“
“The dehydrogenation of methylcyclohexane (MCH) to toluene (TOL) for hydrogen production was theoretically and experimentally investigated

in a bimodal catalytic membrane reactor (CMR), that combined Pt/Al2O3 catalysts with a hydrogen-selective organosilica membrane prepared via sol-gel processing using bis(triethoxysilyl) ethane (BTESE). Effects of SNS-032 in vitro operating conditions on the membrane reactor performance were systematically investigated, and the experimental results were in good agreement with those calculated by a simulation model with a fitted catalyst loading. With H-2 extraction from the reaction stream to the permeate stream, MCH conversion at 250 degrees C was significantly increased beyond the equilibrium conversion of 0.44-0.86. Because of the high H-2 selectivity and permeance of BTESE-derived membranes, a H-2 flow with purity higher than 99.8% was obtained in the permeate stream, and the H-2 recovery ratio reached 0.99 in a pressurized reactor. A system that combined the CMR with a fixed-bed prereactor was proposed for MCH dehydrogenation.

(c) 2015 American Institute of Chemical Engineers AIChE J, 61: 1628-1638, 2015″
“P>Background\n\nPrevious reports have suggested that certain probiotics given PLX4032 clinical trial to mothers and children at risk of atopy halves the incidence of atopic dermatitis (AD) at 2 years of age.\n\nObjectives\n\nTo examine if probiotics given to pregnant women in a nonselected population could prevent atopic sensitization or allergic diseases during the child’s first 2 years.\n\nMethods\n\nIn a randomized, double-blind trial of children from a nonselected maternal population (ClinicalTrials.gov identifier: NCT00159523), women received probiotic milk or placebo from 36 weeks of gestation to 3 months postnatally during breastfeeding. The probiotic milk contained Lactobacillus rhamnosus GG, L. acidophilus La-5 and Bifidobacterium animalis subsp. lactis Bb-12. Children with an itchy rash for more than

4 weeks were assessed for AD. At 2 years of age, all children were assessed for atopic sensitization, AD, asthma and allergic rhinoconjunctivitis. The intention-to-treat (ITT) analysis was enabled by multiple imputations.\n\nResults\n\nFour hundred and fifteen pregnant women were computer randomized. At 2 years, 138 and 140 children in the probiotic and the placebo groups, respectively, were assessed. In the ITT analysis, the odds ratio Selleckchem GSK923295 (OR) for the cumulative incidence of AD was 0 center dot 51 in the probiotic group compared with the placebo [95% confidence interval (CI) 0 center dot 30-0 center dot 87; P = 0 center dot 013]. There were no significant effects on asthma (OR 0 center dot 68, 95% CI 0 center dot 26-1 center dot 80; P = 0 center dot 437) or atopic sensitization (OR 1 center dot 52, 95% CI 0 center dot 74-3 center dot 14; P = 0 center dot 254).\n\nConclusions\n\nProbiotics given to nonselected mothers reduced the cumulative incidence of AD, but had no effect on atopic sensitization.

Genetic factors might contribute to bronchopulmonary dysplasia Selleck Nutlin 3 susceptibility.\n\nObjectives: To identify genetic variants involved in bronchopulmonary dysplasia through a genome-wide association study.\n\nMethods: We prospectively evaluated 418 premature neonates (gestational age <28 wk), of whom 22% developed bronchopulmonary dysplasia. Two discovery series were created, using a DNA pooling strategy in neonates

from white and African ancestry. Polymorphisms associated with the disease were confirmed in an independent replication population. Genes were then explored by fine mapping and associations were replicated in an external Finnish population of 213 neonates. Validated genes expression patterns were studied in rat lung, after air or hyperoxia exposure.\n\nMeasurements and Main Results: SPOCK2 gene was identified by both discovery series. The most significant polymorphism (rs1245560; P = 1.66 x 10(-7)) was confirmed by individual genotyping, and in the replication population (P = 0.002). Fine mapping confirmed the association of rs1245560 with bronchopulmonary dysplasia Selleck BVD-523 in both white and African populations with adjusted odds ratios of 2.96 (95% confidence interval [CI], 1.37-6.40) and 4.87 (95% CI, 1.88-12.63), respectively.

