In particolare, la soluzione di un gioco consiste nel trovare strategie di equilibrio (SdE), cioè strategie individuali che ciascun giocatore dovrebbe assumere man mano che il gioco procede, per creare un equilibrio con gli altri. Se il gioco ammette soluzioni (se non ne ammette si ridiscute il concetto di soluzione, cosa che non si farà in questo lavoro), le SdE possono essere costituite da una sola mossa (SdE pure),

portando a un equilibrio stazionario, o da più mosse scelte con frequenze definite iterando il gioco (SdE miste), portando a un equilibrio dinamico ( Von Neumann and Morgenstern, 1953 and Osborne and Rubinstein, 1994). Un esempio: due giocatori sono a un tavolo 3-deazaneplanocin A concentration pieno di caramelle. Ciascuno ha un cartellino bianco (B) e uno nero (N). A ogni mano, i due giocatori alzano ciascuno uno dei due cartellini contemporaneamente: • se i cartellini sono entrambi N, ciascuno riceve 2 caramelle; Indicando su righe e colonne di una tabella, contrassegnate dalle

mosse possibili B e N, le vincite dei giocatori (il 1. numero in ogni casella sia la vincita del 1. giocatore), il gioco è sintetizzato in Table 1. Questo gioco presenta soluzioni diverse qualora this website i giocatori si accordino o meno: se competono, visto che giocare B porta a minor guadagno o perdita, tenderanno entrambi a un equilibrio stazionario, detto di Nash ( Osborne and Rubistein, 1994), su SdE pura “io gioco N”; se collaborano,

ossia passano da “io gioco N”, “io gioco B”, a “giochiamo NB”, possono scegliere un equilibrio dinamico fra infinite SdE miste di guadagno medio 2, ad es. NB per n mani, poi BN per n mani, ecc. Si noti che competizione e collaborazione sono equivalenti economicamente ma non socialmente: la fiducia può essere tradita giocando n+1 volte N nella precedente SdE. Un comportamento competitivo finalizzato al vantaggio individuale, porterà quindi i giocatori all׳equilibrio stazionario su SdE pura “gioco N”, mentre riconoscere il valore di fiducia o equità favorirà equilibri dinamici Carnitine palmitoyltransferase II su SdE miste. Introdotte le dimensioni economica e sociale, per rendere il gioco di Table 1 adatto a trattare questioni di ESS, occorre aggiungere quella ambientale ( Kyburz-Graber et al., 2010 and Wilhelm, 2014), modificandolo come mostrato in Table 2 e Fig. 1: • i colori B/N dei cartellini, ora a forma di nuvola, indicano i livelli di emissione di CO2 nello stile di vita dei giocatori (B normale, N eccessivo); Le SdE che nel gioco di Table 1 massimizzavano guadagni socioeconomici, in base a Table 2 portano all’affondamento dell’orso: l’equilibrio di Nash è destabilizzato da un dubbio etico che spinge a giocare BB non per la vincita in caramelle, ma per il valore della vita dell’orso.

We further investigated the role of members of the Bcl-2 family of proteins from mitochondria. Bcl-2 family proteins play both pro-apoptotic and anti-apoptotic role in cancer cells. The normally Bcl-2 level is much higher in the cancer cell. We observed a drastic

reduction in Bcl-2 expression after the treatment of MOLT-4 cells to DQQ that might be linked with the loss of mitochondrial membrane potential. Bcl-2 inhibition by DQQ alter the symmetry selleck kinase inhibitor of mitochondria, which causes the opening of the mitochondrial transformable pore and brings about Bax translocation from cytosol to mitochondria and consequent release of small molecules like cytochrome c from mitochondria to cytosol. DQQ drastically decreased the Bcl-2/Bax ratio in MOLT-4 cells in a concentration dependent manner in 24 h time period (Fig. 3 C). Translocation of these proteins impairs mitochondrial functions and brings the cells to a “point

of no return” to enter apoptosis via caspases activation. Caspase activation selleck products is solely regulated by the mitochondrial release of apoptotic protease activating factor-1 (Apaf-1) and cytochrome c, which is a part of the mitochondrial dependant apoptosis pathway [31]. Translocation of cytochrome c from mitochondria to cytosol is considered as one of the main events of mitochondrial dysfunction and subsequent apoptosis; it is also associated with immediate exposure of phosphatidylserine exposure. In light of earlier experiments that demonstrated induction of MMP loss and exposure of phosphatidylserine by DQQ, we decided to check the cytochrome c translocation and found that it significantly induced cytochrome c release from mitochondria that activate caspase-3 (Fig. 3A, B). The elevated level

