It can be performed through either one or two stages of surgery

It can be performed through either one or two stages of surgery. This study aimed to evaluate the operative and postoperative results of two-stage unilateral vs one-stage bilateral thoracoscopic sympathectomy.


November 1995 to February 2011, 270 patients with severe palmar and/or axillary hyperhidrosis were recruited for this study. One hundred and thirty patients received one-stage bilateral, single-port video-assisted thoracoscopic sympathectomy (one-stage group) and 140, two-stage unilateral, single-port video-assisted thoracoscopic sympathectomy, with a mean time interval of 4 months between the procedures (two-stage group).

The mean postoperative follow-up period was 12.5 (range: 1-24 months). After surgery, hands and axillae of all patients were dry and warm. Sixteen (12%) patients of the one-stage group and 15 (11%) of the two-stage group suffered from mild/moderate pain (P = 0.8482). The mean operative time was 38 +/- 5 min in the one-stage group and 39 +/- 8 min in

the two-stage group (P = 0.199). Pneumothorax occurred in 8 (6%) patients of the one-stage group and in 11 (8%) of the two-stage group. Compensatory sweating occurred in 25 (19%) patients of the one-stage group and in 6 (4%) of the two-stage group (P = 0.0001). No patients developed Horner’s syndrome.

Both two-stage unilateral and one-stage bilateral single-port video-assisted thoracoscopic sympathectomies are effective, safe and minimally invasive procedures. Two-stage unilateral sympathectomy Danusertib concentration can be performed with a lower occurrence of compensatory sweating, improving

permanently the quality of life in patients with palmar and axillary hyperhidrosis.”
“Objective: Incorrect Metered-Dose Inhaler (MDI)-spacer technique can result in decreased drug delivery to distal airways and poor asthma outcomes. There is lack of research to examine whether the caregivers utilize proper technique when applying an MDI-spacer delivery system for young minority children with persistent asthma in the United States. The objective of this study was to evaluate MDI-spacer utilization and technique among the caregivers of Bronx minority children with persistent asthma and to determine characteristics associated with correct use. Methods: We analyzed data from 169 caregivers of urban minority children with persistent asthma (aged 2-9 years). MDI-spacer device technique was assessed using a 10-step checklist derived from the national guidelines, literature and manufacturers’ instructions. Based on the median MDI-technique score of six steps demonstrated accurately, caregivers were categorized as correct (seven or more) or incorrect (six or less) users. Results: Of the 169 caregivers, 95% were mothers, mean age 32.3 years (SD 7.

Of 150 disease-associated isolates, 123 (82%) belonged to pulsed-

Of 150 disease-associated isolates, 123 (82%) belonged to pulsed-field gel electrophoresis group USA300, whereas only 19 (18%) of 105 colonization isolates

were of the USA300 lineage. Colonization isolates were less likely to possess staphylococcal cassette chromosome mec type IV, Panton-Valentine Leukocidin, or agr type 1 (P < 0.001).

Conclusions: Colonization strains of CA-MRSA in children differ significantly from those strains recovered from patients with staphylococcal infections. This suggests that only colonization with specific strain types, rather than methicillin-resistant selleck products Staphylococcus aureus colonization in general, increases the risk for CA-MRSA disease.”
“Purpose of review

The most recent findings on preeclampsia with a focus on maternal mortality, haemodynamic changes, clotting disorders and anaesthesia are reviewed.

Recent findings

Preeclampsia is a major cause of maternal morbidity Fer-1 price and mortality. Cerebral haemorrhage is the single most common cause of maternal death in preeclampsia and currently far

outnumbers pulmonary oedema. Although there was a focus on diastolic pressure in the past, the present recommendations of the National Enquiries into Maternal Death advocate treatment of systolic blood pressures above 160 mmHg in order to avoid intracranial bleeding. Noninvasive monitoring techniques such as pulse wave analysis and echocardiography have provided new insights into the haemodynamic changes of preeclampsia and corroborated previous findings. In earlyonset preeclampsia, the most common haemodynamic features include vasoconstriction, low cardiac output

and low filling pressures. Neuraxial anaesthesia aids in providing stable haemodynamics, the incidence of hypotension and the need for vasopressors are reduced compared with healthy parturients, and cardiac output is unchanged. With cautious fluid administration, find more the risk of pulmonary oedema seems negligible. In order to avoid spinal epidural haematoma in the presence of thrombocytopenia, spinal anaesthesia may afford the best risk-benefit analysis. It remains open to question whether thromboelastography will aid in guiding treatment in the future.


