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In the PASCOOL research program, which is part of the European research project Joule II, one task was dedicated to the development of aninteractive software that would summarise the result of the Pascool research program and show the applicability of passive cooling in Mediterranean countries. The aim was to encourage designers to make use of passive cooling strategies in existing and new buildings. Therefore, a software called PEM, Pascool Electronic Metahandbook was created. A selection of buildings from the southern European countries are presented in this software. These buildings had been previously monitored and simulated as a separate task within the Pascool program. In addition, the software contains a climate database and simple predesign tools for dimensioning insulation and solar protection. [ABSTRACT FROM AUTHOR]

Eco-hydrological models, such as SWAT (Soil Water Assessment Tool), are used to simulate complex hydrological processes and LU management in relation to water quality and quantity on a wide range of ecosystems. SWAT, developed by United States Department of Agriculture, is one of the most widely used watershed-scale modelling to assess changes in landscape management practices on water, sediment, and chemical yield. However, the availability of LU maps with good spatial and thematic resolution is one of the limiting factors in watershed modelling. Updated and detailed LU maps are required to grasp the variability and complexity of modelled landscapes. In fact, detailed LU maps with crop types can improve the model's capabilities in simulating evapotranspiration, surface runoff, soil infiltration, nutrient loss, and biomass production. This work reports the achievements in developing an integrated LU map for modelling watershed processes in the Mediterranean context within the Cervaro river basin (900 sq. km ca.), South Italy (Puglia region), with a dominant agricultural LU (Figure 1). Water is a critical natural resource in a Mediterranean country like Italy, vulnerable to risks stemming from climate change such as a related risk of decrease in water availability and crop yields. We applied a methodology for geospatial data integration from the Italian Paying Agency (AGEA) responsible for managing the farmers' subsidies with the Integrated Administration and Control System (IACS) in the framework of the Common Agricultural Policy (CAP). IACS geodata, such as the Land Parcel Identification System (LPIS) and the GeoSpatial Aid Application (GSAA), are the relevant resource on LU parcels managed by Italian farms. This typology of data is one of the best maintained datasets in EU with regular updates and quality controls. Recently, IACS data reusability is becoming a reality thanks to effort of the EU Commission to opening the data within the more general action in "shaping Europe's digital future" by fostering the re-use of government-held data (Directive (EU) 2019/1024). LPIS contains homogeneous land use/cover areas digitized from ortho-imagery with high spatial resolution, resulting in a wall-to-wall map including Italian agricultural and non-agricultural areas with a full update every three years. GSAAcontains digitized on-screen parcels for which an aid is requested yearly by Italian farmers and modified/updated by the paying agency after controls to ensure accuracy. Thematic details on agriculture within GSAA is dramatically higher than the LPIS thanks to the availability of crops classes detailed with a 5-level nomenclature. Within the LPIS an additional geographical layer is also available reporting the cadastral parcels with updated LU information deriving from in-situ field checks and other administrative sources. The conflation method for integrating the three vector layers (two LPIS and GSAA) followed different steps: conversion to a common projection system, topology and geometry checks, aggregation of small polygons and nomenclatures matching (from IACS to SWAT classes) through semantic analysis. Geometric and attributes processing allowed to reduce dimensionality of the "hybrid layer": from 300k to 50k ca. polygons and from 33k LU combinations to 57 SWAT LU classes (Table 1). The "hybrid layer" (Figure 2) enables accurate modelling with SWAT to understand the relationship between LU management and water quality as an important opportunity in the context of both the reformed CAP and the Farm to Fork strategy aiming to reduce the environmental and climate footprint of the EU food system by preserving and restoring the land and freshwater resources. The spatial details coming from very high-resolution imagery and thematic details enhanced by administrative controls and farmers declarations provides much higher performances compared to classical LU maps. The EU-wide data availability, the yearly updates of information and the detailed attributes (e.g., crops typology, greening and organic practices, crop rotation, conservation tillage, etc.) can shift upward the accuracy of the eco-hydrological modelling. [ABSTRACT FROM AUTHOR]

