From: Subject: Genetic Determinants of Size at Birth (Slides With Transcript) Date: Thu, 21 Aug 2008 16:51:08 +0800 MIME-Version: 1.0 Content-Type: multipart/related; type="text/html"; boundary="----=_NextPart_000_0079_01C903AE.1BF28040" X-MimeOLE: Produced By Microsoft MimeOLE V6.00.2900.3350 This is a multi-part message in MIME format. ------=_NextPart_000_0079_01C903AE.1BF28040 Content-Type: text/html; charset="utf-8" Content-Transfer-Encoding: quoted-printable Content-Location: http://www.medscape.com/viewarticle/577681 =EF=BB=BF Genetic = Determinants of Size at Birth (Slides With Transcript)

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Selection = from: Small for = Gestational Age: Issues in 2008

Genetic Determinants of Size at Birth (Slides With=20 Transcript) CME

Ken K. Ong, MD, PhD, MRCP Disclosures

Slide 1.

Welcome and Introduction

Slide 2.

Anita Hokken-Koelega, MD: I would like = to=20 welcome you to this symposium on "Small for Gestational = Age." This=20 symposium will discuss the genetic determinants of size at = birth,=20 also the risk of insulin resistance and the metabolic = syndrome, and=20 also review the treatments with growth hormone of children = born with=20 SGA, who remain short.

Slide 3.

Genetic Determinants of Size at Birth

Ken Ong, MD: Thank you very much.

Slide 4.

First of all, why is size at birth important? I have = three=20 reasons here. To start off life, size at birth is predictive = for=20 perinatal mortality and morbidity. This graph shows one of = the=20 earliest studies to show this relationship between birth = weight,=20 lower birth weight, and increased mortality. While, of = course, the=20 absolute mortality rates are much lower these days, the same = associations with birth weights are also seen.

Slide 5.

Secondly, at the end of childhood, low birth weight is = important=20 for adult height, and particularly, low-birth-weight = children who do=20 not catch up within the first few years of life remain small = as=20 adults. This is clearly exemplified by the control groups of = recent,=20 very long-term published results of growth hormone trials. = Here you=20 can see the control group does not show any spontaneous = catch-up at=20 all from early childhood through to adult life.

Slide 6.

In the next talk, you will hear much more about the = association=20 between low birth weight and increased risk of adult = diseases, such=20 as coronary heart disease and type 2 diabetes.

Slide 7.

What regulates birth weight? I am sure it will be no = surprise to=20 you at all to hear that both maternal factors and fetal = factors are=20 important. An example of maternal factors which can be = either=20 discrete conditions, such as maternal hypertension, which is = associated with lower birth weights of offspring,

Slide 8.

and the maternal factors can be continuous. Here you can = see=20 maternal glucose levels clearly influence birth weight. = Infants of=20 first pregnancies have lower birth weight compared with = second and=20 third pregnancies. But in all cases, you can see a clear, = positive,=20 linear trend between birth weight and increasing maternal = glucose=20 levels.

Slide 9.

Then fetal factors; fetal genes are important, and this = is a very=20 recent example, mutations in HNF4a are a rare cause = of=20 maturity onset diabetes or MODY. But peculiarly, the = phenotype in=20 the neonatal period is one of hypoglycemia due to = hyperinsulinemia.=20 In utero, this increase in insulin levels leads to higher = birth=20 weights in those infants who carry a copy of the = mutation.

Slide 10.

These maternal factors and fetal factors do not operate=20 independently, but of course, are interlinked. This cartoon = here=20 shows the interactions. The maternal-uterine factors = determine the=20 nutrition, the placental transfer of nutrients to the fetus, = which=20 then stimulates insulin and IGF-I and promotes fetal growth. = The=20 fetal genes, specifically those that regulate insulin = metabolism and=20 the insulin-like growth factors, may modify the fetal = responses to=20 the level of nutrition. This explains very schematically the = hormonal control of fetal growth. But it does not tell us = much about=20 the balance between maternal factors or fetal factors.

Slide 11.

What I want to do is to go through three questions: = firstly, is=20 the mother in change of fetal growth? Or can the fetus = regulate the=20 mother? Then finally, what are the implications of these = factors for=20 postnatal growth and early infancy?

Slide 12.