Cerebral haemorrhage is the major cause of maternal mortality in preeclampsia and any increases in maternal blood pressure above 160 mmHg or at induction of general anaesthesia should be treated, Traditional rapid sequence induction is, therefore, best avoided; neuraxial anaesthesia is the technique of choice.”
“In this work, a series of polypropylene/poly(ethylene-co-propylene) (iPP/EPR) in-reactor alloys were prepared by MgCl2/TiCl4/diester type Ziegler-Natta catalyst with triethylaluminium/triisobutylaluminium (TEA/TIBA) mixture as cocatalyst. The influence of cocatalyst and external electron donor, e.g.

Materials and Methods: All COPD patients who were intubated and n

Materials and Methods: All COPD patients who were intubated and needed weaning from mechanical ventilation were screened after extubation. The patients were

placed in half-sitting position and breathed spontaneously. The EFL and the airway occlusion pressure after 0.1 second (P0.1) were measured at the first hour after extubation. In COPD patients with EFL, an IPV session of 30 minutes was promptly performed by a physiotherapist accustomed to the technique. Expiratory flow limitation, gas exchange, and PO. I were recorded at the end of the IPV session.

Results: Among 35 patients studied after extubation, 25 patients presented an EFL and were included in the study. Intrapulmonary percussive ventilation

led to a significant improvement in EFL, respectively, before and 30 minutes after IPV (65.4 +/- 18.2 vs 35.6 +/- 22.8; P < .05). Three patients were not expiratory flow limited after IPV Intrapulmonary percussive ventilation led to a significant decrease in P0.1 (3.9 +/- 1.6 vs 2.8 +/- 1.1; P < .05). Thirty minutes of IPV led to a significant increase in PaO(2) and pH and a decrease in PaCO(2) and respiratory rate (P < .05).

Conclusion: In COPD patients, a session of IPV allowed a significant reduction of EFL and of P01 and a significant improvement of gas

PLX4032 exchange. (C) 2009 Elsevier Inc. All rights reserved.”
“We describe the measurement and modeling Selleckchem C188-9 of lock-in thermograms for three differently processed crystalline silicon on glass thin film silicon solar modules. For the purpose of defect impact evaluation, a bias series of lock-in thermograms for a single cell in each module is measured. The resulting images around maximum power point bias show pronounced Peltier heat redistribution inside the cell, which needs to be taken into account for quantitative evaluation of the thermography results. This is done using a finite differences electronics simulation of the current flow inside the module and convolution of the heat distribution patterns with the thermal blurring. The procedure makes it possible to extract relevant cell performance parameters like the area diode dark saturation current and nonlinear edge shunting current densities as well as to evaluate the relative impact of these on the efficiency under simulated illumination. (C) 2011 American Institute of Physics. [doi:10.1063/1.3651397]“
“Motivated by viral persistence in HIV+ patients on long-term anti-retroviral treatment (ART), we present a stochastic model of HIV viral dynamics in the blood stream.

Head and neck clinicians should be aware of different sites, type

Head and neck clinicians should be aware of different sites, types, and prognoses for the different age groups.”
“This study examined outcomes of patients with MK 1775 acute ischemic stroke (AIS) with major cerebral artery occlusion after the approval of intravenous

recombinant tissue-type plasminogen activator (IV rt-PA) but before approval of the MERCI retriever. We retrospectively enrolled 1170 consecutive patients with AIS and major cerebral artery occlusion (496 women; mean age, 73.9 +/- 12.3 years) who were admitted within 24 hours after the onset of symptoms to 12 Japanese stroke centers between October 2005 and June 2009. Cardioembolism was a leading cause of AIS in this group (68.2%). The occlusion see more sites of the major cerebral arteries included the common carotid artery and internal carotid artery (ICA; 29.6%), middle cerebral artery (52.2%), and basilar artery (7.6%). Recanalization therapy (RT) was performed in 32.0% of patients (IV rt-PA, 20.0%; neuroendovascular therapy, 9.4%; combined, 2.5%). Symptomatic intracerebral hemorrhage within 36 hours with a >= 1-point increase in the National Institutes of Health Stroke Scale score occurred in 5.3% of the patients. At 3 months (or at hospital discharge), 29.3% of the patients had a favorable outcome (based on a modified Rankin scale score of 0-2), 23.8% were bedridden, and 15.6% died. After