In white neonates, rs1049269 was also associated with the disease (odds ratio, 3.21; 95% CI, 1.51-6.82). These associations were replicated in the Finnish population. In newborn rat lungs, SPOCK2 mRNA levels markedly selleckchem increased during the alveolar stage of lung development. After rat exposure to hyperoxia, SPOCK2 expression increased relative to air-exposed controls.\n\nConclusions: We identified SPOCK2 as a new possible candidate susceptibility gene for bronchopulmonary dysplasia. Its lung expression pattern points toward a potential role in alveolarization.”
“Na+/Ca2+ exchange is important to cell physiology and metabolism,

but its role in the secondary metabolite biosynthesis by fungi is yet unclear. In this work, in static liquid cultures of Ganoderma lucidum, which is an efficient process for hyper-production of anti-tumor ganoderic acids (GAs), it was interestingly found that Na+ addition could enhance the GAs production, but K+ did not. Further investigation by intracellular Ca2+ imaging and using a calcineurin inhibitor (i.e., cyclosporin A) revealed that addition of Na+ led to the influx of Ca2+ from culture broth to the cells and calcineurin signals were also triggered. Addition of 100mM Na+ at the beginning of the static liquid cultivation, in which the addition dosage and timing were optimized, resulted in 2.8-fold improvement of total GAs production. Quantitative gene transcription analysis indicated that the expression levels of the genes of Ca2+ sensors and GA biosynthesis were upregulated with Na+ induction while downregulated by using the calcineurin inhibitor, implying that higher GA production might result from higher expression of those genes.

Urologic pathologists show good to excellent agreement when evaluating EPE and SM. Interobserver variability for EPE and SM interpretation was principally related to the lack of a clearly definable prostatic capsule and crush/thermal artifact along the edge of the gland, respectively.”
“Our research group recently reported that pancreatic endocrine cancer cell lines are sensitive to the HDAC inhibitor trichostatin A (TSA). In the present paper, we show that the combined treatment of pancreatic endocrine tumour cell lines with TSA and the DNA methyltransferase inhibitor

5-aza-2′-deoxycytidine (DAC) determines a strong synergistic inhibition of proliferation mainly due to apoptotic cell death. Proteomic analysis demonstrates that the modulation of specific proteins correlates with ON-01910 the antiproliferative effect of the drugs. A schematic network clarifies the most important targets or pathways involved in pancreatic endocrine cancer growth inhibition

by single or combined drug treatments, which include proteasome, mitochondrial apoptotic pathway and caspase related proteins, p53 and Ras related proteins. A comparison between the patterns of proteins regulated by TSA or DAC in endocrine and ductal pancreatic cancer cell lines is also presented.”
“Introduction: Disseminated intravascular coagulation (DIC) with an antifibrinolytic phenotype is characterized by microvascular thrombosis selleck kinase inhibitor leading to poor outcome at the late-stage of trauma. To test the hypothesis that DIC with a fibrinolytic

phenotype at an early stage of trauma also contributes to a poor outcome due to severe bleeding, we conducted a retrospective. cohort study.\n\nMaterials and Methods: The subjects included 314 consecutive severe trauma patients. A systematic review of medical records of the patients was conducted to provide the base line characteristics and DIC-related variables. The data of these variables were obtained at 4 time points within 24 hr after Selleckchem PF-6463922 arrival to the emergency department (ED): Time Point 1, immediately after arrival to the ED to 4 hr after arrival; Time Point 2, 4 to 8 hr after arrival; Time Point 3, 8 to 16 hr after arrival; Time Point 4, 16 to 24 hr after arrival.\n\nResults: Nonsurvivors (87.3%, 48/55) met the Japanese Association for Acute Medicine (JAAM) DIC criteria showing lower fibrinogen levels, a prolonged prothrombin time, and higher fibrin/fibrinogen degradation products (FDP) and D-dimer levels in comparison to those of the 289 survivors. The FDP/D-dimer ratio and lactate level were significantly higher in the nonsurvivors than those of the survivors. Lower fibrinogen levels and higher FDP/D-dimer ratio suggest fibrinogenolysis in DIC of the nonsurvivors. Furthermore a stepwise logistic regression analysis showed that the JAAM DIC score, levels of fibrinogen, FDP and lactate at Time Point 1 are independent predictors of death. Low levels of fibrinogen and high FDP but not D-dimer predict massive bleeding at an early stage of trauma.