First, here is a list of independent significant factors = that=20 impact birth weight. This came from a study of normal = children,=20 about 1000 children born in Bristol in the ALSPAC study. = First of=20 all, there aren't any paternal factors on this list, but = rather a=20 large number of maternal factors, birth weight, mother's = current=20 weight, weight gain, height, smoking, are all independently = related=20 to birth weight, in addition to blood pressure and glucose = that we=20 mentioned earlier.

Slide 13.

Certainly in terms of direct environmental effects, the = maternal=20 uterine environment does have a very large influence on = fetal growth=20 and birth weight. Furthermore, the maternal uterine = environment=20 impacts and modifies whether fetal genes are expressed or = modified=20 or are manifested.

Slide 14.

This study confirmed a finding we published earlier, that = a=20 common variant in the insulin gene, the INS VNTR, was = associated=20 with infants who carried two copies of the class 3 allele = had larger=20 size at birth, than those with class 1 allele. But you can = see that=20 this effect of fetal genotype is only seen in these larger = second=20 and third pregnancies, whereas in first pregnancies, where = the=20 infants are smaller and possibly more restrained by the = mother, the=20 effect of fetal genotype is abolished. The test for = interaction=20 importantly confirms that the effect of fetal genotype is=20 significantly different between these different pregnancies. = This is=20 a common variant in the insulin gene.

Slide 15.

Similar interactions can be seen with rare mutations, = here in the=20 glucokinase gene. This is glucokinase, controls beta cell = insulin=20 secretion and is -- mutations are another cause of MODY or = mature=20 onset diabetes by reducing insulin secretion and elevating = glucose=20 levels.

Slide 16.

Andrew Hattersley and colleagues in Exeter showed that if = the=20 offspring carried the mutation, this exposes the fetus to = lower=20 insulin levels, and therefore lower birth weight; whereas if = mother=20 carries the mutation, the offspring -- the fetus is exposed = to=20 higher glucose levels in utero, and therefore birth weight = is=20 heavier.

Slide 17.

Put together, you can see this graph, in the middle, the = wild=20 type or normal birth weight offspring, in red the lower = birth weight=20 if the fetus carries the mutation that has lower insulin = levels, and=20 dark blue, the effects if just the mother carries the = mutation and=20 has higher glucose levels, provides more nutrient to the = fetus. You=20 can see in the middle here, that the effect of a fetal = mutation can=20 be completely abolished simply by raising glucose levels in = the=20 mother. This is a very rare mutation in the glucokinase,

Slide 18.

but similar to the insulin gene, a common variant in = glucokinase,=20 which does not cause diabetes, but it increases glucose = levels very=20 slightly, again, due to lower insulin secretion. These = authors=20 looked at the effects separately of maternal genotype or = offspring=20 glucokinase genotype from birth weight, and they found an = effect of=20 maternal genotype, but no effect of the offspring = genotype.

Slide 19.

An identical finding is shown with another common variant = in this=20 gene TCF7L2, which is a recently confirmed susceptibility = variant=20 for type 2 diabetes. These authors looked at both maternal = and fetal=20 genotypes, and I have only shown you here the effect of = maternal=20 genotype, which, again through promoting higher glucose = levels in=20 the mother, increased birth weight by 30 grams. I have not = shown you=20 the fetal genotype effect, because there were no independent = effects=20 of fetal genotype.

Slide 20.

Overall, mother's genotype seems to have a more = predominant=20 effect than fetal genotype, as well as modifying the effects = of=20 fetal genes. The third way mother can control things is = actually by=20 directly influencing which specific genes are expressed in = the=20 infant through transmission of her genes.

Slide 21.

This is a schematic diagram of the effects of = insulin-like growth=20 factors, IGF-I and IGF-II, which promote growth by acting on = the=20 type 1 IGF receptor. There is a second IGF receptor, the = type 2=20 receptor, which does not promote growth, but rather binds = IGF-II and=20 degrades it, and therefore it inhibits growth.

Slide 22.

Here is the effect of Igf2. If Igf2 is = knocked=20 out, then the infants are smaller at birth, about 60% of the = normal=20 birth weight. Placental size is also reduced to about 60% of = normal,=20 and identical phenotype is seen, whether you knock out both = copies=20 of Igf2 or just the father's copy of Igf2. = It just=20 seems to be that father's Igf2 gene is specifically = expressed to promote growth.