multivariate adjustment, RT was positively associated with a favorable outcome and negatively associated with death, whereas age, baseline National Institutes of Health Stroke Scale score, and ICA occlusion were negatively associated with a favorable outcome and positively associated with death. KPT-8602 cell line One-third of the patients with AIS and major cerebral artery occlusion were treated with RT, which was independently associated with favorable outcomes and death. However, 40% of the patients became bedridden or died during the post-alteplase,

pre-MERCI era in Japan.”
“Three-component reaction of N-methyl- or N,N-diethyl-3-oxobutanamide with aromatic aldehydes and tetrazol-5-amine monohydrate gave the corresponding N-substituted 7-aryl-5-methyl-4,7-dihydrotetrazolo-[1,5-a]pyrimidine-6-carboxamides.”
“The aim of this study was to evaluate the complication rates and inflammatory response in TachoSil (TM)-sealed small-diameter anastomoses with conventional and reduced suture number as a model for neonatal bowel surgery.

Ileo-ileal anastomoses were performed in 73 rats. In the control group, the anastomosis was accomplished with the conventional technique, using nine interrupted sutures. In the other groups with nine, six, and three interrupted sutures, the anastomotic line was additionally sealed with a fibrin-coated collagen patch (TachoSil (TM)). The rats were sacrificed on days 0, 2, and 10.

In all cases the silk powders absorbed metal ions faster than the

In all cases the silk powders absorbed metal ions faster than their respective silk fibers. Intensive degumming of the fibers and powders significantly reduced the time to absorb respective metal ions and the time to reach equilibrium was reduced from hours to 5-15 min at pH 8. Once bound, 45-100% of the metal ions were released from the sorbents after exposure to pH 3 buffer for 30 min. The transition metal ion loading capacity for the silk sorbents was considerably higher than that found for commercial ion exchange resins (AG MP-50 and AG 50W-X2) under similar conditions. Interestingly, total Cu2+ bound was found to be higher than theoretically predicted values based on known

specific Cu2+ binding sites (AHGGYSGY), suggesting that additional (new) sites for transition metal ion binding sites are present in silk fibers. (C) 2010 Wiley Periodicals, Inc. J Appl Polym Sci 119: 3630-3639, 2011″
“Thanks to their large electrical field-induced strains, electroactive polymers can be used in various applications; as electroactive materials for artificial muscles or as active materials of membranes, due to their flexibility. One drawback concerning their use involves the saturation of the electrical field-induced strain which occurs at around 20% for a polymer film with a thickness of 80 mu m. Few studies CX-6258 manufacturer have been devoted to the understanding of this saturation. To this end, the present paper describes mechanical measurements of the extensive strain versus stress and the determination of the current selleck chemical flowing through an electroactive polymer driven by an electrical field. These experiments have clearly demonstrated that the observed saturation of the electrical induced strain was not due to a mechanical saturation

within the sample but to the saturation of the electrically induced polarization. By carrying out a suitable modeling of the polarization versus electrical field, it was possible to calculate the strain and current versus electrical field. These values were then compared to experimental data, and were found to show a very good agreement. (C) 2010 American Institute of Physics. [doi: 10.1063/1.3504601]“
“Nanofibers of poly(vinylidene fluoride-trifluoroethylene)/polyaniline-polystyrene sulfonic acid (PVDF-TrFE/PANi-PSSA) were fabricated in air at room temperature using electrospinning, with the thinnest fiber having a diameter of similar to 6 nm. This is a cheap, fast, and reliable process for generating PVDF-TrFE/PANi-PSSA composite nanofibers. The presence of conducting PANi-PSSA increased the charge density of the solution and assisted in the fabrication of PVDF-TrFE nanofibers at low polymer concentrations in dimethylformamide without the beading effect. Ultraviolet and visible spectroscopy showed that PANi-PSSA was well incorporated into the PVDF-TrFE solution with no polymer segregation or degradation.

