This compartment likely contains CSCs since it

is express

This compartment likely contains CSCs since it

is expressing the putative CSC markers CD44, ALDH1 and CK14. This cell layer therefore should be considered a major therapeutic target in the treatment of head and neck cancer. (C) 2009 Elsevier Ltd. All rights reserved.”
“Purpose: To prospectively 4 evaluate the clinical effectiveness of snapshot inversion recovery (SNAPIR), which is a dedicated optimized inversion-recovery-prepared single-shot fast CCI-779 spin-echo T1-weighted sequence, in the delineation of normal fetal brain anatomy compared with that of the currently used T1-weighted gradient-echo protocol, which often yields images of poor quality due to motion artifacts and inadequate contrast.\n\nMaterials and Methods: This study was approved by the hospital research ethics committee,

and informed written consent was obtained from all patients. Forty-one fetuses were examined at 19-37 weeks gestation (mean, 29 weeks gestation) by using both the standard T1-weighted protocol and the optimized T1-weighted SNAPIR protocol with a 1.5-T find more imager. Two independent blinded observers performed qualitative analysis, evaluating overall diagnostic quality, detailed anatomic delineation, and severity of motion artifacts. Quantitative analysis comprised calculation of contrast ratios (CRs) for the cortical gray matter, subplate, white matter, and cerebrospinal fluid. The Wilcoxon signed rank test was used to compare image rating scores, the paired t test was used to compare CRs, and kappa statistics were used to test interobserver agreement.\n\nResults: Both overall diagnostic quality (P < .001) and detailed anatomic delineation (P < .001) were enhanced with SNAPIR compared with the standard T1-weighted acquisition. Also, motion artifacts were

less severe (P = .008) and less extensive (P < .001) with SNAPIR. Corresponding CRs were increased with SNAPIR in seven of eight examined regions.\n\nConclusion: SHP099 SNAPIR is a promising robust alternative to the current T1-weighted acquisitions; its role in the detection of disease requires further study. (C) RSNA, 2010″
“Background: Guidelines recommend evaluation of cardiac function, valvular and ischemic heart disease, and thyroid, kidney, and liver function on initial diagnosis of atrial fibrillation (AF). Hypothesis: We hypothesized that initial workup of patients with newly identified AF would vary by age, sex, and burden of comorbid illness. Methods: In a retrospective analysis of a large sample of commercially insured patients 18 to 64 years old (n = 40 245) and a nationally representative 5% cohort of Medicare beneficiaries 65 years or older (n = 204 676), we measured claims for guideline-recommended services for initial evaluation of AF among patients with a new diagnosis between 2000 and 2008.

However, aqueous humor values of VEGF in diabetic dogs are not gr

However, aqueous humor values of VEGF in diabetic dogs are not greater than nondiabetics and may serve to protect the dog against development of diabetic retinopathy.”
“Basal cell carcinoma is the most common type of malignant cutaneous BTSA1 neoplasm in humans, and it can be prevented and diagnosed early. The purpose of this study is to present clinical and microscopic findings of basal cell carcinoma in a population younger than 50 years of age. Microscopic examinations of multiple sections of skin lesion have been done, as well as a review of relevant literature.”
“We aimed to determine whether

the distal end of the humerus had the capacity of spontaneous realignment of the remaining deformity following an inadequate reposition

of the supracondylar fracture. The results in 56 children with a supracondylar humerus fracture were analysed. In 45 patients www.selleckchem.com/products/selonsertib-gs-4997.html (80%), manual repositioning was performed along with transcutaneous fixation, whereas in 11 patients (20%), only manual repositioning and immobilization in plaster cast was applied. Immobilization was removed and physical therapy was started in all patients on the 21st day following the intervention. Anteroposterior and left-lateral radiography was performed and Baumann’s angle was determined. Follow-up radiograph of the elbow of the traumatized and healthy extremity was performed at an interval of 5-15 years (median 9.4). There was no statistically significant difference between the relationship of Baumann’s angle of the injured arm measured on the 21st day after the reduction of fragments on the one hand and the carrying angle

