Adipose derived stem cells (ASCs) were shown to be as effective

Adipose derived stem cells (ASCs) were shown to be as effective

as the other MSCs by their multipotency and proliferative efficiency. However, neither the differentiation of ASCs to tenocytes nor the tendon regeneration using ASCs have been described in literature. Recently, we have studied the effect of ASCs on primary tendon repair in in-vivo model. In this paper, we sought to discuss tendon tissue engineering by focusing on culture of tenocytes, biomaterials, scaffolds, mechanical loading, fibroblasts and mesenchymal stem cells and mainly on adipose derived stem cells. Tendon regeneration using ASCs might be one of the clinical remedies in near future. In addition, the enhancing effect of ASCs on tendon repair and tendon defects might enable better clinical outcomes in musculoskeletal system reconstruction. IAP inhibitor Advances in biomaterial technology will improve the methodology in tendon regeneration however, up to date, ASCs present an ideal cell source for experimental and clinical research on tendon engineering.”
“Already in the early 1980′s, it has been conjectured that the pulsed ultrasonic polar scan (P-UPS) provides a Wnt pathway unique fingerprint of the underlying mechanical elasticity tensor at the insonified material spot. Until now, that premise has not

been thoroughly investigated, nor validated, despite the opportunities this would create for NDT and materials science in general. In this paper, we report on the first-ever implementation of an inverse modeling technique on the basis of a genetic optimization scheme in order to extract quantitative information from a P-UPS. We validate the optimization approach for synthetic data, and apply it to experimentally obtained polar scans for annealed aluminum, cold rolled DC-06 steel as well as for carbon fiber reinforced plastics. The investigated samples are

plate-like and do not require specific preparation. The inverted material characteristics show good agreement with literature, micro-mechanical models as well as with results obtained through conventional testing procedures.”
“Freshly collected individuals of Orchestia gammarellus from the supralittoral zone of Ghar El Melh lagoon (Northern of Tunisia) were housed in spring in a controlled-environment cabinet. Locomotor activity rhythm of this species was recorded in spring, at a constant temperature of 18 +/- 0.5 degrees C. In Citarinostat supplier the first experiment, juveniles and adults specimens were kept under light-dark cycle in phase with the natural diel cycle. In the two other experiments (males/females and mixed/unmixed groups), individuals of O. gammarellus were maintained under constant darkness. According to double-plotted actograms, waveforms and periodogram analysis, results revealed different locomotor pattern. However, locomotor rhythm of juveniles was more stable than adults. Also, the locomotor activity rhythm of groups was more defined than that of the isolated individuals.

Additional Information Please access these websites via the o

\n\nAdditional Information Please access these websites via the online version of this summary at\n\nThe US National Diabetes Information Clearinghouse provides information about diabetes for patients, health care professionals, and the general public (in English and Spanish)\n\nThe UK National Health Service Choices website provides

information (including some personal stories) for patients and carers about type 2 diabetes, the commonest form of diabetes\n\nThe Canadian Diabetes Association also provides information about diabetes for patients (including some personal stories about living with diabetes) and health care professionals; its latest clinical practice guidelines are available on its website\n\nThe UK National Institute for Health and Care Excellence provides general information about clinical guidelines Quisinostat chemical structure MI-503 concentration and about health care quality standards in the UK\n\nThe

US Agency for Healthcare Research and Quality aims to improve the quality, safety, efficiency, and effectiveness of health care for all Americans (information in English and Spanish); the US National Guideline Clearinghouse is a searchable database of clinical practice guidelines\n\nThe International Diabetes Federation provides information about diabetes for patients and health care professionals, along with international statistics on the burden of diabetes”
“PURPOSE: To evaluate the effect of altering microkeratome parameters (oscillation rates see more and head-advance speeds) and repeated blade use on human and porcine laser in situ keratomileusis interface surface quality and to evaluate correlations between human and porcine

interface surface quality.\n\nSETTING: Emory Vision, Atlanta, Georgia, USA.\n\nMETHODS: Corneal flaps were created in porcine eyes and human cadaver eyes with an Amadeus I microkeratome using varying head-advance speeds and oscillation rates. Microkeratome blades were used once in 18 porcine eyes, twice in 18 human eyes (simulating clinical use), and 5 times in 15 porcine eyes. The interface surface was imaged with electron microscopy, with overall bed quality and surface smoothness graded from 1 to 5 (smoothest to roughest) by 5 masked corneal specialists using the same grading criteria for porcine eyes and human eyes.\n\nRESULTS: Neither oscillation rates nor head-advance speeds consistently influenced bed smoothness in any group. There were no differences in bed quality between first cuts and second cuts in human eyes or between porcine eyes with multiple blade use. Porcine eyes had statistically significantly smoother stromal beds than human eyes (P<.01); there was no correlation between porcine eye scores and human eye scores (r = -0.1).