23 mg/dL, 95% CI 0.04 to 0.42) and parathyroid hormone (PTH) (12 studies, 2551 participants; MD 56 pg/mL, SHP099 cost 95% CI 26 to 84) but a significant increase in the risk of hypercalcaemia (12 studies, 1144 participants: RR 0.45, 95% CI 0.35 to 0.59) with calcium-based agents compared to sevelamer hydrochloride. There was a significant increase in the risk of adverse gastrointestinal

events with sevelamer hydrochloride in comparison to calcium salts (5 studies, 498 participants: RR 1.58, 95% CI 1.11 to 2.25). Compared with calcium-based agents, lanthanum significantly reduced serum calcium (2 studies, 122 participants: MD -0.30 mg/dL, 95% CI -0.64 to -0.25) and the Ca x P product, but not serum phosphorus levels. The effects of calcium acetate on biochemical end-points were similar to those of calcium carbonate. The phosphorus lowering effects of novel agents such as ferric citrate, colestilan and niacinamide

were only reported in a few studies.\n\nAuthors’ conclusions\n\nAvailable phosphate-binding agents have been shown to GS-9973 supplier reduce phosphorus levels in comparison to placebo. However, there are insufficient data to establish the comparative superiority of novel non-calcium binding agents over calcium-containing phosphate binders for patient-level outcomes such as all-cause mortality and cardiovascular end-points in CKD.”
“BACKGROUND Atrial fibrillation (AF) is a leading cause of total and fatal ischemic PF-03084014 cost stroke. Stroke risk after AF ablation appears to be favorably affected; however, it is largely unknown whether the benefit extends to all stroke CHADS2 risk profiles of AF patients.\n\nOBJECTIVE To determine if ablation

of atrial fibrillation reduces stroke rates in all risk groups.\n\nMETHODS A total of 4212 consecutive patients who underwent AF ablation were compared (1:4) with 16,848 age-/sex-matched controls with AF (no ablation) and to 16,848 age-/sex-matched controls without AF. Patients were enrolled from the large ongoing prospective Intermountain Atrial Fibrillation Study and were followed for at Least 3 years.\n\nRESULTS Of the 37,908 patients, the mean age was 65.0 +/- 13 years and 4.4% (no AF), 6.3% (AF, no ablation), and 4.5% (AF ablation) patients had a prior stroke (P < .0001). The profile of CHADS2 scores between comparative groups was similar: 0-1 (69.3%, no AF; 62.3%, AF, no ablation; 63.6%, AF ablation), 2-3 (26.5%, no AF; 29.7%, AF, no ablation; 28.7%, AF ablation), and >= 4 (4.3%, no AF; 8.0%, AF, no ablation; 7.7%, AF ablation). A total of 1296 (3.4%) patients had a stroke over the follow-up period. Across all CHADS2 profiles and ages, AF patients with ablation had a Lower long-term risk of stroke compared to patients without ablation. Furthermore, AF ablation patients had similar Long-term risks of stroke across all CHADS2 profiles and ages compared to patients with no history of AF.

To demonstrate the viability of the operando EPR method, two cells using different electrolytes were studied. When using an electrolyte containing fluoroethylene carbonate (FEC) additive, a higher reversibility of the lithium anode and reduced formation of micro-structured (mossy/dendritic) lithium were observed.”
“The 4-(5-fluoro-6-methyl-pyridin-2-yl)-5-quinoxalin-6-yl-1H-imidazol-2-ylamine 3 is a potent and selective inhibitor of TGF-beta R1. Substitution of the amino group of 3 typically led to a

slight decrease in the affinity for the receptor and in TGF-beta-inducted PAI-luciferase reporter activity. However, 2-acetamidoimidazoles were identified as attractive candidates for further optimization as a result of their significant activity combined to their superior pharmacokinetic profile. (C) 2008 Elsevier Ltd. All rights reserved.”
“Engagement of Fc epsilon RI causes its phosphorylation check details by Lyn kinase. Two alternatively spliced variants, Lyn A and B, are expressed in mast cells, and both isoforms interact with Fc epsilon RI. Unlike Lyn

