birth rates. (Fertil Steril (R)

2009;91:1731-8. (C)2009 by American Society for Reproductive Medicine.)”
“Objective: see more To assess changes in the levator plate angle (LPA), anteroposterior length of the levator hiatus (H-line), and pelvic floor descent (M-line) after vaginal hysterectomy and prolapse repair using the Gynecare Prolift Total Pelvic Floor Repair System. Methods: Before and after the intervention, 20 women with pelvic floor prolapse underwent dynamic magnetic resonance imaging in supine position during the Valsalva maneuver to measure the LPA, H-line, and M-line. Paired t tests were performed and Pearson correlation coefficients calculated from values obtained using the pelvic organ prolapse quantification system. Results: After the intervention the LPA was smaller (46.92 degrees vs 55.39 degrees, P<0.05), the H-line was shorter (53.70 cm vs 60.46 cm, P<0.05), and the M-line was shorter (19.58 cm vs 25.27 cm, P<0.05).


“Human cord blood (CB) offers an attractive source of cell


“Human cord blood (CB) offers an attractive source of cells for clinical transplants because of its rich content of cells with sustained repopulating ability in spite of an apparent deficiency of cells with rapid reconstituting ability. Nevertheless, the check details clonal dynamics of nonlimiting CB transplants remain poorly understood. To begin to address this question, we exposed CD34(+) CB cells to a library of barcoded lentiviruses and used massively parallel sequencing to quantify the clonal distributions of lymphoid and myeloid cells subsequently detected in

sequential marrow aspirates obtained from 2 primary NOD/SCID-IL2R gamma(-/-) mice, each transplanted with similar to 10(5) of these cells, and for another 6 months in 2 secondary recipients. Of the 196 clones identified, 68 were detected at 4 weeks posttransplant

and were often lymphomyeloid. The rest were detected later, after variable periods up to 13 months posttransplant, but with generally increasing stability throughout time, and they included clones in which different lineages were detected. However, definitive evidence of individual cells capable of generating T-, B-, and myeloid cells, for over a year, and self-renewal of this potential was also obtained. These findings highlight the caveats and utility of this model to analyze human hematopoietic stem cell control in vivo.”
“Despite MLN4924 clinical trial curative locoregional treatments for hepatocellular carcinoma (HCC), tumour recurrence rates remain high. The current study was designed to assess the safety and bioactivity of infusion of dendritic cells (DCs) stimulated with OK432, a streptococcus-derived anti-cancer immunotherapeutic agent, into tumour tissues following transcatheter hepatic

arterial embolization (TAE) treatment in patients with HCC. DCs were derived selleckchem from peripheral blood monocytes of patients with hepatitis C virus-related cirrhosis and HCC in the presence of interleukin (IL)-4 and granulocyte-macrophage colony-stimulating factor and stimulated with 0.1 KE/ml OK432 for 2 days. Thirteen patients were administered with 5 x 10(6) of DCs through arterial catheter during the procedures of TAE treatment on day 7. The immunomodulatory effects and clinical responses were evaluated in comparison with a group of 22 historical controls treated with TAE but without DC transfer. OK432 stimulation of immature DCs promoted their maturation towards cells with activated phenotypes, high expression of a homing receptor, fairly well-preserved phagocytic capacity, greatly enhanced cytokine production and effective tumoricidal activity. Administration of OK432-stimulated DCs to patients was found to be feasible and safe. Kaplan-Meier analysis revealed prolonged 123 recurrence-free survival of patients treated in this manner compared with the historical controls (P = 0.046, log-rank test).

