Progress in Access and Oral Polio Vaccine Coverage Among Children Aged <5 Years in Polio Campaigns After the Political Change in Afghanistan.

BACKGROUND: Warfare has long impeded vaccination programs in polio-endemic Afghanistan. We aimed to describe progress in access to children under 5, oral polio vaccine (OPV) coverage among children under 5 in nationwide polio campaigns, and polio surveillance performance indicators after the Islamic Republic of Afghanistan collapsed to Taliban forces in August 2021. METHODS: Trends in the number of wild poliovirus type 1 (WPV1) and circulating vaccine-derived poliovirus type 2 (cVDPV2) cases and surveillance indicators from 2015 to 2023, and trends in the OPV coverage in the November 2020-June 2022 polio campaigns, were described. RESULTS: From 2015 to mid-July 2020, 74 of 126 (58.7%) WPV1 cases were reported from inaccessible areas. In November 2020, 34.1% of target children under 5 were inaccessible; in November 2021 (the first postchange polio campaign), all were accessible. From November 2020, under-5 OPV coverage of 69.9% rose steadily to 99.9% in the May 2022 campaign. The number of cVDPV cases fell from 308 (2020) to zero (2022). June 2022's house-to-house OPV coverage was 34.2% higher than non-house-to-house modalities. Nonpolio acute flaccid paralysis and stool adequacy rates rose from 18.5/100 000 and 92.6% in 2020 to 24.3/100 000 and 94.4% in 2022, respectively. CONCLUSIONS: Children's inaccessibility no longer vitiates polio eradication; polio surveillance systems are less likely to miss any poliovirus circulation.

The Improvement of Fluorescence In Situ Hybridization Technique Based on Explorations of Symbionts in Cicadas.

Fluorescence in situ hybridization (FISH) with rRNA-targeted oligonucleotide probes is widely used for the identification of microbes in complex samples, but it suffers from some limitations resulting in the weak or even absence of fluorescence signals of microbe(s), which may lead to the underestimation or misunderstanding of a microbial community. Herein, we explored symbionts in the bacteriomes and fat bodies of cicadas using modified FISH, aiming to improve this technique. We initially revealed that the probes of Candidatus Sulcia muelleri (Sulcia) and the yeast-like fungal symbiont (YLS) are suitable for detection of these symbionts in all cicadas and some other species of Auchenorrhyncha, whereas the probe of Candidatus Hodgkinia cicadicola (Hodgkinia) is only suitable for detection of Hodgkinia in a few cicada species. The fluorescence signal of Sulcia, Hodgkinia and YLS exhibited weak intensity without the addition of unlabeled oligonucleotides (helpers) and heat shock in some cicadas; however, it can be significantly improved by the addition of both helpers and heat shock. Results of this study suggest that heat shock denaturing rRNA and proteins of related microbe(s) together with helpers binding to the adjacent region of the probe's target sites prevent the re-establishment of the native secondary structure of rRNA; therefore, suitable probe(s) can more easily access to the probe's target sites of rRNA. Our results provide new information for the significant improvement of hybridization signal intensities of microbes in the FISH experiment, making it possible to achieve a more precise understanding of the microbial distribution, community and density in complex samples.

Current controversies on mechanisms controlling soil carbon storage: implications for interactions with practitioners and policy-makers. A review.

There is currently an intense debate about the potential for additional organic carbon storage in soil, the strategies by which it may be accomplished and what the actual benefits might be for agriculture and the climate. Controversy forms an essential part of the scientific process, but on the topic of soil carbon storage, it may confuse the agricultural community and the general public and may delay actions to fight climate change. In an attempt to shed light on this topic, the originality of this article lies in its intention to provide a balanced description of contradictory scientific opinions on soil carbon storage and to examine how the scientific community can support decision-making despite the controversy. In the first part, we review and attempt to reconcile conflicting views on the mechanisms controlling organic carbon dynamics in soil. We discuss the divergent opinions about chemical recalcitrance, the microbial or plant origin of persistent soil organic matter, the contribution of particulate organic matter to additional organic carbon storage in soil, and the spatial and energetic inaccessibility of soil organic matter to decomposers. In the second part, we examine the advantages and limitations of big data management and modeling, which are essential tools to link the latest scientific theories with the actions taken by stakeholders. Finally, we show how the analysis and discussion of controversies can guide scientists in supporting stakeholders for the design of (i) appropriate trade-offs for biomass use in agriculture and forestry and (ii) climate-smart management practices, keeping in mind their still unresolved effects on soil carbon storage.