Results: The CAB sequence compared to ABC

prompts qui

\n\nResults: The CAB sequence compared to ABC

prompts quicker recognition of respiratory (CAB vs. ABC = 17.48 +/- 2.19 vs. 19.17 +/- 2.38 s; p < 0.05) or cardiac arrest (CAB vs. ABC = 17.48 +/- 2.19 vs. 41.67 +/- 4.95; p < 0.05) and faster start SC79 solubility dmso of ventilatory maneuvers (CAB vs. ABC = 19.13 +/- 1.47 s vs. 22.66 +/- 3.07; p < 0.05) or chest compressions (CAB vs. ABC = 19.27 +/- 2.64 vs. 43.40 +/- 5.036; p < 0.05).\n\nConclusions: Compared to ABC the CAB sequence prompts shorter time of intervention both in diagnosing respiratory or cardiac arrest and in starting ventilation or chest compression. However, this does not necessarily entail prompter resumption of spontaneous circulation and significant reduction of neurological sequelae, R406 concentration an issue that requires further studies. (c) 2012 Elsevier Ireland Ltd. All rights reserved.”
“Introduction: The development of multispecies

biofilm models are needed to explain the interactions that take place in root canal biofilnns during apical periodontitis. The aim of this study was to investigate the ability of 4 root canal bacteria to establish a multispecies biofilm community and to characterize the main structural, compositional, and physiological features of this community. Methods: Four clinical isolates isolated from infected root canals, Actinomyces naeslundii, Lactobacillus saliva rius, Streptococcus JNK-IN-8 order gordonii, and Enterococcus faecalis, were grown together in a miniflow cell system. Simultaneous detection of the 4 species in the biofilm communities was achieved by fluorescence in situ hybridization in combination with confocal microscopy at different time points. The LIVE/ DEAD Bac Light technique (Molecular Probes, Carlsbad, CA) was used to assess cell viability and to calculate 3dimensional architectural parameters such as biovolume (mu m(3)). Redox fluorescence dye 5-cyano-2,3-ditoly1 tetrazolium chloride was used to assess the metabolic activity of biofilm bacteria. Results: The 4 species tested were able to form stable and reproducible biofilm communities. The biofilms formed in rich medium generally showed continuous

growth over time, however, in the absence of glucose biofilms showed significantly smaller biovolumes. A high proportion of viable cells (>90%) were generally observed, and biofilm growth was correlated with high metabolic activity of cells. The community structure of biofilms formed in rich medium did not change considerably over the 120-hour period, during which E. faecalis, L. salivarius, and S. gordonii were most abundant. Conclusions: The ability of 4 root canal bacteria to form multispecies biofilm communities shown in this study give insights into assessing the community lifestyle of these microorganisms in vivo. This multispecies model could be useful for further research simulating stresses representative of in vivo conditions.

“Though glycyrrhetinic acid (GA) from Glycyrrhiza glabra w

“Though glycyrrhetinic acid (GA) from Glycyrrhiza glabra was known to exert antioxidant, antifilarial, hepatoprotective, anti-inflammatory and anti-tumor effects, the antitumor mechanism of GA was not clearly elucidated in non-small cell lung cancer cells (NSCLCCs). Thus, in the present study, the underlying apoptotic mechanism of GA was examined in NCI-H460 NSCLCCs. GA significantly suppressed the viability Selleckchem PFTα of NCI-H460 and A549 non-small lung cancer cells. Also, GA significantly increased the sub G1 population by cell cycle analysis and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) positive