In addition, exogenous stimulation consistently evoked this neoco

In addition, exogenous stimulation consistently evoked this neocortical-to-hippocampal sequence of activation. Finally, parahippocampal lesions that disrupted functional connections between the neocortex and hippocampus effectively disrupted the transmission of both spontaneous and evoked neocortical activity to the hippocampus. These findings suggest that sleep-related motor activity

contributes to the development of neocortical and hippocampal circuits and provides a foundation on which coordinated activity between these two forebrain structures develops.”
“Background: Pediatric obesity is a growing problem affecting the health of our youth. We sought to identify the barriers to pediatric bariatric referral at a tertiary referral Selleckchem HDAC inhibitor center.\n\nMethods: We performed a Survey of pediatricians and family practitioners at a single institution to assess their perspectives oil pediatric obesity.\n\nResults: A total of 61 physicians completed the survey (response rate 46%). All believed pediatric obesity is a major problem, and 82.0% noted an increase in the incidence during

a mean period of 15 years (range HIF inhibitor 3-25). Of the 61 physicians. 88.5% used nonoperative weight loss techniques, with only 1.8% reporting satisfactory results. However, 42.6% had referred a patient (adult or pediatric) for a bariatric procedure. of whom 84.6% were 123 satisfied with the operative outcomes. Despite the high satisfaction with bariatric procedures, 88.5% would be unlikely

or would never refer a child for a bariatric procedure, and 44.3% would be somewhat or very likely to refer all adolescent.\n\nConclusion: physicians caring for children recognize the growing problem of childhood and adolescent obesity. Despite the poor outcomes with nonoperative methods and the high satisfaction with the outcomes of bariatric procedures, physicians are still reluctant to refer children and adolescents for surgical weight loss procedures. (Surg Obes Relat Dis 2009;5:88-93.) (C) 2009 American Society for Metabolic and Bariatric surgery. All rights reserved.”
“Sinonasal aspergillosis is an uncommon, yet debilitating and often frustrating condition to treat in dogs despite years of research Elacridar ic50 evaluating pathogenesis, diagnosis and treatment. The disease is most commonly caused by non-invasive fungal infection, thought to be secondary to altered innate and/or adaptive immune responses. Attempts to confirm this have however failed. A variety of conflicting opinions regarding the diagnosis and treatment of sinonasal aspergillosis exist. Often the use of a particular treatment protocol is based upon personal or regional preference. Evaluation of the veterinary literature demonstrates that the evidence base in support of individual treatment recommendations is weak.

Cyclosporine or tacrolimus were reintroduction in two patients af

Cyclosporine or tacrolimus were reintroduction in two patients after complete clinical and laboratory recovery. Both patients developed recurrence of HUS. While the former did not the latter did recover on further treatment of HUS.\n\nConclusion. Anemia, thrombocytopenia, elevated LDH and FDP are the most frequent manifestations of HUS. Early CNI elimination and fresh plasma transfusion can revert CNI induced HUS and save the graft. Reintroduction of CNI WH-4-023 order may be deleterious to the graft and should be avoided.”
“Objectives: Pre-eclampsia affects approximately 5-8% of pregnant women. The aim of

this study was to compare the serum level of Lactate dehydrogenase (LDH), Homocystein, Hemoglubin and platelet https://www.selleckchem.com/products/vx-661.html in pregnant women diagnosed as pre-eclampsia and a normal group in Gorgan city, Northeastern Iran from 2007-2008.\n\nMethodology: In this case control study, 50 cases of pre-eclampsia were compared with the

control group women hospitalized in Dezyani hospital. Pre-eclampsia criteria were: Blood pressure more than or equal to 140/ 90 mm hg and Proteinuria greater or equal to 300 mg/ 24 hours urine sample in the third trimester. Hemoglobin, platelet, LDH and hemocystein were measured. Data were analyzed by the mean of SPSS-14 program & Chi-2 or t-student were used.\n\nResults: The difference of BMI and family incomes was significant between two groups (P-value<0.01). LDH level was not statistically different between healthy and pre-eclamptic individuals. Six cases (12%) in controls and 9 cases (18%) in pre-eclamptic group had thrombocytopenia (P-value>0.01). Hemocystein level was more than normal range