Odds ratios (OR) and 95% confidence intervals were also calculate

Odds ratios (OR) and 95% confidence intervals were also calculated.


Data from this study show that subjects heterozygous and homozygous for the most

frequent allele of the osteopontin gene at position 89261521 [OR: 0.035 (P=0.035*) (allele A)] and 89253600 [OR: 0.20 (P=0.025*) (allele T)], respectively, are protected against postorthodontic EARR. Nevertheless, a highly significant association was found Selleck C59 in the comparative analysis of homozygous subjects [2/2 (CC)] for the osteopontin gene (rs9138), resulting in an increased risk of suffering postorthodontic EARR[OR: 4.10; P=0.045*;CI: 95%]. Subjects who were homozygous [2/2 (CC)] for the osteopontin gene (rs11730582) were more likely, and to a greater extent, to be affected with EARR [OR: 11.68; PCI: 95%] compared with other genotypes.


Variations in the osteopontin gene

(rs9138 and rs11730582) are determinants of a genetic predisposition to suffer EARR secondary to orthodontic treatment.”
“Objective: To assess the effectiveness and safety of sodium selenite in treatment of patients with Kashin-Beck disease (KBD).

Methods: We searched for all publications between January 1966 and October 2011 using seven electronic databases. All randomized controlled trials (RCTs) assessing the effects of sodium selenite on KBD vs no treatment or placebo were included. For dichotomous data, odds ratios (OR) and 95% confidence intervals (Cl) Smoothened Agonist Stem Cells & Wnt inhibitor were estimated according to the intention-to-treat principles. For continuous data, mean difference (MD) was used for outcomes pooled on the same scale.

Results: A total of 10 RCTs involving 2244 patients were included. The methodological quality of the included studies was low. When comparing the outcome of sodium selenite treatment group vs the control group, the OR of repairing rate of metaphyseal lesions was 5.63 (95% CI: 3.67-8.63) and repairing rate at the distal end of

phalanges was 2.98 Staurosporine mouse (95% CI: 1.32-6.70) based on X-ray assessment, which was statistically significant difference in favour of sodium selenite. In one RCT which reported data on clinical improvement, no statistically significant difference was observed in the treatment vs control group (OR 1.50, 95% CI: 0.43-5.30). Se content in hair was (MD 0.11, 95% CI: 0.09-0.13) which was statistically significant higher in selenium group.

Conclusions: Current evidence suggests that sodium selenite is more effective than placebo or no treatment in patients with KBD. However, the evidence was limited by potential biases; thus, further high quality large-scale RCTs are still needed to evaluate the short term and long term effects of selenium. (C) 2012 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

6 +/- 10 3 vs 72 3 +/- 18 3, P < 0 03) than those without NTM

6 +/- 10.3 vs 72.3 +/- 18.3, P < 0.03) than those without NTM infections. All except one had received ICS treatment for more than 5 years, and 12 of the 14 patients used inhaled fluticasone propionate daily (four patients at a dose of 400 mu g/day and eight patients at a dose > 800 mu g/day).

Conclusions: These findings suggest that the risk of NTM infection may be greater in asthmatic patients who check details are older, have more severe airflow limitation and receive higher doses of ICS therapy.”
“Patients with Rett syndrome are

known to respond well to music irrespective of their physical and verbal disabilities. Therefore, the relationship between auditory rhythm and their behavior was investigated employing a two-dimensional motion analysis system. Ten female patients aged from three to 17 years were included. When

music with a simple regular rhythm started, body rocking appeared buy Cyclopamine automatically in a back and forth direction in all four patients who showed the same rocking motion as their stereotyped movement. Through this body rocking, voluntary movement of the hand increased gradually, and finally became sufficient to beat a tambourine. However, the induction of body rocking by music was not observed in the other six patients who did not show stereotyped body rocking in a back and forth direction. When the music stopped suddenly, voluntary movement of the hand disappeared. When the music changed from a simple regular rhythm to a continuous tone without an auditory rhythm, the periodic movement of both the hand and body prolonged. Auditory rhythm shows a close relationship with body movement and facilitates synchronized body movement. This mechanism was demonstrated to be preserved in some patients with Rett syndrome, and stimulation selleck chemicals llc with music could be utilized for their rehabilitation.”
“Bonding to porcelain remains to be a challenge in orthodontic treatments. The objective of this study was to evaluate the effect of CO2 laser conditioning of porcelain surfaces on shear bond strength (SBS) of orthodontic brackets. Eighty feldspathic porcelain specimens were divided into four groups of 20. In