cells in a concentration dependent manner in NCI-H460 non-small lung cancer cells. Consistently, GA cleaved poly (ADP-ribosyl) polymerase (PARP), caspase 9/3, attenuated the expression of Bcl-XL, Bcl-2, Cyclin D1 and Cyclin E in NCI-H460 cells. Interestingly, GA attenuated the phosphorylation of protein kinase C (PKC) a/bII and extracellular activated protein kinase (ERK) as well as activated the phosphorylation of PKC d and c-Jun NH2-terminal kinase in NCI-H460 cells. Conversely, PKC promoter phorbol 12-myristate 13-acetate (PMA) and JNK inhibitor SP600125 reversed the cleavages of caspase 3 and PARP induced by GA in NCI-H460

cells. Overall, our findings suggest that GA induces apoptosis via inhibition of PKC a/bII and activation of JNK in NCI-H460 non-small lung cancer cells as a potent anticancer candidate for lung cancer treatment. (C)

2013 Elsevier learn more Ltd. All rights reserved.”
“Recently we showed that exchanging intact casein with extensively hydrolysed casein in Western diets prevented diet-induced obesity in obesity-prone C57BL/6J mice. To gain further insight into the underlying mechanisms for the metabolic alterations induced by intake of hydrolysed casein, we performed an exploratory investigation using proton NMR spectroscopy, multi-block click here PCA (MBPCA) and a multi-compartment model including analyses of plasma, urine, faeces and tissue samples from mice fed diets with intact or hydrolysed casein and 16 or 32 energy% protein. The MBPCA superscores showed a clear separation between samples from mice fed intact and hydrolysed casein diets, respectively. Block loadings revealed that fecal fat content was higher, and tissue and plasma lipid levels were lower in mice fed hydrolysed casein diets compared with mice fed intact casein. Amino acid metabolism was also altered by dietary protein form, and levels of branched-chain amino acids were higher in faeces and urine and lower in plasma and spleen in mice fed hydrolysed protein. Moreover, hepatic levels of the sulphur-containing metabolites taurine and glutathione were increased in mice fed hydrolysed casein, and hepatic glycogen amount was increased in mice fed hydrolysed casein. In contrast, the levels of glucose and its metabolite lactate were reduced in faeces, liver and plasma.

The results show that customers of the commercial restaurant are

The results show that customers of the commercial restaurant are directly benefitted since the nutritional quality of the

fruits was preserved during all of the handling and distribution A-769662 mouse periods.”
“Men are different from women, and patients with epilepsy are different in many aspects from healthy control subjects. Quantitative or semiquantitative analysis of neuroimaging data depends on the comparison between either a single patient against a group of healthy or unaffected controls, or comparisons between groups of patients and controls. Matching for gender is desired, but is sometimes not possible, for example, in the case of nuclear medicine with women in childbearing age usually not being recruited as healthy controls. Antiepileptic drug treatment is the other major confounder for comparisons of cognitive functioning between patients and healthy control subjects. Whether these two covariates, gender and drug effects, are

of interest or nuisance variables depends on the question and design of the neuroimaging study.”
“In this work, a semi-analytical model was developed to determine the contrast-to-noise ratio (CNR) and the normalized average glandular dose ((D) over bar (gN)) in digital mammography, taking into account interactions LDN-193189 up to second order. The optimal x-ray spectra were investigated using a Figure of Merit (FOM), for different breast thicknesses (3 cm <= L <= 7 cm) and glandularities (20% and 50%), anti-scatter grids types, considering a-Se and CsI image receptors. The anode/filter combinations evaluated were: Mo/Mo, Mo/Rh, Rh/Rh, and a W anode combined with k-edge filters (Mo, Ru, Rh, Pd, Ag, Cd, In and Sn), for tube potential between 23 and 35 kVp. Results demonstrate that the W-anode

spectra SB203580 inhibitor combined with k-edge filters show a superior performance compared to the Mo/Mo combination traditionally employed in mammography, for all conditions analyzed. The optimum general x-ray spectra for 3 cm, 5 cm and 7 cm breasts are, respectively, W/Mo at 23 kVp, W/Pd at 28 kVp and W/Ag at 30 kVp. For the a-Se receptor, the optimum filter atomic number is one unit higher than that obtained for the CsI, while the optimal tube potentials are the same. The optimal tube potential was up to 1-2 kVp greater for a linear grid than that obtained without grid or with a cellular grid. For breast thicker than 7 cm, the optimum filter atomic number also increases by one unit for a linear grid. Compared to standard technique, the performance improvement of a W anode with proper k-edge filters is more noticeable for thicker and denser breasts, for a a-Se receptor and a linear grid. Finally, it was verified that the semi-analytical model implemented provided results of optimum x-ray spectra in a fast and simple way, with a good agreement with those obtained experimentally or by Monte Carlo simulation.”
“We examined lifetime clutch production and size at maturity for blue crabs Callinectes sapidus Rathbun in North Carolina, USA.