of the injured and healthy arm measured at the long-term follow-up on the other (t=0.48, P=0.63). Similarly, there was no statistically significant difference between the relationship of Baumann’s angle of the injured arm measured at the long-term follow-up and the findings SHP099 of the carrying angle of both the injured and the healthy arm obtained on the same examination (t=0.78, P=0.44). On the basis of our experience, we conclude that there is no biological capacity to rectify a possible remaining postreduction varus deformity by spontaneous remodelling.”
“Aims: The elastic behaviour (acute recoil) of a valve prosthesis stent following 123 transcatheter aortic valve implantation (TAVI) is unknown. This study sought to determine the occurrence, severity, predictive factors and haemodynamic consequences of acute recoil following TAVI. Methods and results: A prospective angiographic analysis of the stent frame dimensions in 111 consecutive patients who underwent TAVI with a balloon-expandable valve (36 Edwards SAPIEN; 75 SAPIEN XT) was performed. Acute recoil was defined as the difference between minimal lumen diameter (MLD) at full balloon expansion and immediately after balloon deflation. MLD during balloon inflation was significantly larger than MLD after balloon deflation (23.40 +/- 2.


“Background: Bacteriophages (phages) have been used extens


“Background: Bacteriophages (phages) have been used extensively as analytical tools to type bacterial cultures and recently for control of zoonotic foodborne pathogens in foods and in animal reservoirs.\n\nMethods: We examined the host range, morphology,

genome and proteome of the lytic E. coli O157 phage rV5, derived from phage V5, which is a member of an Escherichia Acalabrutinib concentration coli O157:H7 phage typing set.\n\nResults: Phage rV5 is a member of the Myoviridae family possessing an icosahedral head of 91 nm between opposite apices. The extended tail measures 121 x 17 nm and has a sheath of 44 x 20 nm and a 7 nm-wide core in the contracted state. It possesses a 137,947 bp genome (43.6 mol%GC) which encodes 233 ORFs and six tRNAs. Until recently this virus appeared to be phylogenetically isolated with almost 70% of its gene products ORFans. rV5 is closely related to coliphages Delta and vB-EcoM-FY3, and more distantly related to Salmonella phages PVP-SE1 and SSE-121, Cronobacter sakazakii phage vB_CsaM_GAP31, and coliphages phAPEC8 and phi92. A complete shotgun proteomic analysis was carried out on rV5, extending what had been gleaned from the genomic analyses. Ispinesib Host range studies revealed that rV5 is active against several other E. coli.”
“Systemic isosporosis, also known as atoxoplasmosis, is a common parasitic 123 disease of passerines. Infection is thought to be endemic

in wild birds with fulminant, fatal disease occurring under the influence of stress, concurrent infections, or immunosuppression. Here, we describe the histologic and immunohistochemical characteristics of the cellular infiltrate occurring in captive colonies of American goldfinches and house sparrows. Necropsies were performed on 9 birds, and histologic examination www.selleckchem.com/products/SRT1720.html was performed on the intestines

of 7 additional birds. Lesions were most severe in the proximal small intestines. Histologically, the changes ranged from variably intense infiltrates of lymphocytes that filled the lamina propria to sheets of large, atypical cells that expanded and obliterated normal mucosal epithelium and invaded through the wall of the intestine and into the ceolomic cavity. Both the smaller lymphocytes and large atypical cells were immunoreactive for CD3. Intracellular parasites consistent with Isospora were detected in the large atypical cells, but they were more easily detectable in the more differentiated lymphocytes. Polymerase chain reaction and virus isolation performed on tissues from 7 birds were negative for retroviruses and herpesvirus. The immunohistochemical results of this study and the destructive nature of the cellular infiltrate suggest that the lesion represents T-cell lymphoma. In birds, lymphomas are most often associated with herpes and retroviruses; the absence of these viruses suggests that the parasite initiated neoplastic transformation.

Because the silanization

Because the silanization Raf inhibitor reaction is simple, rapid, and performed under aqueous conditions, it is also an industrially

attractive functionalization route. (C) 2014 Elsevier Ltd. All rights reserved.”
“Idiopathic pulmonary fibrosis (IPF) is a devastating, age-related lung disease of unknown cause that has few treatment options. Once thought to be a chronic inflammatory process, current evidence indicates that the fibrotic response may primarily be driven by abnormally activated alveolar epithelial cells and the underlying mesenchyme. The mediators produced and present in this microenvironment induce the formation of fibroblast foci through the proliferation of resident mesenchymal cells, attraction of circulating fibrocytes, and stimulation of epithelial to mesenchymal transition. The fibroblast and myofibroblast foci secrete excessive amounts of extracellular matrix, mainly collagens, resulting in scarring and destruction of the lung architecture. The detailed mechanisms that link IPF with ageing and aberrant epithelial activation are unknown, but some evidence suggests that the abnormal recapitulation of developmental

