The prepared particles were sensitive to both temperature and pH, and they had good reversibility

in solution at different temperatures and pH values. The swelling ratios of PNIPAAm/CS hydrogel particles decreased slightly with the addition of CS, which did not shift the lower critical solution temperature. The drug-release behavior of the particles was investigated using cyclic adenosine 3′,5′-monophosphate (CAMP) as a model drug. The release of cAMP from the hydrogel particles was affected by temperature, pH, and the CS content in the particles. These results showed that semi-IPN hydrogen particles appeared to be of great TPCA-1 NF-��B inhibitor promise in pH- and temperature-sensitive oral drug release. (C) 2009 Wiley Periodicals, Inc. J Appl Polym Sci 116: 1342-1347, 2010″
“The objective of the review is to present the possible role of urocortin, a novel peptide of the corticotrophin releasing factor family, in different conditions of obstetrics and gynecology such as preterm labor, preeclampsia or ovarian steroidogenesis.

A

learn more MEDLINE search was commenced with the terms “”urocortin”", “”preterm labor”", “”preeclampsia”", “”ovary”", “”endometrium”", “”myometrium”", “”placenta”", “”plasma”", “”amniotic fluid”". Seventy-three articles were found to be relevant on the field and the potential role of urocortin in such conditions is presented.

Amounting data suggest that urocortin could play a significant role in human reproduction (steroidogenesis in the ovary, maintenance of the placental function and labor). Further investigation on the field is necessary in order to clarify the natural role of this newly identified molecule in the field of obstetrics and gynecology.”
“The literature shows that triplet-triplet annihilation (TTA) Nocodazole ic50 can provide a substantial contribution to the electroluminescence (EL) of fluorescent organic light-emitting devices

(OLEDs). In this study, we utilized delayed EL measurements to probe the TTA emission zone of archetypical 8-hydroxyquinoline aluminum (Alq(3)) based OLEDs. The results demonstrate that the TTA emission zone of these devices is much larger than the prompt emission zone of singlet states that are formed in the electron-hole recombination. The larger TTA emission zone is attributed to the longer diffusion length of the Alq(3) triplet states (60 nm) than that of Alq(3) singlet states (20 nm). (c) 2010 American Institute of Physics. [doi:10.1063/1.3410678]“
“The purpose of this study was to investigate the effects of purple-fleshed potatoes on blood glucose level (BGL), insulin and lipid levels in streptozotocin (STZ) induced diabetic rats for 7 weeks. Test groups were divided into non-diabetic control and diabetic groups. The diabetic groups were further divided into three groups: diabetes mellitus (DM) control, 10% purple-fleshed potato DM (10PP-DM), and 20% purple-fleshed potato DM (20PP-DM) groups.

The comparison between the two crosslinking methods showed that formaldehyde crosslinking was significantly more efficient than irradiation. The HCHO crosslinking technique was selected for the following of the study. Nevertheless, even for highly crosslinked samples, the plasticizer exuded out of the film. A second

part of this work was focused on the effect of surface modification on plasticizer exudation in TEA plasticized caseinate films. Considering that silicone grease coating onto the film surface was able to control TEA exudation, surface modifying additives (SMA) based on NaCAS and organo-silicones were used to modify films surface properties. Surface wettability and energy were determined Apoptosis Compound Library datasheet from contact angle measurements. TEA exudation ratios AZD8931 manufacturer in water were also monitored for films containing SMA. SMA were less efficient in controlling TEA exudation rates but could significantly reduce surface energy to 42 mJ m(2). (C) 2010 Wiley Periodicals, Inc. J Appl Polym Sci 117: 1828-1836, 2010″
“Lactase persistence (LP) is common among people of European ancestry, but with the exception of some African, Middle Eastern and southern Asian groups, is rare or absent elsewhere in the world. Lactase gene haplotype conservation around a polymorphism strongly associated with LP in Europeans (-13,910 C/T) indicates that the derived allele is recent in origin and has

been subject to strong positive selection. Furthermore, ancient DNA work has shown that the -13,910*T (derived) allele was very rare or absent in early Neolithic central Europeans. It is unlikely that LP would provide a selective advantage