A, Lyn B lacks a 21-aa region in the N-terminal unique domain. In this study, we investigated the role of Lyn A and B isoforms in mast cell signaling and responses. Lyn B was found to be a poor inducer of mast cell degranulation and was less potent in both inositol 1,4,5-triphosphate production and calcium responses. Expression of Lyn B alone showed reduced phosphorylation of both phospholipase C gamma-1 and -2 and decreased interaction of phospholipase C gamma-1 with the phosphorylated linker for activation of T cells. Lyn Immunology & Inflammation inhibitor B also showed increased binding of tyrosine-phosphorylated proteins, which included the negative regulatory lipid phosphatase SHIP-1. In contrast, both Lyn Selleck GSK923295 A and B caused similar total cellular tyrosine

phosphorylation and Fc epsilon RI phosphorylation and neither Lyn A nor Lyn B alone could completely restore mast cell degranulation or dampen the excessive cytokine production seen in the absence of Lyn. However, expression of both isoforms showed complementation and normalized responses. These findings demonstrate that Lyn B differs from Lyn A in its association with SHIP-1 and in the regulation of calcium responses. However, complementation of both isoforms is required in mast cell activation. The Journal of Immunology, 2010, 184: 5000-5008.”
“Tie2 is a receptor tyrosine kinase expressed on vascular endothelial cells (ECs). It has dual roles in promoting angiogenesis and stabilizing blood vessels, and it has been suggested that Tie2 forms dimers and/or oligomers in the absence of angiopoietin-1 (Ang1); however, the mechanism of ligand-independent dimerization of Tie2 and its biological significance have not been clarified. Using a bimolecular fluorescence complementation assay and a kinase-inactive Tie2 mutant, we show here that ligand-independent Tie2 dimerization is induced without Tie2 phosphorylation.

We conducted a cross-sectional survey of health workers in Africa and Asia in order to profile the availability of health technologies considered to be essential to providing safe childbirth care.\n\nMethods: Health workers in Africa and Asia were surveyed using a web-based questionnaire. A list of essential childbirth-related health technologies was drawn from World Health Organization guidelines for preventing and managing complications associated with

the major causes of maternal and newborn mortality globally. Demographic data describing each birth center were obtained and health workers reported on the availability of essential childbirth-related health technologies at their centers. Comparison analyses were conducted using Rao-Scott chi-square test statistics.\n\nResults: Health workers from 124 birth centers in 26 African and 15 Asian countries participated.

see more All facilities exhibited gaps in the availability of essential childbirth-related health technologies. Availability was significantly reduced in birth centers that had lower birth volumes and those from lower income countries. On average across all centers, health workers reported the availability of 18 of 23 essential childbirth-related health technologies (79%; 95% CI, 74%, 84%). Low-volume facilities suffered severe shortages; on average, these centers reported reliable availability of 13 of 23 technologies (55%; 95% CI, 39%, 71%).\n\nConclusions: Substantial gaps exist in the availability Tubastatin A mw of essential childbirth-related health technologies across health sector levels in Africa and Asia. Strategies that facilitate reliable access to vital health technologies in these regions are an urgent priority.”
“Hirschsprung disease (HD), a neurocristopathy characterized by failed migration of neural crest cells to the distal colon, requires surgical resection of the aganglionic segment. Advances in stem cell and regenerative medicine research have opened the possibility to treat HD less invasively using selleck kinase inhibitor enteric nervous system (ENS) cell replacement therapy. This article

reviews the progress to date of culturing and delivering ENS stem cells in various in vitro and in vivo models, as well as review the available evidence of functionality of the transplant-derived cells. Potential areas of future study are identified, and application of conditions other than HD is briefly discussed.”
“Four alkaloids named hosieines A-D were isolated from the root and stem of Ormosia hosiei. Their flat structures were established by mass spectrometry and by a combination of NMR experiments. These molecules probably share a common biosynthetic origin with the lupin alkaloids but they differ in the formation of the last ring, being here part of a rare 2-azabicyclo[3.2.1]octane system. Their absolute configuration was determined by X-ray crystallography using CuK alpha radiation.

