There is now information on embryonic and larval expression of ov

There is now information on embryonic and larval expression of over 12,000 genes and just

under 1000 mutant phenotypes. We review the remarkable similarity of the zebrafish genetic blueprint for the nervous system to that of mammals and assess recent technological advances that make the zebrafish a model of choice for elucidating the development and function of neuronal circuitry, transgene-based neuroanatomy, and small molecule neuropharmacology. (C) 2010 Elsevier Ltd. All rights reserved.”
“Background: Although aortoiliofemoral GSK690693 ic50 bypass grafting is the optimal revascularization method for patients with severe aortoiliac occlusive disease (AIOD), previous studies have documented poor patency rates in young adults. This study investigated whether young patients with AIOD have worse outcomes in patency, limb salvage, and long-term survival rates after reconstructive surgery than their older counterparts.

Methods: Patients aged <= 50 years undergoing reconstructive surgery at our institution for AIOD between 1995 and 2010 were compared with a cohort of randomly selected patients aged >= 60 years (two for each of the young patients, matched for year of operation), analyzing demographics, risk factors, indications for surgery, operative details, and outcomes.

Results: Among 927 consecutive patients undergoing primary surgery 5-Fluoracil solubility dmso for AIOD, 78 (8.4%) aged <=

50 years (mean age, 48.4 years) and 156 older control patients (mean age, 71.2 years) were identified. The younger patients were Rho mainly men (81%) and 59% had surgery for limb salvage and 41% for disabling claudication (P = .02). Compared with older patients, they were significantly more likely to be smokers (90% vs 72%; P = .002) and had previously needed significantly more inflow procedures (28% vs 16%; P = .03). Only one death occurred perioperatively (30-day) among the control

patients, and no major amputations or graft infections occurred in either group. The need for subsequent infrainguinal reconstructions was greater in the younger patients (18% vs 7%; P = .01). The primary patency rates were inferior in the younger patients at 5 years (82% and 75%) and 10 years (95% and 90%; P = .01), whereas assisted secondary patency (89% and 82% vs 96% and 91%; P = .08), secondary patency (93% and 86% vs 98% and 92%; P = .19), limb salvage (88% and 83% vs 95% and 91%; P = .13), and survival rates (87% and 76% vs 91% and 84%; P = .32) were comparable in the two groups.

Conclusions: This study shows that despite a higher primary graft failure rate than that in older patients, aortoiliofemoral revascularization for complex AIOD is a safe procedure for younger patients with disabling claudication or limb-threatening ischemia, providing they are willing to follow a regular protocol to complete their postoperative surveillance and to undergo graft revision as necessary. (J Vasc Surg 2012;56:1606-14.)”
“Swimming movements in the leech and lamprey are highly analogous, and lack homology.

By contrast, treatment with calcimimetics,

By contrast, treatment with calcimimetics, LY2874455 ic50 which provided a better control of plasma PTH levels, did not result in extraskeletal mineral accumulation and did not cause mortality. More important, when added to calcitriol, calcimimetics prevented the development of VC and reduced mortality. Paricalcitol administration

to uremic rats resulted in calcification levels and mortality rates that were lower than in rats treated with calcitriol but higher than in rats treated with calcimimetics. The mechanism(s) of action responsible for the anticalcification effect of calcimimetics are likely related to the fact that these drugs can control PTH levels without increasing the plasma Ca x P product. In addition calcimimetic activation of vascular calcium-sensing receptor may also modulate the expression of proteins that prevent the development of VC, like matrix Gla protein.”
“Background Invasive pneumococcal disease declined among children and adults after the introduction of the pediatric heptavalent pneumococcal conjugate vaccine ( PCV7) in 2000, but its effect on pneumococcal meningitis is unclear.

Methods We examined trends in pneumococcal meningitis from 1998 through

2005 using active, population- based surveillance data from eight sites in the United States. Isolates were grouped into PCV7 serotypes ( 4, 6B, 9V, 14, 18C, 19F, and 23F), PCV7- related serotypes ( 6A, 9A, 9L, 9N, 18A, 18B, 18F, 19B, 19C, 23A, and 23B), and non- PCV7 serotypes ( all others). Changes in the incidence of pneumococcal meningitis were assessed against baseline values from 1998- 1999.