Purpose: To determine whether maternal age and number of transferred embryos influence early pregnancy losses in twin pregnancies compared to singletons following IVF/JCSI. Methods: We compared the pregnancy loss rates in singleton (n = 549) and twin (n 252) gestations, stratified by maternal age (≤35 and >35 years) and the number of transferred embryos (1-3 and 4-9). Results: Loss rates of singleton pregnancies were significantly higher than that in twins (OR 3.0, 95% CI 1.9, 4.9), especially among singletons conceived after transfer of 4-9 embryos (OR 5.0, 95% CI 2.2, 11.9). Younger mothers of twins had lower loss rates (OR 0.3, 95% CI 0.1, 0.9). Conclusion: Twins have a significantly reduced spontaneous miscarriage rate compared with singletons following IVF/ICSI. Higher implantation rates per cycle (i.e., development of twins rather than one live embryo) may represent a better capacity of the uterus for early embryonic development. [ABSTRACT FROM AUTHOR]

Objective: To determine whether pregnancies after IVF, with and without intracytoplasmic sperm injection (ICSI), have different early spontaneous loss rates. Design: Retrospective analysis of IVF/ICSI dataset. Setting: The Center of Reproductive Medicine, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy. Patient(s): Women undergoing IVF with or without ICSI. Intervention(s): First-trimester sonography at 6-7 weeks to count the number of embryos with positive heartbeat. The number of embryos lost was calculated from a second-trimester sonogram. Main Outcome Measure(s): Embryonic loss rates related to the initial number of embryos, maternal age <35 or > or =35 years, and IVF procedure. Result(s): In vitro fertilization and ICSI had similar embryonic loss rates (odds ratio [OR] 1.2, 95% confidence interval [CI] 0.9-1.7, and OR 1.3, 95% CI 0.9-1.8 for women aged <35 years and > or =35 years, respectively). Younger women had fewer losses after IVF (OR 0.7, 95% CI 0.5-0.9). Multiples had lower loss rates compared with singleton pregnancies. Conclusion(s): In vitro fertilization and ICSI have similar spontaneous embryonic loss rates. Factors other than the initial number of embryos, maternal age, and IVF technique, such as embryo quality or uterine environment, might be involved in the outcome of multiple pregnancies in assisted reproductive technology procedures. [ABSTRACT FROM AUTHOR]

The “Solar Complex of Plan-les-Ouates” is a traditional multifamily building with some commercial and administrative areas. It was designed to consume a minimum amount of thermal energy by combining several renewable energy systems (1400 m2 of solar roof, buried pipe and exhausted air heat exchangers) with an optimised envelope and electrical equipment. Initially predicted to consume 160 MJ/m2 per year of gas, a gas energy use index (per unit heated floor area) of 246 MJ/m2 per year was measured. The energy analysis of the building, based on a 3-year period of monitoring, brought up the most relevant points that explain this difference: the real conditions of utilisation (such as the interior temperature) and the real performance of the complete technical system are not taken into account in the theoretical value. Both technical and economical aspects of the renewable energy systems were analysed in detail. An important lesson learned from this experiment is that the energy concept of buildings must be simple and consistent and the complexity of the technical installations must be carefully managed from the design-stage to the exploitation. Detailed monitoring of innovative low-energy buildings is recommended to understand the possible discrepancies between theoretical and real heat consumption and to improve the transfer of new energy technologies to large-scale real constructions. [Copyright &y& Elsevier]

Background: To increase the accessibility of qualified and anonymous information on sexually transmitted diseases (STDs) in Italy, a national telephone hotline was initiated in February 1997. Goal: The goal was to determine the profile of callers to the national STD hotline, assess their concerns, identify their sources for the hotline telephone number, and to compare callers' disease interests with diagnoses made at STD clinics. Study Design: The survey analyzed 3577 calls received from February 1997 to December 1999. Hotline operators addressed callers' questions, asked 6 short-answer questions, and recorded the data collected. Results: The survey showed callers' sex distribution (49.8% women, 50.2% men), average age (women's mean ± standard deviation [SD], 34.3 ± 11.8 y; men's mean ± SD, 36.2 ± 12.2 y), level of education (66.4% had a secondary school degree), residence (47.9% northern part of Italy), risk category (44% reported being definitely infected by a STD), specific disease interest (30% were concerned about HIV), and source of hotline telephone number (67.3% learned the hotline telephone number from magazines or newspapers). Hotline callers' specific disease interests were compared with diagnoses made at STD clinics; the top 4 disease concerns of hotline callers were HIV, genital herpes, human papillomavirus/genital warts, and mycosis, whereas the top 4 diagnoses made at STD clinics were genital warts, nonspecific vaginitis, nonspecific urethritis, and genital herpes. Conclusion: The hotline seems to be an effective way to deliver information and to allay fears about STDs, although it needs to be promoted more widely, especially in central and southern Italy. [ABSTRACT FROM AUTHOR]

