Prevalence of atopy and allergic diseases in Korean children: associations with a farming environment and rural lifestyle

BACKGROUND

The results of recent studies suggest that factors in rural environments may protect against the development of allergic diseases, but the underlying mechanisms are not well understood. The aim of this study was to investigate the prevalence of allergic diseases, to establish if this prevalence is influenced by migration from rural to urban areas and to identify environmental risk factors associated with these diseases.

METHODS

A cross-sectional study of children aged 9-12 years from a rural village, a rural town and an urban city in Korea was conducted. Demographic and disease-related information was obtained via a detailed questionnaire, and skin prick tests were performed.

RESULTS

There were significant differences in lifestyle and environmental factors between children from the rural village, the rural town and the urban children. The prevalence of allergic diseases and atopy was higher in urban children. A lower prevalence of allergic diseases and atopy was associated with farming parents, contact with farm animals during pregnancy, owning pets or a stable, breast-feeding and having older siblings. A comparison of rural village and rural town children revealed no evidence of an association of allergic diseases and atopy with farming parents, contact with farm animals during pregnancy or owning a stable. On the other hand, having older siblings and antibiotic use during infancy were significantly associated with allergic diseases and atopy in these children.

CONCLUSIONS

Protective factors associated with a farming environment and/or rural lifestyle may influence the prevalence of allergic diseases and atopy in Korean children.

Randomised clinical trial: a comparative study of 10-day sequential therapy with 7-day standard triple therapy for Helicobacter pylori infection in naïve patients

BACKGROUND

The eradication rates following standard triple therapy for Helicobacter pylori infection are declining worldwide. Recent studies have shown that sequential therapy for H. pylori infection yields high cure rates.

AIM

To compare the efficacy and tolerability of a sequential regimen as first-line treatment of H. pylori infection with a standard triple regimen.

METHODS

A total of 348 naïve H. pylori-infected patients from six hospitals in Korea were assigned randomly to standard triple or sequential therapy groups. Standard triple therapy consisted of 20 mg of rabeprazole, 1 g of amoxicillin and 500 mg of clarithromycin, twice daily for 7 days. Sequential therapy consisted of a 5-day dual therapy (20 mg of rabeprazole and 1 g of amoxicillin, twice daily) followed by a 5-day triple therapy (20 mg of rabeprazole, 500 mg of clarithromycin, and 500 mg of metronidazole, twice daily).

RESULTS

The intention-to-treat (ITT) and per-protocol (PP) eradication rates were 62.2% (95% CI 54.8-69.6%) and 76.0% (95% CI 68.5-83.5%) in the standard triple group, and 77.8% (95% CI 71.4-84.2%) and 87.9% (95% CI 82.3-93.5%) in the sequential group, respectively. The eradication rate was significantly higher in the sequential group compared with the standard triple group in both the ITT and PP populations (P = 0.002 and P = 0.013 respectively), whereas the incidence of adverse events was similar.

CONCLUSIONS

Ten-day sequential therapy is more effective and equally tolerated for eradication of H. pylori infection compared with standard triple therapy. Sequential therapy may have a role as first-line treatment for H. pylori infection.

Randomised clinical trial: a comparative study of 10-day sequential therapy with 7-day standard triple therapy for Helicobacter pylori infection in naïve patients

BACKGROUND

The eradication rates following standard triple therapy for Helicobacter pylori infection are declining worldwide. Recent studies have shown that sequential therapy for H. pylori infection yields high cure rates.

AIM

To compare the efficacy and tolerability of a sequential regimen as first-line treatment of H. pylori infection with a standard triple regimen.

METHODS

A total of 348 naïve H. pylori-infected patients from six hospitals in Korea were assigned randomly to standard triple or sequential therapy groups. Standard triple therapy consisted of 20 mg of rabeprazole, 1 g of amoxicillin and 500 mg of clarithromycin, twice daily for 7 days. Sequential therapy consisted of a 5-day dual therapy (20 mg of rabeprazole and 1 g of amoxicillin, twice daily) followed by a 5-day triple therapy (20 mg of rabeprazole, 500 mg of clarithromycin, and 500 mg of metronidazole, twice daily).