Results We identified 1379 cases of pneumococcal this website meningitis. triclocarban The incidence declined from 1.13 cases to 0.79 case per 100,000 persons between 1998- 1999 and 2004- 2005 ( a 30.1% decline, P< 0.001). Among persons younger than 2 years of age and those 65 years of age or older, the incidence decreased during the study period by 64.0% and 54.0%, respectively ( P< 0.001 for both groups). Rates of PCV7- serotype meningitis declined from 0.66 case to 0.18

case ( a 73.3% decline, P< 0.001) among patients of all ages. Although rates of PCV7- related- serotype disease decreased by 32.1% ( P = 0.08), rates of non- PCV7- serotype disease increased from 0.32 to 0.51 ( an increase of 60.5%, P< 0.001). The percentages of cases from non- PCV7 serotypes 19A, 22F, and 35B each increased significantly during the study period. On average, 27.8% of isolates were nonsusceptible to penicillin, but fewer isolates were nonsusceptible to chloramphenicol ( 5.7%), meropenem ( 16.6%), and cefotaxime ( 11.8%). The proportion of penicillin-nonsusceptible isolates decreased between 1998 and 2003 ( from 32.0% to 19.4%, P = 0.01) but increased between 2003 and 2005 ( from 19.4% to 30.1%, P = 0.03).

Conclusions Rates of pneumococcal meningitis have decreased among children and adults since PCV7 was introduced.

Substantial heterogeneity exists in rankings of leading causes of

Substantial heterogeneity exists in rankings of leading causes of disease burden among regions.

Interpretation Global disease burden has continued to shift away from communicable to non-communicable diseases and from premature death to years lived with disability.

In sub-Saharan Africa, however, many communicable, maternal, neonatal, and nutritional disorders remain the dominant causes of disease burden. The rising burden from mental and behavioural disorders, musculoskeletal disorders, and diabetes will impose new challenges on health systems. Regional https://www.selleckchem.com/products/lxh254.html heterogeneity highlights the importance of understanding local burden of disease and setting goals and targets for the post-2015 agenda taking such patterns into account. Because of improved definitions, methods, and data, these results for 1990 and 2010 supersede all previously published Global Burden of Disease results.”
“The aims of this study were buy Pifithrin-�� to demonstrate the feasibility of centrally collecting and processing high-quality cerebrospinal fluid (CSF) samples for proteomic studies within a multi-center consortium and to identify putative biomarkers for medulloblastoma in CSF. We used 2-DE to investigate the CSF proteome from 33 children with medulloblastoma and compared it against the CSF proteome from 25 age-matched controls. Protein spots

were subsequently identified by a combination of in-gel tryptic digestion and MALDI-TOF TOF MS analysis. On average, 160 protein spots were detected by 2-DE and 76 protein spots corresponding to 25 unique proteins were identified using MALDI-TOF. Levels of prostaglandin D2 synthase (PGD2S) were found to be six-fold decreased in the tumor samples versus control Aldehyde_oxidase samples (p < 0.00001).

These data were further validated using ELISA. Close examination of PGD2S spots revealed the presence of complex sialylated carbohydrates at residues Asn(78) and Asn(87). Total PGD2S levels are reduced six-fold in the CSF of children with medulloblastoma most likely representing a host response to the presence of the tumor. In addition, our results demonstrate the feasibility of performing proteomic studies on CSF samples collected from patients at multiple institutions within the consortium setting.”
“Iatrogenic injury to the spinal cord (SC) is not an uncommon complication of spinal surgery. In an attempt to establish a preventive therapy for anticipated SC injury, we tested the effect of a single dose (SD) vaccine vs. the addition of a booster dose (BD) of a neural-derived peptide (A91) prior to SC contusion. Immunization with A91 immediately after SC injury has demonstrated to induce significant tissue protection and motor recovery. After injury, only the BD vaccination schedule had a neuroprotective effect. It was capable of improving neurological recovery that was always significantly higher than the one observed in rats with SD immunization or those only treated with PBS.

Patients requiring concomitant renal artery reconstruction were e

Patients requiring concomitant renal artery reconstruction were excluded from this review. Suprarenal cross-clamp was used in 51 patients with temporary vessel-loop control of the renal arteries. Creatinine (Cr) and glomerular filtration rates (eGFR) were

measured pre-, post-, and long-term after surgery. Outpatient records of all patients that had survived more than 12 months were also reviewed in order to evaluate the late effects on renal function or symptoms possibly related to LRVDAL.