By power scaling of LEDs pump concentrators we demonstrated a visible light source (centered at 550 nm) producing 294 W with a radiance of 668 W/cm 2 /sr in the air. Using more than 1100 LEDs, this setup represents one order of magnitude improvement in terms of output power and brightest of LED pump concentrator ever reported. We pushed further the concept of low cost high brightness light source using this concentrator to pump a very simple Nd:YAG laser in free running mode and in passively Q-switched regime using a Cr:YAG saturable absorber. Output energies up to 263 µJ with a pulse duration of 33 ns have been obtained at 1064 nm, leading to a peak power of 8 kW in a TEM 00 mode. [ABSTRACT FROM AUTHOR]

In Italy fluoroquinolones (FQs) are extensively prescribed in empirical therapy of uncomplicated urinary tract infection (UTI) despite recommendations in national guidelines and widespread antibiotic resistance in community. To survey the dissemination of plasmid-mediated quinolone resistance in a peak area of FQs consumption, E. coli strains from 154 community and 41 local hospital patients were collected; low level ciprofloxacin resistance qnrA, qnrB, qnrS, and aac(6)′-Ib-cr genes were screened by PCR and patterns of transferable resistances were determined. Clinical ciprofloxacin resistance in hospital doubled community value, while overall rates of FQ resistance genes were similar (31.6% and 27.8%). Prevalence of aac(6′)-Ib-cr gene was 11% in outpatients (21%, inpatients) and risk of harbouring this variant was significantly associated with gentamicin resistance; linkage to ceftazidime resistance was significant ( P = 0.001) and six out of eight strains produced CTX-M-15 and TEM-1 beta lactamases. In transconjugants, the unique pattern ampicillin/kanamycin-gentamicin/ ESBL + was associated with aac(6′)-Ib-cr gene presence and with an increase of ciprofloxacin MIC value. Data highlight the need to monitor the resistance risk factors in the local community to provide clinicians with well-grounded guidelines for UTI therapy. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented regarding a study on chemical ear peeling (CEP), a treatment for chronic otitis externa.

Objective: To investigate the hypothesis that Z-score criteria represent a reliable predictor of implantation rate and pregnancy outcome in in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles, excluding the possibility of embryo selection before the embryo transfer. Design: Retrospective clinical study. Setting: Centre of Reproductive Medicine, Department of Obstetrics and Gynecology, Arcispedale S. Maria Nuova (ASMN), Reggio Emilia, Italy. Patient(s): We analyzed 393 pregnancies obtained by IVF or ICSI cycles. Intervention(s): Morphologic evaluations of Z-score in pre-embryos obtained from IVF or ICSI cycles. Main Outcome Measure(s): Evaluations of Z-scores, implantation rate, and clinical pregnancy outcome. Result(s): We did not find any statistically significant correlation between the Z-score of 1032 embryos transferred in 393 embryo transfers and the implantation rate or the pregnancy outcome. In particular, the best Z-score identified (Z1, 7.2%) did not seem to correlate with embryo implantation rate or pregnancy outcomes any better than those with worse scores (Z2, 6.9% and Z3, 85.9%). Conclusion(s): Our results seem to confirm that Z-score alone cannot be considered a better tool than standard morphologic criteria for identifying, controlling, or selecting embryos with a better chance of successful ongoing pregnancy. [Copyright &y& Elsevier]

