[Rehabilitation after Spinal Cord Injury : Current trends and principles]. / Rehabilitation nach einer Querschnittlähmung : Aktuelle Trends und Grundlagen.

Traumatic and non traumatic spinal cord injury are rare and an orphan disease in comparison to common diseases. Those affected represent a very special patient population in the treatment even at the site of the accident and in emergency medicine and require a high level of professional expertise. The rehabilitation with the complexity of a spinal cord injury can only succeed with a multiprofessional team that is less focused on the often similar diagnoses according to the International Classification of Diseases (ICD) but on functional disorders and associated activity impairments. Only then the best possible integration and participation/inclusion in sociocultural and professional life can be achieved. In addition to the importance of classical physiotherapy and occupational therapy, this article highlights important but often missing team players, such as neurourology and electrical stimulation. In addition, the problems of frequent and some less recognized complications, such as autonomic dysfunction and the benefits of airway management are highlighted. For a comprehensive overview of rehabilitation in spinal cord injury, reference textbooks and guidelines are recommended that are cited in the text.

Validation of a novel testing machine for the investigation of the biomechanical properties of lumbar vertebrae in an osteoporotic rat model.

BACKGROUND: For the investigation of the biomechanical properties of bone, various testing devices have been described. However, only a limited number have been developed to test the vertebral body of small animals. The aim of this study was to develop and validate a new bone testing device, which investigates the different biomechanical properties in small-animal vertebrae as a whole, three-dimensional unit, respecting its anatomical structure. METHODS: Thirty-five twelve-week-old female Sprague Dawley rats were utilized. Group 1 was composed of 17 rats with a normal bone metabolism without osteoporosis, while Group 2 consisted of 18 rats with manifest osteoporosis, 8 weeks after ovariectomy. The 5th lumbar vertebra of each animal was tested using the new bone testing device. This device has the ability to be adjusted to the slanted nature of each individual vertebral body and fix the vertebra in a natural position to allow for a non-dislocating axial force application. The device is designed to respect the anatomical three-dimensional shape of the vertebral body, thus avoiding the application of non-anatomic, non-physiological forces and thus preventing a distortion of the biomechanical testing results. The parameters investigated were stiffness, yield load, maximum load and failure load, and the results were compared to current literature values. RESULTS: The conduction of the biomechanical bone testing of the vertebral bodies with the new device was conductible without any instances of dislocation of the vertebrae or machine malfunctions. Significant differences were found for stiffness, maximum load and failure load between groups, with a lower value in the osteoporotic rats in each parameter tested. The yield load was also lower in the osteoporotic group, however not significantly. The values achieved correlate with those in current literature. CONCLUSIONS: This study demonstrates that the newly developed testing machine is easy to handle and produces valid data sets for testing biomechanical bone parameters of whole vertebral bodies in an established small animal model. Therefore, it can be utilized, also as reference data, to test different structural properties and changes in vertebral bone, for example, in different metabolic settings or under the influence of different pharmaceutical entities in further studies.

Congenital aural atresia: hearing rehabilitation using active middle-ear implants.

OBJECTIVE: To assess hearing rehabilitation in patients with congenital aural atresia using an active middle-ear implant (Vibrant Soundbridge). METHODS: Of a cohort of 70 microtia and atresia patients, 10 underwent Vibrant Soundbridge implantation between 2008 and 2021. Two of the 10 patients had binaural implantation, resulting in 12 ears for analysis. Pre- and post-operative audiometry data were analysed, and patient satisfaction was evaluated. Surgical issues regarding coupling sites and outcomes were analysed. RESULTS: Pure tone average (0.5, 1, 2 and 4 kHz) improved from a pre-operative mean (standard deviation) of 65.3 (8.7) dB HL to a post-operative mean of 26.8 (4.9) dB HL. This resulted in a mean pure tone average gain of 38.5 dB HL. The results indicate no obvious difference between stapes (n = 8) and incus (n = 4) coupling. The mean effective gain for 0.5, 1, 2 and 4 kHz was -17.8 dB HL (standard deviation = 4.3). Concerning effective gain, Vibrant Soundbridge performed best at 2 kHz. Patients reported high overall satisfaction, good sound quality and strongly improved directional hearing. CONCLUSION: An active middle-ear implant (Vibrant Soundbridge) allows hearing rehabilitation in selected atretic ears, and provides long-term hearing stability in children and adults.