pathways and epigenetic changes may play a role. This review provides a brief synopsis of highlights in the current understanding of the pathophysiology of IPF, as well as PF-00299804 clinical trial novel therapeutics being explored in clinical trials for the treatment of this devastating disease.”
“Hindeodus parvus and Hindeodus typicalis occur in a deep-water chert and claystone section in the Mino Terrane,

Japan, which has been identified find more as a Jurassic accretionary complex. Conodont fossils are preserved as natural assemblages of impression fossils on bedding planes in claystone. In this study, 13 assemblages of Hindeodus species were recognized, comprising at most 13 elements which generally maintain the original composition and structure of an apparatus. We discriminated pairs of carminiscaphate P-1, angulate P-2 and makellate M elements, as well as a single alate S-0 element and two digyrate and four bipennate elements constituting the S array. Although the digyrate and bipennate elements are preserved in the S-2 and S3-4 positions, respectively, a pair of S-1 elements was not found due to incompleteness in the natural assemblages. The conodont biostratigraphy indicates that the lithological 4 boundary between chert and claystone units in the study section corresponds exactly to the Permian-Triassic boundary.”
“Objective To compare the presence of post-operative residual disease by magnetic resonance imaging (MRI) and [F-18] fluorothymidine (FLT)-positron emission tomography (PET)-computer tomography (CT) in patients with malignant glioma and to estimate the impact of F-18-FLT PET on the delineation of post-operative target volumes for radiotherapy (RT) planning. Methods Nineteen patients with post-operative residual malignant gliomas were enrolled in this study.

BACKGROUND Conduction disturbances are a frequent complication of

BACKGROUND Conduction disturbances are a frequent complication of transcatheter aortic valve replacement. The rates of PPI in the published reports vary according to bioprosthesis type and the indications for PPI. METHODS The primary endpoint was the 30-day Selleck MEK inhibitor incidence of PPI with Class I/II indications when

the Medtronic CoreValve System was implanted at an optimal depth (# 6 mm below the aortic 123 annulus). The timing and resolution of all new-onset conduction disturbances were analyzed. RESULTS A total of 194 patients were treated. The overall rate of PPI for Class I/II indications was 18.2%. An optimal depth was reached in 43.2% of patients, with a nonsignificantly lower incidence of PPI in patients with depths # 6 mm, compared with AC220 mouse those with deeper implants (13.3% vs. 21.1%; p = 0.14). In a paired analysis, new-onset left bundle branch block and first-degree

atrioventricular block occurred in 45.4% and 39.0% of patients, respectively, and resolved spontaneously within 30 days in 43.2% and 73.9%, respectively. In patients with new PPI, the rate of intrinsic sinus rhythm increased from 25.9% at 7 days to 59.3% at 30 days (p = 0.004). CONCLUSIONS Optimal Medtronic CoreValve System deployment and adherence to international guidelines on cardiac pacing are associated with a lower rate of new PPI after transcatheter aortic valve replacement, compared with results reported in previous studies. (CoreValve Advance-II Study: Prospective International Post-Market Study [ADVANCE II]; NCT01624870) ( C) 2015 by the American College of Cardiology Foundation.”
“Complications of acute respiratory distress syndrome (ARDS) are common among critically ill patients infected with highly pathogenic influenza viruses. Macrophages and neutrophils

constitute the majority of cells recruited into infected lungs, and are associated with immunopathology in influenza pneumonia. We examined pathological manifestations in models Volasertib cost of macrophage- or neutrophil-depleted mice challenged with sublethal doses of influenza A virus H1N1 strain PR8. Infected mice depleted of macrophages displayed excessive neutrophilic infiltration, alveolar damage, and increased viral load, later progressing into ARDS-like pathological signs with diffuse alveolar damage, pulmonary edema, hemorrhage, and hypoxemia. In contrast, neutrophil-depleted animals showed mild pathology in lungs. The brochoalveolar lavage fluid of infected macrophage-depleted mice exhibited elevated protein content, T1-alpha, thrombomodulin, matrix metalloproteinase-9, and myeloperoxidase activities indicating augmented alveolarcapillary damage, compared to neutrophil-depleted animals.