Objective: To document outcomes of oocyte cryopreservation performed as a routine procedure in an IVF program. Design: Describing the rate of oocyte survival, embryo transfer (ET), implantation, and live births of IVF–intracytoplasmic sperm injection performed on thawed oocytes. Setting: Reproductive medicine center in Italy. Patient(s): Women (n = 696) who failed to conceive after IVF–intracytoplasmic sperm injection with fresh oocytes. Intervention(s): Surplus oocytes obtained during a failed cycle with fresh oocytes were frozen and then were thawed, micromanipulated, and transferred in a later cycle. Main Outcome Measure(s): Rates of oocyte survival, ETs, implantation, and live births were calculated in the entire cohort and in patients aged ≤38 and >38 years. Result(s): There were 29 pregnancies, for a total implantation rate of 6.3% (95% CI: 4.3, 9.0) per 456 ET cycles. The clinical-pregnancy rate was 19 (4.2%; 95% CI: 2.6, 6.4) of 456 ET cycles, with a take-home-baby rate of 7 (1.5%; 95% CI: 0.7, 3.0) of 456 ET cycles. Conclusion(s): Cryopreservation performed as a routine procedure for so-called salvaging of surplus oocytes is associated with poor implantation rates and with a probability of 1 live birth in 65 ET cycles. [Copyright &y& Elsevier]

Objectives: To determine the prevalence of herpes simplex virus (HSV) shedding among women attending Italian colposcopy clinics and describe their lifestyle, demographic characteristics, genital symptoms and signs. Study design: A cross-sectional study was performed to assess shedding of HSV among 4565 women requiring a gynecological consultation. An amplified enzyme immunoassay that detects an HSV type-common glycoprotein D was used to reveal HSV shedding in cervical specimens. Statistical analysis was performed using Chi-square test and Student’s t test. Results: A prevalence of 7.8% was found among colposcopy clinic patients. No significant differences regarding patients’ average age, age at first sexual intercourse, contraceptive method used, and number of sexual partners in the previous year were found between subjects with and without viral shedding (P > 0.05). The detection of a concomitant genital infection with Trichomonas vaginalis as well as the report of previous episodes of genital herpes (GH) were significantly higher in the positive group (P < 0.01). Only 2.8% of the patients shedding HSV presented with vesicles and ulcers, with the majority of them being asymptomatic. Conclusion: This is the first Italian survey on genital herpes conducted among colposcopy clinic patients. Our data show that the prevalence of HSV shedding in this study population is high and confirms that the disease is often asymptomatic. The demographics and behavioural variables of women shedding HSV seem to differ from the ones assessed in high risk patients. [Copyright &y& Elsevier]

The role of distributor system operators is experiencing a gradual but relevant change to include enhanced ancillary and energy dispatch services needed to manage the increased power provided by intermittent distributed generations in medium voltage networks. In this context, the paper proposes the insertion, in strategic points of the network, of specific power electronic systems, denoted as active nodes, which permit the remote controllability of the active and reactive power flow. Such capabilities, as a further benefit, enable the distributor system operators to provide ancillary network services without requiring any procurement with distributed generation systems owners. In particular, the paper highlights the benefits of active nodes, demonstrating their capabilities in reducing the inverse power flow issues from medium to high voltage lines focusing on a network cluster including renewable energy resources. As a further novelty, this study has accounted for a real cluster operated by the Italian distributor system operator Areti. A specific simulation model of the electrical lines has been implemented in DigSilent PowerFactory (DIgSILENT GmbH–Germany) software using real operating data obtained during a 1-year measurement campaign. A detailed cost-benefit analysis has been provided, accounting for different load flow scenarios. The results have demonstrated that the inclusion of active nodes can significantly reduce the drawbacks related to the reverse power flow. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to analyze the usefulness of the principal embryological strategies to reduce time to pregnancy., Evidence Acquisition: A systematic search of publications in the PubMed/MEDLINE, Embase and Scopus databases from inception to present including "IVF," "blastocyst," "embryo colture," "competent embryo," "time to pregnancy," "aneuploid," "euploid," "vitrification," "preimplantation genetic," "IVF strategies" and "embryo selection" alone or in combinations has been done., Evidence Synthesis: We have selected 230 articles and 9 of them have been included in this mini-review., Conclusions: Several embryological strategies aimed to select the most competent embryo and reduce time to pregnancy have been proposed, even if few publications on this specific topic are available. preimplantation genetic testing (PGT-A) represents the unique method able to assess the embryonic chromosomal status, but this does not mean that PGT-A is a reliable strategy to reduce time to pregnancy. There is no consensus on a specific method to reduce time to pregnancy, nevertheless this final goal could be probably reached through a harmonious combination of procedures. Thus, a reliable strategy to reduce time to pregnancy could be achieved when embryo culture, embryo cryopreservation and PGT-A are perfectly integrated and appropriately offered to selected patients.