without a supply of fresh milk, and this has lead to a gene-culture coevolutionary model where lactase persistence is only favoured in cultures practicing dairying, and dairying is more favoured in lactase persistent populations. We have developed a flexible demic computer simulation model to explore the spread of lactase persistence, Galardin purchase dairying, other subsistence practices and unlinked genetic markers in Europe and western Asia’s geographic space. Using data on -13,910*T allele frequency and farming arrival dates across Europe, and approximate Bayesian computation to estimate parameters of interest, we infer that the -13,910*T allele first underwent selection among dairying farmers around 7,500 years ago in a region between the central Balkans and central Europe, possibly in association with the dissemination of the Neolithic Linearbandkeramik culture over Central Europe. Furthermore, our results suggest that natural selection favouring a lactase persistence allele was not higher in northern latitudes through an increased requirement for dietary vitamin D. Our results provide a coherent and spatially explicit picture of the coevolution of lactase persistence and dairying in Europe.”
“We investigate 100 nm thick epitaxial monolayer of SrTiO3 strained by 1% in biaxial tension and grown on (110) DyScO3.

There has been a lack of research into awareness of MOH. We distributed an electronic survey to undergraduate students and their contacts via social networking sites. Analgesic use, awareness of MOH, perceived change in behaviour following educational intervention about the risks of MOH and preferred terminology for MOH was evaluated.

485 respondents completed the questionnaire (41% having received healthcare training). 77% were unaware of the possibility of MOH resulting from regular analgesic use for headache. Following education about MOH, 80% stated they would reduce analgesic consumption or seek medical advice. 83% indicated that over GDC-0973 ic50 the counter analgesia should carry a warning of MOH. The preferred

terminology for MOH was painkiller-induced headache.

This study

highlights the lack of awareness of MOH. Improved education about MOH and informative packaging of analgesics, highlighting the risks in preferred lay terminology (i.e. painkiller-induced headache), may reduce this iatrogenic morbidity and warrants further evaluation.”
“The carrier lifetime in boron-doped Czochralski-grown silicon is ultimately limited SB203580 mw by light-induced boron-oxygen-related recombination centers. These centers can be permanently deactivated by illumination at elevated temperature (70-220 degrees C). However, the detailed defect reactions leading to permanent deactivation are still unresolved. In this work, we study the impact of oxygen on the deactivation process. We examine the dependence of the deactivation rate on the interstitial oxygen concentration as well as the impact of long-term annealing at 450 degrees C, leading to the generation of oxygen clusters acting as donors (thermal donors). We find a decrease in the deactivation rate with both increasing

interstitial oxygen concentration and increasing thermal donor concentration, suggesting that oxygen is involved in the deactivation process. (C) 2010 American Institute of Physics. [doi:10.1063/1.3431359]“
“Background: In June 2006, the Advisory Committee on Immunization Practices (ACIP) expanded its June 2005 recommendation for a second dose of varicella vaccine during outbreaks to a recommendation for routine SNX-5422 concentration school entry second dose varicella vaccination. In October 2006, the Arkansas Department of Health was notified of a varicella outbreak among students where some received a second dose during an outbreak-related vaccination campaign in February 2006.

Methods: The outbreak was investigated using a school-wide parental survey with a follow-up survey of identified case patients. Vaccination status was verified using state and local immunization records. Limited laboratory testing confirmed circulation of wild-type varicella, including varicella in 2-dose vaccine recipients.

Results: Vaccination information was available for 871 (99%) of the 880 children. Varicella vaccination coverage was 97% (2-dose, 39%; 1-dose, 58%).

v. formulation whenever possible), over 72% of evaluable patients had a very slow clinical, microbiological, and imaging ameliorement (1-6 months), with persistance of sputum and/or bronchoalveolar lavage (BAL) fluid positive for M. tuberculosis microscopy and/or culture for over 1-4 months (mean 9.2 +/- 3.2 weeks), PXD101 cost during an apparently adequate treatment. When excluding

patients suffering from XDR and MDR tuberculosis, in four subjects we observed that off-label linezolid adjunct together with at least three drugs with residual activity against tuberculosis, led to a significantly more rapid clinical-radiological improvement and negative microbiological search, with consequent possibility to led to a protected discharge, supported by a sequential, oral therapy. Linezolid was also successfully employed in all the four patients with XDR or MDR pulmonary tuberculosis:

among these patients, a definitive or temporarily negativization of respiratory secretions, and consequent discharge, was achieved only after linezolid adjunct. Notwithstanding the maintained microbiological susceptibility of M. tuberculosis strains responsible of the great majority of cases of pulmonary tuberculosis to first-line drugs, an unexpected tendency of patients to have a persistingly positive sputum and/or SB203580 BAL, and to experience prolonged hospitalization for cure and isolation, has been recognized in the last years. No particularly suggestive radiological imaging seems predictive of a so prolonged course, so that we presently lack of clinical and imaging elements which may be predictive of this slow treatment response.

