A custom auricular implant healing abutment: A dental technique.

Skin overgrowth is a complication that hinders bone-anchored prosthetic ear rehabilitation. In order to accurately transfer the healing skin for prosthetic reconstruction, this article introduces a custom-made autopolymerizing acrylic resin auricular cap (button) through indirect pick up of the metal housing. The caps are secured during the healing stage to shape the skin, preventing surgical edema, swelling, and skin overgrowth in patients suffering from keloid reactions from covering the implant abutments. Since skin height and form are changeable, the caps can be relined directly or indirectly if greater skin compression is required. Moreover, these custom-made caps can be utilized during prosthetic silicone ear fabrication to retain the metal housing.

Modified genioglossus advancement with radiofrequency tongue base reduction for retroglossal collapse in Obstructive sleep apnea patients.

OBJECTIVE: To study the combined effect of modified genioglossus advancement (MGGA) and radiofrequency tongue base reduction (RFTBR) a long with anterolateral advancement (ALA) pharyngolplasty on OSA patients with retrolingual airway collapse. STUDY DESIGN: Prospective clinical study. SETTING: Zagazig and Benha Universities Medical Hospitals. PATIENTS AND METHODS: Twenty-one patients (21)with multilevel OSA underwent modified genioglossus advancement with radiofrequency tongue base reduction and anterolateral advancement pharyngolplasty. All patients were assessed before and 6 months after surgery by history talking, clinical examination, Epworth Sleepiness Scale evaluation fiberoptic examination during muller's maneuver, drug induced sleep endoscopy (DISE), panoramic X-ray, Cephalometry and polysomnography. RESULTS: Postoperative mean ± SD Epworth Sleepiness Scale (ESS) significantly decreased from 18.86 ± 2.03to 8.19 ± 1.86 (P-value was <0.001 95% (CI) 9.80 to 11.53).postoperative mean ± SD AHI decreased from 53.39 ± 14.10 to 26.66 ± 5.44 (P-value was <0.001 95% CI 22.37 to 32.81), postoperative mean ± SD LOS increased from 68.33 ± 9.12 to 86.0 ± 4.96 (P-value was <0.001 95% (CI) 15.24 to21.33).Based on cephalometric analysis postoperative mean ± SD PAS at mid retrolingual point in mm increased from 6.43 ± 1.25 to 11.98 ± 1.69 (P-value was <0.001 95% (CI) 4.78 to 6.32), also postoperative mean ± SD Distance between H-MP in mm decreased from 23.38 ± 1.14 to 15.17 ± 0.97 (P-value was 0.001 95% (CI) 7.66 to 8.76).The postoperative mean ± SD distance from hyoid to menton (H-me) in mm decreased from 39.47 ± 2.37to24.83 ± 2.43(P-value was 0.001 95% (CI) 7.31 to 8.41), the mean ± SD distance of genioglossus muscle advancement in mm was 14.45 ± 1.12.With a success rate defined as AHI < 20 and/or 50% reduction in AHI of the pre- operative value, the surgical success was 81%. CONCLUSION: MGGA with RFTBR along with anterolateral advancement pharyngoplasty in a single session is well tolerated and safe surgery in the treatment of multilevel OSA patients. It is effective in reducing respiratory parameters and subjective symptoms of OSA.

Instantaneous oxidation of levofloxacin as toxic pharmaceutical residuals in water using clay nanotubes decorated by ZnO (ZnO/KNTs) as a novel photocatalyst under visible light source.

Kaolinite nanotubes were synthesized by a simple scrolling process and decorated by ZnO nanoparticles as a novel nanocomposite (ZnO/KNTs). The synthetic ZnO/KNTs composite was characterized as an effective photocatalyst in the oxidation of levofloxacin pharmaceutical residuals in the water resources. The composite displays a surface area of 95.4 m2/g, average pore diameter of 5.8 nm, and bandgap energy of 2.12 eV. It is of high catalytic activity in the oxidation of levofloxacin in the presence of visible light source. The complete oxidation for 10 mg/L of levofloxacin was recognized after 55 min, 45 min, and 30 min with applying 30 mg, 40 mg, and 50 mg of ZnO/KNTs as catalyst dosage, respectively. Additionally, it achieved complete oxidation for 20 mg/L and 30 mg/L of levofloxacin after 45 min and 75 min, respectively using 50 mg as catalyst dosage. The degradation efficiency was confirmed by detecting the residual TOC after the treatment tests and the formed intermediate compounds were identified to suggest the degradation pathways. In addition to the oxidation pathway, the mechanism was evaluated based on the active trapping tests that proved the dominance of hydroxyl radicals as the essential active species. Finally, the ZnO/KNTs composite is of promising recyclability properties and achieved better results than several studied photocatalysts in literature.