RESULTS

The intention-to-treat (ITT) and per-protocol (PP) eradication rates were 62.2% (95% CI 54.8-69.6%) and 76.0% (95% CI 68.5-83.5%) in the standard triple group, and 77.8% (95% CI 71.4-84.2%) and 87.9% (95% CI 82.3-93.5%) in the sequential group, respectively. The eradication rate was significantly higher in the sequential group compared with the standard triple group in both the ITT and PP populations (P = 0.002 and P = 0.013 respectively), whereas the incidence of adverse events was similar.

CONCLUSIONS

Ten-day sequential therapy is more effective and equally tolerated for eradication of H. pylori infection compared with standard triple therapy. Sequential therapy may have a role as first-line treatment for H. pylori infection.

Observation of D+ → K(+)η(') and search for CP violation in D+ → π(+)η(') decays

We report the first observation of the doubly Cabibbo-suppressed decays D(+)→K(+)η((')) using a 791 fb(-1) data sample collected with the Belle detector at the KEKB asymmetric-energy e(+)e(-) collider. The ratio of the branching fractions of doubly Cabibbo-suppressed relative to singly Cabibbo-suppressed D(+)→π(+)η((')) decays are B(D(+)→K(+)η)/B(D(+)→π(+)η)=(3.06±0.43±0.14)% and B(D(+)→K(+)η')/B(D(+)→π(+)η')=(3.77±0.39±0.10)%. From these, we find that the relative final-state phase difference between the tree and annihilation amplitudes in D(+) decays, δ(TA), is (72±9)° or (288±9)°. We also report the most precise measurements of CP asymmetries to date: A(CP)(D(+)→π(+)η)=(+1.74±1.13±0.19)% and A(CP)(D(+)→π(+)η')=(-0.12±1.12±0.17)%.

Bolus Effective Dose of Ketamine for Preventing Withdrawal Movement on Injection of Rocuronium in Paediatric Patients

The bolus effective dose of ketamine required to prevent withdrawal movement on injection of rocuronium was determined in 27 paediatric patients undergoing elective surgery. A predetermined dose of ketamine was given intravenously on arrival in the operating room and anaesthesia (2.5% thiopental, 5 mg/kg) was administered 1 min later. After loss of consciousness, 1% rocuronium at 0.6 mg/kg was injected over 5 s and the presence or absence of withdrawal movement recorded. The effective dose of ketamine was determined using a modified Dixon up-and-down method with a step size of 0.1 mg/kg, successful prevention of withdrawal movement being defined as no response or movement at the wrist only. The bolus effective dose of ketamine for preventing withdrawal movement after injection of rocuronium following thiopental anaesthesia in 50% of paediatric patients (ED50) was 0.21 mg/kg according to the modified Dixon up-and-down method. Probit analysis indicated an ED50 of 0.18 mg/kg and an ED95 of 0.33 mg/kg. The latter was the most satisfactory dose in the clinical setting.

Factors predictive of perforation during endoscopic submucosal dissection for the treatment of colorectal tumors

BACKGROUND AND AIM

Although perforation of the colon is known as one of the main complications of endoscopic submucosal dissection (ESD) for colorectal tumor management, factors predictive of perforation have not been fully evaluated. This study aimed to determine the factors associated with perforation during colorectal ESD.

METHODS

Patients with colorectal tumors undergoing ESD were enrolled and their records were reviewed retrospectively. Age, sex, co-morbidity, medication history, procedure time, resection method, tumor size, location, gross morphology, the presence of fibrosis, and histologic findings were included as possible risk factors. In the cases where perforation had occurred, factors associated with the duration of hospitalization were analyzed.

RESULTS

One hundred eight lesions in 108 patients were eligible for inclusion in the study (68 patients were male; mean patient age was 63.01 ± 10.71 years). Mean tumor size was 27.59 ± 10.10 mm (range: 8 - 53 mm). Laterally spreading tumor was the most common type (75 %), followed by the protruding type (25 %). Procedure time was 61.95 ± 41.90 minutes (range: 5 - 198 minutes). Complete en bloc resection was achieved for 85 lesions (78.7 %). Perforation occurred in 22 patients (20.4 %). Multivariate analysis confirmed that tumor size [odds ratio (OR): 1.084; 95 % confidence interval (CI): 1.015 - 1.158; P = 0.017] and the presence of fibrosis (OR: 4.551; 95 %CI: 1.092 - 18.960; P = 0.037) were independent risk factors for perforation. All cases of perforation were managed with nonsurgical treatment. Younger age and abdominal pain appeared to be related to prolonged hospitalization.