[Do the new molecular assays-microarray and realtime polymerase chain reaction-for dermatophyte detection keep what they promise?] / Halten die neuen molekularen Teste ­ Microarray und Realtime-Polymerasekettenreaktion ­ zum Dermatophytennachweis das, was sie versprechen?

In this study, a novel real-time polymerase chain reaction (PCR) assay (DermaGenius®2.0, PathoNostics BV, Maastricht, The Netherlands) and a recently developed microarray test (EUROArray Dermatomycosis, Euroimmun, Lübeck, Germany) were evaluated regarding their diagnostic specificity to identify dermatophyte DNA. The tests were compared to conventional methods and sequencing. The microarray Dermatomycosis test allows the detection of 50 dermatophytes and definitive identification of 23 dermatophyte species, 6 yeasts and moulds combined in one test. In comparison, real-time PCR is able to identify 11 dermatophytes and one yeast at the species level. Using the EUROArray, 22 out of 24 dermatophyte species were correctly identified. Using real-time PCR, 9 out of the 11 different dermatophytes included in the test kit were correctly identified. Both molecular tests for detection and differentiation of dermatophytes are useful tools for daily clinical practice. The real-time PCR test does not detect as many species, and specificity is slightly lower. However, real-time PCR is a very fast and easy to perform test, especially since no post-PCR step is necessary. Real-time PCR detects the most frequent dermatophytes like T. rubrum, T. interdigitale, and M. canis without any problems. The EUROArray is more elaborate to perform in the lab, due to the hybridization step. However, the EUROArray shows higher specificity and can detect a much broader range of causative agents, including rare species, in dermatomycology.

Level Attraction Due to Dissipative Magnon-Photon Coupling.

We report dissipative magnon-photon coupling caused by the cavity Lenz effect, where the magnons in a magnet induce a rf current in the cavity, leading to a cavity backaction that impedes the magnetization dynamics. This effect is revealed in our experiment as level attraction with a coalescence of hybridized magnon-photon modes, which is distinctly different from level repulsion with mode anticrossing caused by coherent magnon-photon coupling. We develop a method to control the interpolation of coherent and dissipative magnon-photon coupling, and observe a matching condition where the two effects cancel. Our work sheds light on the so-far hidden side of magnon-photon coupling, opening a new avenue for controlling and utilizing light-matter interactions.

Development and Characterization of a Porcine Mitral Valve Scaffold for Tissue Engineering.

Decellularized scaffolds represent a promising alternative for mitral valve (MV) replacement. This work developed and characterized a protocol for the decellularization of whole MVs. Porcine MVs were decellularized with 0.5% (w/v) SDS and 0.5% (w/v) SD and sterilized with 0.1% (v/v) PAA. Decellularized samples were seeded with human foreskin fibroblasts and human adipose-derived stem cells to investigate cellular repopulation and infiltration, and with human colony-forming endothelial cells to investigate collagen IV formation. Histology revealed an acellular scaffold with a generally conserved histoarchitecture, but collagen IV loss. Following decellularization, no significant changes were observed in the hydroxyproline content, but there was a significant reduction in the glycosaminoglycan content. SEM/TEM analysis confirmed cellular removal and loss of some extracellular matrix components. Collagen and elastin were generally preserved. The endothelial cells produced newly formed collagen IV on the non-cytotoxic scaffold. The protocol produced acellular scaffolds with generally preserved histoarchitecture, biochemistry, and biomechanics.

Spin Pumping in Electrodynamically Coupled Magnon-Photon Systems.

We use electrical detection, in combination with microwave transmission, to investigate both resonant and nonresonant magnon-photon coupling at room temperature. Spin pumping in a dynamically coupled magnon-photon system is found to be distinctly different from previous experiments. Characteristic coupling features such as modes anticrossing, linewidth evolution, peculiar line shape, and resonance broadening are systematically measured and consistently analyzed by a theoretical model set on the foundation of classical electrodynamic coupling. Our experimental and theoretical approach paves the way for pursuing microwave coherent manipulation of pure spin current via the combination of spin pumping and magnon-photon coupling.

The effect of GWAS identified BMI loci on changes in body weight among middle-aged Danes during a five-year period.

