“Al(1-x)In(x)N layers with an indium content between x=10.


“Al(1-x)In(x)N layers with an indium content between x=10.5% and x=24% were grown by metal-organic vapor-phase epitaxy and characterized concerning their optical, structural and morphological properties with regard to the realization of optoelectronic devices. The indium content and the strain of these layers were measured by high resolution x-ray diffraction. Ellipsometric measurements were used to determine the optical constants [refractive index n(lambda) and extinction coefficient kappa(lambda)] in dependence of wavelength and indium content. The values determined for the electronic bandgaps

are in good agreement with theoretical predictions and previous publications on this topic but are more S63845 datasheet Cyclopamine clinical trial focused on AlInN layers which are pseudomorphically grown on GaN. A bowing parameter of b=10.3 +/- 0.1 was determined for fully strained layers with an indium content between 13% and 24%. In order to investigate the suitability of these layers for use in distributed Bragg reflectors, the surface morphology is characterized with respect to the indium content. Furthermore, the influence of an annealing step which often is necessary during device growth, was studied. The influence of this annealing step on the roughness was analyzed by atomic force microscopy, while structural features are monitored by high resolution secondary electron microscopy images. Based on these results

distributed Bragg reflectors for the green spectral region with up Citarinostat to 40 pairs and a peak reflectivity of 97% have been realized. Transmission electron microscopic analysis of the layer interfaces are in good agreement with the atomic force and secondary electron microscopy images of the single layer surfaces. (C) 2010 American Institute of Physics. [doi:10.1063/1.3467964]“
“Introduction: Virtual reality (VR) simulation has been known to shorten learning curves. The aim of this research was to determine whether VR transurethral bladder tumor resection (TURBT) with and without photodynamic diagnostic (PDD) can improve endourological skills in novice and trained endoscopists.

Materials and Methods: Residents without experience (n = 15) completed five 5-min white light VR-TURBT scenarios. The trained endoscopists (>= 25 TURBTs; n = 15) performed five 5-min VR resections using white light and PDD cystoscopy. The VR-TURBT performance with the Uro-Trainer (R) (Karl Storz GmbH, Germany) was compared between the first and last 5 cases using computer-generated parameters [inspected area (%), resected tumor mass (%) and bleeding (ml)]. The trained endoscopists’ parameters were compared with white light versus PDD-VR-TURBT. Results: Among novices, the inspected area increased from 36.8 (+/- 12.9) to 54.3% (+/- 7.3), p < 0.05. Significant improvements were noted for resection rates from 26.5 (+/- 9.6) to 52.

09 with both demonstrating total pyroelectric coefficient of appr

09 with both demonstrating total pyroelectric coefficient of approximately -20×10(-4) C m(-2) K(-1) at R=0.09, which corresponds to approximately 300% increase in the coefficient. PZT5H-CPVC also showed maximum of 800% rise in the pyroelectric coefficient while figure of merit for efficiency indicated up to twentyfold increase in its electrical response output per HSP990 cost given thermal stimuli when compared to that of PZT5H by itself.”
“In this study, a flavonoid malonyltransferase (OsMaT-2) was cloned from Oryza sativa, and the recombinant protein OsMaT-2

was purified via affinity chromatography. OsMaT-2 utilized a variety of flavonoid glucosides, including flavanone glucosides, flavone glucosides, flavonol glucosides, and isoflavone glucosides as substrates, but did not utilize anthocyanin. As an acyl donor, OsMaT-2 utilized only malonyl-CoA. Based on reactions with various quercetin 3-O-sugars, we identified the probable position of malonylation as the 6 ”-hydroxyl group of the sugar. AC220 price This is the first report, to the best of our knowledge, of the cloning of a flavonoid malonyltransferase from O. sativa. (C) 2009 Elsevier Masson SAS. All rights reserved.”
“Purpose We evaluated personality dimensions captured by an abbreviated 8-item questionnaire and examined associations of the personality traits

with health behaviours and subjective well-being (SWB) measures.

Methods The subjects were 11,554 participants in the Kyushu University Fukuoka Cohort Study who completed a self-administered questionnaire inquiring health behaviours, morbidity, personality, and SWB. Personality was assessed by using a questionnaire appeared to capture neuroticism and extraversion traits, and SWB-related variables were assessed with 3 single-item questions.