The study of healthcare facility utilization problems faced by pregnant women in urban north India.

OBJECTIVES: Sub-Saharan African countries account for nearly half of maternal deaths, and Southern Asian countries are second in the 85% of deaths that occur worldwide. Despite this fact, there is a rapid enhancement in the number of skilled health workers. There has been a sharp increase of 53% in 1990 and 61% in 2007 in trained birth attendant utilization shows that attention is being paid to the management of labor services. But surprisingly, still, the births take place without the assistance of trained health personnel in Southern Asian countries and Sub-Saharan Africa. The objective of this study is the assessment of barriers to health care facility utilization and its management concerning labor problems in urban North India. METHODS: A sample of "300" pregnant urban women was taken for study and analysis. A convenience sampling method was used. The factor analysis was applied for the interpretation and analysis of the data. RESULTS: It was found that there were inadequacies in services as well as unawareness of services in almost all urban areas among pregnant women. CONCLUSIONS: The tremendous increase in the cost of services and corrupt behavior among the service providers rampantly found in the urban locations, inaccessibility of proper means of communication and also economic backwardness and low literacy became the impediment to the utilization of maternal healthcare services in North-India.

The delay of breast cancer diagnosis and management during the Syrian war.

BACKGROUND: Early detection of breast cancer (BC) is crucial for better prognosis especially in low-income countries, where advanced cancer stages are common. The Syrian war severely affected the healthcare system restraining the proper timely management of BC cases. We aimed to investigate the prevalence of patient- and system-related delays in BC diagnosis and management in Syria in addition to their predisposing characteristics and impact on the staging. METHODS: This is a cross-sectional retrospective cohort study on patients followed by the BC unit at Al-Bairouni main cancer center in Syria. The data were collected through personal interviews and retrospective revision of patients' records. RESULTS: A total number of 519 patients were recruited; A quarter of them (n = 126) reported more than three months intervals between symptoms recognition and presentation to a physician. Additionally, 72 (13.9 %) patients received a confirmed diagnosis more than three months after presentation, and 12 (2.3 %) started treatment at least three months after the diagnosis. Patients who suffered from war-related inaccessibility to healthcare were 2.55 [1.58-4.11] times more likely to report significant delays. Additionally, the most common self-reported reasons for patient delay were the lack of awareness, which was more evident for less common symptoms like the change in breasts size, and shyness. Patients who reported significant delays were more likely to receive an advanced-stage diagnosis. CONCLUSION: War-related inaccessibility to healthcare rendered a significant group of BC patient susceptible to evident delay. This combined with significant system delays because of the overwhelmed hospitals, high costs, and insufficient personnel, equipment, medications, and training. However, personal factors, which might not be directly related to the war, like the inadequate awareness of rare symptoms and shyness still necessitate urgent interventions on the public knowledge and performed screening practices. These delays associated with receiving advanced-stage diagnoses and minimizing them can return better prognoses.

Older Adults' Perceptions of Campus Accessibility.

Attention should be devoted to the accessibility of campus facilities to older adults and as a means to increase age-diversity. In this paper, we sought to uncover older adults' perceptions of campus accessibility via an online survey. Participants were recruited through local newsletters, and word of mouth, and included 81 community members (M Age = 71.58 years; 79% female; 89% White). Descriptive analyses were conducted for closed-ended responses and a constant comparative method was used to code open-ended responses. Based on the closed-ended responses, participants felt that the campus was somewhat accessible, moderately easy to walk around, and felt somewhat welcome on campus. The following general themes emerged in the open-ended responses: 1) inaccessibility on campus was related to parking and topography constraints (e.g., due to stairs, distance, hills); 2) accessibility on campus was due to sidewalks and access to transportation; 3) feeling welcome on campus was related to people being helpful, and 4) not feeling welcome was related to not 'being in the know' and not feeling like they belonged. These findings have implications for campus initiatives that aim to attract older adults, especially for campuses that have topography constraints.

Historical reconstruction of inaccessibility status in Local Government Areas (LGAs) of Borno and Yobe States, Nigeria, 2010-2020.