The same is for demographic and epidemiological issues, eventual underlying diseases, and clinical presentation, so Staurosporine mouse that a major problem for health care providers is to distinguish upon admission patients who will be prone to have slow therapeutic response and a related prolonged hospitalization. The novel oxazolidinone linezolid is characterized by an affordable in vitro activity against M. tuberculosis, and an extremely elevated intracellular concentration in respiratory tissues.

Worldwide, increasing microbiological, pharmacological, and clinical evidences may recommend the use as linezolid adjunct as an off-label salvage treatment o pulmonary tuberculosis refractory to treatment, although not necessarily determined by resistant (MDR-XDR) M. tuberculosis strains. Randomized clinical trials including initially patients with ascertained chemioresistant tuberculosis, are strongly warranted.”
“OBJECTIVE: Most lung transplants are obtained from brain-dead donors. The physiopathology of brain death involves hemodynamics, the sympathetic nervous system, and inflammatory mechanisms. Administering methylprednisolone 60 min after inducing brain death in rats has been shown to modulate pulmonary inflammatory activity.

(C) 2008 Wiley

Periodicals, Inc. J Appl Polym Sci 111: 2104-2115, 2009″
“An enzyme https://www.selleckchem.com/products/pf-04929113.html immunoassay-based test system for Y. pestis V antigen detection was developed. The specificity and sensitivity of this system met the requirements for medical immunobiological preparations for the identification of causative agents of highly fatal diseases. The sensitivity of the test system was assessed, and its high specificity was also demonstrated: the test system did not detect bacterial cells of closely related (four Y. pseudotuberculosis strains) and heterologous microorganism strains. The test system developed was able to detect the V antigen at concentrations as low as 2.0 ng/mL in cells of nine experimental Y. pestis cultures. The obtained preparation can be recommended for use in laboratory diagnostics of plaque.”
“This GNS-1480 molecular weight study examined factors that mediate and moderate the relationship between gender and utilization of mental health and medical services in the past year among Puerto Rican drug users (308 females; 892 males) recruited in New York City. Experience of sexual or physical abuse, injection drug use, relationship variables (e.g., having a sexual partner who is an injection drug user), and serious or chronic mental/medical conditions were used as potential

mediators and moderators. Both sexual and physical abuse mediated gender effects on use of mental health services. Having chronic medical problems mediated the relationship between gender and utilization of medical and mental health services. Significant interaction effects of gender by depression, physical abuse, and HIV sero-status on utilization of medical services were found. Health (particularly mental health) care was Under-Utilized by both women and men, despite high rates of depression and chronic medical conditions. The finding of under-Use of medical services by HIV-positive drug users (particularly by HIV-positive women) indicates

a need for further efforts to engage all HIV-positive persons in care. The findings also indicate an on-going need for mental and other health services for drug users who have been victims of abuse. (C) 2009 Elsevier Ireland Ltd. All rights reserved.”
“Insulin resistance and pancreatic beta cell dysfunction Duvelisib mw are major contributors to the pathogenesis of diabetes. Various conditions play a role in the pathogenesis of pancreatic beta cell dysfunction and are correlated with endoplasmic reticulum (ER) stress. Pancreatic beta cells are susceptible to ER stress. Many studies have shown that increased ER stress induces pancreatic beta cell dysfunction and diabetes mellitus using genetic models of ER stress and by various stimuli. There are many reports indicating that ER stress plays an important role in the impairment of insulin biosynthesis, suggesting that reduction of ER stress could be a therapeutic target for diabetes.

Sequence analysis of eleven field isolates and four laboratory strains showed that these antigenic regions of the basic domain of the MB2 gene are highly conserved in parasites obtained from different parts of the world. Moreover, anti-MB2 antibodies also were detected in the plasma of 83% of the individuals living in a malaria endemic area of Kenya Nutlin-3 in vivo (n = 41).