OBJECTIVE: Genome-wide association studies have identified genetic variants associating with BMI, however, it is un-clarified whether the same variants also influence body weight fluctuations. METHODS: Among 3,982 adult individuals that attended both a baseline and a five-year follow-up examination in the Danish Inter99 intervention study, a genetic risk score (GRS) was constructed based on 30 BMI variants to address whether it is associated with body weight changes. Moreover, it was examined whether the effect of lifestyle changes was modulated by the GRS. RESULTS: The GRS associated strongly with baseline body weight, with a per risk allele increase of 0.45 (0.33-0.58) kg (P = 2.7 × 10(-12) ), corresponding to a body weight difference of 3.41 (2.21-4.60) kg comparing the highest (≥ 30 risk alleles) and lowest (≤ 26 risk alleles) risk allele tertile. No association was observed with changes in body weight during the five years. Changes in lifestyle, including physical activity, diet and smoking habits associated strongly with body weight changes, however, no interactions with the GRS was observed. CONCLUSION: The GRS associated with body weight cross-sectionally, but not with changes over a five-year period. Body weight changes were influenced by lifestyle changes, however, independently of the GRS.

Type 2 diabetes risk alleles near ADCY5, CDKAL1 and HHEX-IDE are associated with reduced birthweight.

AIMS/HYPOTHESIS: The fetal insulin hypothesis suggests that variation in the fetal genotype influencing insulin secretion or action may predispose to low birthweight and type 2 diabetes. We examined associations between 25 confirmed type 2 diabetes risk variants and birthweight in individuals from the Danish Inter99 population and in meta-analyses including Inter99 data and reported studies. METHODS: Midwife records from the Danish State Archives provided information on mother's age and parity, as well as birthweight, length at birth and prematurity of the newborn in 4,744 individuals of the population-based Inter99 study. We genotyped 25 risk alleles showing genome-wide associations with type 2 diabetes. RESULTS: Birthweight was inversely associated with the type 2 diabetes risk alleles of ADCY5 rs11708067 (beta = -33 g [95% CI -55, -10], p = 0.004) and CDKAL1 rs7756992 (beta = -22 g [95% CI -43, -1], p = 0.04). The association for the latter locus was confirmed in a meta-analysis (n = 24,885) (beta = -20 g [95% CI -29, -11], p = 5 x 10(-6)). The HHEX-IDE rs1111875 variant showed no significant association among Danes (p = 0.09); however, in a meta-analysis (n = 25,164) this type 2 diabetes risk allele was associated with lower birthweight (beta = -16 g [95% CI -24, -8], p = 8 x 10(-5)). On average, individuals with high genetic risk (>or=25 type 2 diabetes risk alleles) weighed marginally less at birth than those with low genetic risk (<25 type 2 diabetes risk alleles) (beta = -35 g [95% CI -69, -2], p = 0.037). CONCLUSIONS/INTERPRETATION: We report a novel association between the fetal ADCY5 type 2 diabetes risk allele and decreased birthweight, and confirm in meta-analyses associations between decreased birthweight and the type 2 diabetes risk alleles of HHEX-IDE and CDKAL1. No strong general effect on birthweight can be ascribed to the 25 common type 2 diabetes risk alleles.

Development of a new quality fair access best value performance indicator (BVPI) for recycling services.

Recycling schemes are being used worldwide to reduce the impact of municipal waste. Those using public funds are usually obliged to set performance indicators by which the standards of such schemes can be measured. In the UK, a set of statutory Best Value Performance Indicators (BVPI) must be reported annually, such as the Quality of Fair Access, which monitors the public's access to recycling facilities within 1000 m (known as BVPI 91). This work shows that BVPI 91, and performance indicators like it, quantify only very basic recycling services. A much more sensitive performance indicator is developed in this paper, labelled as the Maximum Practicable Recycling Rate Provision (MPRRP) achievable by a local authority. It indicates the percentage of local waste that could be reasonably recycled using the services provided, calculated on the basis of the average composition of the local waste, the local population coverage for collection of any materials, and nationally provided information stating how much of each material stream is generally suitable (practical) for recycling. Evidence for the usefulness of this new quantity is presented. Although this paper refers a particular performance indicator in the UK, its findings are applicable to all urban areas worldwide needing to monitor recycling service. Furthermore, the MPRRP could be used for planning purposes, and for determining the level of performance of an existing service, by comparing its predicted recycling rate to that actually obtained. Further work is now being carried out on this.