Promoting the decontamination of different types of water pollutants (Cd2+, safranin dye, and phosphate) using a novel structure of exfoliated bentonite admixed with cellulose nanofiber.

Exfoliated bentonite sheets admixed with nano-cellulose fibers (EXB/CF) were prepared as advanced bio-composite of enhanced decontamination properties for different species of water pollutants (Cd2+, safranin dye, and phosphate). The composite achieved promising adsorption capacities with experimental values of 206.8 mg/g (Cd2+), 336 mg/g (safranin), and 296 mg/g (phosphate); and predicted maximum capacities of 212.9 mg/g (Cd2+), 341 mg/g (safranin), and 305 mg/g (phosphate). The adsorption systems for the three species follow the Freundlich isotherm model and Pseudo-First order as kinetic model considering both the linear and nonlinear fitting demonstrating heterogeneous and multilayer uptake properties of physisorption type. The operation of physisorption mechanisms was supported by the obtained adsorption energies from D-R model that are less than 8 kJ/mol as well as the calculated free energies and enthalpies. The thermodynamic investigation revealed the nature of the adsorption reactions of the three pollutants by EXB/CF as exothermic, favorable, and spontaneous reactions. The EXB/CF composite also is of significant recyclability value and applied in five decontamination reusing runs for Cd2+, safranin dye, and phosphate achieving promising removal percentages.

Extracorporeal blood purification with Oxiris® filter in critically ill patients with COVID-19 requiring continuous renal replacement therapy.

INTRODUCTION: Severe COVID-19 is associated with a dysregulated immune response that usually leads to cytokine release syndrome. This study aimed to compare the use of extracorporeal blood purification therapy (Oxiris®) versus standard continuous renal replacement therapy (CRRT) in critically-ill patients with severe COVID-19. METHODS: This was a national, multicenter, retrospective study of patients with COVID-19 admitted to the intensive care unit (ICU) between March and October 2020 who required CRRT. Patients were categorized into two groups: Oxiris® CRRT and standard CRRT. The primary outcome was the number of patients alive and ventilator-free at 30-days post-CRRT treatment. Key secondary endpoints included change in inflammatory markers, Sequential Organ Failure Assessment (SOFA) scores, and PaO2/FiO2 ratio at 24- and 72-h post Oxiris® initiation. RESULTS: Thirty-five patients received Oxiris® CRRT and 23 patients received standard CRRT. The primary outcome was 31.4% in the Oxiris® group versus 4.3% in the standard CRRT group (adjusted odds ratio 5.97, 95% confidence interval [CI], 0.64-55.6; p = 0.117). In the Oxiris® group, interleukin-6 (IL-6) concentrations significantly decreased at 24 and 72-h (p = 0.033) and PaO2/FiO2 ratio significantly increased at 24 and 72 h after Oxiris® initiation (p = 0.001). There was no significant change in SOFA scores at 24- and 72-h after Oxiris® initiation. CONCLUSION: The number of patients alive and ventilator-free at 30-days was higher in the Oxiris® group than that in the standard CRRT group; however, the difference did not reach statistical significance after adjusting for the baseline severity of illness. There was a significant reduction in IL-6 and significant improvement in PaO2/FiO2 ratio after Oxiris® CRRT initiation.

Crossing effect for improving egg production traits in chickens involving local and commercial strains.