The mouse cortex displays a number of other features that disting

The mouse cortex displays a number of other features that distinguish it from the cortex of primates and suggest a somewhat less complex pattern of organization. Nevertheless, dramatic findings on the origins and migratory patterns of newly specified GABAergic cortical interneurons in the embryonic mouse have led to a prevailing view that GABAergic cortical interneurons of all species are born ICG-001 chemical structure in the ganglionic eminence and undergo the same long tangential migration toward the cortex that is

seen in the mouse. Recent observations in fetal human and monkey brains, although clearly identifying GABAergic neurons that reach the neocortex via the tangential route, also demonstrate that substantial numbers of GABA neurons are generated in the lateral ventricular neuroepithelium and migrate into the cortex via the same radial route followed by glutamatergic neurons. In the course of evolution of the higher primate cortex, it is likely that new forms of cortical interneuron with origins in the ventricular neuroepithelium have been added to an older population derived Kinase Inhibitor Library from the ganglionic eminence.”
“Light-at-night (LAN) has become a defining feature of human and animal ecosystems and may possibly compromise human and animal physiology and health. Spectral and acclimation duration (AD) sensitivity were compared between social voles

(Microtus socialis) and ‘blind’ mole rats (Spalax ehrenbergi) in four increasing ADs (0, 1, 7 and 21 days) to LAN (1×30 min, 293 mu W cm(-2)) of three different monochromatic lights [blue (479 nm), yellow (586 nm) and red (697 nm)]. Animals were sampled

for urine and oxygen consumption (Vo(2)) promptly after each LAN-AD. Urine samples were analyzed for production rate, urinary 6-sulfatoxymelatonin and urinary metabolites of adrenalin and cortisol. Overall, the blue light elicited the greatest effects on the biological markers of M. socialis, whereas similar effects were detected for S. ehrenbergi in response to red light. The increasing LAN-AD resulted in a dose-dependent decrement selleck chemicals of all markers tested, except of stress hormones, which showed a direct positive correlation with LAN-AD. Our results suggest that: (1) photoperiod is an important cue for entraining physiological functions in the ‘blind’ S. ehrenbergi, which is essentially characterized by red-shifted sensitivity compared with the blue-shifted sensitivity detected for the sighted counterpart species, and (2) there is a strong association between LAN of the appropriate wavelength and adrenal endocrine responses, suggesting that LAN is a potential environmental stressor.”
“In the search for new therapeutic tools against parasitic diseases caused by the Kinetoplastids Leishmania spp.

Overall 131 suspected NET cases were included The most commo

\n\nOverall 131 suspected NET cases were included. The most common condition considered suspicious for NET Selleck GSK461364 was the increase of blood markers (66), followed by inconclusive findings at conventional imaging (CI, 41), clinical signs/symptoms (10), equivocal F-18-fluorodeoxyglucose (FDG) PET (7) or somatostatin receptor scintigraphy (SRS, 4), or a combination of the above (3). PET/CT results were true-positive in 17 cases, true-negative in 112 and false-negative in 2 (overall sensitivity 89.5 %, specificity 100 %). Interestingly, increased blood markers and clinical signs/symptoms were associated with the lowest frequency of true-positive findings (1/66 and 1/10, respectively),

while CI findings were confirmed in one third of the cases (13/41).

Overall, the incidence of NET in the studied population was 14.5 % (19/131).\n\nOur data confirm the good accuracy (98 %) of Ga-68-DOTA-NOC PET/CT in NET lesion detection. However, our results also suggest that Ga-68-DOTA-NOC PET/CT may not be routinely recommended in patients with a suspicion of NET based on the mere detection of increased blood markers or clinical symptoms. Positive CI alone or in association with clinical/biochemical findings is on the contrary associated with a higher probability of true-positive findings.”
“Despite the increased use of complementary and alternative medicine (CAM) by breast cancer patients, there is little published information regarding CAM use in the Scottish breast cancer population.\n\nA questionnaire comprising five sections-demographics; see more perceived health Cyclosporin A cell line status, prescribed medicines; use, indications, satisfaction and expenditure on CAMs; attitudes towards and factors associated with CAM use; and attitudinal statements-was issued to patients attending the Aberdeen Breast Clinic.\n\nA total of 453