20 (OS), P = 0 23 (DFS)] Subset analysis (n = 420) on vinorelbin

20 (OS), P = 0.23 (DFS)]. Subset analysis (n = 420) on vinorelbine-cisplatin gave similar results.\n\nConclusions: The prognostic effect of high TUBB3 expression in patients

with R-NSCLC has been validated. We were unable to confirm a predictive effect for TUBB3.”
“Rationale, aims and objectivesLoss of situation awareness (SA) by health professionals during handover is a major threat to patient safety in perinatal care. SA refers to knowing what is going on around. Adequate handover communication and process may support situation assessment, a precursor of SA. This study describes current practices and opinions of perinatal handover to identify potential improvements.\n\nMethodsStructured direct observations of shift-to-shift patient handovers (n=70) in an academic perinatal setting were used to measure handover communication (presence and order of Selleckchem SB273005 levels of SA: current situation, background, assessment and recommendation) and process (duration, interruptions/distractions, eye contact, active inquiry and reading information back). Afterwards, receivers’ opinions of handover communication (n=51) were measured by means of a questionnaire.\n\nResultsAll ACY-241 supplier levels of SA were present

in 7% of handovers, the current situation in 86%, the background in 99%, an assessment in 24% and a recommendation in 46%. In 77% of handovers the background was mentioned first, followed by the current situation. Forty-four percent of handovers took 2 minutes or more per patient. In 52% distractions occurred, in 43% there was no active inquiry, in 32% no eye contact and in 97% information was not read back. The overall mean of the receivers’ opinions of handover communication was 4.1 (standard deviation0.7; scale 1-5, where 5 is excellent).\n\nConclusionsPerinatal handovers are currently at risk for inadequate situation assessment because of variability and limitations in handover communication and process. However, receivers’ opinions of handover communication were very positive, indicating a lack of awareness of patient safety threats during handover. Therefore, the staff’s awareness

of current limitations should be raised, for example through video reflection or simulation PP2 price training.”
“A large skull is disadvantageous to animals that move quickly in three-dimensional space, such as fishes and birds in water or air. A cerebral neocortex with a six-layered sheet has not evolved, most likely due to the limited cranial space. Instead of the laminar cortex, telencephalic nuclear masses seem to have evolved as the pallium in teleost fishes. We consider that the nuclear masses contain rather 4 simple neural circuits sharing a skeleton of simple circuits in the mammalian cortex, which have been elaborated by additional circuits in mammals. Such basic similarities at the connectional level shared by nuclear and cortical pallium might underlie similar or equivalent functions.

AFCs are characterised by typical environmental problems such as

AFCs are characterised by typical environmental problems such as changes in land use, CO2 emissions, energy and water consumption, and chemical pollution. Recent technological changes in the agri-food industry have influenced the economic and social development of AFCs towards progressive industrialization. Such changes

have also been the source of new environmental problems, such as those related to the large-scale use and disposal of auxiliary materials. Industrial Ecology (IE) proposes approaches and applied solutions to reduce the environmental impacts and improve the competitiveness of production activities. Major applications of IE in AFCs currently involve the valorisation of animal and vegetable by-products and scraps. Further

improvements can be achieved by adopting IE-based solutions focused on auxiliary material wastes. This article analyses #4 randurls[1|1|,|CHEM1|]# the potential development of IE-based approaches in a representative Italian AFC. Empirical evidence shows that efficient solutions can be implemented through material substitution, repair, and recycling, and by exploiting collaborative strategies among the agri-food PD-L1 inhibitor and industrial companies established in the area. (C) 2015 Elsevier B.V. All rights reserved.”
“Introduction: Organic anion transporting polypeptide (OATP) uptake transporters are important for the disposition of many drugs and perturbed OATP activity can contribute to adverse drug reactions (ADRs). It is well documented that both genetic and environmental factors can alter OATP expression and activity. Genetic factors include single nucleotide polymorphisms (SNPs) that change OATP activity and epigenetic regulation that modify OATP expression levels. SNPs in OATPs contribute to