in five patients with pre-eclampsia (P-value<0.001).\n\nConclusions: In this study, hemocystein level was significantly selleck products higher in pre-eclampsia patients but LDH, hemoglobin and platelet level had no significant difference.”
“A variety of techniques have been used to determine intra-operative leg length during total hip arthroplasty. One method often described is using the tip of greater trochanter as the reference for the rotation centre of the femoral head to align the femoral component. There is little in the literature to support this method of leg length restoration.\n\nWe analysed standard anterior-posterior pelvic radiographs of 225 patients with osteoarthritis of the hip who were about to undergo total hip arthroplasty. The distance between the tip of the greater trochanter and the rotation centre of the femoral head was measured for the affected hip.\n\nThe average location of the tip of greater trochanter is 3.4 mm proximal to the centre of the femoral head, with a range from 20 mm proximal to 10 nun distal to the femoral head centre.

Significant structure was absent within Hudson

Significant structure was absent within Hudson HM781-36B River, whereas weak but significant genetic differences were observed between northern and southern samples in

Chesapeake Bay. The largest and smallest effective striped bass population sizes were found in Chesapeake Bay and South Carolina, respectively. Coalescence analysis indicated that the highest historical gene flow has been between Chesapeake Bay and Hudson River populations, and that exchange has not been unidirectional. Bayesian analysis of 432 contemporary migration indicated that Chesapeake Bay serves as a major source of migrants for Atlantic coastal regions from Albemarle Sound northward. In addition to examining population genetic structure, the data acquired during this project were capable of serving as a baseline for assigning fish MRT67307 clinical trial with unknown origin to source region.”
“Although post-mortem MRI (PMMR) was proposed as an alternative to conventional autopsy more than a decade ago, the lack of systematic validation has limited its clinical uptake. Minimally invasive autopsy (MIA) using PMMR together with

ancillary investigations has now been shown to be as accurate as conventional autopsy in foetuses, newborns and infants and is particularly useful for cerebral, cardiac and genitourinary imaging. Unlike conventional autopsy, PMMR provides a permanent three-dimensional auditable record, with accurate estimation of internal organ volumes. MIA is becoming highly acceptable selleck to parents and professionals, and there is widespread political support and public interest in its clinical implementation in the UK. In the short to medium term, it is desirable that a supraregional network of specialist centres should be established to provide this service

within the current National Health Service framework.”
“Cell polarity proteins regulate tight junction formation and directional migration in epithelial cells. To date, the mechanism by which these polarity proteins assemble at the leading edge of migrating epithelial cells remains unclear. We report that occludin, a transmembrane protein, is localized at the leading edge of migrating cells and regulates directional cell migration. During migration, occludin knockdown disrupted accumulation of aPKC-Par3 and PATJ at the leading edge, and led to a disorganized microtubule network and defective reorientation of the microtubule organization center (MTOC). Phosphorylation of occludin at tyrosine 473 residue allowed recruitment of p85 alpha to the leading edge via association with its C-terminal SH2 domain. Loss of occludin attenuated activation of PI3K, leading to disorganization of the actin cytoskeleton and reduced cell protrusions. Our data indicate that occludin is required for the leading-edge localization of polarity proteins aPKC-Par3 and PATJ and promotes cell protrusion by regulating membrane-localized activation of PI3K.

The subunits of K(ATP): Kir6 1, Kir6 2, SUR1 and SUR2 expressing

The subunits of K(ATP): Kir6.1, Kir6.2, SUR1 and SUR2 expressing changes were observed by double immunofluorescence BAY 73-4506 and immunoblotting when the neurons were

exposed to A beta(1-42)(2 mu M) for different time (0, 24, 72 h). We found a significant increase in the expression of Kir6.1 and SUR2 in the cultured neurons being exposed to A beta(1-42) for 24 h, while Kir6.2 and SUR1 showed no significant change. However, after being treated with A beta(1-42) for 72 h, the expression of the four subunits was all increased significantly compared with the control. These findings suggest that being exposed to A beta(1-42) for different time (24 and 72 h) induces differential regulations of K(ATP) subunits expression in cultured primary rat basal forebrain cholinergic neurons. The change in composition of K(ATP) may contribute to resist the toxicity of A beta(1-42).”
“Purpose: this website To examine the impact of hospital volume and specialization on the cost of orbital trauma care.\n\nDesign: Comparative case series and database study.\n\nParticipants: Four hundred ninety-nine patients who underwent orbital reconstruction at either a high-volume