Introduction: ultimately detected in 2016, wild poliovirus (WPV) transmission continued undetected after 2011 in Northeast Nigeria Borno and Yobe States in security-compromised areas, inaccessible due to armed insurgency. Varying inaccessibility prevented children aged <5 years in these areas from polio vaccination interventions and surveillance, while massive population displacements occurred. We examined progress in access over time to provide data supporting a very low probability of undetected WPV circulation within remaining trapped populations after 2016. Methods: to assess the extent of inaccessibility in security-compromised areas, we obtained empirical historical data in 2020 on a quarterly and annual basis from relevant polio eradication staff for the period 2010-2020. The extent of access to areas for immunization by recall was compared to geospatial data from vaccinator tracking. Population estimates over time in security-compromised areas were extracted from satellite imagery. We compared the historical access data from staff with tracking and population esimates. Results: access varied during 2010-2020, with inaccessibility peaking during 2014-2016. We observed concurrent patterns between historical recalled data on inaccessibility and contemporaneous satellite imagery on population displacements, which increased confidence in the quality of recalled data. Conclusion: staff-recalled access was consistent with vaccinator tracking and satellite imagery of population displacments. Despite variability in inaccessibility over time, innovative immunization initiatives were implemented as access allowed and surveillance initiatives were initiated to search for poliovirus transmission. Along with escape and liberation of residents by the military in some geographic areas, these initiatives resulted in a massive reduction in the size of the unvaccinated population remaining resident.

Service delivery inaccessibility as a predictor of teenage pregnancy in South Africa.

Background: With the onset of the South African democracy in 1994 it was hoped that many social inequalities would be addressed urgently. However, studies have shown that service delivery inaccessibility remains a challenge and investigating the social implications of such injustices remains important. Objective: This study determined to establish the association between service delivery inaccessibility and adolescent pregnancy in South Africa. Methods: Using data from 2019 and 2021 general household surveys, 7 737 teenage females were included. The study applied descriptive statistics, chi-squared testing as well as multilevel binary logistic regression. Results: Random-intercept multilevel binary logistic regression revealed that the risk of adolescent pregnancy independently increased as the level of service inaccessibility increased at household level (no services: OR=1.73, 1 service: OR=1.40, 2 services: OR=1.28) and community level (medium: OR=1.22, high: OR=1.38) at a P-value of 0.05. Conclusion: Findings highlight the need to guarantee universal service delivery urgently not only for development, but also to prevent adolescent pregnancy. Furthermore, the findings present evidence of structural factors driving adolescent pregnancy in South Africa, which renders continued cycles of poverty, injustice and early pregnancy amongst the majority of Blacks.

Breast cancer screening during the Syrian crisis: A cross-sectional study.

INTRODUCTION: Although breast cancer has a lower incidence in developing countries, mortality rates are higher, mainly due to delay in diagnosis and the poor diagnostic and therapeutic capacities. Although screening tests have been available for quite a long time, delayed and advanced presentation is still common, especially in developing countries. The decade-long Syrian crisis has severely crippled the healthcare system and depleted the already-limited capacities of the healthcare services, which under prioritized the care provided to unurgent cases like breast cancer. This study aimed to investigate the practices of breast cancer screening among breast cancer patients. METHODS: A cross-sectional study conducted in Al-Beiruni Hospital at Damascus University in 2019, through personal interviews using a structured questionnaire. RESULTS: The sample consisted of 519 patients with breast cancer. One-hundred twenty (23.2%) of them reported undergoing one or more of the different screening methods at least once every six months prior to diagnosis. Several factors had a statistically significant association with the probability of undergoing or performing screening methods including living in large cities, having fewer children, having a full-time or part-time job, and the level of education. Patients who reported having a relative diagnosed previously with breast cancer or any other malignancies were also more likely to screen themselves. Inaccessibility to healthcare services, which was exaggerated by the armed conflicts, had a significant association with less practicing of the screening methods too (OR: 0.4 [0.3-0.7]). CONCLUSION: The Syrian war and its direct and indirect consequences negatively affected screening practices of breast cancer.

Phubbing and Social Intelligence: Role-Playing Experiment on Bystander Inaccessibility.