Results Neuroticism was negatively and extraversion was positively associated with BMI. Extraversion, but not neuroticism, was positively associated with smoking and alcohol drinking. After multivariate KU-57788 order adjustment, neuroticism was strongly associated with each of 3 SWB measures.

The multivariate-adjusted odds ratios for the highest versus lowest quintile of neuroticism were 6.09 (95% confidence interval [CI], 5.05-7.33) for perceived stress; 0.21 (95% CI, 0.18-0.25) for good health condition; and 0.26 (95% CI, 0.22-0.31) for life satisfaction. Extraversion showed no clear association with the SWB measures.

Conclusions The neuroticism and extraversion scales were associated with health behaviours and BMI differently. The neuroticism scale, but not the extraversion scale, was strongly associated with higher perception of stress, poorer perceived health, and lower satisfaction with life in a Japanese population.”
“Various geometric sizes and helical types (i.e., armchair, zigzag, and chiral) of single-walled carbon nanotubes (CNTs) are considered in molecular dynamics simulations in order to systematically examine the length-to-radius ratio and chirality effects on the buckling mechanism.

The results showed that all four compounds significantly reduced

The results showed that all four compounds significantly reduced the intracellular learn more level of ROS, the release of NO and MMP-9 as well as LPS-induced phosphorylation of ERK1/2. These results strongly suggested that S. chinensis may be useful to modulate inflammation-mediated brain damage by regulating microglial activation.”
“High-density polyethylene (HDPE) is the polymer most used for geomembranes, and one of the tests

to determine its applicability is its long term resistance to oxidation. In this sense, this work focuses on the study of the chemical and morphological changes that PE films may experiment when subjected to digestion in nitric acid, simulating RG-7112 the severe ambient conditions of a landfill. The effect of

digestion of HDPE, on its chemical and morphological structure, was evaluated. It was observed that the molecular weight of HDPE decreases, forming acid and nitro groups, as the time of digestion increases. Also, the oxidative degradation first produced a bimodal MW distribution, but as the time of strong acid treatment increases, a trimodal MW distribution appears, at lower molecular weights. Finally, as time of digestion continued, a bimodal MW distribution appears again, but at much lower molecular weights. The crystal size of the treated HDPE is directly related to the HDPE molecular weight, that is, as time of digestion increases, the molecular weight decreases and the crystal size decreases. In addition, the heterogeneity of molecular weights, such as bimodal and trimodal distributions, and the presence of chemical groups other than the normal -CH2- strings of pure PE produced defects

in the unit cell parameters a and b. (C) 2011 Wiley Periodicals, Inc. J Appl Polym Sci 123: 3248-3254, 2012″
“To investigate the expression of calprotectin, the receptor of advanced glycation end products (RAGE) and tumor necrosis factor-alpha (TNF-alpha) in hypertensive disorders in pregnancy as well as the significance of their expression.

The research assessed levels of plasma calprotectin and TNF-alpha using the enzyme-linked immunosorbent assay, and expression BMS-777607 inhibitor of calprotectin, RAGE and TNF-alpha in placenta tissues using the immunohistochemistry streptavidin-peroxidase (S-P) method in 60 women with hypertensive disorders in pregnancy and 32 women with normal pregnancy (as the controls).

Compared with the control group, the levels of calprotectin, RAGE and TNF-alpha were elevated in plasma or placenta tissues in the group with hypertensive disorders in pregnancy, and were positively correlated with severity of hypertensive disorders in pregnancy. The levels of calprotectin were consistent with TNF-alpha in plasma and placenta tissues in the group with hypertensive disorders in pregnancy.


“Lipomas are benign mesenchymal tumors composed of mature


“Lipomas are benign mesenchymal tumors composed of mature lipocytes grown in different parts of the body. The giant lipomas are very rare in children, however, highly active antiretroviral treatment (HAART) can increase their frequency.

We present a case of a HIV-infected child who developed the rapidly growing lipoma

in the thigh after receiving long-term HAART.

The purpose of this report is to highlight the existence of unspecific clinical presentation of lipodystrophy syndrome as the side effect of long HAART in children.”
“BackgroundTo date, extensive research has been undertaken NSC 649890 HCl on a potential link of breastfeeding (BF) to wheezing illnesses. Nevertheless, an association remains to be established, partly due to age-dependent discrepancies and different definitions of exposures/outcomes across studies. We thus investigated the relation of diverse infantile feeding patterns with wheeze/asthma prevalence in two cohorts of children of different ages (preschool and preadolescent).