regional eye trauma center, its academic parent institution, or all other hospitals in Maryland between 2004 and 2009.\n\nMethods: We used a publicly 4 available database of hospital discharge data to identify the study population’s clinical and cost characteristics. Multivariate models were developed to determine the impact of care setting on hospital costs while controlling for patient demographic and clinical variables. Main Outcome Measures: Mean hospital costs accrued during hospital admission for orbital reconstruction in 3 separate care settings.\n\nResults: Almost half (n = 248) of all patients received surgical care at the regional eye trauma Cytoskeletal Signaling inhibitor center and had significantly lower adjusted mean hospital costs ($6194; 95%

confidence interval [CI], $5709-$6719) compared with its parent institution ($8642; 95% CI, $7850-$9514) and all other hospitals ($12 692; 95% CI, $11 467-$14 047). A subpopulation analysis selecting patients with low comorbidity scores also was performed. The eye trauma center continued to have lower adjusted costs ($4277; 95% CI, $4112-$4449) relative to its parent institution ($6595; 95% CI, $5838-$7451) and other hospitals ($7150; 95% CI, $5969-$8565).\n\nConclusions: Higher volume and specialization seen at a regional eye trauma center are associated with lower costs in the surgical management of orbital trauma. (C) 2013 by the American Academy of Ophthalmology.”
“Presbyopia remains a major visual impairment for patients, who have previously undergone laser refractive correction and enjoyed unaided distance vision prior to the onset of presbyopia. Corneal stromal volume restoration through small incision lenticule extraction (SMILE) lenticule re-implantation presents an opportunity for restoring the patients’ non-dominant eye to previous low myopia to achieve a monovision.

We express these sensitivities for conductance tensor components

We express these sensitivities for conductance tensor components and for other charge

transport quantities. Both resistive and Hall sensitivities, for a van der Pauw specimen see more in a finite magnetic field, are a superposition of the zero-field sensitivities to both sheet resistance and Hall sheet resistance. Strong perturbations produce a nonlinear correction term that depends on the strength of the inhomogeneity. Solution of the specific case of a finite-sized circular inhomogeneity coaxial with a circular specimen suggests a first-order correction for the general case. Our results are confirmed by computer simulations on both a linear four-point probe array on a large circular disc and a van der Pauw square geometry. Furthermore, the results also agree well with Nahlik et al. published experimental results for physical holes in a circular copper foil disc. (C) 2014 AIP Publishing LLC.”
“Here we show how agricultural practices by indigenous peoples as well as forest recovery relate to the structure and composition of Amazon soil bacterial communities. Soil samples were collected in different land use systems and bacterial community composition and diversity were explored by

T-RFLP, cloning and sequencing, and data were 4 analyzed with multivariate techniques. The main differences in bacterial community structure were related to changes in the soil attributes that, in turn, were correlated to land use. Community structure changed significantly along gradients of base saturation, [Al(3+)] and pH. The relationship with soil attributes accounted for ACY-738 datasheet about 31% of the variation of the studied communities. Clear differences were observed in community composition as shown by the differential distribution of Proteobacteria, Bacteroidetes, Firmicutes, Acidobacteria and Actinobacteria. Similarity between primary and secondary forest communities indicates the recovery of bacterial community structure during succession. Pasture and crop soil communities were among the most diverse, showing that these land use types did not deplete bacterial

diversity under the conditions found in our sites. The ISME Journal (2009) 3, 1004-1011; doi:10.1038/ismej.2009.47; published online 14 May 2009″
“Generation of the pleiotropic sphingolipid mediator ceramide by acid and Autophagy inhibitor neutral sphingomyelinases is a key event in many cellular pathophysiological processes including survival, death, proliferation, and differentiation, in which also the short-lived gaseous messenger nitric oxide plays a crucial role. This review describes how the outcome of these key cellular processes is finely tuned by surprising and complex interplays among nitric oxide, ceramide, and their effectors.”
“Fine-needle aspiration cytology (FNAC) of breast masses has been replaced by ultrasound-guided core-needle biopsy (USG-CNB) in many countries.