Cholesterol and iron availability in yolk of laying hens feed with annatto ( Bixa orellana).

Pigmented egg yolks are more attractive. Popular culture treats annatto as a powerful anticholesterolemic agent, besides being widely used in the form of industry pigment. This work evaluated the effects of the addition of annatto (Bixa orellana L.) in the feed of hens, verifying a possible alteration of cholesterol in the yolks, content of carotenes, and iron and available iron, over time. One hundred and twenty-five hens divided in control (0% - T1) and four annatto-added treatments (0.5% - T2; 1.0% - T3; 1.5% - T4, and 2.0% - T5) were used. Eggs were collected at 23, 25, 27, 29 and 30 weeks. The animals were randomly separated into five groups of five animals each. The cholesterol was measured by the colorimetric method, vitamin A (ß and α carotene) by spectrophotometry, total iron by atomic absorption spectrophotometry, and dialysable iron by dialysis. Tukey's test was used at the 5% level for comparison of the averages. Regarding cholesterol, treatments T2 and T3 did not differ significantly. However, other treatments differed ( P ≤ 0.05) from the control, decreasing the cholesterol level as the percentage of annatto in the feed increased. In time, there was a significant increase ( P ≤ 0.05). For ß and α carotene, T5 presented statistically higher values than the others ( P ≤ 0.05). With regard to total iron, T5 had higher values than the others. Dialysable iron was also higher, probably due to the increase in carotenes. Thus, we can conclude that the use of annatto in the feed of layer hens is useful, as it provokes the reduction of cholesterol and promotes an increase in the content of iron and carotenes in eggs.

Genotyping of different varicella vaccine strains.

BACKGROUND: Little is known about single nucleotide polymorphism (SNP) in different lots of varicella vaccines distributed by the manufacturers. Recently, the genetic analysis of several genomic regions revealed a polymorphism in different vaccine lots of Varilrix manufactured by GlaxoSmithKline. These findings need attention since mutations in the vaccine strain could result in changes of virulence and efficacy of the vaccine. OBJECTIVES: To identify SNPs in three varicella vaccine lots of Varilrix and to compare the results with that of Varivax as well as the published sequences of the Oka vaccine strain (V-Oka) and its parental virus (P-Oka). STUDY DESIGN: The open reading frames (ORF) 1, 6, 10, 21, 50, 54, and 62 were analyzed by sequencing of amplified DNA fragments. RESULTS: Wild-type nucleotides identical to that of P-Oka and/or the European wild-type reference strain Dumas and in contrast to V-Oka could be identified in ORF 1 of a Varilrix vaccine lot distributed in 1991. In the ORF 62 probably responsible for attenuation of V-Oka, this vaccine strain contained 16 SNPs which were nearly all wild-type-like. By contrast, different lots of the Varivax vaccine revealed uniform sequencing results. The vaccine Varilrix 1999 showed a high similarity to the Varivax vaccine currently available. CONCLUSIONS: The obvious genetic diversity of different lots of the varicella vaccine Varilrix cannot be explained with the coexistence of several strain variants in the vaccine, but most likely with different seed lot preparations used for vaccine production.

Participation in curbside recycling schemes and its variation with material types.

Local authorities throughout the UK are refining or implementing curbside recycling schemes as they attempt to achieve challenging statutory recycling targets. Despite the importance of curbside schemes there are few published studies that have reported on actual measured levels and frequency of participation by residents, hindering transferability of lessons learned nationally and internationally. This paper reports measurements and analysis over at least four weeks for three different curbside recycling schemes operating in England, with at least 1400 samples in each. It is found that the participation rate is higher in schemes that collect more types of materials. Participation rates of 38%, 49% and 65% were measured for schemes that collected 1, 2 and 3 material types, respectively. The increase appears to be related not only to extra participants setting out the additional materials, but also increased participation for the common materials. It is found that for one scheme, more households tend to set out plastics and cans compared to newspapers.

The development of a UK kerbside scheme using known practice.