Results. Median procedure duration was 157 (61-375) minutes. Median cross-clamp time was 16 (10-45) minutes. Median intensive care unit (ICU) and hospital length TGF-beta inhibitor of stays were 2 (1-11) days and 7 (4-58) days, respectively. There were no deaths. There were no complications directly related to renal vein ligation. Hematuria, seen in 2 patients, was a result

PP2 of traumatic insertion of a Foley catheter. Median pre-op and discharge Cr levels were 1.1 mg/dL (0.7-2.4 mg/dL) and 1.1 mg/dL (0.6-2.1 mg/dL), respectively (P < .5). Median change in Cr was 0.0 mg/dL and only increased in 14 patients (maximum increase 0.9 mg/dL). Median pre-op and discharge eGFR was 61 mL/minute (28-137 mL/minute/1.73 m2) and 67 mL/minute (32-138 mL/minute/1.73 m2), respectively (P < .5). Cr and eGFR in the 2 patients with a Cr of >2.0 mg/dL remained unchanged post-op. Only 2 patients with a Cr of <2.0 mg/dL had a post-op Cr >2.0 mg/dL and both returned to normal by day 3 post-op. Thirty-six patients have been followed for more than a year (median 34.5 months, maximum 144 months) and Cr has remained stable in all but 2 patients. These 2 patients, both with a pre-op Cr of 1.5 mg/dL, subsequently

developed Cr levels of 2.1 mg/dL and 2.4 mg/dL but maintained baseline Cr levels for 25 and 34 months, respectively, before demonstrating these elevated levels which have proven to be unrelated to renal vein ligation. Hematuria and flank pain have see more never been recorded after discharge.

Conclusion: Restoration of left renal vein continuity after LRVDAL may be unnecessary since renal compromise and hematuria was not encountered in this long-term analysis. (J Vasc Surg 2009;50:500-4.)”
“OBJECTIVE:The subtemporal approach for a superficial temporal artery-to-superior cerebellar artery bypass requires significant superior retraction that can injure the temporal lobe, compromise veins, and cause edema postoperatively. In contrast, the pretemporal approach requires posterolateral retraction that seems to be less injurious to the temporal lobe and better tolerated clinically. We hypothesized that the pretemporal approach provides ample exposure, more gentle retraction, and better clinical results than the subtemporal approach.

METHODS: Standard orbitozygomatic-pterional and subtemporal approaches were performed on both sides of 4 formalin-fixed cadaver heads for morphometric measurements.

However, the functional and structural connectivity between the b

However, the functional and structural connectivity between the bilateral auditory cortices and the left inferior frontal gyrus (a region involved in higher-level phonological processing) is significantly hampered in dyslexics, suggesting deficient access to otherwise intact phonetic representations.”
“The control of motor behavior in animals and humans requires constant adaptation

of neuronal networks to signals of various types and strengths. We found that microRNA-128 (miR-128), which is expressed in adult neurons, regulates motor behavior by modulating neuronal signaling networks and excitability. miR-128 governs motor activity by suppressing the expression of various ion channels and signaling components of the extracellular signal-regulated kinase ERK2 network that regulate neuronal excitability. In mice, a reduction of miR-128 expression in postnatal neurons causes find more increased motor activity and fatal epilepsy. Overexpression of miR-128 attenuates neuronal responsiveness, suppresses motor activity, and

alleviates motor abnormalities associated with Parkinson’s-like disease and seizures in mice. These data suggest a therapeutic potential for miR-128 in the treatment of epilepsy and movement disorders.”
“Background: Semen and semen-derived amyloid fibrils boost HIV infection in vitro but their impact on sexual virus transmission in vivo is unknown. Here, we examined selleck compound the effect of seminal plasma (SP) and semen-derived enhancer of virus infection (SEVI) on vaginal virus transmission in the SIV/rhesus macaque (Macacca mulatta) model.