AIM: This study aimed to contribute to the productivity improvement of the local chickens by enhancing their egg production traits using a crossbreeding program between Alexandria (local strain) and Lohmann White (commercial strain). MATERIALS AND METHODS: One thousand two-hundred and eighty-five 4-week-old chicks from two strains: Alexandria local strain (AA) and Lohmann White commercial strain (LL) and their reciprocal crosses obtained from 16 males and 160 females, were used to produce four genetic groups (AA, LL, AL, and LA). Differences among genotypes, direct additive, heterosis, and reciprocal effects were investigated regarding the following traits: Body weight at 4 and 8 weeks and at the age of sexual maturity, age at sexual maturity, egg production, average egg weight, and egg mass during the first 90 days of laying. RESULTS: Statistically significant effects of the genotypes were observed on traits studied. Analysis of direct additive effects showed that AA was superior as a sire strain for improving body weight at early age. For egg traits (age at sexual maturity, egg production, average egg weight, and egg mass), LL was better as a sire strain to improve these traits. Significant positive heterosis percentages were observed for body weight. The crosses (AL and reciprocal) were significantly superior in egg traits (egg production, average egg weight, and egg mass) compared to the local strain. The cross (LA) laid significantly earlier than the local strain. Analysis of reciprocal effects cleared that the local strain could be used as a strain of dam to improve body weight and egg traits. CONCLUSION: Crossing improved egg production, egg weight, and egg mass in hybrids compared to the local strain.

A Myriad of Scleroma Presentations: The Usual and Unusual.

To prospectively study a series of scleroma patients with a focus on socioeconomic status, clinical presentation, pathology, microbiology, and treatment. A total of 52 patients diagnosed with scleroma were included in the study. Demographic data of the patients were collected and clinical, radiographic, and histopathologic findings were analyzed. Biopsies from atypical patients were sent for electron microscopic examination. Patients were treated both medically and surgically with clinical follow-up to determine outcomes and the incidence of recurrence. Fifty-two patients were included in the study. There were 23 males (44.2%) and 29 females (55.8%). The highest incidence of scleroma was identified in individuals from poor, rural areas in the third to fourth decades of life. The nose was affected in all cases. Other affected sites included the nasopharynx, soft and hard palate, larynx and trachea, lacrimal passages, skin, and gingiva. Some patients had atypical presentations. Complete follow-up of all patients was hindered by non-compliance with clinic visits and the long duration of medical treatment. Recurrence or relapse of the granulomatous lesions after initial improvement occurred in 11 patients (21.2%) within 1 to 3 years. Scleroma is a stubborn, chronic, granulomatous bacterial disease. The diverse presentations may mimic neoplasms and other granulomatous conditions. We present cases with unusual presentations and demonstrate the transmission electron microscopic features of these lesions. Furthermore, we confirm the importance of achieving full eradication of the etiologic bacilli to prevent recurrent disease.

Effect of Trichoderma reesei Degraded Date Pits Supplementation on Growth Performance, Immunoglobulin Levels, and Intestinal Barrier Functions of Broiler Chickens.

BACKGROUND: Date palm (Phoenix dactylifera L.) is a dominant fruit crop in most Arabian countries. Date pits, as a major byproduct which remained after consumption of date flesh, proved to be a valuable source of energy. OBJECTIVES: The impact of degraded date pits (DDP) on growth performance, intestinal bacterial population, and expression profiles of intestinal genes in broilers was determined. Recent patents have been established on DDP from the European patent office (EP2586318B1), Hong Kong patent registry office (HK1184642) and by the United States patent and trademark office (US8968729B2 and US10265368B2). METHODS: Solid-state degradation system (SSD) was used for the preparation of DDP using Trichoderma reesei. One-day-old Brazilian broiler chicks "Cobb 500" were randomly divided into six treatments with six replicates, which consisted of a normal diet containing only corn-soy (control), diet containing corn-soy + (20%, 50g/100Kg oxytetracycline), diet containing corn-soy + 10% (DDP), diet containing corn-soy + 0.2% mannan oligosaccharides (MOS), diet containing corn-soy + 0.1% mannose, and diet containing corn-soy + 0.2% mannose. RESULTS: There were no significant differences in body weight, feed intake, and feed conversion ratio (FCR) in broilers among the treatments. The bacterial count was significantly decreased in 10% DDP diet-fed broilers, 0.2% MOS and antibiotic diet-fed broilers. Immunoglobulin levels in serum and intestinal contents and expression pattern of genes in jejunum were upregulated in 10% DDP and 0.2% MOS diet-fed broilers. CONCLUSION: DDP can be used as an energy source for replacing part of corn, mannan oligosaccharide and also recommended as a potential alternative to antimicrobials in broilers diet.

Potential role of circulating microRNAs (486-5p, 497, 509-5p and 605) in metabolic syndrome Egyptian male patients.