The suitability of cryptochrome for this purpose has been argued,

The suitability of cryptochrome for this purpose has been argued, in part, by analogy with DNA photolyase, although no effects of applied magnetic fields have yet been reported

for any member of the cryptochrome/photolyase family. Here, we demonstrate a magnetic-field effect on the photochemical yield of a flavin-tryptophan radical pair in Escherichia coli photolyase. This result provides a proof of principle that photolyases, and most likely by extension also cryptochromes, have the fundamental properties needed to form the basis of a magnetic compass.”
“Introduction: Microparticles are small vesicles shed by cells upon activation and during apoptosis which participate in physiologically relevant phenomena, including blood coagulation. Intracellular calcium mobilization is one of the mechanisms CH5183284 research buy of microparticle generation during cell activation. Because selleck inhibitor the renin-4 angiotensin system has been proposed as a link between hypertension and increased thrombotic risk, we investigated whether angiotensin II upregulates the generation of procoagulant microparticles by human mononuclear cells.\n\nMaterials and Methods: Human mononuclear cells were exposed to angiotensin II for 15 min. Intracellular calcium concentration was assessed by a Fluo 4 based kit. The supernatants

were analyzed for both microparticle content, with a commercially available kit based on phosphatidylserine analysis, and microparticle-associated tissue factor, with a one-stage clotting assay.\n\nResults: Intracellular calcium concentration is increased upon exposure of mononuclear cells to angiotensin NVP-LDE225 inhibitor II. Incubation with angiotensin II stimulates microparticles

release; microparticle-associated tissue factor is also upregulated. The effect is inhibited by an angiotensin receptor type 2 antagonist (PD123319) and not by two angiotensin type 1 antagonists (Losartan and Olmesartan).\n\nConclusions: Angiotensin receptor 2-mediated upregulation of tissue factor-bearing, procoagulant microparticle generation represents a novel mechanism linking the renin-angiotensin system to thrombosis. (C) 2013 Elsevier Ltd. All rights reserved.”
“Patients with acute brain injury but normal lung function are often intubated for airway protection, but extubation often fails. Currently, no clinical data exist that describe the events leading to extubation failure in this population. We examined the extubation failure rate, reintubation rate, and clinical characteristics of patients whose reason for intubation was a primary neurological injury. We then identified the clinical characteristics of those patients with primary brain injury who were reintubated.\n\nWe conducted a retrospective review of patients admitted to the neurocritical care unit of a tertiary care hospital from January 2002 to March 2007.

The study of visual perception and object recognition was once li

The study of visual perception and object recognition was once limited to investigations of brain-damaged individuals or lesion experiments in animals. However, in the last 25 years, new methodologies, such as functional neuroimaging see more and advances in electrophysiological approaches, have provided scientists with the opportunity to examine this problem from new perspectives. This review highlights how some of these recent technological advances have contributed to the study of visual processing and where we now stand with respect to our understanding of neural mechanisms underlying object recognition.

Published by Elsevier Ltd.”
“Background: Arterial hypertension and premature coronary, artery disease are poorly understood complications of cardiac transplantation in children. Arterial stiffness is associated with cardiovascular risk in adults. Pulse wave velocity