MethodsWheeze Fer-1 inhibitor ever/in the last 12months (current) and doctor-diagnosed asthma were retrospectively reported by parents of the participants of two cross-sectional studies: the Genesis study (1871 children aged 1-5) and the Healthy Growth study (1884 children aged 9-13). Information on feeding practices (exclusive breastfeeding vs. mixed vs. formula feeding)

and their duration (2 vs. 4 vs. 6months) was recorded. Perinatal and anthorpometric data were also collected.

ResultsIn pre-schoolers, regimes that did not entail exclusive BF were positively correlated to current/ever wheeze, both before and after adjustment for confounders. No differences between the associations of regimes with 2, 4 or 6months of exclusive BF with current/ever wheeze were shown. selleck chemical Furthermore, there was no consistent correlation of feeding practices with physician-diagnosed asthma. In pre-adolescents, no association of infantile feeding patterns with the wheeze/asthma outcomes

was observed.

ConclusionsExclusive BF is associated with reduced prevalence of current/ever wheeze in pre-schoolers; however, this appears to wane in older children. The association of a period of exclusive BF as low as 2months with pre-school wheeze prevalence, appeared to be comparable with that of 6months of exclusivity.”
“Antibody-based therapeutics are of great value for the treatment of human diseases. In addition to functional activity, affinity or physico-chemical properties, antibody specificity is considered to be one of the most crucial attributes for safety and efficacy. Consequently, appropriate studies are required before entering clinical trials.

High content protein arrays are widely applied to assess antibody specificity, but this commercial solution can only be applied to final therapeutic antibody candidates because such arrays are expensive and their throughput is limited.

(C) 2011 American Institute of Physics. [doi:

(C) 2011 American Institute of Physics. [doi: www.selleckchem.com/products/ly-411575.html 10.1063/1.3597827]“
“Objective. The purpose of this study was to analyze craniofacial characteristics from lateral head profile radiographs of patients with cri-du-chat (CdC) syndrome.

Study design. The craniofacial morphology of 10 CdC

patients was evaluated using standard cephalometric methods, measuring 39 craniofacial variables on cephalometric x-ray images.

Results. The principal characteristics were skeletal class II malocclusion, caused by mandibular retrognathism, dental biprotrusion, and a small upper airway. Additionally, 70% of patients had a steep palatal plane angle; the cranial base angle was flattened, also in 70% KU-57788 mouse of patients.

Conclusions. Results indicated that the deletion of 5p had an impact on the cranial base, maxilla, mandible, and upper airway, causing distinctive features to become apparent through irregular growth. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;110:e38-e44)”
“Lagerstroemia

(crape myrtle) are famous ornamental plants with large pyramidal racemes, long flower duration, and diverse colors. However, little is known about the genetic structure and diversity of germplasm in Lagerstroemia. We genotyped 81 L. indica cultivars, five other species of Lagerstroemia, and 10 interspecific hybrids using 30 simple sequence repeat markers; 275 alleles were generated with a mean of nine alleles per locus. The mean polymorphism information content value, a measure of gene diversity, was 0.63, with a range from 0.25 to 0.86. The mean observed heterozygosity (0.51) tended to be lower than the mean expected heterozygosity (0.67). The mean F-statistics (F-ST,

F-IS, and F-IT) were 0.05, 0.20, and 0.24, respectively, indicating a high level of genetic variation among cultivars. Clustering analysis based on genetic distance divided the 96 genotypes into three distinct groups, which corresponded with their SB203580 ic50 genetic backgrounds and geographic regions. L. indica cultivars and the other five L. species were grouped into different sub-clusters. Chinese and North American cultivars were divided into different clusters. These data about the genetic relationship among cultivars demonstrated the potential value of L. indica cultivars and other Lagerstroemia species for widening the genetic basis of breeding programs for this ornamental flower.”
“Hyper-Raman scattering is used to investigate the vibrations in two prototypical relaxors, PbMg(1/3)Nb(2/3)O(3) and PbMg(1/3)Ta(2/3)O(3) (PMT). First-order scattering from polar modes is clearly observed. Most of the triply-degenerate cubic vibrations are split into doublets and their frequencies compare very well to that of PbTiO(3) in its tetragonal phase. Their shape and scattering intensities are sensitive to the local chemical ordering and ferroelectric distortions.