Objective: This study aims to evaluate the expression pattern of circulating microRNAs (miR)-486-5p, miR-497, miR-509-5p, and miR-605 in the serum of metabolic syndrome (MetS) Egyptian male patients. Methods: In this study, the circulating miR-486-5p, miR-497, miR509-5p, and miR-605 were amplified and quantitatively detected by quantitative real-time polymerase chain reaction in sera of 55 MetS male patients in comparison to 20 male controls. The level of fasting plasma glucose and triacylglycerol (TAG) were measured using calorimetric assay. Blood pressure was measured using mercuric sphygmomanometer. Anthropometric measurements were done to each individual. Furthermore, MetS patients were defined according to the criteria proposed by the American Heart Association and divided into three groups according to MetS index. Results: The study was performed on three groups and a control group defined as follows: group 1: 15 MetS patients who fulfilled all diagnostic criteria of MetS; group 2: 20 MetS patients with normal blood pressure; group 3: 20 MetS patients with normal TAG levels.The levels of miRs are expressed as [median (IQR)]. miR-486-5-p and miR-497 expression were elevated in group 1 [31.9(49), p˂0.0001; 73.1(42.5), p˂0.0001], group 2 [36.4(15.7), p˂0.0001; 68.3(54.8), p˂0.0001], and group (3) [10.8(18.9), p=0.0014; 27.5(39.7), p=0.0012]. MiR-509-5p was elevated in groups 1 and 2 [501(468), p=0.0001], [309(436), p=0.0006], respectively, while normally expressed in group 3 [0.93(0.077), p=0.0001]. miR-605 was elevated in groups 1 and 3 [25.4(20.0), p=0.0018], [54.8(65.8), p˂0.0001], while normally expressed in group 2 [0.84(0.67), p˂0.0001]. Conclusion: miRs (486-5p, 497, 509-5p, and 605) serum levels were higher in MetS patients than in healthy control subjects; therefore, these serum miRs can serve as early biomarkers and can be used to follow-up the prognosis of MetS.

Transnasal Transsphenoidal Endoscopic Repair of CSF Leakage Using Multilayer Acellular Dermis.

UNLABELLED: Cerebrospinal fluid (CSF) leaks result from a communication between the subarachnoid space and the upper aerodigestive tract. Because of the risk of complications such as meningitis, brain abscess, and pneumocephalus, all persistent CSF leaks should be repaired. Surgical repair may be achieved transcranially or extracranially using a wide variety of autogenous, allogenic, and synthetic patching materials. We report our results with a transnasal transsphenoidal endoscopic approach for the repair of CSF leaks coupled with a multilayer closure using acellular dermis (Allodermtrade mark). We conducted a retrospective review of all patients presenting to our institution over the past 5 years with isolated sphenoid sinus CSF fistulas. RESULTS: Twenty-one patients were included in the study. Nineteen patients (90.5%) had their sphenoid sinus CSF fistula repaired during the first attempt; 2 patients (9.5%) needed a second attempt. The multilayer repair of the CSF leak using acellular dermis via a transsphenoidal endoscopic approach is an effective and successful method of surgical repair of the fistula site. Neither the number, size, nor cause of the CSF fistula affected surgical outcomes. However, the presence of hydrocephalus was a significant negative variable, altering the surgical outcomes of our patients. The acellular dermis offers the advantage of not requiring autogenous tissue for the effective repair of CSF leaks in the sphenoid sinus.

Circulating Maternal Total Cell-Free DNA, Cell-Free Fetal DNA and Soluble Endoglin Levels in Preeclampsia: Predictors of Adverse Fetal Outcome? A Cohort Study.