Objective: To study a possible role of nitric oxide (NO) as a marker of development in the early phases of human embryo cleavage during assisted reproduction., Study Design: 179 women having ART were included. 123 women used fresh oocytes and 56 oocyte thawing cycles in the Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Arcispedale S. Maria Nuova, between July 2005 and June 2006; 57 patients had IVF and 122 patients had ICSI. NO concentrations in IVF or ICSI embryo culture media were assessed by monitoring levels of NO stable oxidation products (nitrites/nitrates). Analysis of embryo quality was performed. Student's t-test or Mann-Whitney and logistic regression model tests were applied to the data., Results: In patients using fresh oocytes, there were greater NO production in embryos derived from ICSI than from IVF after 52 h of culture (38.64 micromol/L vs 11.2 micromol/L, p<0.05). No correlation with embryo quality was observed. Embryos derived from fresh oocytes produce more NO than embryos from thawed oocytes both after 48 and 52 h of culture (16.12 micromol/L vs 6.83 micromol/L and 25.93 micromol/L vs 2.98 micromol/L respectively, p<0.05)., Conclusion(s): NO in embryo culture media is not a metabolic cleavage marker or a marker of embryo quality in ART. However, it could be an important parameter in the investigation of metabolism in frozen/thawed oocytes.

The new Italian law on assisted reproduction technology rules that no more than three oocytes can be fertilized at one time, and that all embryos obtained must be transferred to the maternal uterus simultaneously. The aim of the present study was to investigate the influence of the new law on spontaneous embryonic/fetal losses through comparison of data collected over an identical period of time: the first year of application of the new law compared with the same time period 1 year before (March 10, 2004 to March 9, 2005 versus March 10, 2003 to March 9, 2004). A total of 271 clinical pregnancies were analysed. In the post-law period, a significantly lower percentage of total spontaneous embryonic losses compared with the pre-law period, and a higher percentage of surviving embryos in singletons and twins was observed. In conclusion, the impact of the limitations imposed by the new legislation regulating assisted reproduction in Italy seems to exert positive effects on spontaneous embryonic loss both in singletons and multiple pregnancies. These findings are in contrast to international predictions on this issue and, in general, are counter-intuitive. This suggests that further investigations on a larger cohort of women are required to confirm these preliminary results.

Objectives: The purpose of this study was to determine the early spontaneous loss rate in multiple pregnancies following assisted reproductive technology (ART)., Study Design: Analysis of pregnancies following ART as related to the initial number of embryos and maternal age was performed., Results: At least one spontaneous loss was observed in 47.0% (95% CI 29.8-64.9) of quadruplets, 59.3% (95% CI 48.2-69.8) of triplets, and 35.2% (95% CI 29.6-41.2) of twins. The increased loss rates in mothers > or =35 years was related to early twin pregnancies, but not to early triplet and quadruplet gestations. We could not find an effect of the starting number of embryos on either gestational age or birth weight characteristics., Conclusion: Our observations did not identify a clear relation between early spontaneous loss of multiple gestations and either initial number of embryos or maternal age. Other factors might be involved in the outcome of ART multiple pregnancies.

Background: Present opinions regarding developmental delay of children conceived with intracytoplasmic sperm injection (ICSI) are variable and without consensus., Methods: We compared developmental outcome at 1 and 2 years of 50 children conceived by ICSI with 51 spontaneously conceived children. Assessments were performed using the Bayley Scales of Infant Development for motor and mental development and quality of behavior, and the CARE-Index for the quality of parent-child interaction., Results: No difference was present in the motor and mental development of study and control groups, as assessed by the Bayley Scales. However, 1-year-old ICSI children had lower Behavioral Index scores than controls in the "Motor Quality" item (p = 0.04). Regarding interaction with parents, ICSI families had lower "father cooperation" CARE-Index scores (p = 0.02) and lower sensitivity scores (p = 0.007). No significant differences were present between study and control groups for the 2-year-old children., Conclusions: ICSI conceived children develop normally. When assessed by the Bayley Scales of Infant Development and the CARE-Index, the differences in quality of development and social interaction observed at 1 year of age had no negative effect on the overall level of development, and appeared to be related to developmental processes of the entire family unit rather than to ICSI-related biological effects. Observed differences dissipated with familial adaptation and were not observed at 2 years of age.