questionnaires were distributed and 360 (79.5%) returned. Respondents were prescribed a mean of 3.2 medicines (95% CI 2.83-3.47). With regard to CAM use, 33.1% of respondents reported current use, 36.4% prior use, and 30.6% reported never having used CAMs. The key indications for use were general well being, boosting immune system and cancer prophylaxis, with high levels of satisfaction reported. The strongest association for CAM use was use by friends and family and higher educational attainment (p < 0.001). Supplements with estrogenic activity, such as soya or red clover, were taken by 29% of respondents. Herbs (echinacea, pomegranate, peppermint, chamomile, grapefruit, garlic, ginseng) that have the potential to interact with adjuvant endocrine therapies (tamoxifen, anastrazole, letrozole, exemestane) were being taken by 38% of treated patients.\n\nThe level of CAM use by Scottish breast cancer patients is similar to that reported from other countries, although there are marked differences in the type, nature and frequency of specific CAM therapies.

in net-concentrated phytoplankton samples were picked out and a p

in net-concentrated phytoplankton samples were picked out and a partial sequence of the large subunit ribosomal RNA gene (LSU rDNA) was amplified using a single-cell

polymerase chain reaction (PCR) method. Cells of both toxic A. tamarense species complex and non-toxic A. affine were identified from the phytoplankton samples based on the partial LSU rDNA sequence information. According to these findings, it is implied that A. tamarense species complex is the major toxic species related to PST contamination in scallops of the northern Yellow Sea. The presence of both toxic and non-toxic Alexandrium spp. in this region requires for a species-specific method to monitor the distribution and dynamics of A. tamarense species complex.”
“Background: The use of prophylactic anticonvulsants following BVD-523 inhibitor brain injury is controversial. When used for this reason or for treatment of early seizures, anticonvulsants, particularly phenytoin, can cause severe cognitive side-effects.\n\nCase report: This study presents a case of a woman with a severe brain injury with severe cognitive impairment who improved dramatically following withdrawal of phenytoin. The literature regarding such cognitive side-effects

is contradictory with no consistent indication of choice of anticonvulsants to use in this situation.\n\nConclusion: As a result of the dramatic improvement in this case, one should now routinely withdraw or change phenytoin Bromosporine datasheet treatment in all brain injury patients with significant cognitive impairment.”

and nanoporous membranes have a wide range of applications in many fields, including medical diagnostics, drug delivery, and hemodialysis. Ultrananocrystalline diamond coatings are becoming more and more significant in medical applications because of the highest degree of biocompatibility, unmatched by other materials. The pores ranging in diameter from 100 to 2000 nm have been fabricated in a 1-mu m-thick ultrananocrystalline diamond film on silicon wafers using e-beam and optical lithography, reactive ion etching, and laser writing. (C) 2010 American Vacuum Society. [DOI: 10.1116/1.3501345]“
“Objective: To determine which demographic, injury, and rehabilitation factors are associated with employment rates in Hispanic individuals 1 year post traumatic brain injury (TBI).\n\nDesign: Retrospective study.\n\nSetting: Longitudinal dataset of the TBI Model Systems National Database.\n\nParticipants: 418 Hispanic individuals with TBI hospitalized between 1990 and 2009 having year 1 follow-up data (18-55 years and not retired at injury).\n\nMain outcome measure: Competitive employment status 1 year post-injury (yes/no).