ADRs. Environmental factors include the pharmacological context of drug-drug interactions and the physiological context of liver diseases. Liver diseases such as nonalcoholic fatty liver disease, cholestasis and hepatocellular carcinoma change the expression of multiple OATP isoforms. The role of liver diseases in the occurrence of ADRs is unknown.\n\nAreas covered: This article covers the roles OATPs play in ADRs when considered in the context of genetic or environmental factors. The reader will gain selleck chemicals a greater appreciation for the current evidence regarding the salience and importance of each factor in OATP-mediated ADRs.\n\nExpert opinion: A SNP in a single OATP transporter can cause changes in drug pharmacokinetics and contribute to ADRs but, because of overlap in substrate specificities, there is potential for compensatory transport by other OATP isoforms. By contrast, the expression of multiple OATP isoforms is decreased in liver diseases, reducing compensatory transport and thereby increasing the probability of ADRs.

In addition, the effect of curing temperature and time on the per

In addition, the effect of curing temperature and time on the performance characteristics of pigment printed poly (lactic acid) fabrics in terms of colour fastness, burst strength, abrasion resistance,

Kawabata Evaluation System for Fabrics (KES-F) parameters and surface morphology were evaluated and optimum curing conditions for the pigment printing of poly (lactic acid) fabrics were established. Crown Copyright (C) 2013 Published by Elsevier Ltd. All rights reserved.”
“It is well known that vegetables are good sources of natural antioxidants and dietary fiber. Vegetables in cabbage group have long been used in human nutrition due to their rich nutritional value, and also they are grown in relatively cold areas where other CBL0137 supplier vegetables cannot be produced. The nutritional value of white cabbage stands out among other vegetables, due to its high levels of

antioxidants, phenolic compounds, dietary fiber, minerals and low calorie content. The most important reason for increasing interest in cabbage and cabbage products in the recent years is due to their protective effects against cancer. The aim of this study was Stem Cell Compound Library supplier to evaluate the effects of dehydrated white cabbage powder (DWCP) supplement on chemical, physical, nutritional and sensorial characteristics as well as the consumers’ acceptance and purchase intent of the cookies. The studies indicated that dried white cabbage contained 20.65% of total dietary fiber and 846.53 mg GAE/g of polyphenols. Cookie samples were prepared with blends containing

0, 2.5, 5.0 and 7.5% of DWCP substituted for wheat flour. Total dietary fiber and mineral (calcium, potassium) contents of the cookies were improved with increased levels of DWCP. The total level of phenolic compounds, antioxidant activity, width, thickness, spread ratio, and surface cracking did not differ significantly among the cookies. Cookies with a 2.5% substitution level of DWCP 432 showed the highest scores for sensory see more attributes, consumers’ acceptance and purchase intent. Thus, white cabbage, particularly its outer leaves, which are a by-product of the cabbage processing industry, could be utilized for the preperation of cookies and other food products with improved functional and nutraceutical properties.”
“Chlorpyrifos is a pesticide that is metabolically activated to chlorpyrifos oxon (acetylcholinesterase inhibitor) primarily by the cytochrome P450 2B (CYP2B) enzyme subfamily in the liver and brain. We have previously shown that intracerebroventricular pretreatment with a CYP2B inhibitor, C8-Xanthate, can block chlorpyrifos toxicity. Here, we assessed whether delayed introduction of C8-Xanthate would still reduce toxicity and whether peripheral administration of C8-Xanthate could also inhibit chlorpyrifos activation in the brain and block toxicity.


“A 63-year-old man presented with an asymptomatic papillar


“A 63-year-old man presented with an asymptomatic papillary, sessile lesion of the juxtalimbal bulbar conjunctiva that was surgically Selleck PP2 excised with cryotherapy. Histopathologically, the lesion created some diagnostic confusion as it displayed an endophytic, or inverted, growth pattern-with squamous cells pushing into the substantia propria around fibrovascular cores, but without significant cytologic atypia, consistent with a conjunctival inverted papilloma (IP). Unlike previously reported cases of conjunctival IP, there were no goblet cells or cysts within the tumor. Immunostaining was diffusely positive for cytokeratin (CK) 7, and CK14 stained the basilar and

suprabasilar cells, as in normal conjunctiva. CK17 weakly and non-uniformly stained the tumor, ruling out a dysplasia, which is usually strongly