Smartphone use has changed patterns of online and offline interaction. Phubbing (i.e., looking at one's phone instead of paying attention to others) is an increasingly recognized phenomenon in offline interaction. We examined whether people who phub are more likely to have lower social intelligence, whether phubbing is considered more annoying than being ignored due to reading a magazine, and if people describe smartphones and magazines differently as sources of social distraction. We collected two survey samples (N = 112, N = 108) for a cartoon-based role-playing experiment (the Bystander Inaccessibility Experiment) in which a smartphone user and a person reading a magazine ignored the respondents' conversational initiatives. Annoyance in each scenario was measured, and written accounts were collected on why the respondents rated the scenarios the way they did. Other measures used included the Generic Scale of Phubbing, Generic Scale of Being Phubbed, and Tromsø Social Intelligence Scale. The results showed that participants in both samples were more annoyed by phubbing than by being ignored due to reading a magazine. Linear regression analyses showed that phubbing was associated with lower social intelligence, even after adjusting for confounding factors. The annoyingness of phubbing was explained with negative attitudes toward smartphones, which were assumed to be used for useless endeavors, while magazines were more appreciated and seen as more cultivating. The role of bystanders' epistemic access to the smartphone user's activities is discussed.

Measuring barriers to fistula care: investigating composite measures for targeted fistula programming in Nigeria and Uganda.

BACKGROUND: Accessing surgical repair poses challenges to women living with female genital fistula who experience intersectional vulnerabilities including poverty, gender, stigma and geography. Barriers to fistula care have been described qualitatively in several low- and middle-income countries, but limited effort has been made to quantify these factors. This study aimed to develop and validate composite measures to assess barriers to accessing fistula repair in Nigeria and Uganda. METHODS: This quantitative study built on qualitative findings to content validate composite measures and investigates post-repair client surveys conducted at tertiary hospitals in Northern and Southern Nigeria and Central Uganda asking women about the degree to which a range of barriers affected their access. An iterative scale development approach included exploratory and confirmatory factor analyses of two samples (n = 315 and n = 142, respectively) using STATA 13 software. Reliability, goodness-of-fit, and convergent and predictive validity were assessed. RESULTS: A preliminary 43-item list demonstrated face and content validity, triangulated with qualitative data collected prior to and concurrently with survey data. The iterative item reduction approach resulted in the validation of a set of composite measures, including two indices and three sub-scales. These include a Financial/Transport Inaccessibility Index (6 items) and a multidimensional Barriers to Fistula Care Index of 17 items comprised of three latent sub-scales: Limited awareness (4 items), Social abandonment (6 items), and Internalized stigma (7 items). Factor analyses resulted in favorable psychometric properties and good reliability across measures (ordinal thetas: 0.70-0.91). Higher levels of barriers to fistula care are associated with a woman living with fistula for longer periods of time, with age and geographic settings as potential confounders. CONCLUSIONS: This set of composite measures that quantitatively captures barriers to fistula care can be used separately or together in research and programming in low- and middle-income countries.

Sonhar e brincar: o espaço psíquico a ser construído / Dream and play: the psychical space to be built / Soñar y jugar: el espacio psíquico a construir / Rêver et jouer: l'espace psychique à construire

Este trabalho examina o significado e a função do sonhar, como forma essencial de funcionamento psíquico. O objetivo do processo analítico é gerar condições para que a pessoa sonhe seus sonhos não sonhados e sonhos interrompidos. É apresentado um caso clínico que se caracterizava por extremo retraimento e pela sensação de pouca vivacidade. A paciente tinha pouco contato consigo mesma e parecia incapaz de dar vazão a seus sonhos. Ao lado da posição de inacessibilidade da paciente na análise, havia um pedido silencioso de ajuda. Foi ressaltada a necessidade da analista de levar em conta as condições possíveis da paciente para estabelecer com ela um canal de comunicação. Isso se deu por meio da série Friends, que trouxe um espaço transicional no qual a proximidade pôde ocorrer. O sonhar e o brincar foram considerados processos correspondentes, e foi discutido o trabalho clínico possível com pacientes que apresentam uma capacidade simbólica muito prejudicada.

This work examines the meaning and function of dreaming as an essential form of psychic functioning. The purpose of the analytical process is to create conditions for the person to dream of his/her undreamed dreams and interrupted dreams. We present a clinical case that was characterized by extreme withdrawal and by the sensation of poor alertness. The patient had little contact with herself and seemed unable to vent her dreams. Beside the position of patient inaccessibility in the analysis, there was a silent request for help. It was emphasized the need of the analyst to take into account the possible conditions of the patient to establish a communication channel with her. This was done through the Friends series, which established a transitional space in which proximity could occur. Dreaming and playing were considered as corresponding processes and the possible clinical work with patients with a very impaired symbolic capacity was discussed.