of caspase-3 could utilize poly-ADP Ribose polymerase (PARP, 116 kDa), a DNA repair enzyme as its substrate. As a result a cleaved product (85 kDa) of PARP was observed in our study. Subsequently, DQQ treatments also induce caspase-8, which was part of the extrinsic apoptosis pathway. (Fig. 3A, B). So these findings suggest that DQQ caused induction of apoptosis through both intrinsic and extrinsic apoptotic pathways in human leukemia MOLT-4 cells. We have also found DQQ as a potent inducer of autophagy during in MOLT-4 cells. The autophagy induction was confirmed by acridine orange staining, LC3 immunofluorescence and western blot analysis. PI3 K/AKT signaling pathway is one of the important targets in cancer therapy and has been found to be negatively associated with both autophagy and apoptosis [26]. DQQ significantly inhibited the expression of major proteins of this pathway suggesting the role of PI3 K/AKT pathway in autophagy and apoptosis induced by DQQ in MOLT-4 cells. Caspases have been found to have a regulatory role on both apoptosis and autophagy (Zhang et al.

In addition, M. tuberculosis is able to down-regulate the expression of antibacterial immune effectors, such as nitric oxide, by infected macrophages.

The intestinal Gram-negative pathogen Salmonella enterica is able to modify its LPS into a form that is less identifiable by TLR4. Impairment of the LPS/TLR4 interaction reduces early activation of the innate immune response and hence allows Salmonella to better survive and proliferate within the host’s intestinal cells. Viruses such as cytomegalovirus (CMV) also have highly evolved host avoidance strategies. This member of the herpesvirus family has evolved multiple genes for the manipulation of host immunity, including those whose products prevent the display of viral proteins VX-809 cell line in association with MHC class I molecules (hence

avoiding triggering or being targets of specific CD8+ cytotoxic T cells) by both diverting viral products out of the degradation pathway and by suppressing expression of MHC class I molecules. Ordinarily, this would attract click here the attention of NK cells, which are activated by nucleated cells lacking surface expression of MHC class I molecules. However, CMV possesses genes encoding MHC class I mimics, which are expressed on the surface of infected cells and are able to bind to receptors which switch off the cytotoxic activity of circulating NK cells. Parasites present a challenge to vaccine design because the parasite life cycle comprises distinct phases within

a single host, during which it will reside in different anatomical locations and, most importantly, express different surface antigens. Thus, parasites represent an immunological ‘moving target’. In addition, the immune response to parasites is very complex and may be modulated by the parasite itself, and host–parasite interactions are often poorly defined. There are currently no available vaccines for parasitic diseases of humans, although one vaccine for malaria is currently in Phase III clinical trials (see Chapter 6 – Vaccines of the future). Other important considerations in vaccine immunology include Rucaparib clinical trial the phenomena of immune tolerance and immunological/antigenic interference, which can suppress or prevent development of adequate immune responses following vaccination. Immune tolerance refers to the induction of immunological non-responsiveness by repeated exposure to similar antigens, such as polysaccharide antigens; this effect is dose-dependent and may be limited in time as increasing the interval between subsequent doses can partially restore responsiveness. Immunological/antigenic interference occurs when previous or concomitant exposure to another antigen prevents the development of adequate responses to the vaccine antigen, which may be due to previous or concurrent vaccinations.

In other cases the comments may indicate, for example, that a particular enzyme is a flavoprotein or that it requires Zn+, or they may mention the variations in specificity found in different organisms. The list of other names of hexokinase hints (“type IV”) at the variety of isoenzymes known. However, it is hardly practical to deal with isoenzymes in any systematic way, not only because of the great increase in complexity of the list as a whole that it would entail, but also because nature itself is not systematic. Although all vertebrates contain hexokinase, and all known

vertebrates contain isoenzymes of hexokinase, there is great variation, even between similar species, in the particular isoenzymes present. This