CONCLUSION

Tumor size and fibrosis are important factors related to complications during colorectal ESD. Younger age and development of abdominal pain can predict the hospital course in patients with perforation after ESD.

A multicenter, randomized, placebo-controlled, double-blind phase II trial evaluating the optimal dose, efficacy and safety of LC 15-0444 in patients with type 2 diabetes

AIM

The objective of this study was to evaluate the optimal dose, efficacy and safety of a novel dipeptidyl peptidase-4 (DPP-IV) inhibitor, LC15-0444, in Korean subjects with type 2 diabetes mellitus treated by diet and exercise.

METHODS

This study was a double-blind, randomized, multicenter and parallel-group, dose-range finding study. We enrolled 145 patients (91 men and 54 women) with a median age of 53 years and a median body mass index of 25.1 kg/m(2) . The median baseline fasting plasma glucose (FPG) was 8.1 mmol/l, the median HbA1c was 7.9% and the median time since the diagnosis of diabetes was 3 years. After 2 weeks of an exercise/diet programme followed by 2 weeks of a placebo period, the subjects were randomized to one of the four following groups for a 12-week active treatment period: placebo and 50, 100 or 200 mg of LC15-0444.

RESULTS

All three doses of LC15-0444 significantly reduced the HbA1c from baseline compared to the placebo group (-0.06 vs. -0.98, -0.74 and -0.78% in the placebo and 50, 100 and 200 mg groups, respectively), without a significant difference between the doses. Subjects with a higher baseline HbA1c (≥8.5%) had a greater reduction in HbA1c. Insulin secretory function, as assessed using homeostasis model assessment-beta cell, C-peptide and the insulinogenic index, improved significantly with LC15-0444 treatment. Insulin sensitivity, as assessed using homeostasis model assessment-insulin resistance, also improved significantly after 12 weeks of treatment. The 50 and 200 mg groups had significantly reduced total cholesterol and low-density lipoprotein cholesterol levels at 12 weeks compared to the placebo group. No dosage of LC15-0444 affected weight or waist circumference. The incidences of adverse events were similar in all study subjects.

CONCLUSIONS

LC15-0444 monotherapy (50 mg for 12 weeks) improved the HbA1c, FPG level, oral glucose tolerance test results, β-cell function and insulin sensitivity measures, and was well tolerated in Korean subjects with type 2 diabetes.

First measurement of inclusive B→Xsη decays

We report a first measurement of inclusive B→Xsη decays, where Xs is a charmless state with unit strangeness. The measurement is based on a pseudoinclusive reconstruction technique and uses a sample of 657×10(6)BB pairs accumulated with the Belle detector at the KEKB e+e- collider. For MXs < 2.6 GeV/c2, we measure a branching fraction of [26.1±3.0(stat)-2.1+1.9(syst)-7.1+4.0(model)]×10(-5) and a direct CP asymmetry of ACP=-0.13±0.04-0.03+0.02. Over half of the signal occurs in the range MXs > 1.8 GeV/c2.

Ethyl 4-hy-droxy-2,6-diphenyl-1-[2-(piperidin-1-yl)acet-yl]-1,2,5,6-tetra-hydro-pyridine-3-carboxyl-ate

In the title compound, C₂₇H₃₂N₂O₄, the piperidine and tetra­hydro­pyridine rings adopt chair and half-chair conformations, respectively. The dihedral angle between the two phenyl rings is 32.9 (1)°. The mol­ecular structure is stabilized by a strong intra­molecular O—H⋯O hydrogen bond, generating an S(6) motif. In the crystal, inter­molecular C—H⋯O inter­actions form a ribbon-like structure along the a axis.

Submitral left ventricular aneurysm of ischemic origin: report of two surgical cases

Submitral left ventricular aneurysm has been exclusively recognized in the young African population and its occurrence in other than black Africans is rarely reported. Here we describe two surgical cases of submitral left ventricular aneurysm in Asian elderly persons. Although the aneurysms were typically located beneath the posterior mitral valve leaflet, we could identify diseased coronary arteries as well, unlike the reports in the literature asserting that this type of aneurysm occurs in the absence of coronary disease. The possible racial difference with regard to the etiology is addressed.