Results: A total of 18 non-synchronized female rhesus macaques (six per group) were exposed intra-vaginally to increasing doses of the pathogenic SIVmac239 molecular clone in the presence or absence of SEVI and SP. Establishment of productive virus infection was assessed by measuring plasma viral RNA loads

at weekly intervals. We found that the first infections occurred at lower viral doses in the presence of SP and SEVI compared to the control group. Furthermore, the average peak viral loads during acute infection were about 6-fold higher after exposure to SP- and SEVI-treated virus. Overall infection rates after a total of 27 intra-vaginal exposures Sitaxentan to increasing doses of SIV, however, were similar in the absence (4 of 6 animals) and presence of SP (5 of 6), or SEVI (4 of 6). Furthermore, the infectious viral doses required for infection varied considerably and did not differ significantly between these three groups.

Conclusions: Semen and SEVI did not have drastic effects on vaginal SIV transmission in the present experimental setting but may facilitate spreading of virus infection after exposure to low viral doses that most closely approximate the in vivo situation.

Acute, I day administration had no affect on proliferation Caffe

Acute, I day administration had no affect on proliferation. Caffeine administration does not affect the expression of early or late markers of neuronal SN-38 nmr differentiation, or rates of long-term survival. However, neurons induced in response to supraphysiological levels of caffeine have a lower survival

rate than control cells; increased proliferation does not yield an increase in long-term neurogenesis. These results demonstrate that physiologically relevant doses of caffeine can significantly depress adult hippocampal neurogenesis. (C) 2009 Elsevier Ltd. All rights reserved.”
“Background Most malaria deaths occur in rural areas. Rapid progression from illness to death can be interrupted by prompt, effective medication. Antimalarial treatment cannot rescue terminally ill patients but could be effective if given earlier. If patients who cannot be treated orally are several hours from facilities for injections, rectal artesunate can be given before referral and acts rapidly on parasites. We investigated whether this intervention reduced mortality and permanent disability.

Methods A-1155463 in vitro In Bangladesh, Ghana, and Tanzania, patients with suspected severe

malaria who could not be treated orally were allocated randomly to a single artesunate (n=8954) or placebo (n=8872) suppository by taking the next numbered box, then referred to clinics at which injections could

be given. Those with antimalarial injections or negative blood smears before randomisation were excluded, leaving 12068 patients (6072 artesunate, 5996 placebo) for analysis. Primary endpoints were mortality, assessed 7-30 days later, and permanent disability, reassessed periodically. All investigators were masked to group assignment. Analysis was by intention to treat. This study is registered in all three countries, numbers ISRCTN83979018, 46343627, and 76987662.

Results Mortality was 154 of 6072 artesunate versus 177 of 5996 placebo (2.5% vs 3 . 0%, p=0 . 1). Two versus 13 (0 . 03% vs 0 . 22%, p=0 . 0020) were permanently disabled; total dead or disabled: 156 versus 190 (2 . 6% vs 3.2%, p=0 science . 0484). There was no reduction in early mortality (56 vs 51 deaths within 6 h; median 2 h). In patients reaching clinic within 6 h (median 3 h), pre-referral artesunate had no significant effect on death after 6 h or permanent disability (71/4450 [1.6%] vs 82/4426 [1.9%], risk ratio 0.86 [95% Cl 0.63-1.18], p=0.35). In patients still not in clinic after more than 6 h, however, half were still not there after more than 15 h, and pre-referral rectal artesurate significantly reduced death or permanent disability (29/1566 [1.9%] vs 57/1519 [3.8%], risk ratio 0.49 [95% CI 0.32-0.77], p=0 . 0013).

(C) 2010 Elsevier Ltd All rights reserved “
“Visual short-t

(C) 2010 Elsevier Ltd. All rights reserved.”
“Visual short-term memory (VSTM) capacity is often assessed using change detection tasks, and individual differences in performance have been shown to predict cognitive aptitudes across a range of domains in children and adults. We recently showed that intelligence correlates with an attentional component necessary for change detection rather than with memory capacity per se (Cusack, Lehmann, Veldsman, & Mitchell, 2009). It remained unclear, however, whether different attentional strategies during change detection have most impact during the encoding or maintenance of information. Here we present recent findings from our laboratory supporting

selleck chemical the hypothesis that attentional selection during encoding dominates individual differences in change detection measures of visual short-term memory. In a first study, we unpredictably varied whether short-term memory was probed using change detection or whole report, encouraging participants to adopt the same encoding strategy throughout the tasks. Change detection performance of lower-IQ STI571 research buy individuals improved. In a second study, we found that deficits in top-down attentional selectivity can be alleviated in participants with low change detection performance by providing helpful grouping information during encoding. Finally, a meta-analysis of