BACKGROUND: The diagnosis of preeclampsia (PE) is based on the measurement of maternal blood pressure and proteinuria; however, these parameters are not used in the prediction of adverse fetal outcomes that may occur due to fetal stress. The plasma concentrations of total cell-free DNA (cf-DNA), cell-free fetal DNA (cff-DNA) and soluble endoglin (sEng) are higher in women with established PE than in normotensive controls, and the increase is particularly marked in those with severe PE. We aimed to evaluate the levels of cf-DNA, cff-DNA and sEng in pregnant Egyptian women with PE in order to assess the severity of the disease and to detect their potential utility in the future prediction of time of delivery and adverse fetal outcome. SUBJECTS AND METHODS: The study included 107 pregnant females with established PE during their third trimester (51 with mild PE and 56 with severe PE), together with 93 normotensive pregnant women. Absolute quantitation of the hemoglobin subunit beta (HBB) and testis-specific protein, Y-linked 1 (TSPY1) genes for the measurement of cf-DNA and cff-DNA in maternal blood, respectively, was carried out using real-time polymerase chain reaction (PCR) together with the measurement of serum sEng using ELISA. RESULTS: An almost twofold increase in cf-DNA and cff-DNA was detected in the severe PE group over the mild group, and both were significantly different from the control group. Significantly higher levels of cf-DNA, cff-DNA and sEng, with variable magnitudes, were detected in the preterm labor and unfavorable fetal outcome groups compared with the term and favorable outcome groups, respectively. The three markers were almost equivalent with regard to the area under the curve for predicting adverse fetal outcome in the severe PE group. The same was also true for cf-DNA and cff-DNA within the mild PE group. CONCLUSIONS: Incorporation of cf-DNA, cff-DNA and sEng into the prenatal care service should be considered as a serious addition for the screening and detection of adverse pregnancy outcomes in view of their significant elevations in cases of preeclamptic women whose babies ultimately suffered a poor outcome.

One-year clinical evaluation of IPS Empress CAD versus polished Celtra Duo ceramic Laminate veneers (randomized controlled clinical trial) / Avaliação clínica de um ano de IPS Empress CAD versus laminados de cerâmica Celtra Duo polidos (ensaio clínico randomizado controlado)

Objective: To evaluate fracture resistance and survival rate of IPS Empress CAD versus Polished Celtra Duo ceramic laminate veneers. Material and Methods:Thirty-six ceramic laminate veneers were fabricated for maxillary anterior teeth. The patients were divided into two groups according to the material Group 1(control group) fabricated from IPS Empress CAD laminate veneers and group 2 (intervention group) fabricated from Polished Celtra Duo laminate veneers. Standardized the same preparation with butt joint design and chamfer finish line located supra gingival were performed for all the teeth. The fabrication of the veneers was performed using Cad\Cam (Ceramill motion) machine, with software (Exocad). The veneers surfaces were treated and silanated according to the manufacture instruction of each ceramic and enamel surfaces were etched where total etch adhesive protocol was obeyed using BISCO. Follow up sessions were done every two months up to one year for each patient using dental probe and operator vision to evaluate the fracture, survival rate, marginal adaptation, sensitivity and caries. according to USPHS criteria (United States Public Health Service). This was performed by an experienced, blinded investigator. Results: Fracture resistance, marginal adaptation, retention, caries and sensitivity were evaluated according to the criteria of USPHS and we found there is no significant difference as both groups scaled zero score. Conclusion: Both IPS Empress Cad and Polished Celtra Duo laminate veneers revealed successful clinical performance in terms of fracture resistance, marginal adaptation, retention, and sensitivity after one year follow up period (AU)

Objetivo: Avaliar a resistência à fratura e a taxa de sobrevivência de laminados de cerâmica IPS Empress CAD versus Celtra Duo polidos. Material e Métodos: Trinta e seis facetas cerâmicas laminadas foram confeccionadas para dentes anteriores superiores. Os pacientes foram divididos em dois grupos de acordo com o material Grupo 1 (grupo controle) confeccionado com laminados IPS Empress CAD e grupo 2 (grupo intervenção) confeccionado com laminados Celtra Duo polidos. A mesma forma de preparo e acabamento de chanfro localizado supra-gengival padronizados foram realizados para todos os dentes. A confecção das facetas foi realizada em máquina Cad \ Cam (Ceramill motion), com software (Exocad). As superfícies laminadas foram tratadas e silanizadas de acordo com as instruções do fabricante de cada cerâmica e as superfícies de esmalte foram condicionadas seguindo o protocolo adesivo de condicionamento ácido total com BISCO. Sessões de acompanhamento foram realizadas a cada dois meses durante um ano para cada paciente usando sonda exploradora e visão do operador para avaliar a fratura, taxa de sobrevivência, adaptação marginal, sensibilidade e cárie; de acordo com os critérios USPHS (Serviço de Saúde Pública dos Estados Unidos). Isso foi realizado por um investigador experiente e cego. Resultados: a resistência à fratura, adaptação marginal, retenção, cárie e sensibilidade foram avaliadas de acordo com os critérios da USPHS e não encontramos diferença significativa, pois ambos os grupos escalonaram pontuação zero. Conclusão: As facetas laminadas IPS Empress Cad e Celtra Duo polido revelaram desempenho clínico bem-sucedido em termos de resistência à fratura, adaptação marginal, retenção e sensibilidade após um período de acompanhamento de um ano. (AU)

Onset of juvenile dermatomyositis following varicella infection in a 12-month-old child: a case report.