Conclusion: A preliminary analysis of the human humoral response against MB2 indicates that it may be an additional highly conserved target for immune intervention at the pre-erythrocytic stage of P. falciparum

life cycle.”
“Objective. This study aimed to assess the impact of preoperative body mass index (BMI) on postoperative complications, cancer-specific survival (CSS) and overall survival (OS) in patients operated for renal cell carcinoma (RCC). Material and methods. The study included 397 patients with BMI values, who underwent surgery for RCC between 1 January 1997 and 31 December 2010. Obese patients (BMI > 30 kg/m(2)) were compared to non-obese patients (BMI < 30 kg/m(2)) in regard to CSS and OS. A Cox proportional hazard model was used for the multivariate survival analyses. The mean age of the patients was 62.1 years. There were 259 males (65%) and 325 patients (82%) were non-obese. Mean BMI was 26 kg/m(2). Results. In the total material, CSS was 94.7%

for obese patients and 74.8% for non-obese patients (p A-1331852 Apoptosis inhibitor = 0.06). The obese group had significantly better CSS in univariate analysis see more for presumed radically treated disease (pT1-3N0M0). Obesity was a significant protective prognostic factor in multivariate analysis. An accelerating protective effect for CSS was found with increasing levels of BMI. In regard to OS, no difference was found between the two groups. Obese patients had a significantly lower age, and a higher rate of diabetes mellitus, hypertension and incidental detection. Obese patients had a significantly

higher total incidence of postoperative complications, but not surgery-related complications. Conclusions. In this material, increasing BMI was associated with improved CSS for presumed radically treated patients. However, obese patients had a higher total rate of postoperative complications.”
“P>Kidney transplant glomerulopathy (TG) has a poor outcome as there are no known effective therapies. Therefore, we investigated whether rituximab therapy (RTx) could halt progression of established TG. Fourteen kidney-transplant patients (nine of whom were men), with median age of 54 (range: 30-74) years, of whom seven had biologic markers for HCV infection, underwent a kidney biopsy (KB) at 118 months post-transplant because of impaired allograft function, associated with albuminuria (95-13430 mg/day), within nephrotic-range albuminuria in seven patients. KBs showed no evidence of acute cellular rejection but showed TG. Donor-specific anti-HLA antibodies were present in six cases.

For the monoclinic structure at room temperature, CuMnO2 behaves like a frustrated spin-lattice. For the triclinic structure at low temperature, the obtained magnetic configurations of the lowest energy for both alpha-NaMnO2 and CuMnO2 are consistent with experiments. However, the exchange constants are all positive. This reveals that the magnetic frustration is only partially

relieved at low temperature. It is also found that the Mn3+ ions are in a high-spin state. Taking into account the on-site Coulomb correlations, our results show that alpha-NaMnO2 and CuMnO2 are charge-transfer insulators. (C) 2011 American Institute of Physics. [doi:10.1063/1.3536533]“
“In Algeria, a significant quantities of olive husk are rejected to nature causing by the way major nuisances to environment, to give us a reason for which our work is focused on the valorization of this waste by its incorporation in a polypropylene GPCR Compound Library in vitro matrix. The hydrophilic nature of natural fibers affects negatively selleck inhibitor its adhesion to hydrophobic

polymeric matrix. To improve interfacial adhesion, two modes of chemical treatments were done using vinyltriacetoxysilane (VTAS) and maleic-anhydride-polypropylene (PPMA) compatibilisant agent. Several formulations of PP filled with 10 and 20% by mass of olive husk flour treated (OHFT) and untreated (OHFUT) were prepared. The chemical modification of olive husk flour was studied by Fourier transform infrared (FTIR) spectroscopy. The tensile properties, the water-absorption behavior, the thermal

degradation properties, and crystallinity of the composites were investigated. It was found that, the incorporation of the treated and untreated OHF improves the thermal stability of the composites. However, the use of the compatibilizer agent PPMA leads to a better thermal stability compared with the treatment of the OHF by the VTAS and the OHFUT. (C) 2011 Wiley Periodicals, Inc. J Appl Polym Sci 122: 1382-1394, 2011″
“We present a systematic study of the anisotropy configuration effects on the magnetic properties of exchange-biased ferromagnetic/antiferromagnetic (FM/AFM) Co/IrMn bilayers. The interfacial unidirectional anisotropy is set extrinsically via Selleckchem Ricolinostat a field cooling procedure with the magnetic field misaligned by an angle beta(FC) with respect to the intrinsic FM uniaxial anisotropy. High resolution angular dependence in-plane resolved Kerr magnetometry measurements have been performed for three different anisotropy arrangements, including collinear beta(FC) = 0 degrees and two opposite noncollinear cases. The symmetry breaking of the induced noncollinear configurations results in a peculiar nonsymmetric magnetic behavior of the angular dependence of magnetization reversal, coercivity, and exchange bias.