Local authorities in the UK have been set challenging new targets for recycling household waste for 2003/4. This means many of them are urgently trying to determine which parameters in kerbside schemes are most important for increasing recycling rates. In this work information from previous kerbside schemes was used to plan significant improvements in an existing scheme in Horsham District, UK, and a trial was conducted using 1000 homes including a control group. It used fortnightly collection of residual waste with sets of recyclables collected on alternate weeks. The new scheme resulted in improvements of participation rates from 72 to 84%, and set-out rates from 45 to 59% (falling to 76 and 50% respectively, some months later). Details on participation and set-out for different groups of materials are given, as well as levels of excess waste and participation in the collection of garden waste.

Urinary iodine concentration during pregnancy in an area of unstable dietary iodine intake in Switzerland.

We prospectively investigated urinary iodine concentration (UIC) in pregnant women and in female, non-pregnant controls in the canton of Berne, Switzerland, in 1992. Mean UIC of pregnant women [205 +/- 151 microg iodine/g creatinine (microg l/g Cr); no. = 153] steadily decreased from the first (236 +/- 180 microg l/g Cr; no. = 31) to the third trimester (183 +/- 111 microg l/g Cr, p < 0.0001; no. = 66) and differed significantly from that of the control group (91 +/- 37 microg l/g Cr, p < 0.0001; no. = 119). UIC increased 2.6-fold from levels indicating mild iodine deficiency in controls to the first trimester, demonstrating that high UIC during early gestation does not necessarily reflect a sufficient iodine supply to the overall population. Pregnancy is accompanied by important alterations in the regulation of thyroid function and iodine metabolism. Increased renal iodine clearance during pregnancy may explain increased UIC during early gestation, whereas increased thyroidal iodine clearance as well as the iodine shift from the maternal circulation to the growing fetal-placental unit, which both tend to lower the circulating serum levels of inorganic iodide, probably are the causes of the continuous decrease of UIC over the course of pregnancy. Mean UIC in our control group, as well as in one parallel and several consecutive investigations in the same region in the 1990s, was found to be below the actually recommended threshold, indicating a new tendency towards mild to moderate iodine deficiency. As salt is the main source of dietary iodine in Switzerland, its iodine concentration was therefore increased nationwide in 1998 for the fourth time, following increases in 1922, 1965 and 1980.

Linking osteoarthritis-specific health-status measures to the International Classification of Functioning, Disability, and Health (ICF).

OBJECTIVES: The objective of this study was to link the Western Ontario and McMaster Universities (WOMAC) and Lequesne-Algofunctional indices to the ICF on the basis of linking rules developed specifically to accomplish this aim. The linking process enables the understanding of the relationship between health-status measures and the ICF. METHODS: Since the fifth World Health Organisation/International Liege Against Rheumatism (WHO/ILAR) Task Force and the Outcome Measures in Rheumatology Clinical Trials (OMERACT) group recommend the use of WOMAC and the Lequesne-Algofunctional indices in patients with osteoarthritis of the hip and knee in clinical trials, these two health-status measures have been used in this study. Both health-status measures were linked to the ICF separately by two trained health professionals. Consensus between health professionals was used to decide which ICF category should be linked to each item/concept of the two questionnaires. To resolve disagreements between the two health professionals, a third person trained in the linking rules was consulted. RESULTS: Except for the concept of 'morning stiffness', both health professionals agreed on the ICF category chosen to link all the items/concepts of both questionnaires. Altogether, 29 different ICF categories have been linked. Five ICF categories belong to the ICF component 'body functions', 23 categories to the component 'activities and participation', and one category to 'environmental factors'. Both questionnaires have 10 ICF categories in common. CONCLUSIONS: The results of the linking process reflect both the structure of the two questionnaires studied and the relationship between them, showing that the ICF classification can become the cardinal reference for existing health-status measures.

The nonfunctional allele TCRBV6S1B is strongly associated with Helicobacter pylori infection.

To determine genetic susceptibility factors for Helicobacter pylori infection, polymorphic T-cell receptor gene elements were investigated in 203 H. pylori-infected individuals and 180 uninfected individuals (controls). H. pylori infection is highly associated with individuals homozygous for the nonfunctional TCRBV6S1B element (odds ratio = 5.9; chi(2) = 13; P = 0.00032; P value corrected for multiple comparisons [Bonferroni correction] = 0. 00063).

Electrospray ionization Fourier transform ion cyclotron resonance mass spectrometric analysis of the recombinant human macrophage colony stimulating factor beta and derivatives.