type of complexity is best dealt with by supplying a suitable reference, in this case to Ref. 5 of the list. As already noted, PD0325901 datasheet classification and definitive naming of new enzyme activities is the task of the Nomenclature Committee of the IUBMB. A certain proportion of new entries result from searches of the literature by find more the members of the Committee or by people involved in compiling databases such as BRENDA (Scheer et al., 2011). However, it is obviously more efficient if new activities are directly reported by the researchers who discover and publish them, using the form at http://www.enzyme-database.org/newform.php. Likewise researchers who find errors or omissions in existing entries can report them on the form at http://www.enzyme-database.org/updateform.php.16 The information requested for a new enzyme activity is as follows: • Proposed sub-subclass (e.g. EC 1.2.3.–). Note that there is no field

for the fourth number, which should not be suggested. Although the reaction Resveratrol catalysed is the only required item, in practice at least one reference should be given, and suggested entries are only likely to be accepted if they are supported by at least one paper that is published or in press (“in preparation”, “submitted for publication”, “personal communication”, etc. are unlikely to be acceptable). Cofactor and specificity information should also be included if they are appropriate. In addition to information about the enzyme, contact details for the person suggesting the entry are also required: • Name (required) Published work cited should be submitted with the suggested entry. This can be done either by sending hard copies by post, or by attaching PDF files to e-mail messages. The addresses are given on the form, and at present are Andrew McDonald, Department of Biochemistry, Trinity College, Dublin 2, Ireland; fax: +353-1-6772400; e-mail: [email protected]. The form for reporting an error or suggesting a revision in an existing entry asks for the following information: (EC number, e.g. EC 1.2.3.4). In this case the complete four-part number is to be given as the change refers to an enzyme that has already been listed.

Histologic sections of ventricular tissue AT13387 of 4-μm thickness were stained with Masson’s trichrome. Three sections for each animal were analyzed using a high resolution monochromatic photocamera CCD (SonyXC-75CE) attached to a photomicroscope (LeicaDMRB). The morphometric analyses were performed with an Image System Analysis (Leica Q500MC) with 8 bits of images in gray gradation (256 levels of gray: 0 representing black as blank and 255 colors). The binary edition was used to remove artifacts that did not correspond to cardiomyocyte (cell body) stained

area. Cardiomyocyte (60–80 per animal) analyses were performed with 40× lenses in which the cell nuclei were clearly observed. The same illumination conditions were used for all measurements. Calibration of the system was carried out using a stage micrometer (Leitz) that allowed computation of the object area in units of μm2. Regarding the collagen content evaluation we used Picrius Sirius red staining. This technique is widely used for measuring collagen content in different tissues. Tissue samples were dehydrated, embedded in paraffin and cut in sections of (4 μm) thickness. These sections

were stained with 0.5% Sirius Red F3BA (Aldrich Chemical Company). The quantification of collagen in left ventricle was performed using an image analysis system from LEICA (LEICA 500YW, Cambridge, UK) www.selleckchem.com/products/INCB18424.html and expressed as percent of tissue area. A single researcher unaware of the experimental groups performed the analysis. Results are reported as means ± SEM. Differences were analyzed using Student’s t-test or two-way ANOVA followed by a Tukey test. p ≤ 0.05 was considered significant. For protein expression, data are expressed as the ratio between signals on the immunoblot corresponding to the studied protein and GAPDH. In rats exposed to 30-day HgCl2 treatment no differences in body weight between groups were observed either before or after treatment. Left and right ventricles weight normalized by body weight also showed no differences (Table 1). In order to investigate cardiac effects, Langendorff-perfused hearts from both controls and from 30-day exposed rats were used. Fig. 1

shows that the LVISP was reduced in the mercury-treated group with diastolic pressure fixed at 5 mm Hg. Decitabine nmr Reduction was also observed for positive and negative dP/dt, while coronary perfusion pressure did not change. When performing ventricular function curves, LVISP was reduced in the mercury-treated group for all diastolic pressure values (Fig. 2A). Similar behavior was obtained with positive and negative dP/dt (Figs. 2B–C), but diastolic pressure increments did not change the coronary perfusion pressure (data not shown). Isoproterenol was used in order to test if HgCl2 treatment could alter the myocardial response to inotropic interventions. Isoproterenol administration (100 μL, 10 μM, in bolus) increased LVISP and positive and negative dP/dt in both groups.