neuroimaging data from 112 participants performing a variety of VSTM tasks showed that performance correlates with activity in several parietal and frontal regions during the encoding but not the maintenance phase. Taken together, these results support the notion that encoding strategy and not short-term memory capacity itself largely determines individual differences in visual change detection performance. (C) 2010 Elsevier Ltd. All rights reserved.”
“We study the stochastic susceptible-infected-recovered (SIR) model with time-dependent forcing using analytic techniques which allow us to disentangle the interaction of stochasticity and external forcing. Maltase The model is formulated as a continuous time Markov process, which is decomposed into a deterministic dynamics

together with stochastic corrections, by using an expansion in inverse system size. The forcing induces a limit cycle in the deterministic dynamics, and a complete analysis of the fluctuations about this time-dependent solution is given. This analysis is applied when the limit cycle is annual, and after a period doubling when it is biennial. The comprehensive nature of our approach allows us to give a coherent picture of the dynamics which unifies past work, but which also provides a systematic method for predicting the periods of oscillations seen in whooping cough and measles epidemics. (C) 2010 Elsevier Ltd. All rights reserved.”
“The allocation of visual processing capacity is a key topic in studies and theories of visual attention.

All rights reserved “
“A young woman was filmed during 2 d o

All rights reserved.”
“A young woman was filmed during 2 d of her ordinary life. A few months and then again a few years later she was tested for the memory

of her experiences in those days while undergoing fMRI scanning. As time passed, she came to accept more false details as true. After months, activity of selleck screening library a network considered to subserve autobiographical memory was correlated with memory confidence rather than with accuracy. After years, mainly regions of the temporal pole displayed this pattern. These results might reflect a slow process of increased reliance on schemata at the expense of accuracy.”
“Substantial data are accumulating that implicate the lateral hypothalamus (LH) as part of the descending pain modulatory system. The LH modifies nociception in the spinal cord dorsal horn partly through connections with the periaqueductal

gray (PAG), an area known to play a central role in brainstem modulation of nociception. Early work demonstrated a putative substance P connection between the LH and the PAG, but the connection is not fully defined. To determine whether LH-induced antinociception mediated by the PAG is neurokinin1 (NK1) receptor-dependent, we conducted behavioral experiments in which the cholinergic agonist carbachol (125 nmol) was microinjected into the LH of lightly anesthetized female Sprague-Dawley rats (250-350 g) and antinociception was obtained on the tail flick or foot withdrawal tests. Cobalt chloride (100 nM), which reversibly blocks synaptic activation, blocked LH-induced antinociception. In another set of experiments, the specific NK1 receptor antagonist L-703,606 (5 mu g) was see more microinjected in the PAG following LH stimulation with carbachol abolished LH-induced antinociception as well. Microinjection of cobalt chloride or L-703,606 in the absence of LH stimulation had no effect. These behavioral experiments coupled with earlier work provide converging evidence

to support the hypothesis that antinociception produced by activating neurons in the LH is mediated in part by the subsequent activation of neurons in the PAG by NK1 receptors. (C) 2009 Elsevier Ireland Ltd. All rights reserved.”
“New granule cells are born throughout life in the dentate ifenprodil gyrus of the hippocampal formation. Given the fundamental role of the hippocampus in processes underlying certain forms of learning and memory, it has been speculated that newborn granule cells contribute to cognition. However, previous strategies aiming to causally link newborn neurons with hippocampal function used ablation strategies that were not exclusive to the hippocampus or that were associated with substantial side effects, such as inflammation. We here used a lentiviral approach to specifically block neurogenesis in the dentate gyrus of adult male rats by inhibiting WNT signaling, which is critically involved in the generation of newborn neurons, using a dominant-negative WNT (dnWNT).