It is not uncommon to find more than one abnormality among these

It is not uncommon to find more than one abnormality among these patients. This information may be used in advising patients and their physicians as to the risks of additional TED following future surgical procedures and can be the basis for recommending

life style changes. Blood Coagul Fibrinolysis 24:59-63 (C) 2012 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.”
“Cystatin C is a cysteine protease inhibitor produced by a variety of human tissues. The blood concentration of cystatin C depends on the glomerular filtration rate and is an endogenous marker of renal dysfunction. Recombinant cystatin C protein with high immunogenicity is therefore in demand for the diagnostic market. In this study, to establish an efficient production system, a synthetic cystatin C gene was designed and synthesized in accordance with the codon preference of Escherichia

coil genes. Recombinant cystatin C was expressed as a fusion with a peptide-tag, 4AaCter, which facilitates formation of protein inclusion bodies in E. coli cells. Fusion with 4AaCter-tag dramatically increased the production level of cystatin C, and highly purified protein was obtained without the need for complicated purification steps. The purity and yield of the final product was estimated as 87 +/- 5% and 7.1 +/- 1.1 mg/l culture, respectively. The recombinant cystatin C prepared by our method was as reactive against anti-cystatin C antibodies as native human cystatin click here C. Our results suggest that protein production systems using 4AaCter-tag could be a powerful means of preparing significant amounts of antigen protein. (C) 2013 Elsevier Inc. All rights reserved.”
“Establishing specific biomarkers for the assessment of human male fertility status is an important goal to ensure the fitness of the male contribution so as to support the birth of a healthy child. Spermatozoa are considered an optimal

surrogate tissue for the evaluation of spermatogenic function. LY3023414 mouse Unlike the cells of the testis, spermatozoa do not require invasive procedures to procure a sample. A broad range of sperm biomarkers and tests have been described as useful for the assessment of the sperm function. However, these approaches appear limited considering the current state of the art of molecular diagnostics that could be developed for this purpose. In this review, we outline the suite of sperm biomarkers that are currently in use to assess human male fertility status. Their use as indicators of genotoxic exposure will be discussed.”
“Based on a line of evidence (logP, pKa, H-1-, and C-13-NMR, and molecular modeling studies), it appears that cocaine undergoes a hydrophobic collapse which may account for its unprecedented ADME properties, in particular, its exceptional capacity to cross biological membranes.

These observations are consistent with an allosteric response ari

These observations are consistent with an allosteric response arising from changes in protein motion rather than conformation, and suggest ligands that modulate protein dynamics may be effective inhibitors of this enzyme.”
“Background: The sentinel lymph click here node (SLN) technique aims at predicting the absence of regional nodal metastasis and seems promising in the management Of cervical cancer patients. Patients and Methods: Fort)? patients undergoing surgery

for early cervical cancer were submitted to the SLN procedure, using Blue Patente alone in 3, radiocolloid injection alone in 4 and both methods in 33 (82.5%). All patients underwent radical hysterectomy and pelvic lymphadenectomy. Results: The detection rate was as follows: overall 85%, blue dye alone 66%, radiocolloid alone 75%, dual method 87%. Detection was successful in 34 patients, with one false-negative result. No micrometastases were demonstrated during ultrastaging of the sentinels. The detection rate was higher in tumors <2 cm (94.1%)

than in larger tumors (78.2%, p>0.09). Significant negative correlation between lymphatic vascular space invasion (LVSI) and detection rate was found (p<0.001). Conclusion: SLN detection is feasible in early cervical cancer but presence of LVSI and a tumor size >2 cm negatively affect the detection rate and may increase the incidence of false negatives.”
“Objective: To explore the constructs underlying a self-report assessment of multimorbidity.\n\nStudy Design and Setting: We conducted a cross-sectional survey of 352 HMO members aged 65 years or more with, at a minimum, diabetes, depression, and osteoarthritis. We assessed self-reported ‘disease burden’ (a severity-adjusted count of conditions) as a function of biopsychosocial factors, two data-based comorbidity indices, and demographic variables.\n\nResults: In multivariate regression, age, ‘compound effects of conditions’ (treatments and symptoms interfering with each other), self-efficacy, financial constraints,

and physical functioning were significantly (p <= 0.05) associated with disease burden. An ICD-9-based morbidity index did not significantly contribute to disease burden, and a pharmacy-data-based morbidity index was minimally significant.\n\nConclusion: This measure of self-reported disease burden represents an amalgamation of functional capabilities, social considerations, and medical conditions that are not captured by two administrative data-based measures of morbidity. This suggests that (a) self-reported descriptions of multimorbidity incorporate biopsychosocial constructs that reflect the perceived burden of multi morbidity, (b) a simple count of diagnoses should be supplemented by an assessment of activity limitations imposed by these conditions, and (c) choice of the morbidity measurement instrument should be based on the outcome of interest rather than on the most convenient method of measurement. (C) 2009 Elsevier Inc. All rights reserved.