1-(2-Bromo-acet-yl)-3-methyl-2,6-diphenyl-piperidin-4-one

In the title compound, C(20)H(20)BrNO(2), the piperidone ring adopts a boat conformation. The phenyl rings are oriented at dihedral angles of 97.8 (2) and 96.0 (1)° with respect to the best plane through the piperidine ring. The dihedral angle between the two phenyl rings is 49.7 (1)°. In the crystal, bifurcated C-H⋯O hydrogen bonds form a R(2) (1)(7) ring motif, linking the mol-ecules into centrosymmetric dimers.

r-2,c-6-Bis(2-methoxy-phen-yl)-t-3,t-5-dimethyl-piperidin-4-one acetic acid solvate

In the title compound, C₂₁H₂₅NO₃·C₂H₄O₂, the piperidone ring adopts a chair conformation. The two meth­oxy groups are nearly coplanar with the aromatic rings to which they are attached. The dihedral angle between the two aromatic rings is 60.9 (2)°. There are two short intra­molecular N—H⋯O contacts. The crystal packing is stabilized by inter­molecular O—H⋯N and C—H⋯O inter­actions.

Genetic analysis of norovirus GII.4 variants circulating in Korea in 2008

Noroviruses are the enteric pathogens most commonly responsible for infectious gastroenteritis and outbreaks of foodborne illness. The GII.4 norovirus, in particular, is responsible for the majority of epidemics. Here, we present data on the distribution of norovirus genotypes in Chungnam, Korea, in 2008, measure genetic variation among GII.4 strains, and compare Korean GII.4 variants with reference strains based on the 237-bp junction of ORF1 and ORF2. We detected 139 different strains, which formed two distinct genetic clusters with significant sequence diversity. One Korean cluster (2008-Korea_a) showed high similarity to the Sakai cluster that appeared in Japan and Europe in 2006. The other cluster (2008-Korea_b) was unique and unrelated to previously reported clusters. Genotype GII.4 was confirmed as the predominant cause of norovirus epidemics in Korea. Foodborne norovirus infections, on the other hand, were generally caused by emerging GII.4 genetic variants similar to those responsible for global epidemics.

Influence of human allogenic bone marrow and cord blood-derived mesenchymal stem cell secreting trophic factors on ATP (adenosine-5'-triphosphate)/ADP (adenosine-5'-diphosphate) ratio and insulin secretory function of isolated human islets from cadaveric donor

Successful islet transplantation (ITx) is not only dependent on the number of islets, but also their quality, including viability, metabolic activity, and function. Islet quality decreases during cultivation after the isolation procedure. To overcome this obstacle, we established the practice of islet and mesenchymal stem cells (MSCs) coculture. This coculture condition improved the ATP (adenosine-5'-triphosphate)/ADP (adenosine-5'-diphosphate) ratio and insulin secretory function in vitro. It is believed that the enhancement of islet quality in islet-MSCs cocultures may be caused by the secretion of active agents by MSCs. Herein we have shown that interleukin-6 (IL-6), vascular endothelial growth factor-A (VEGF-A), hepatocyte growth factor (HGF), and transforming growth factor-beta (TGF-beta) were significantly increased as measured by enzyme-linked immunosorbent assay (ELISA) in MSCs-cultured medium, factors that have been shown to improve the survival, function, and angiogenesis/revascularization of islets. These results indicated that the quality of human islets was enhanced by trophic molecules secreted by MSCs, which influence the intracellular islet ATP content and insulin secretory function.

Measurement of |V{ub}| from inclusive charmless semileptonic B decays

We present the partial branching fraction for inclusive charmless semileptonic B decays and the corresponding value of the Cabibbo-Kobayashi-Maskawa matrix element |V{ub}|, using a multivariate analysis method to access approximately 90% of the B-->X{u}lnu phase space. This approach dramatically reduces the theoretical uncertainties from the b-quark mass and nonperturbative QCD compared to all previous inclusive measurements. The results are based on a sample of 657x10{6} BB[over ] pairs collected with the Belle detector. We find that DeltaB(B-->X{u}lnu;p(l){*B}>1.0 GeV/c)=1.963x(1+/-0.088{stat}+/-0.081{syst})x10{-3}. Corresponding values of |V{ub}| are extracted using several theoretical calculations.