“The effects of surface stress on the lattice thermal cond


“The effects of surface stress on the lattice thermal conductivity are investigated for a JNJ-26481585 price silicon nanowire.

A phonon dispersion relation is derived based on a continuum approach for a nanowire under surface stress. The phonon Boltzmann equation and the relaxation time are employed to calculate the lattice thermal conductivity. Surface stress, which has a significant influence on the phonon dispersion and thus the Debye temperature, decreases the lattice thermal conductivity. The conductivity varies with changing surface stress, e. g., due to adsorption layers and material coatings. This suggests a phonon engineering approach to tune the conductivity of nanomaterials. (C) 2011 American Institute of Physics. [doi:10.1063/1.3583668]“
“Osteochondroma is a cartilage capped benign tumor developing mainly at the juxta-epiphyseal region of long bones. The rate of malignant transformation, mainly into chondrosarcoma, is estimated to be less than 1-3%. Transformation into osteosarcoma is very rare and CP-456773 cell line has been reported only thirteen times. There

is little information on treatment and outcome. We report the case of a secondary osteosarcoma arising in the left tibia of a 23-year-old male, 10 years after the initial diagnosis of osteochondroma and after two partial resections. Malignant transformation occurred at the stalk and not at the cartilage cap, as would normally be expected. Chromosome banding analysis revealed the karyotype: 46,XY, t(3;13)(q21;q34) [2]/46,XY [18]. Records from additional cases

will help determine the parameters that define these rare secondary bone lesions.”
“Here, selleck compound a report on diffusion tensor imaging (DTI) using a 125.3 MHz high-temperature superconducting (HTS) surface resonator for magnetic resonance imaging (MRI) is presented. A 40 mm in diameter Bi(2)Sr(2)Ca(2)Cu(3)O(x) (Bi-2223) tape surface resonator was built. Using a HTS surface resonator at 77 K than a similar copper surface resonator at 300 K, the capacity to save the accuracy of DTI in a reduced scan time (11 min) was demonstrated. The standard deviation of deviation angles of DTI fiber tracking was also improved by 2.5 gains. The use of HTS surface resonator may improve the reliability of fiber tracking experiments. (C) 2011 American Institute of Physics. [doi:10.1063/1.3573600]“
“Cognitive dysfunction frequently occurs during the course of multiple sclerosis (MS). In patients with MS the severity of cognitive manifestations is not closely related to indices of structural brain damage. Neuroplasticity may contribute to the maintenance of normal performance despite scattered brain lesions. Changes in functional organization of the cerebral cortex have been reported by functional magnetic resonance imaging (fMRI) studies in MS.

The AC concluded that cetuximab in combination with platinum-base

The AC concluded that cetuximab in combination with platinum-based CTX should not be recommended for the treatment of patients with recurrent and/or metastatic

SCCHN. Patients already receiving this treatment for this indication should have the option to continue treatment until they and their clinician consider it appropriate NVP-BSK805 inhibitor to stop. This was the first appraisal to consider the end-of-life medicines criteria introduced by NICE in January 2009.”
“In this study we investigate the clinical outcomes of 305 breast cancer (BC) patients, aged 55 years or younger, with long follow-up and according to intrinsic subtypes. The cohort included 151 lymph node negative (LN-) and 154 lymph node positive (LN+) patients. Luminal A tumors were mainly LN-, well differentiated, and of stage I; among them AR was an indicator of good prognosis. Luminal B and HER2 positive nonluminal check details cancers showed higher tumor grade and nodal metastases as well as higher proliferation status and stage. Among luminal tumors, those PR positive and vimentin negative showed a longer survival. HER2-positive nonluminal

and TN patients showed a poorer outcome, with BC-specific death mostly occurring within 5 and 10 years. Only luminal tumor patients underwent BC death over 10 years. When patients were divided in to LN- and LN+ no differences in survival were observed in the luminal subgroups. LN- patients have good survival even after 20 years of follow-up (about 75%), while for LN+ patients survival at 20 years (around 40%) was comparable to HER2-positive nonluminal and TN groups. In conclusion, in our experience ER-positive breast tumors are better divided by classical clinical stage than molecular classification,