, 2000). The ‘additional’ KaiC proteins from Cyanothece and Crocosphaera lack both DXXG motifs and display a proline or arginine aligning to Q115 of S. elongatus-KaiC following the DXXG2 motif. In S. elongatus-KaiC mutation of Q115 to arginine abolishes kaiBC expression ( Nishiwaki et al., 2000). Hence it is very unlikely that these additional KaiC proteins drive kaiBC expression rhythms. Cyanobacteria form a highly diverse group of photoautotrophic prokaryotes, which

click here is reflected not only by their various habitats, morphologies, metabolic needs and behavior but also by the complex diversity of their KaiC-based timing systems. When we analyzed the conservation of clock-related genes in a subset of marine cyanobacterial genomes (Table 1), we detected a large genetic diversity. There are strains lacking some or even all Kai components, others encode multiple copies of kaiC and/or kaiB. For other known clock-related components a similar complex pattern appeared. In summary, the diversity in cyanobacterial Kai-based timing systems appears to be evident primarily regarding the core oscillator and the input pathways. The phosphorylation selleck inhibitor status of KaiC differs in Cyanobacteria, which possess KaiA and in those, where KaiA is absent. In the first case, KaiC exhibits periodic oscillations of phosphorylation like in S. elongatus. In the other case however, KaiC remains hyperphosphorylated as shown for MED4 in vitro.

Thus, KaiA might be required to turn a timing system into a self-sustained oscillation ( Simons, 2009). Accordingly, diurnal cycles observed in MED4 and other Cyanobacteria lacking KaiA are very likely under the control of an hourglass

instead of a true circadian clock. The KaiABC core clock is not universal when we look at diverse marine genomes of Cyanobacteria. Only KaiC homologs can be found almost always, and even in Proteobacteria, Chloroflexi and Archaea (Aoki and Onai, 2009 and Dvornyk et al., 2003). Thus, a minimal timing system simply based on KaiC might exist that could Megestrol Acetate represent a general prokaryotic mechanism. Here, UCYN-A presents a fascinating and unprecedented example. Although KaiA and KaiB homologs are absent, output components are present as well as some input components. The exploration of such a minimal KaiC-based system will be an exciting future challenge. Some of the species listed in Table 1 produce cyanotoxins and other secondary metabolites. The most common toxin-producing Cyanobacteria also include the genera Nodularia and Trichodesmium ( Paerl and Otten, 2013). Both of them are also potent formers of the highly visible and harmful cyanobacterial blooms mentioned above and they inhabit brackish water as well as marine ecosystems ( Huisman et al., 2005 and Paerl and Otten, 2013). The circadian clock was shown to improve reproductive fitness in Cyanobacteria living in rhythmic environments ( Gonze et al., 2002, Mori and Johnson, 2001, Ouyang et al., 1998 and Woelfle et al., 2004).

21 from B. cangicum [85] and the new toxins ( Fig. 4A) found in our study U-AITX-Bg1a, U-AITX-Bg1b, U-AITX-Bg1d. Two more APETx-like homologous were found, U-AITX-Bg1c and U-AITX-Bg1e, but unfortunately it was not possible to locate them among the peptides found in the examined reversed-phase samples. In previous works it was proposed that APETx-like peptides BcIV, a crab paralyzing toxin, and Bcg 31.16, act on crustacean sodium channels. In contrast, we observed no effect on crabs even at 2000 μg/kg, when tested the last eluting

reversed-phase fractions of B. granulifera, which include the new APETx-like peptides. In terms of the possible contact surfaces of these new molecules, Fig. 5B shows that U-AITX-Bg1c and 1d have patches of positively find more charged and aromatic residues in similar disposition as observed in APETx1 and APETx2 (see Suppl. Fig. 1B for comparison). On the contrary, U-AITX-Bg1a and 1b have only a single K8, which is positioned close to F5 and W5, respectively, forming a putative basic-aromatic dyad. Consequently, these dyads K8/F5 and K8/W5 may represent a possible contact surface of those peptides, which we suggest may dock onto their pharmacological targets in different spatial orientation than the other U-AITX-Bg1 peptides. In terms