each group, half of the porcelain surfaces were deglazed, while the others remained glazed. The specimens in groups 1 to 3 were treated with a fractional CO2 laser for 10 s using 10 mJ of energy, frequency of 200 Hz and powers of 10 W (group 1), 15 W (group 2) and 20 W (group 3). In group 4, a 9.6 % hydrofluoric (HF) acid gel was used for 2 min. A silane coupling agent was applied before bracket bonding, and the SBS was measured with a universal testing machine after 24 h. Deglazing caused significant increase in SBS of laser treated porcelain surfaces (p < 0.05), but had no significant effect on SBS when HF acid was used for etching (p = 0.137). ANOVA revealed no significant difference in SBS values of the study groups when glazed surfaces were compared (p = 0.269).

“The authors report the case of 5-year-old girl who presen

“The authors report the case of 5-year-old girl who presented with 4 episodes of recurrent meningitis. Her initial workup revealed

a lumbosacral dermoid sinus associated with diastematomyelia and a tethered cord. Therefore, a surgical repair to correct the anomaly was performed. However, another episode of meningitis occurred after surgery, and a subsequent temporal bone scan revealed the presence of left Mondini dysplasia. To the authors’ knowledge, this is the first report of Mondini dysplasia in association with diastematomyelia.”
“The calcifying AZD1480 chemical structure odontogenic cyst (COC), first identified as a separate and distinct lesion by Gorlin et al. in 1962, is an uncommon benign lesion, consisting of a proliferation of odontogenic epithelium and

scattered nests of ghost cells and calcifications that may form the lining of a cyst or present as a solid mass. The COC occurs alone or occasionally with odontomas or other odontogenic tumors, and it is this variable histology and clinical behavior that has raised the question of whether or not it is a cyst or a true neoplasm. The odontogenic keratocyst (OKC) is a locally aggressive odontogenic cyst lined by parakeratinizing epithelium that also exhibits characteristics of a neoplasm, including rapid growth, a high rate of recurrence when treated conservatively, and the presence of a gene mutation. We describe a patient diagnosed with an OKC of the mandible that arose simultaneously with a COC of the anterior maxilla. The occurrence Pexidartinib mw of 2 “”cystic neoplasms”" in the same patient is an occurrence which to our knowledge has not been previously reported. We discuss the significance of the case and review the current literature regarding these lesions. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 109: e40-e45)”
“Background: The purpose of this study was to determine whether self-perceived

health status is predictive of a doctor’s office visit in the Longitudinal Study on Aging (LSOA).

Methods: This was a population-based longitudinal study of persons aged >70 years who participated in the Study on Aging in 1984 and a follow-up survey of the LSOA in selleck chemical 1986. The cohort for the study consisted of 560 blacks and 6880 whites who were 70 years or older in 1984. Multivariable logistic regression analysis was performed separately for blacks and for whites.

Results: The study sample was predominantly Caucasian (91.2%) with a mean age 76.8 +/- 5.5 years and mean education grade 10 +/- 3.7. The majority (82%) lived above the poverty level. Self-reported poor health status predicted the use of doctor’s office services among whites (odds ratio [OR] 5.15; 95% confidence interval [CI] 3.34-7.95), but not in blacks (OR 1.6; 95% CI 0.54-4.76).

Conclusion: Self-perceived health status predicted the use of doctor’s office services among older whites but not in older blacks in the LSOA.”
“This study sought to genetically define the first family diagnosed with neuronal ceroid lipofuscinosis from Qatar.

Before and after genetic sonogram, state and trait-anxiety was me

Before and after genetic sonogram, state and trait-anxiety was measured.

The mean state anxiety score before genetic sonogram was statistically, significantly higher than the mean score after the examination. Before genetic sonogram, the mean state-anxiety score of the women with high risk for fetal chromosomal/structural defects was significantly higher than the mean score of women with low risk. Following genetic sonogram,

although the anxiety scores decreased, the scores of women with high risk still remained significantly higher than the scores of women with low risk and the anxiety scores significantly further increased among women with a positive minor or major ultrasound finding.