Diabetes mellitus is one of the main endocrinological disease complicating the course of thalassemia major. This study aimed evaluate beta-cell secretion in 24 patients with thalassemia major attending the hematological Day Hospital at the Pediatric Clinic in Modena where transfusion therapy is performed in all thalassemic patients so as to maintain minimum hemoglobin levels above 10.5 g/dl, together with intensive ferrochelating therapy (desferrioxamine 50-60 mg/kg/die s.c. 6 days a week). A C peptide challenge with glucagon was performed in three patients already receiving insulin therapy for diabetes mellitus; this unexpectedly revealed a slight residual beta-cell secretion. An intravenous glucose tolerance test (IVGTT) was performed in the remaining 21 non-diabetic patients, with widely varying findings regarding insulin secretion: from below 50 microUl/ml in 5 patients to above 200 microUl/ml in 5 patients, and between 50 and 150 microUl/ml in the remaining 11 patients. This study therefore confirmed that insulin secretion frequently alters in thalassemic patients. Moreover, insulin secretion is not correlated to ferritinemia or influenced by familiar diabetes or patient age.

Chronic stress affects the reproductive function by modifying the neuroendocrine homeostasis. The aim of the present study was to clarify the neuroendocrine and the gonadal changes following chronic intermittent stress in male rats and the action of a neuroactive drug, acetyl-l-carnitine (ALC). The effect of two different stressors, cold water swimming or ether, on central beta-endorphin (beta-EP) and GnRH contents, and on plasma testosterone levels was investigated. In addition, the response to an acute stress in chronically stressed rats, treated or untreated with ALC (10 mg/day/rat p.o.), was evaluated. The stressors were applied twice a day for 10 days, and rats were killed before, during and after the last stress session. Mediobasal hypothalamus (MBH) beta-EP and GnRH contents, and plasma testosterone levels were evaluated by radioimmunoassay. The following results were obtained: (1) both chronic swimming and ether stress caused a decrease in hypothalamic beta-EP contents; (2) MBH GnRH contents increased after chronic swimming stress but not after ether stress; (3) chronic swimming stress induced a twofold decrease in plasma testosterone levels, while no changes were observed after ether stress; (4) the treatment with ALC prevented the decrease in plasma testosterone levels after chronic swimming stress, and (5) acute stress in chronically stressed animals caused an increase in MBH-beta-EP. The present data showed that chronic swimming stress reduces the reproductive capacity and impairs the capacity to respond to the acute stress and that ALC modulates the hormonal changes to physical stress and prevents the antireproductive effect of chronic cold swimming.

The aims of the present study were: 1) to compare the effect of two different chronic intermittent stressors i.e. cold-swimming versus ether, on the pituitary opioidergic system; 2) to evaluate the response of pituitary and plasma beta-endorphin (beta-EP) to an acute stress in chronically stressed rats; and 3) to evaluate the effect of acetyl-l-carnitine treatment (10 mg/day/rat per os at night) on pituitary and plasma beta-EP changes induced by two different types of chronic stress. The stressors were applied twice a day for 10 days. Rats were killed either before, during or after the last swimming or ether stress session. beta-EP was measured by radioimmunoassay in anterior pituitary and in neurointermediate lobe extracts and in plasma. The following observations were made: 1) Chronic intermittent cold-swimming stress increased anterior pituitary contents and plasma beta-EP levels; 2) both chronic intermittent cold-swimming stress and ether stress caused an increase of neurointermediate lobe beta-EP contents; 3) as in control animals, rats exposed to chronic intermittent swimming stress reduced pituitary beta-EP contents and raised plasma beta-EP levels in response to the last acute swimming stress; 4) in contrast to control animals, rats exposed to chronic intermittent ether stress did not show any significant response of the pituitary-plasma opioidergic system to the last acute ether session; 5) the acetyl-l-carnitine treatment counteracted the changes evoked by chronic intermittent cold-swimming stress on the pituitary and plasma beta-EP levels.(ABSTRACT TRUNCATED AT 250 WORDS)