002). Faecal fat concentrations were increased post-DS vs obese (p = 0.038) and RYGB (p = 0.024) and were also higher post-RYGB vs obese (p = 0.033). Urinary excretion of d-xylose and l-rhamnose was not different between the groups; however, lactulose/rhamnose ratio was elevated post-DS vs other groups (all p < 0.02), suggesting increased

intestinal permeability.

Conclusions Following RYGB, there are surprisingly 5-Fluoracil molecular weight few abnormalities or indications of severe malabsorption of fats or sugars. Small bowel adaptation after bariatric surgery may be key to understanding the mechanisms responsible for the beneficial metabolic effects of these operations.”
“A carotenoid aglycone Ag-NY1 was isolated from the orange coloured tubular calyx of flowers of Nyctanthes arbor-tristis. The elucidation of the structure through a detailed spectroscopic study revealed that the carotenoid molecule is crocetin, which is the major aglycone present in the stigma of Crocus sativus. The compound exhibited a good membrane stabilising activity as compared to the corresponding glycoside crocin.”
“Objective: Nausea and vomiting of pregnancy, the most common medical condition of pregnancy, affects up to 80% of all pregnancies to some extent, and hyperemesis gravidarum does less than 1% of pregnant women. When hyperemesis gravidarum induces diaphragmatic tear, diagnosis can be missed because of nonspecific presentation with abdominal pain,

nausea and vomiting. Methods: We reported a pregnant case suffering from intractable vomiting at the beginning of the second trimester (the 13th week of Protein Tyrosine Kinase inhibitor gestation) with delayed diagnosis of diaphragmatic tearing. Results: The patient was misdiagnosed initially, which delayed the surgical intervention and unnecessary abortion. Conclusion: It is worthwhile considering the maternal diaphragmatic

cause as an unusual one of refractory vomiting C188-9 supplier accompanied by clinically significant progressive epigastric pain, distension and respiratory embarrassment.”
“Background Studies have shown that obesity is associated with venous flow disturbances that lead to changes of the biomechanical forces on the venous wall known as shear stress. We hypothesized that weight loss due to bariatric surgery affects the venous hemodynamics and biomechanical forces on the venous wall. The aim of this study was to evaluate the effects of laparoscopic sleeve gastrectomy (LSG) on the wall shear stress (WSS) and the venous hemodynamics of the femoral vein.

Methods We studied ten morbidly obese patients who underwent LSG. We investigated venous hemodynamics before, 6 and 12 months after LSG. The femoral vein diameter, cross-sectional area, peak (PeakV) and maximum (TA(max)) velocities, WSS, and shear rate (SR) were assessed.

Results PeakV and TA(max) were significantly lower in the obese patients compared with the control group. WSS and SR were significantly lower in the obese patients compared with the control subjects.

(C) 2009 American Association of Oral and Maxillofacial Surgeons”
“Minority carrier diffusion

length in p-type Sb-doped ZnO nanowires was measured as a function of temperature and forward bias injection duration. The minority carrier diffusion length displays a thermally activated length increase with the energy of 144 +/- 5 meV. The forward bias injection exhibits an increase in diffusion length with the activation energy of 217 +/- 20 meV, indicating the possible involvement of a Sb(Zn)-2V(Zn) acceptor complex. (C) 2011 American Institute of Physics. [doi:10.1063/1.3633224]“
“Tests were carried out to determine whether variations in the hydraulic architecture of eight Populus deltoidesxPopulus nigra genotypes could be related to variations in leaf function