INTRODUCTION: Infections can act as a trigger for juvenile dermatomyositis, with a predominance of respiratory tract infections reported previously. We present the first case of juvenile dermatomyositis following varicella infection to be described in the literature. CASE PRESENTATION: A 15-month-old Caucasian girl was diagnosed with juvenile dermatomyositis 3 months after a varicella infection. The diagnosis was challenging due to her young age, but was supported by magnetic resonance imaging, and confirmed following a later appearance of the characteristic skin rash. CONCLUSION: Varicella infection may be a trigger for juvenile dermatomyositis. Further understanding of disease triggers is required.

Nasal base narrowing: the alar flap advancement technique.

OBJECTIVE: To evaluate the role of creating an alar-based advancement flap in narrowing the nasal base and correcting excessive alar flare. STUDY DESIGN: Case series with chart review. SETTING: This is a retrospective record review study. SUBJECTS AND METHODS: The study included 35 cases presenting with a wide nasal base and excessive alar flaring. The surgical procedure combined the alar base reduction with alar flare excision by creating a single laterally based alar flap. Any caudal septal deformities and any nasal tip modification procedures were corrected before the nasal base narrowing. The mean follow-up period was 23 months. RESULTS: The mean alar flap narrowing was 6.3 mm, whereas the mean width of sill narrowing was 2.9 mm. This single laterally based advancement alar flap resulted in a more conservative external resection, thus avoiding alar wedge overresection or blunting of the alar-facial crease. No cases of postoperative bleeding, infection, or keloid were encountered, and the external alar wedge excision healed with no apparent scar that was hidden in the depth of the alar-facial crease. The risk of notching of the alar rim at the sill incision is reduced by adopting a 2-layer closure of the vestibular floor. CONCLUSION: The alar base advancement flap is an effective technique in narrowing both the nasal base and excessive alar flare. It adopts a single skin excision to correct the 2 deformities while commonly feared complications were avoided.

EP4 and EP2 receptor subtypes involved in colonic secretion in rat.

The study was designed to determine the prostaglandin EP receptor subtypes functionally involved in electrogenic ion secretion in rat colon. With 30 rats, measurements of short circuit current (SCC) and slope conductance were obtained by Ussing chamber technique. Prostaglandin E2 (PGE(2)) and other EP receptor selective agonists were employed on stripped rat colon pre-treated with indomethacin and theophylline. Receptor-specific agonists were butaprost (EP(2)), sulprostone (EP(1) and EP(3)) and PGE(1) alcohol (OH-PGE(1)) (EP(4)). GW627368X was used as a specific EP(4) receptor antagonist. Forskolin-induced SCC was used as a control of tissue viability. The mean basal SCC was 24.5 +/- 0.9 microA/cm(2) (range 9.8-45.1), and mean basal slope conductance was 23.7 +/- 6.1 mS/cm(2) (range 9.7-39.8). The basal SCC decreased after pre-treatment with indomethacin and increased after pre-treatment with theophylline. PGE(2), butaprost and OH-PGE(1) stimulated maximal increase in SCC (55.8 +/- 4.1, 43.9 +/- 3.8 and 93.9 +/- 2.7 microA/cm(2), respectively), while sulprostone had no apparent effects. GW627368X eliminated OH-PGE(1)-induced SCC and partially PGE(2)-induced SCC, leaving butaprost-induced SCC almost unperturbed. Bumetanide, 20 microM, inhibited between 40% and 80% of the agonist-induced changes in SCC. In conclusion, compilation of the results on induced SCC by subtype specific receptor agonists for EP receptors and the pattern of induced SCCs inhibited by GW627368X indicate the EP(4) receptor subtype as the major mediator of PGE(2)-induced electrogenic ion secretion with a lesser induction through the EP(2) receptor subtype.