We also used functional magnetic resonance

imaging (fMRI) to examine how the time available for stopping affects activity in the putative right inferior frontal gyrus and presupplementary motor area (right IFG-preSMA) network that is known to support stopping. While undergoing fMRI scanning, participants performed a stop-signal variant where the time available for stopping was kept approximately constant across participants, which enabled us to compare how the time available for stopping affected stop-signal task difficulty both within and between subjects. Selleckchem GSK2126458 Importantly, all behavioural and neuroimaging data were consistent with previous findings. We found that the time available for stopping distinguished successful from unsuccessful inhibition trials, was independent of stop-signal delay, and affected successful inhibition depending upon individual SSRT. We also found that right IFG and adjacent anterior insula were more strongly activated during more difficult stopping. These findings may have critical implications for stop-signal studies that compare different patient or other groups using 5-Fluoracil manufacturer fixed stop-signal delays. Crown Copyright (C) 2013 Published by Elsevier B.V. All rights

reserved.”
“Background: Copy number variation (CNV) contributes to the variation observed between individuals and can influence human disease progression, but Adriamycin the accurate measurement of individual copy numbers is technically challenging. In the work presented here we describe a modification to a previously described paralogue ratio test (PRT) method for genotyping the CCL3L1/CCL4L1 copy variable region, which we use to ascertain CCL3L1/CCL4L1 copy number in 1581 European samples. As the products of CCL3L1 and CCL4L1 potentially play a role in autoimmunity we performed case control association studies with Crohn’s disease, rheumatoid arthritis and

psoriasis clinical cohorts.\n\nResults: We evaluate the PRT methodology used, paying particular attention to accuracy and precision, and highlight the problems of differential bias in copy number measurements. Our PRT methods for measuring copy number were of sufficient precision to detect very slight but systematic differential bias between results from case and control DNA samples in one study. We find no evidence for an association between CCL3L1 copy number and Crohn’s disease, rheumatoid arthritis or psoriasis.\n\nConclusions: Differential bias of this small magnitude, but applied systematically across large numbers of samples, would create a serious risk of false positive associations in copy number, if measured using methods of lower precision, or methods relying on single uncorroborated measurements. In this study the small differential bias detected by PRT in one sample set was resolved by a simple pre-treatment by restriction enzyme digestion.

The results contrast with the inertness of a nearby relict spill, which occurred in 1969 in West Falmouth, MA. Sequences of 16S rRNA genes from our experimental samples also were consistent with previous reports suggesting the importance of Gamma- and Deltaproteobacteria and Firmicutes in the remineralization of hydrocarbons. The magnetic bead capture approach makes it possible to quantify uptake of petroleum hydrocarbons by microbes in situ. Although employed here at the domain level, RNA capture procedures can be highly specific. The

same strategy could be used with genus-level specificity, something which is not Compound C datasheet currently possible using the C-13 content of biomarker lipids.”
“Muscle cells are often exposed to bone morphogenetic proteins (BMPs) in pathological muscle and/or bone conditions. Because BMPs function as strong bone inducers as well as myogenesis inhibitors, certain molecules likely prevent muscle cells from converting into pathologic bone; without these molecules, de novo bone would form as observed in myositis ossificans traumatica. When C2C12 myoblasts are exposed to BMPs, they differentiate Selleckchem JQ-EZ-05 into osteoblastic cells but cannot mature into bone cells. As the Osterix gene, a transcription factor for osteoblast differentiation, is only transiently induced upon BMP stimulation in C2C12 cells, we hypothesized that unknown transcriptional repressor(s)

inhibit Osterix expression and prevent complete osteoblastic differentiation. Gene microarray analyses were performed to identify putative inhibitors selleck products for osteoblastic differentiation, and the paired-like homeodomain transcription factor Pitx2 (also termed Rieg), which plays an important regulatory

role in left-right asymmetry, was identified. Pitx2 was induced 2 days after BMP stimulation in C2C12 cells in concert with Osterix down-regulation. Overexpression of Pitx2 repressed Osterix expression and subsequent osteoblastic differentiation, whereas Runx2, the most upstream regulator of osteogenesis, was unaffected. Conversely, the induction of short hairpin RNA for Pitx2 in C2C12 cells enhanced Osterix expression and osteoblastic maturation upon BMP stimulation. Moreover, mouse embryonic fibroblasts containing myoblasts from Pitx2-null embryos showed enhanced Osterix expression upon BMP stimulation. These findings suggest that Pitx2 suppresses osteogenic signals induced by BMPs in myoblasts to prevent their osteoblastic conversion.”
“Is knowledge structured and acquired as independent facts and concepts, as parcels of independent domains, or as domains that share conceptual abilities? For an answer, we looked at the development of two concepts, belief and identity. These concepts are not part of the same domain, but the application of both depends on the common ability to separate sense from reference.