Genetic sonogram presents an anxiety-inducing situation for the parents-to-be. The level selleck compound of experienced anxiety was found to be proportional to the level of the perceived risk. Women with low Selleckchem Compound C risk for chromosomal/structural defects experienced lower anxiety than women with high risk. Following the examination, women with a negative result were found to have a significant reduction of anxiety and emotional relief whereas a positive test result led to a further increase in anxiety scores.”
“Background: Individual human subjects are differentially attractive to mosquitoes and other biting insects. Previous investigations have demonstrated that this

can be attributed partly to enhanced production of natural repellent chemicals by those individuals that attract few mosquitoes in the laboratory. The most important compounds in this respect include three this website aldehydes, octanal, nonanal and decanal, and two ketones, 6-methyl-5-hepten- 2-one and geranylacetone [(E) 6,10 dimethylundeca 5,9 dien 2 one]. In olfactometer trials, these compounds interfered with attraction of mosquitoes to a host and consequently show promise as novel mosquito repellents.

Methods: To test whether these chemicals could provide protection against mosquitoes, laboratory repellency trials were carried out to test the chemicals individually at different concentrations and in different mixtures and ratios with three major disease vectors: Anopheles gambiae,

Culex quinquefasciatus and Aedes aegypti.

Results: Up to 100% repellency was achieved depending on the type of repellent compound tested, the concentration and the relative composition of the mixture. The greatest effect was observed by mixing together two compounds, 6-methyl-5-hepten-2-one and geranylacetone in a 1: 1 ratio. This mixture exceeded the repellency of DEET when presented at low concentrations. The repellent effect of this mixture was maintained over several hours. Altering the ratio of these compounds significantly affected the behavioural response of the mosquitoes, providing evidence for the ability of mosquitoes to detect and respond to specific mixtures and ratios of natural repellent compounds that are associated with host location.

CFA provided a marginally acceptable fit to the a priori four-fac

CFA provided a marginally acceptable fit to the a priori four-factor model when two matching content item pairs were allowed to be correlated; chi(2) (244) = 1836, RMSEA = 0.088, NNFI = 0.898, CFI = 0.909. This factorial structure was shown to be equivalent

between the participants with and without chronic illness. The differences in means between these two groups were significant but small in some domains; effect size = 0.55, 0.15, 0.18 in the physical, psychological, and social relationship domains respectively. Furthermore, males had significantly higher QOL scores than females in the psychological domain, while individuals with a younger age, higher income, and higher education levels also had significantly higher QOL. Compared with the international data, the Chinese in this study had relatively low QOL scores with about Nepicastat order 5% of males and 16% of females being at risk for poor QOL.

Conclusions: This study has provided psychometric properties of the WHOQOL-BREF as used in China and should definitely PF-6463922 purchase be useful for researchers who would like to use or further refine the instrument.”
“The incidence of spinal epidural abscess has increased in the past decades. Traditionally, management was

based on surgical decompression. More recent studies have shown conservative management has successful outcomes in selected patients.

We present a case, in which an elderly woman presented with new onset radicular pain and mild leukocytosis more than a week after a complicated revision of an intrathecal catheter in place

for management of chronic axial low back pain. Magentic resonance imaging (MRI) revealed a posterior epidural abscess from T12 to L2. Two Touhy needles were placed in the epidural space with fluoroscopic guidance for drainage of the abscess. A catheter was then advanced 5-Fluoracil into the epidural space for irrigation with saline and an antibiotic solution. Intravenous antibiotics were continued for a total of 6 weeks. Radicular pain resolved immediately post-procedure. Serial MRIs also showed decreasing size of the abscess.

Posterior spinal epidural abscesses may be successfully treated by way of the two Touhy needle and catheter technique for drainage and irrigation. This procedure should be reserved for patients that present with no neurological deficits or deemed nonsurgical candidates. Patients should continue on prolonged intravenous antibiotics and be monitored closely for clinical deterioration and undergo serial follow-up MRIs.”
“The review considers recent advances in using diethanolamine (DEA) in the synthesis of amides, polymerization reactions, and synthesis of heterocycles, crown ethers, Mannich bases, and ionic liquids. Biological activity of DEA and its derivatives is also reviewed.”
“Emotional arousal induced by stress and/or anxiety can exert complex effects on learning and memory processes in mammals.