Isotocin is the teleost homolog of the mammalian hormone oxytocin

Isotocin is the teleost homolog of the mammalian hormone oxytocin, and like oxytocin, it regulates reproductive and social behavior. Therefore, the high calcium permeability of CNGA5 CHIR99021 channels and their strategic location in isotocin-secreting

synaptic terminals suggest that activation of CNGA5 channels in response to cyclic nucleotide signaling may have wide-ranging neuroendocrine and behavioral effects. (C) 2010 IBRO. Published by Elsevier Ltd. All rights reserved.”
“Although stroke can affect cerebral structure and function, the brain has a potential for plasticity thanks to which some degree of function can be restored. The pathways of such recovery are of great interest, since the dynamics of rewiring of the injured brain may become the basis for designing appropriate strategies of rehabilitation. We investigated the spontaneous plasticity of cortical somatosensory representations following a focal unilateral stroke in the barrel cortex of rats. Ischemic lesions were produced with the photothrombotic technique in the cortical representation

of vibrissae. Functional activation of the brain in response to the stimulation of vibrissae with destroyed cortical representation AZD4547 molecular weight was monitored through the 2 months post-stroke survival period with [(14)C]2-deoxyglucose (2DG) autoradiographic brain mapping (1, 7, 28, 56 days after the stroke). 2DG uptake was measured on autoradiograms of tangential sections in several regions of somatosensory cortex and in motor, auditory and prefrontal cortex. Behavioral deficit was assessed by the gap-crossing

test 3, 28, 56 days after the stroke. Changes in the activation pattern of the intact hemisphere and non-vibrissal somatosensory representations of the lesioned hemisphere evolved during the observation period. Full recovery of the behavioral function was reached 2 months after Dolichyl-phosphate-mannose-protein mannosyltransferase the stroke and at the same time, new foci of activation were observed in the lesioned hemisphere. At that time, hyperactivation of the somatosensory areas in the intact hemisphere subsided. The new activation foci located in representations of anterior vibrissae, front paw and hind paw were specific for the vibrissae stimulation and were most probably a new functional representation of the vibrissae. We demonstrated spatial and temporal remodeling of the brain induced by cortical stroke, leading to vicariation of function. (C) 2010 IBRO. Published by Elsevier Ltd. All rights reserved.”
“Homophone interference effects in Stroop experiments are often taken as evidence for the hypothesis that semantic access in written Chinese language is mediated by activation of phonological processing. We here aim to test this hypothesis with Chinese single-character words by means of event related potential (ERP) recordings.

Interpretation These findings support the need for stronger preve

Interpretation These findings support the need for stronger prevention efforts for infectious diseases, and reinforce the need to reduce ethnic and social inequalities and to address disparities in broad social determinants such as income levels, housing conditions, and access to health services. Our method could be adapted for infectious disease surveillance in other countries.”
“This study explored the effects of tonic blood pressure on the Etomoxir price association between baroreceptor cardiac reflex sensitivity and cognitive performance. Sixty female participants completed a mental arithmetic task. Baroreceptor reflex sensitivity was assessed using sequence analysis. An interaction was found,

indicating that the relationship between baroreceptor reflex sensitivity and cognitive performance is modulated by blood pressure levels. Reflex sensitivity was inversely associated Batimastat molecular weight to performance indices in the subgroup of participants with systolic blood pressure above the mean, whereas the association was positive in participants with systolic values below the mean. These results are in accordance with the findings in the field of pain perception and suggest that tonic blood pressure modulates the inhibitory effects of baroreceptor stimulation on high central nervous functions.”
“Background

Previous community-randomised trials of interventions to control sexually transmitted heptaminol infections (STIs) have involved rural settings, were rarely multicomponent, and had varying results. We aimed to assess the effect of a multicomponent intervention on curable STIs in urban young adults and female sex workers (FSWs).

Methods In this community-randomised trial, baseline STI screening was done between August, and November, 2002, in random household samples of young adults (aged 18-29 years) and in FSWs in Peruvian cities with more than 50

000 inhabitants. Geographically separate cities were selected, matched into pairs, and randomly allocated to intervention or control groups with an S-PLUS program. Follow-up surveys of random samples were done after 2 years and 3 years. The intervention comprised four modalities: strengthened STI syndromic management by pharmacy workers and clinicians; mobile-team outreach to FSWs for STI screening and pathogen-specific treatment; periodic presumptive treatment of FSWs for trichomoniasis; and condom promotion for FSWs and the general population. Individuals in control cities received standard care. The composite primary endpoint was infection of young adults with Chlamydia trachomatis, Trichomonas vaginalis, or Neisseria gonorrhoeae, or syphilis seroreactivity. Laboratory workers and the data analyst were masked, but fieldworkers, the Peruvian study team, and participants in the outcome surveys were not. All analyses were done by intention to treat. This trial is registered, ISRCTN43722548.