of the electrostatic potential of this family of peptides, we observe a great variety (see Fig. 5C and D). Curiously, both APETx1 and APETx2 present a similar distribution of positive and negative charges in their electrostatic potentials (see Suppl. Fig. 1B), however the slight differences among selleck kinase inhibitor them result in different orientation of their dipole moments and consequently distinct contact surfaces, as reported [15], [16] and [25]. Thus, we may assume that the putative dipole moments of each individual toxin will vary drastically, and the putative contact surfaces of each peptide will be also variable. Anyway, only screening of each individual peptide toward Phospholipase D1 ion channels or receptors may clarify their exact targets

and the role of specific residues. In addition we can clearly observe strong evidence that APETx-like peptides constitute a very diverse family of abundant toxins in sea anemones belonging to the family Actiniidae. Therefore, new targets of these peptides, as well as new isoforms, await being properly isolated and characterized. From the genetic point of view, our data are the first to determine the full CDS of these peptides, including their complete precursors. It also suggests that a micro-heterogeneity of precursors (reflecting possibly variable mature toxins in their C-termini) of this group of peptides occurs, by the comparison of U-AITX-Bg1e with the others, U-AITX-Bg1b–d (from B. granulifera) and U-AITX-Ael1a (from A. elegantissima). Our results also indicate that the APETx-like peptide family is not present in S. helianthus, a species from a different family. Conversely, type 2 sodium channel toxins are so far represented by ShI in S. helianthus.

The dominant species belonging to 8 functional groups confirmed the eutrophic nature of this water

body. The contributions of groups K (containing cyanobacterial picoplankton species) and J (green algae) were the most significant. In conclusion, several metrics are used to describe phytoplankton quantity or production, but only a few of them fulfil the requirements for being good indicators of eutrophication. We wish to thank Anna Krakowiak for her technical assistance. “
“Aphasia is a common consequence of stroke that typically results from injury to an extended network of cortical and subcortical structures perfused by Selleck Luminespib the middle cerebral artery in the left hemisphere (Alexander, 1997 and McNeil and Pratt, 2001). Most patients who experience aphasia in the setting of acute stroke show some degree of spontaneous recovery, most notably during the first 2–3 months following

stroke onset (Laska et al., 2001, Lendrem and Lincoln, 1985 and Nicholas et al., 1993). However, the majority of patients with post-stroke aphasia are left with some degree of chronic deficit for which current rehabilitative treatments are marginally effective (Basso and Marangolo, 2000, Nickels, 2002, Robey, 1994, Robey, 1995 and Robey et al., 1999). A number of factors have been shown to influence aphasia recovery, including lesion site and size, and the existence of prior strokes (Lazar, Speizer, Festa, Selleck Z VAD FMK Krakauer, & Marshall, 2008). Recent neuroimaging and behavioral data indicate that considerable changes in the cortical representation of language processing can occur in the days, weeks, and months following Protein tyrosine phosphatase stroke in the left hemisphere (Horn et al., 2005), and that language recovery after stroke depends significantly on the degree of plastic change observed in the brains of patients after injury (Cherney and Small, 2006, Musso et al., 1999, Thompson, 2000 and Thompson et al., 1997). TMS and tDCS are safe noninvasive methods that can be used to induce or enhance neuroplastic changes in brain activity (Antal, Nitsche, & Paulus,

2001): a small but growing body of evidence indicates that noninvasive brain stimulation can have beneficial effects in the treatment of aphasia after stroke. These studies also inform our understanding of potential mechanisms of language recovery following injury to language networks. Current evidence suggests that three kinds of changes in neural activity after stroke may be most relevant for aphasia recovery: (1) Recruitment of lesioned and perilesional left hemisphere regions for language-related tasks, (2) acquisition, unmasking or refinement of language processing ability in the nondominant right hemisphere, and (3) dysfunctional activation of the nondominant hemisphere that may interfere with language recovery. We will examine the evidence for each of these kinds of plasticity in language recovery after stroke.

If a factor of 2% is applied for each of ten ships involved in the oil-combating operations, the ultimate fleet efficiency is 80% and the total clean-up costs increases by 10%. If a factor 4% is applied, the fleet efficiency is reduced by 40%, and HTS assay the clean-up costs increases by 25%, compared to the situation where the combating efficiency of ships is not reduced. However such drastic reduction of the fleet efficiency does not seem realistic, thus our choice for this parameter can be indirectly justified and its effect quantified. The nature of BBNs allows an efficient updating of this factor in light of new knowledge and evidences. This variable quantifies the amount of oil