“
“Plants exposed to limited water availability respond with a series of developmental, morphological, biochemical and molecular adaptations, aiming at safeguarding Natural Product Library basal levels of metabolic activity. Given that sorghum (Sorghum bicolor L. Moench) is regarded as a drought-tolerant species, it provides an ideal model to study the molecular and physiological mechanisms underlying such tolerance. Young sorghum seedlings grown under controlled conditions were subjected to drought stress, induced by polyethylene glycol (PEG) 6000 at two levels of stress

(2.5% and 5% PEG), for 7 days. Non-stressed plants were also included as controls. Metabolite profiling on leaves and roots of stressed and control plants was performed by Gas-chromatography combined with Mass-spectrometry (GC-MS). For each treatment and tissue type, four biological replications were conducted. In total, the analysis yielded 143 quantifiable compounds with highly reproducible patterns. Comparative metabolite profiling of stressed versus control plants revealed that drought stress substantially alters the metabolite content in both leaves and roots. In leaves, most profound alterations were observed in compounds belonging to the group of sugars, including D-mannose,

https://www.selleckchem.com/products/jph203.html D-glucose, isomaltose, fructose and sucrose, but also myo-inositol and L-asparagine whereas in roots, most

influencing compounds were certain sugars, such as D-glucose, fructose, sucrose and D-(+)trehalose, as well as D-mannitol. Deduced metabolomics data are discussed and suggested as functional tools towards understanding the underlying regulatory networks involved in the Belnacasan price physiology of drought tolerance in sorghum.”
“The efficient delivery of viral vectors to tumors is an active area of investigation. A number of barriers exist that must be overcome to achieve good penetration of vectors into tumors and distribution of their effects throughout the tumor mass. Replicating oncolytic viruses have the advantage of being able to amplify the initial dose, but progeny virus are prevented from spreading because of a dense mass of tightly packed cells with a dense extracellular matrix, admixed normal stromal cells, and high interstitial pressure. Although intratumoral injection may ensure initial delivery the distribution achieved by intravenous administration may be superior and come with beneficial bystander damage to the tumor vasculature. Strategies to enhance intravenous delivery and subsequent spread of these vectors within tumors are being developed by a number of groups.

Results The Killip 2-4 patients were more likely to have a higher age and proportion of women and exhibited a higher prevalence of previous myocardial infarction, diabetes mellitus and BVD-523 chronic kidney disease or anemia on admission, lower systolic blood pressure (SBP) values on admission, a higher rate of multivessels or left main trunk as the culprit artery, a larger

number of diseased vessels, a lower Thrombolysis In Myocardial Infarction (TIMI) grade in the infarct-related artery (IRA) before/after primary PCI and a significantly higher in-hospital mortality rate than the Killip 1 patients. According to a multivariate analysis, age was found to be an independent positive predictor of in-hospital mortality, while admission SBP was an independent positive predictor of in-hospital survival in both groups. In contrast, anemia on admission was found to be an independent predictor of in- hospital death, while the TIMI 3 flow in the IRA after PCI was found to be an independent factor for survival in the Killip 2-4 patients, but not the Killip 1 patients. Conclusion

Anemia on admission and the final LGX818 TIMI 3 flow in the IRA are critical determinants of in-hospital death in AMI patients with a Killip class status of bigger than = 2 undergoing primary PCI.”
“ObjectivesThe objectives were to assess the test characteristics of ultrasound (US) in AZD0530 diagnosing appendicitis in children and to evaluate site-related variations based on the frequency of its use. Additionally, the authors

assessed the test characteristics of US when the appendix was clearly visualized. MethodsThis was a secondary analysis of a prospective, 10-center observational study. Children aged 3to 18years with acute abdominal pain concerning for appendicitis were enrolled. US was performed at the discretion of the treating physician. ResultsOf 2,625 patients enrolled, 965 (36.8%) underwent abdominal US. US had an overall sensitivity of 72.5% (95% confidence interval [CI]=58.8% to 86.3%) and specificity 97.0% (95% CI=96.2% to 97.9%) in diagnosing appendicitis. US sensitivity was 77.7% at the three sites (combined) that used it in 90% of cases, 51.6% at a site that used it in 50% of cases, and 35% at the four remaining sites (combined) that used it in 9% of cases. US retained a high specificity of 96% to 99% at all sites. Of the 469 (48.6%) cases across sites where the appendix was clearly visualized on US, its sensitivity was 97.9% (95% CI=95.2% to 99.9%), with a specificity of 91.7% (95% CI=86.7% to 96.7%).