Este trabajo examina el significado y función del soñar, como forma esencial de funcionamiento psíquico. El objetivo del proceso analítico es generar condiciones para que la persona sueñe sus sueños no soñados y sueños interrumpidos. Se presenta un caso clínico que se caracterizaba por extremo retraimiento y por la sensación de poca vivacidad. La paciente tenía poco contacto consigo misma y parecía incapaz de dar flujo a sus sueños. Al lado de la posición de inaccesibilidad de la paciente en el análisis, había una petición silenciosa de ayuda. Se resalta la necesidad de la analista de tener en cuenta las condiciones posibles de la paciente para establecer con ella un canal de comunicación. Esto se dio a través de la serie Friends, que estableció un espacio transicional en el que la proximidad pudo ocurrir. El soñar y el juego fueron considerados procesos correspondientes y se discutió el trabajo clínico posible con pacientes que presentan una capacidad simbólica muy perjudicada.

Cet article examine le sens et la fonction du rêve en tant que forme essentielle du fonctionnement psychique. Le processus analytique a pour but de créer des conditions permettant à la personne de rêver ses rêves non atteints et ses rêves interrompus. Nous présentons un cas clinique caractérisé par un retrait extrême et un sentiment de faible vivacité. La patiente avait peu de contact avec elle-même et semblait incapable de donner libre cours à ses rêves. Cependant, à côté de la position inaccessible du patient dans l'analyse se trouvait une demande d'aide silencieuse. La nécessité pour l'analyste de prendre en compte les conditions possibles de la patiente pour établir un canal de communication avec elle a été soulignée. Cela s'est fait à travers la série Friends, qui a créé un espace transitionel dans lequel la proximité pouvait exister. Rêver et jouer ont été considérés comme des processus correspondants et le travail clinique possible avec des patients ayant une capacité symbolique très altérée a été discuté.

Inaccessible rocky cliffs: An optimized method for plant data collection in extreme environments.

Counts are normally used to assess the densities of plants. However, due to the physical characteristics of these sites, habitats and species associated with inaccessible rocky cliffs and other extreme environments pose additional challenges. It is therefore necessary to apply changes to the usual data collection methods. This system allows population sizes to be estimated from an incomplete data collection. This is important because when data collection sites are inaccessible, the fieldwork cannot be carried out within the time that is normally allocated. Furthermore, the minimum sampling effort involved enables economic resources to be saved. This method allows the time spent and the material, methodological and human resources used to be reduced while simultaneously allowing the highest level of accuracy to be maintained. •The minimum effort needed to carry out data collection of plants on vertical walls and other difficult-to-access environments is calculated.•The proposed method is based on the search for the theoretical distribution function with a better adjustment to the actual distribution of the studied species.•This system allows to reduce the necessary resources, while the maximum accuracy is maintained in the calculations.

Agent Inaccessibility as a Fundamental Principle in Quantum Mechanics: Objective Unpredictability and Formal Uncomputability.

The inaccessibility to the experimenter agent of the complete quantum state is well-known. However, decisive answers are still missing for the following question: What underpins and governs the physics of agent inaccessibility? Specifically, how does nature prevent the agent from accessing, predicting, and controlling, individual quantum measurement outcomes? The orthodox interpretation of quantum mechanics employs the metaphysical assumption of indeterminism-'intrinsic randomness'-as an axiomatic, in-principle limit on agent-quantum access. By contrast, ontological and deterministic interpretations of quantum mechanics typically adopt an operational, in-practice limit on agent access and knowledge-'effective ignorance'. The present work considers a third option-'objective ignorance': an in-principle limit for ontological quantum mechanics based upon self-referential dynamics, including undecidable dynamics and dynamical chaos, employing uncomputability as a formal limit. Given a typical quantum random sequence, no formal proof is available for the truth of quantum indeterminism, whereas a formal proof for the uncomputability of the quantum random sequence-as a fundamental limit on agent access ensuring objective unpredictability-is a plausible option. This forms the basis of the present proposal for an agent-inaccessibility principle in quantum mechanics.