and they need longer clinical follow-up especially in cases with lymph node involvement.”
“The evolution of meningococcal vaccines illustrates nicely the incremental technological process that is common to much medical innovation and particularly appropriate STA-9090 cost to economic analysis. However, the economic evaluation of vaccines is complicated by several features unique to vaccines, including the possibility of indirect (herd immunity) benefits and the shear breadth of vaccination strategies available to decision makers. As with the vaccines themselves, the modelling approaches applied to the economic evaluation of meningococcal vaccines have evolved to become increasingly complex. Despite such innovation, concerns remain about the quality of economic studies of meningococcal vaccines. This article reviews evaluations of meningococcal vaccine strategies in developed countries and provides recommendations for future work in this area. Four potentially problematic areas in the existing literature are identified indirect costs, herd immunity, quality of life and comparison programmes and approaches to these issues are discussed. Recommendations for reporting a ‘minimum analysis profile’ case are also made.

Methods: All trauma patients admitted to the surgical ward in the

Methods: All trauma patients admitted to the surgical ward in the period 2000 to 2008 were analyzed (n = 4,377). All activities registered during admission were obtained. The integral in-hospital cost prices of each activity were divided into various product groups. Median and

interquartile ranges were presented for the number of activities in the product groups, stratified by age and Injury Severity Score. The relationship between both institutional-and trauma-related complications and the number of activities in the different product groups was tested with linear regression analysis with adjustment for confounding.

Results: Significant associations between trauma-related complications and LOS, therapeutic paramedical products, diagnostic radiologic products, other diagnostic products, diagnostic laboratory products, therapeutic surgical CHIR-99021 mouse procedures, other therapeutic products, and total costs (beta = 5,420; 95% confidence interval, 4,912-5,929) were found. Significant associations between institutional-related complications and LOS, therapeutic paramedical products, diagnostic radiologic products, therapeutic surgical procedures, and other therapeutic products were found. Total costs (beta = 170; 95% confidence interval, -760 to 1,099) showed a nonsignificant association with institutional-related complications.

Conclusion: Complications

increase hospital costs, and even a small reduction in the number of complications will result in a substantial hospital cost savings and a reduction in the emotional and physical burdens of patients.”
“We report the case of a 5-year old girl, who presented with GW786034 research buy a true ulnar artery aneurysm, and the aetiology, clinical presentation and treatment of

the disease.”
“3,6-Dinitrobenzo[e]pyrene (DNBeP) is an extremely strong mutagen in Salmonella Typhimurium TA98 without a mammalian metabolic system (S9 mix). 3,6-DNBeP shows genotoxicity in vitro to mammalian cells, and produces DNA damage in the cells of several organs in mice in the comet assay. In a previous study, we developed an analytical method GSK621 and clarified that 3,6-DNBeP widely exists in the environment, i.e., surface soil and airborne particles, and that diesel engines and municipal incinerators are probable sources of 3,6-DNBeP. In this study, we improved the method of analyzing 3,6-DNBeP by combining one step of clean-up and fluorescence detection utilizing a two-dimensional HPLC system, and analyzed 3,6-DNBeP in tea leaves (n = 6), which is a possible exposure source of 3,6-DNBeP in our daily life, and in human hair samples (n = 8), as a possible biomarker of 3,6-DNBeP. 3,6-DNBeP was detected in all examined tea leaves and human hair as single peaks on the chromatograms, and was well purified by the HPLC system. 3,6-DNBeP was detected in the range of 8-1823 pg/g of tea leaves and the amount of 3,6-DNBeP in tea leaves differed depending on the growth site of the tea leaves.