and growth performance. Measurements Fosbretabulin cost were performed in a coppice plantation on 1-year-old shoots under optimal irrigation. Hydraulic architecture was characterized through estimates of hydraulic efficiency (the ratio of conducting sapwood area to leaf area, A(X):A(L); leaf- and xylem-specific hydraulic conductance of defoliated shoots, k(SL) and k(SS), respectively; apparent whole-plant leaf-specific hydraulic conductance, k(plant)) and xylem safety (water potential inducing 50% loss in hydraulic conductance). The eight genotypes spanned a significant range of k(SL) from 2.63 kg s(-1) m(-2) MPa-1 to 4.18 kg s(-1) m(-2) MPa-1, variations selleck being mostly driven by k(SS) rather than A(X):A(L). There was a strong trade-off between hydraulic efficiency and xylem safety. Values

Tanespimycin molecular weight of k(SL) correlated positively with k(plant), indicating that high-pressure flowmeter (HPFM) measurements of stem hydraulic efficiency accurately reflected whole-plant water transport efficiency of field-grown plants at maximum transpiration rate. No clear relationship could be found between hydraulic efficiency and either net CO2 assimilation rates, water-use efficiency estimates (intrinsic water-use efficiency and carbon isotope discrimination against C-13), or stomatal characteristics (stomatal density and stomatal pore area index). Estimates of hydraulic efficiency were negatively associated with relative growth rate. This unusual pattern, combined with the trade-off observed between hydraulic efficiency and xylem safety, provides the rationale for the positive link already reported between relative growth rate and xylem safety among the same eight P. deltoidesxP. nigra genotypes.”
“Nano-fibrous hydroxyapatite/chitosan (HA/CS) composites with HA contents of 070 wt % were prepared by in situ hybridization with a preprepared chitosan film as semipermeable membrane to slow down the hybridization process.

There was no significant difference in the average hallux valgus angle between the early and most recent follow-up evaluations in the feet that were considered to be in the normal-position group at the time of the early follow-up selleck chemical (p = 0.084). In the

feet that were considered to be in the displacement group at the time of the early follow-up, the average hallux valgus angle at the time of the most recent follow-up was significantly greater than that at the time of the early follow-up (19.5 degrees +/- 8.4 degrees compared with 15.0 degrees +/- 5.8 degrees) (p = 0.0082). The feet that were in the displacement group at the time of the early follow-up had a greater risk of having recurrence of the hallux valgus at that time than did those Fedratinib datasheet in the normal-position group (odds ratio, 10.0; 95% confidence interval, 2.75 to 36.33).

Conclusions: Postoperative incomplete reduction of the sesamoids can be a risk factor for the recurrence of hallux valgus. The identification of incomplete reduction

of the sesamoids intraoperatively may allow modification of surgical procedures and improvement of the surgical results.”
“Lupeol-3-(3′R-hydroxy)-stearate, also known as procrim b (1), was isolated from the methanolic stem extract of Pentalinon andrieuxii and initially mistaken as lupeol acetate when analyzed by GC-MS only. The correct structure of 1 was established following a careful analysis of its NMR and MS data. (C) 2013 Phytochemical Society of Europe. Published by Elsevier B.V. All rights reserved.”
“The aim of our study was to genotypically characterise isoniazid (INH) and rifampicin (RMP) resistant Mycobacterium tuberculosis isolates in Sousse, Central Tunisia, using DNA sequencing and multispacer sequence typing (MST). The results show that 27/28 (96.4%) and 1/28 (3.6%) INH-resistant isolates yielded respectively the katG S315T and the inhA -15C -> T mutations. Two-thirds of RMP-resistant isolates yielded the ipoB D516V mutation and one sixth yielded either H526D or S531L mutations. Genotyping analysis revealed the

multiclonal spread of drug-resistant isolates find more in Central Tunisia. Data presented here complete the previously published map of resistant M. tuberculosis isolates and highlight their regional disparity in Tunisia.”
“Background: Allograft-prosthetic composite reconstruction of the proximal part of the tibia is one option following resection of a skeletal tumor. Previous studies with use of this technique have found a high prevalence of complications, including fracture, infection, extensor mechanism insufficiency, and loosening. To address some of these problems, we adopted certain measures, including muscle flap coverage, meticulous tendon reconstruction, rigid implant fixation, and careful rehabilitation. The goal of the present study was to evaluate the functional outcome and complications in patients undergoing allograft-prosthetic composite reconstruction of the proximal part of the tibia.