Nerve growth factor and expression of its receptors in patients with diabetic neuropathy

AIMS

Low serum nerve growth factor (NGF) levels have been reported in patients with diabetic peripheral neuropathy (DPN), but the role of NGF in the development of neuropathy is unclear. Thus, we investigated the associations of serum NGF level and NGF receptor activity with the presence and severity of DPN.

METHODS

One hundred and thirty-six patients with Type 2 diabetes were included in this cross-sectional study. Serum NGF levels were measured by ELISA. Expressions of NGF receptors (TrkA and p75(NTR)) were measured by immunohistochemical staining. The presence and severity of DPN were assessed by neuropathy disability score (NDS) and by corneal nerve fibre length (cNFL) and nerve branch density (cNBD) using in vivo confocal microscopy.

RESULTS

Patients with DPN had higher serum NGF levels (56-451 pg/ml) than patients without DPN (4-54 pg/ml). However, in DPN patients, serum NGF was negatively associated with neuropathy severity (mild 222 +/- 64 pg/ml; moderate 114 +/- 17 pg/ml; severe 89 +/- 20 pg/ml). This negative association was consistent in all severity indices (NDS, P < 0.001; cNFL, P < 0.001; cNBD P = 0.010) even after adjustment for age, sex, diabetes duration, insulin use, fasting glucose and glycated haemoglobin. Although NGF receptor activities had significantly (P < 0.05) negative associations with the presence and severity of neuropathy, these associations were not significant when adjusted for other factors.

CONCLUSIONS

Serum NGF level was positively associated with the presence of DPN but negatively associated with neuropathy severity in DPN patients. The change in serum NGF might be a consequence of, rather than a contributor to, the early development of DPN.

Measurement of the differential branching fraction and forward-backward asymmetry for B --> K(*)l+l-

We study B --> K(*)l+l- decays (l = e, mu) based on a data sample of 657 x 10(6) BB pairs collected with the Belle detector at the KEKB e+e- collider. We report the differential branching fraction, isospin asymmetry, K* polarization, and the forward-backward asymmetry (A(FB)) as functions of q2 = M(ll)(2)c2. The fitted A(FB) spectrum exceeds the standard model expectation by 2.7 standard deviations. The measured branching fractions are B(B --> K*l+l-) = (10.7(-1.0)(+1.1) +/- 0.9) x 10(-7) and B(B --> Kl+l-) = (4.8(-0.4)(+0.5) +/- 0.3) x 10(-7), where the first errors are statistical and the second are systematic, with the muon to electron ratios R(K*) = 0.83 +/- 0.17 +/- 0.08 and R(K) = 1.03 +/- 0.19 +/- 0.06.

Development of functional human immune system with the transplantations of human fetal liver/thymus tissues and expanded hematopoietic stem cells in RAG2-/-gamma(c)-/- MICE

BACKGROUND

There is an increasing need for suitable animal models for the study of the human immune system and disease. The purpose of this study was to develop a practical in vivo model of human immune cell repopulation using ex vivo expanded human fetal liver-derived CD34(+) hematopoietic stem cells and subrenally coimplanted fetal liver/thymus tissues.

METHODS

Freshly isolated fetal liver-derived CD34(+) hematopoietic stem cells were frozen until injected and ex vivo expanded with various cytokines for 7 days. After fetal liver/thymus tissues were subrenally coimplanted into preirradiated Rag2(-/-)gamma(c)(-/-) mice, frozen and ex vivo expanded CD34(+) cells were injected intravenously. The peripheral blood of the mice was monitored for the detection of human cell engraftment using flow cytometry. Then we confirmed human T-cell function by in vitro function assays.

RESULTS

After fetal liver/thymus tissues were coimplanted into the irradiated Rag2(-/-)gamma(c)(-/-) mice, with frozen and ex vivo expanded CD34(+) hematopoietic stem cells, human cell engraftments were determined using hCD45 and multilineage markers. The cultured cells with the cytokine combination of stem cell factor, thrombopoietin, Flk2/Flk3 ligand (FL), and interleukin-3 showed stable and long-term engraftment compared to other combinations. The ex vivo expanded human fetal liver-derived CD34(+) hematopoietic stem cells, under our culture conditions, accomplished a large volume of expanded cells that were sustained, demonstrating self-renewal of the evaluated markers, which may have indicated long- term repopulation activity.