Efficient production, purification and correctly folded form of t

Efficient production, purification and correctly folded form of this protein are important requirements for functional studies. We produced

and quantitatively compared fusion expression of the “”maltose binding protein (mbp)-maize sinat5″” construct in two different strains of Escherichia coli. One-step purification of fused products gave about 33 mg protein/L bacterial cell culture for E. coli TB1 cells and approximately 18 mg protein/L bacterial cell culture for E. coli DH5 alpha cells. Continuous expression of the fused product and similarity of growth patterns were observed in both cultures.”
“By applying nonequilibrium Green’s functions in combination with density-function theory, we investigate SN-38 clinical trial the electronic transport properties of armchair graphene nanoribbons devices with one undoped and one nitrogen-doped armchair graphene nanoribbons electrode. For the doped armchair graphene nanoribbons electrode, an N dopant is considered to substitute the center or edge carbon atom. The results show that the electronic transport properties are strongly dependent on the width of the ribbon and the position

of the N dopant. The rectifying behavior with large rectifying ratio can be observed and can be modulated by changing the width of the ribbon or the position of the N dopant. A mechanism for the rectifying behavior is suggested. (C) 2011 American Institute of Physics. [doi:10.1063/1.3600067]“
“Dynamic energy budget models for growth of individual cockles (Cerastoderma edule) and mussels (Mytilus CFTRinh-172 price edulis) are adjusted and calibrated to the Oosterschelde by formulating and parametrizing their functional responses using an extensive

set of field observations. The resulting model predictions fit the observations satisfactorily. Results indicate that food quality and the importance of GSK2126458 mw detritus as a food source are site-specific as well as species-specific. Despite these differences in their calibrated parameter values, both species show a very similar functional response. Compared with other systems, however, the functional responses of mussels in the present study are clearly higher than those of mussels in other systems. This may be explained by the absence of intra-specific competition in the measurement set-up that was used, and therefore supports the idea that the generally small functional response of M. edulis is caused by intra-specific competition.”
“Farming of Haliotis midae is the most lucrative aquaculture venture in South Africa. The genome of this species needs to be studied to assist in selective breeding programs aimed at increasing overall yield, and molecular markers will be required to attain this goal. We identified and characterized 82 polymorphic microsatellite loci by using repeat-enriched genomic libraries and high-throughput pyrosequencing technology. The observed number of alleles ranged from 2 to 21, expected heterozygosity from 0.063 to 0.968, observed heterozygosity from 0.


“Endothelial hyperpermeability is a significant problem


“Endothelial hyperpermeability is a significant problem

in vascular inflammation associated with trauma, ischaemia-reperfusion injury, sepsis, adult respiratory distress syndrome, diabetes, thrombosis and cancer. An important mechanism underlying this process is increased paracellular leakage of plasma fluid and protein. Inflammatory stimuli such as histamine, thrombin, vascular endothelial growth factor and activated neutrophils can cause dissociation of cell-cell junctions between endothelial cells as well as cytoskeleton contraction, leading to a widened intercellular space that facilitates transendothelial flux. Such structural changes initiate with agonist-receptor binding, followed find more by activation of intracellular signalling molecules including calcium, protein kinase C, tyrosine kinases, myosin light chain kinase, and small Rho-GTPases; these kinases and GTPases then phosphorylate BTSA1 or alter the conformation of different subcellular components that control cell-cell adhesion, resulting in paracellular hypermeability. Targeting key signalling molecules that mediate endothelial-junction-cytoskeleton dissociation demonstrates a therapeutic potential

to improve vascular barrier function during inflammatory injury.”
“To examine the association between self-assessed quality of life (QOL) and perceived neighborhood safety, social cohesion, and walkability among older adults in New York City (NYC).

We used data from the 2008 Health Indicators Project, a cross-sectional survey of 1,870 older adults attending 56 NYC senior centers. QOL, a binary measure, was created

by dichotomizing a 5-point Likert-scaled global assessment. Neighborhood safety, social cohesion, and walkability were multi-component scale variables that were standardized due to varying response metrics. Multivariate binomial logistic regression analysis was performed on 1,660 participants with complete data.

After adjusting for covariates, QOL was significantly associated with neighborhood safety and social cohesion. A one-standard deviation increase in neighborhood safety and social cohesion increased the log odds of having higher R788 chemical structure QOL by 30% (odds ratio (OR) = 1.30; 95% confidence interval (CI) = 1.14, 1.48; P a parts per thousand currency sign 0.001) and 36% (OR = 1.36; 95% CI = 1.16, 1.59; P a parts per thousand currency sign 0.001), respectively. Higher QOL was not significantly associated with neighborhood walkability.

The results of this study underscore the need for initiatives that focus on enhancing age-friendly neighborhood features in large urban centers such as NYC and beyond.”
“Chlamydia trachomatis infection is the most common sexually transmitted bacterial infection worldwide, with over 91 million cases estimated annually.