The potential of electrospray ionization (ESI) Fourier transform ion cyclotron mass spectrometry (FTICR-MS) to assist in the structural characterization of monomeric and dimeric derivatives of the macrophage colony stimulating factor beta (rhM-CSF beta) was assessed. Mass spectrometric analysis of the 49 kDa protein required the use of sustained off-resonance irradiation (SORI) in-trap cleanup to reduce adduction. High resolution mass spectra were acquired for a fully reduced and a fully S-cyanylated monomeric derivative (approximately 25 kDa). Mass accuracy for monomeric derivatives was better than 5 ppm, after applying a new calibration method (i.e., DeCAL) which eliminates space charge effects upon high accuracy mass measurements. This high mass accuracy allowed the direct determination of the exact number of incorporated cyanyl groups. Collisionally induced dissociation using SORI yielded b- and y-fragment ions within the N- and C-terminal regions for the monomeric derivatives, but obtaining information on other regions required proteolytic digestion, or potentially the use of alternative dissociation methods.

Helicobacter pylori infection and polymorphisms in the tumor necrosis factor region.

Twin studies evidence that genetic factors of the host influence the acquisition and the clinical outcome of Helicobacter pylori infections in addition to bacterial and environmental factors. In the tumor necrosis factor (TNF) alpha-gene, allelic frequencies of the polymorphic microsatellite TNFa and the promoter polymorphism TNF-308 were studied for 209 H. pylori+ patients and compared to 184 H. pylori- controls. In the H. pylori+ group 34 individuals suffered from duodenal ulcer and 45 from gastric ulcer. Genotyping of the TNFa microsatellite and TNF-308 polymorphisms was performed after polymerase chain reaction by polyacrylamide gel electrophoresis (PAGE) and allele-specific oligonucleotide hybridizations, respectively. The phenotype frequency of microsatellite allele TNFa6 was lower in the H. pylori+ females as well as infected females with gastric ulcer compared to uninfected controls. Infected men with duodenal ulcer had a decreased frequency of allele TNFa10. The genotype TNF1/TNF1 of the polymorphism TNF-308 is a risk factor for duodenal ulcer in H. pylori+ females; p = 0.01; relative risk (RR) = 10.7; corrected p-value (Pc) = 0.05. Thus, the TNF region is crucial in the complex genetic predisposition for H. pylori infection for certain patient subgroups.

Major immunogenic proteins of phocid herpes-viruses and their relationships to proteins of canine and feline herpesviruses.

The immunogenic proteins of cells infected with the alpha- or the gamma-herpesvirus of seals, phocid herpesvirus-1 and -2 (PhHV-1, -2), were examined in radioimmunoprecipitation assays as a further step towards the development of a PhHV-1 vaccine. With sera obtained from convalescent seals of different species or murine monoclonal antibodies (Mabs), at least seven virus-induced glycoproteins were detected in lysates of PhHV-1-infected CrFK cells. A presumably disulphide-linked complex composed of glycoproteins of 59, 67 and 113/120 kDa, expressed on the surface of infected cells, was characterized as a major immunogenic infected cell protein of PhHV-1. This glycoprotein complex has previously been identified as the proteolytically cleavable glycoprotein B homologue of PhHV-1 (14). At least three distinct neutralization-relevant epitopes were operationally mapped, by using Mabs, on the glycoprotein B of PhHV-1. Among the infected cell proteins of the antigenically closely related feline and canine herpesvirus, the glycoprotein B equivalent proved to be the most highly conserved glycoprotein. Sera obtained from different seal species from Arctic, Antarctic, and European habitats did not precipitate uniform patterns of infected cell proteins from PhHV-1-infected cell lysates although similar titres of neutralizing antibodies were displayed. Thus, antigenic differences among the alphaherpesvirus species prevalent in the different pinniped populations cannot be excluded. PhHV-2 displayed a different pattern of infected cell proteins and only limited cross-reactivity to PhHV-1 at the protein level was detected, which is in line with its previous classification as a distinct species, based on nucleotide sequence analysis, of the gammaherpesvirus linenge. A Mab raised against PhHV-2 and specific for a major glycoprotein of 117 kDa, cross reacted with the glycoprotein B of PhHV-1. The 117-kDa glycoprotein could represent the uncleaved PhHV-2 glycoprotein B homologue.