CONCLUSION

The results of this study demonstrated a practical mouse model of expanded human immune cells especially T cells in Rag2(-/-)gamma(c)(-/-) mice.

Sjögren’s syndrome myelopathy: spinal cord involvement in Sjögren’s syndrome might be a manifestation of neuromyelitis optica

Objective

To evaluate clinical characteristics, aquaporin (AQP)-4 antibody results, and probability of developing symptoms of neuromyelitis optica (NMO) in patients with Sjögren’s syndrome myelopathy (SSM).

Methods

We identified eight patients with spinal cord involvement from 112 patients with Sjögren’s syndrome (SS) referred to the neurology department. The clinical characteristics and AQP-4 antibody status, based on immunoprecipitation of EGFP-tagged AQP-4, of the patients with SSM were assessed.

Results

All patients with SSM had extensive spinal cord lesions, high mean annual relapse rates, and poor response to steroid treatment. Of the eight patients with SSM, seven patients satisfied the revised diagnostic criteria for NMO or showed positive results from AQP-4 antibody testing; one patient had incomplete follow-up. The clinical manifestations and AQP-4 autoantibody status of patients with SSM did not differ significantly from those of NMO patients without SS.

Conclusion

All patients with SSM had poor prognosis with high mean annual relapse rates, and most seemed to have the clinical and immunological characteristics of NMO. Early aggressive immune therapies should be considered in patients with SSM irrespective of the presence or absence of optic neuritis.

Physiology and pathophysiology of the 5‐HT3receptor

OBJECTIVE

Macrophage inhibitory protein-1alpha (MIP-1alpha), a C-C chemokine, stimulates the activation and migration of leukocytes. We investigated the expression of MIP-1alpha in patients with Behçet's disease (BD) and evaluated the association of the MIP-1alpha levels with disease activity of BD.

METHODS

Serum samples were obtained from 67 BD patients and 30 healthy controls. Simultaneously, whole blood cells were isolated from BD patients (n = 25) and healthy controls (n = 11) and cultured in the absence or presence of lipopolysaccharide (LPS), phytohaemagglutinin (PHA), and phorbol 12-myristate 13-acetate (PMA) plus ionomycin. The concentrations of MIP-1alpha, interleukin-8 (IL-8), regulated on activation, normally T cell expressed and secreted (RANTES), and monocyte chemoattractant protein-1 (MCP-1) were measured in the sera and culture supernatants by enzyme-linked immunosorbent assay (ELISA).

RESULTS

The serum levels of MIP-1alpha were higher in BD patients than in healthy controls. When whole blood cells were stimulated with LPS or PMA plus ionomycin, but not PHA, BD patients had higher levels of MIP-1alpha in the culture supernatants compared to healthy controls. In sera and culture supernatants of whole blood cells, MIP-1alpha levels correlated well with those of RANTES, MCP-1, and IL-8 in BD patients. Moreover, patients with active disease had significantly higher levels of serum MIP-1alpha levels compared with those with inactive disease.

CONCLUSION

MIP-1alpha levels were elevated in patients with BD, and correlated well with IL-8, RANTES, and MCP-1 levels. These results suggest that the increased MIP-1alpha levels in serum of BD patients may lead to activation and migration of leukocytes, playing a role, like other chemokines, in the pathogenesis of BD.

Observation of the doubly cabibbo-suppressed decay D_{s};{+}-->K;{+}K;{+}pi;{-}

We report the first observation of the doubly Cabibbo-suppressed decay D_{s};{+}-->K;{+}K;{+}pi;{-} using 605 fb;{-1} of data collected with the Belle detector at the KEKB asymmetric-energy e;{+}e;{-} collider. The branching ratio with respect to its Cabibbo-favored counterpart B(D_{s};{+}-->K;{+}K;{+}pi;{-})/B(D_{s};{+}-->K;{+}K;{-}pi;{+}) is (0.229+/-0.028+/-0.012)%, where the first uncertainty is statistical and the second is systematic. We also report a significantly improved measurement of the doubly Cabibbo-suppressed decay D;{+}-->K;{+}pi;{+}pi;{-}, with a branching ratio B(D;{+}-->K;{+}pi;{+}pi;{-})/B(D;{+}-->K;{-}pi;{+}pi;{+})=(0.569+/-0.018+/-0.014)%.