Cytoskeleton reorganization/disorganization is a key feature of induced inaccessibility for defence to successive pathogen attacks.

In this work, we investigated the involvement of the long-term dynamics of cytoskeletal reorganization on the induced inaccessibility phenomenon by which cells that successfully defend against a previous fungal attack become highly resistant to subsequent attacks. This was performed on pea through double inoculation experiments using inappropriate (Blumeria graminis f. sp. avenae, Bga) and appropriate (Erysiphe pisi, Ep) powdery mildew fungi. Pea leaves previously inoculated with Bga showed a significant reduction of later Ep infection relative to leaves inoculated only with Ep, indicating that cells had developed induced inaccessibility. This reduction in Ep infection was higher when the time interval between Bga and Ep inoculation ranged between 18 and 24 h, although increased penetration resistance in co-infected cells was observed even with time intervals of 24 days between inoculations. Interestingly, this increase in resistance to Ep following successful defence to the inappropriate Bga was associated with an increase in actin microfilament density that reached a maximum at 18-24 h after Bga inoculation and very slowly decreased afterwards. The putative role of cytoskeleton reorganization/disorganization leading to inaccessibility is supported by the suppression of the induced resistance mediated by specific actin (cytochalasin D, latrunculin B) or general protein (cycloheximide) inhibitors.

Adherence to tuberculosis infection control guidelines by nurses in Lesotho.

BACKGROUND: Lesotho has a high prevalence rate of tuberculosis (TB) that has been exacerbated by high prevalence of HIV. Adherence to the TB infection control guidelines recommended by the World Health Organization is pivotal in TB infection control. OBJECTIVES: We assessed the level of adherence to the TB infection control guidelines by nurses in TB wards and outpatient departments and the factors associated with nonadherence to the guidelines in Lesotho. METHODS: This was an analytical study based on a semistructured questionnaire administered on 55 purposively sampled nurses working in TB wards and outpatient departments at Motebang and Mafeteng Hospitals. Logistic regression analysis was used to determine the variables associated with nonadherence to TB infection control guidelines. RESULTS: Fear of occupational exposure (P = .026), female gender (P = .03), lack of equipment (P = .02), inadequate staff (P = .005), and the keeping of guidelines by certain nurses (P = .02) were significantly associated with nonadherence. Overall, 43.6% of the respondents had poor adherence to the guidelines. Adherence to the guidelines was not influenced significantly by age, TB ward work experience, and qualifications of nursing staff. CONCLUSIONS: There is poor adherence to World Health Organization TB infection control guidelines by nurses in Lesotho. There is need to improve access to equipment, increase accessibility of guidelines, and ensure adequate staff to increase adherence to TB infection control guidelines.

Immunohistochemical detectability of cerebrovascular utrophin depends on the condition of basal lamina.

Utrophin is an autosomal homologue of dystrophin. Dystrophin is a member of the dystrophin-glycoprotein complex, which is a cell surface receptor for basal lamina components. In recent opinions utrophin occurs in the cerebrovascular endothelium but not in the perivascular glia. Cerebrovascular laminin immunoreactivity can only be detected in the subpial segments of the vessels, in circumventricular organs lacking blood-brain barrier, in immature vessels and following brain lesions. In our former experience utrophin immunoreactivity showed similar phenomena to that of laminin. The present study investigates the parallel occurrence of vascular utrophin and laminin immunoreactivity in the brain tissue, especially in the circumventricular organs, and during the parallel postnatal regression of both utrophin and laminin immunoreactivity. Their cerebrovascular immunoreactivity observed in frozen sections renders plausible the role of hidden but explorable epitopes, instead of a real absence of laminin and utrophin. The laminin epitopes are supposed to be hidden due to the fusion of the glial (i.e. brain parenchymal) and vascular basal laminae (Krum et al., Exp. Neurol. 111 (1991) 151). In all cases including its post-lesion re-appearance published formerly by us, laminin immunoreactivity may be attributed to the separation of glial and vascular basal laminae. Utrophin is localized, however, intracellularly, therefore a more complex molecular mechanism is to be assumed and it remains to be investigated how structural changes of the basal lamina may indirectly affect the immunoreactivity of utrophin. The results indicate that immunoreactivity may be influenced not only by the presence or absence of macromolecules but also by their functional state.