that is expected to be collected before the oil slick reaches the shore. It indicates the amount of oil that the combating vessels will collect by multiplying the vessel’s reduced oil-combating efficiency with the time they have at their disposal. The variable has 13 states ranging from 0 to 50,000 m3, and find more its CPT is obtained using the following expression: equation(3) Amount of oil recovered offshore=C3ifC8·C12>C3C8·C21otherwisewhere C8 is Time to collect oil (hours); C21 is Reduced removal efficiency (m3/h); C3 stands for Amount to be recovered (m3). This variable expresses how much oil is still left in the water after

the oil-combating vessels have collected as much oil as possible in the time frame given. This variable contains 23 states, ranging from 0 to 50,000 m3, and its CPT is obtained through the following conditional Rebamipide expression: equation(4) Amount of oil washed ashore=0.01·C3ifC3⩽C5C3–C5otherwisewhere C3 is Amount to be recovered (m3); C5 means Amount of oil recovered offshore (m3). The expression means that if the

amount of oil recovered at sea is higher or the same as the amount to be recovered, there is no significant spill reaching the shore – we assume that 1% of the amount to be recovered is washed ashore. Otherwise, the fraction of what is left from the offshore clean-up is assumed to pollute the coast. We estimate that the oil mixture that reaches the shore and needs to be collected there contains 10% oil, 40% water and 50% other substances and materials; see for example Kaakkois-Suomen (2009). The amount of waste that needs to be collected is divided between the mechanical and manual clean-up methods. Their respective shares are determined based on m/t Prestige case, thus we assume 60% of the remaining spill being treated with mechanical methods and 40% is left for manual operations. Both nodes Amount of waste mechanical removal and Amount of waste manual removal exist in 21 states defined in intervals from 0 to 50,000 m3, and the CPTs are obtained by solving the following equations: equation(5) Waste(mechanical)=Amount of oil washed ashore·0.6/0.1 equation(6) Waste(manual)=Amount of oil washed ashore·0.4/0.

Twenty-four hours post-surgery, her symptoms became more severe, and she became dyspneic and hypotensive. Additional laboratory testing showed a significant drop in hemoglobin (10.2 g/dl), and blood cultures taken upon admission revealed gram-positive cocci that were confirmed to be GAS. The patient’s condition continued to deteriorate, with progressive signs and symptoms of multiorgan impairment. Her condition necessitated an emergency diagnostic

laparotomy, which was conducted in a different operating room. Diffuse ischemia of all intra-abdominal organs, with fluid throughout the abdominal cavity, see more was apparent. Peritoneal fluid samples that were taken intraoperatively also grew GAS. A diagnosis of TSS was made, and treatment with intravenous meropenem and vancomycin was started. Despite intensive care management and adequate resuscitative efforts, the patient expired on the third day following surgery. Case 2: After the first case of TSS, a 31-year-old female, para 6 + 1, presented to the gynecological clinic for an elective tubal ligation. Nineteen hours following BMS387032 the surgery of the 1st case, the second patient underwent laparoscopic bilateral tubal ligation in the same operating room in which the surgery on the index patient had been performed.

The second patient did not receive any preoperative antibiotic prophylaxis and was discharged in very good condition on the same day. Less than 24 h later, she was readmitted with severe abdominal pain and nausea. The physical examination revealed generalized abdominal tenderness and absent bowel sounds. The laboratory tests were insignificant, and the abdominal X-ray showed free gas under the diaphragm. She was started on intravenous meropenam and vancomycin. The patient’s condition continued to deteriorate, and signs and symptoms of multiorgan failure were observed. A bedside ultrasound revealed a moderate to large amount of free fluid in the peritoneal cavity. A laparotomy was performed to rule out bowel perforation. Megestrol Acetate A bilateral salpingectomy was performed,

and the drained peritoneal fluid grew GAS. A diagnosis of TSS was made, and clindamycin was added to the treatment regime. With continued intensive care treatment, the patient exhibited signs of improvement, and two weeks later, she was discharged in very good condition. Following the identification of the two GAS cases, infection prevention and control precautions were implemented as follows: • Both patients were promptly isolated using contact and standard precautions. All specimens were cultured on 5% sheep blood agar plates and were anaerobically incubated for 48 h. All beta-hemolytic Streptococci colonies were typed as GAS using a latex test (Remel Streptex, Remel Europe Ltd. Dartford, Kent, UK).