positive. The lesion’s cytokeratin profile therefore paralleled that of normal conjunctiva. The proliferation index with Ki67 nuclear staining was extremely low ( smaller than 1%), as was p53 nuclear staining (10-20%), both in contrast to squamous cell dysplasias or carcinomas that have a much higher percentage of positive cells. The lesion was negative for human papillomavirus subtypes associated with squamous neoplasias including carcinomas. We review the’previous literature devoted to this comparatively rare condition GSK3326595 research buy and contrast its benign clinical course with that of inverted papillomas of the sinonasal, lacrimal drainage, and genitourinary systems and provide a set of criteria for establishing the diagnosis. (C) 2015 Elsevier Inc. All rights reserved.”
“Inflammatory kidney disease is a major clinical problem that can result in end-stage renal failure. In this article, we show that Ab-mediated inflammatory kidney injury and renal disease in a mouse nephrotoxic serum nephritis model was inhibited by amino acid metabolism and a protective autophagic response.

The metabolic signal was driven by IFN-gamma-mediated induction of indoleamine 2,3-dioxygenase 1 (IDO1) enzyme activity with subsequent activation of a stress response dependent on the eIF2 alpha kinase Adavosertib purchase general control nonderepressible 2 (GCN2). Activation of GCN2 suppressed proinflammatory cytokine production in glomeruli and reduced macrophage recruitment to the kidney during the incipient stage of Ab-induced glomerular inflammation. Further, inhibition of autophagy or genetic ablation of Ido1 or Gcn2 converted Ab-induced, self-limiting nephritis to fatal end-stage renal disease. Conversely, increasing kidney IDO1 activity or treating mice with a GCN2 agonist induced autophagy and protected mice from nephritic kidney damage. Finally, kidney tissue from patients with Ab-driven 123 nephropathy showed increased IDO1 abundance and stress gene expression.

Acquired or inherited thrombophilia is moreover associated with a

Acquired or inherited thrombophilia is moreover associated with adverse outcomes in pregnancy. For this reason, in the past, pregnant women at risk of venous thromboembolism or pregnancyes have been treated with oral anticoagulants or unfractionated heparin. Both of them are associated with fetal or maternal side effects. Low-molecular-weight heparins (LMWHs) offer several advantages, but they have no or only partial indication for use in pregnancy in AP24534 supplier many countries. We have prospectively evaluated 114 patients and overall 130

pregnancies treated with prophylactic or therapeutic LMWHs from January 2004 to February 2007. The occurrence of allergic reactions, hemorrhagic episodes, low platelet count, pathological fractures, thromboembolic events and adverse outcomes in pregnancy were considered. There was a significant difference in pregnancy outcome following prophylaxis with LMWHs (chi(2) p<0.0001) and the absolute and the relative

risks were significantly decreased in the patients with treated pregnancy compared with those with previous untreated pregnancies. Moreover, in our series of patients, the long-term use of LMWH in pregnancy was confirmed well tolerated, with the rate of adverse effects, though very low, comparable with that in literature. Our experience confirms the safety and the efficacy of LMWH but suggests the need of randomized controlled trials. Blood Coagul Fibrinolysis 20:240-243 (C) 2009 Wolters Kluwer Health vertical bar Lippincott Williams RG-7112 cost & 123 Wilkins.”
“Rapid binding of peptides to MHC class II molecules

is normally limited to a deep endosomal compartment where the coordinate GW786034 molecular weight action of low pH and HLA-DM displaces the invariant chain remnant CLIP or other peptides from the binding site. Exogenously added peptides are subject to proteolytic degradation for extended periods of time before they reach the relevant endosomal compartment, which limits the efficacy of peptide-based vaccines and therapeutics. In this study, we describe a family of small molecules that substantially accelerate the rate of peptide binding to HLA-DR molecules in the absence of HLA-DM. A structure-activity relationship study resulted in analogs with significantly higher potency and also defined key structural features required for activity. These compounds are active over a broad pH range and thus enable efficient peptide loading at the cell surface. The small molecules not only enhance peptide presentation by APC in vitro, but are also active in vivo where they substantially increase the fraction of APC on which displayed peptide is detectable. We propose that the small molecule quickly reaches draining lymph nodes along with the coadministered peptide and induces rapid loading of peptide before it is destroyed by proteases. Such compounds may be useful for enhancing the efficacy of peptide-based vaccines and other therapeutics that require binding to MHC class II molecules.