(PWV) may be used as a surrogate for arterial rigidity. In this study We investigate PWV in children after cardiac transplantation.\n\nMethods: Sitting blood pressure was Measured in 22 children (>6 months after transplantation) and 95 controls and PWV was measured using the SphygmoCor device by high-fidelity applanation tonometry at the carotid, radial and 3 femoral arteries.\n\nResults: The transplant group was significantly older than the control group (13.4 years vs 11.1 years; p 0.006), but there was no significant height or weight www.selleckchem.com/products/BMS-777607.html difference. The diastolic (but not systolic) pressure was

significantly higher in the transplant group (75 ram Hg vs 65 mm Hg; Panobinostat p = 0.003). Aortic (carotid/femoral) PWV was significantly associated with age, height, weight (in the control group only) and systolic blood pressure according to univariate analysis, whereas brachial (carotid/radial) PWV was unrelated to these. According to multivariate analysis, height accounted best for all relationships with aortic PWV, and age and weight for brachial PWV. Using multivariate analysis, PWV was significantly higher in the cardiac transplant group for brachial (7.6 m/s vs 6.6 m/s; p < 0.01) and aortic (5.3 m/s vs 4.7 m/s; p < 0.001) measurements. The relation between length of time since transplantation and aortic PWV was statistically significant (p < 0.01).\n\nConclusions: Arterial rigidity is increased in children after cardiac transplantation. An improved understanding of blood pressure and arterial stiffness may help inform the choice of blood pressure medication in these patients. J Heart Lung Transplant 2009 28:21-5. Copyright (C) 2009 by the International Society for Heart and Lung Transplantation.”
“Aerobic granular sludge is a new type of microbe auto-immobilization technology; in this paper, short-cut nitrification and denitrification were effectively combined with the granular sludge technology.

However, lymph flow via the thoracic duct into systemic veins is

However, lymph flow via the thoracic duct into systemic veins is opposed by elevations in central Venous pressure. Various management strategies have the potential to prevent and/or correct SVHT. The case of a 54-year-old man with a dilated cardiomyopathy who presented with decompensated biventricular failure, expressed as anasarca and ascites, is used to illustrate the importance of SVHT.”
“The effect of position isomerism on the co-crystals formation and physicochemical properties was evaluated. Piracetam #4 randurls[1|1|,|CHEM1|]# was used

as the model compound. Six position isomers, 2,3-, 2,4-, 2,5-, 2,6-, 3,4-, and 3,5-dihydroxybenzoic acid (DHBA), were used as the co-crystal formers. Co-crystals were prepared on a 1: 1 molar ratio by crystallization from acetonitrile. The solid-state properties of co-crystals were characterized using X-ray powder diffractometry (XRD), differential scanning calorimetry (DSC), and Fourier transform check details infrared (FTIR). All co-crystal formers formed co-crystal with piracetam except 2,6-DHBA. This failure was possibly due to steric hindrance of two bulk hydroxyl groups and preference of intra-molecular hydrogen bonding formation between hydroxyl group and carboxylic acid group. The XRD patterns of resulting co-crystal

indicated that they are highly crystalline and different than parental compounds. Based on the single crystal data, P_23DHBA is orthorhombic while P_24DHBA, P_34DHBA, and P_35DHB belong to monoclinhe system. The hydrogen bonding network patterns of the co-crystals are also different. DSC data showed that the melting temperatures of resulting co-crystals are all lower than that of the starting materials. The melting point rank order of the co-crystals is: P_24DHBA > P_34DHBA selleck compound > P_23DBBA > P_25DHBA > P_35DHBA. (C) 2009 Wiley-Liss, Inc. and the American Pharmacists Association J Pharm Sci 99:246-254, 2010″
“Cyclic-di-GMP and cyclic-di-AMP are second messengers produced by bacteria and influence

bacterial cell survival, differentiation, colonization, biofilm formation, virulence, and bacteria-host interactions. In this study, we show that in both RAW264.7 macrophage cells and primary bone marrow-derived macrophages, the production of IFN-beta and IL-6, but not TNF, in response to cyclic-di-AMP and cyclic-di-GMP requires MPYS (also known as STING, MITA, and TMEM173). Furthermore, expression of MPYS was required for IFN response factor 3 but not NF-kappa B activation in response to these bacterial metabolites. We also confirm that MPYS is required for type I IFN production by cultured macrophages infected with the intracellular pathogens Listeria monocytogenes and Francisella tularensis.