Slide 23.

In contrast, the type 2 IGF receptor that inhibits growth = is=20 exclusively expressed by mother's transmitted copy, and so = knocking=20 out this inhibitory type 2 receptor leads to a fourfold = increase in=20 circulating Igf2 levels in the fetus, and then = larger birth=20 weight. It is an effect specifically to the maternal = transmitted=20 allele to the fetus.

Slide 24.

This difference between paternally-transmitted and=20 maternally-transmitted alleles has led to this Haig = Hypothesis, that=20 the mother may be more interested in survival, thus passes = on genes=20 to restrain fetal growth such as the Igf2r; whereas = the=20 father is more interested in promoting fetal growth through=20 exclusively paternally-expressed genes, such as = Igf2.

Slide 25.

In summary, my first question, certainly there does seem = to be a=20 predominant effect of maternal factors, first through direct = effects=20 of the maternal-uterine environment, although, as we have = seen, this=20 term maternal environment itself can relate to the effects = of=20 maternal genes acting on mother's metabolism, and therefore=20 controlling the nutrient to the offspring. Secondly, this=20 maternal-uterine environment can modify the expression or = the=20 manifestation of fetal genotype. Thirdly, the mother can = also=20 directly influence expression of genes in the fetus through=20 maternally-transmitted genes.

Slide 26.

In the face of this seemingly overwhelming effect by the = mother,=20 is it possible that the fetus can influence maternal = metabolism?=20 There is some growing evidence for this.

Slide 27.

I think the first evidence also came from the = Igf2 gene=20 model in the mouse. Igf2 is quite a complex gene. = There are=20 a range of promoters, which lead to a number of varying = length mRNA=20 transcripts, which are expressed in specific tissues. There = is a=20 further promoter upstream, which is specific to the = placenta, and=20 leads to a very long mRNA transcript which, again, is = specifically=20 expressed in the placenta.

Slide 28.

Interestingly, if you knock out just this P0 = placental-specific=20 promoter, so you only knock out Igf2 in the = placenta, you=20 get identical phenotype to knocking Igf2 completely = in the=20 fetus, the placenta is reduced to 60%, and birth weight is = also=20 reduced to 60%. This shows the placental weight is reduced = in the=20 mutations throughout pregnancy. But curiously, fetal weight = is=20 preserved until very late pregnancy, and the authors = proposed that=20 there was a compensation by this small placenta to safeguard = or=20 protect fetal growth until the end.

Slide 29.

Indeed, that is what they found. Compared with the wild = type=20 allele, they found that this mutant small placenta was = actually=20 upregulating active transport of nutrients across the = placenta, as=20 illustrated by these labeled markers of glucose and amino = acid=20 transport across the placenta, compared with the wild type. = This=20 upregulation of active transport of glucose and amino acids = was=20 driven by Igf2 in the fetus.

Slide 30.

If you then further knock out Igf2 in the fetus, = we no=20 longer see this upregulated active transport. That is quite = a=20 complex story, so this cartoon summarizes that. If you knock = out=20 Igf2 specifically in the placenta, then fetal = Igf2=20 produces a signal to increase efficiency in the active = function of=20 the placenta. In this paper, published about 3 years ago = now, the=20 authors summarize that this is the first direct evidence = that the=20 fetal genetic growth potential can demand placental supply = of=20 nutrients.

Slide 31.

Of course, we do not have such experimental data in = humans, but=20 in this naturally occurring experiment of Igf2=20 overexpression in humans is the Beckwith-Wiedemann Syndrome, = where=20 infants are larger at birth and have hypertrophy of various=20 organs.

Slide 32.

It has been noted that mothers carrying = Beckwith-Wiedemann=20 Syndrome fetuses -- so these are mothers who are otherwise=20 completely normal -- they are carrying a fetus that = overexpresses=20 Igf2. These pregnancies have higher rates of = preterm=20 delivery, polyhydramnios, and hypertension, so that there = appear to=20 be effects of fetal genome on the mother's metabolism.

Slide 33.

These are some data we have had from Cambridge showing = that fetal=20 number also impacts mother's glucose levels during = pregnancy, so=20 that glucose levels increase from singletons to twins, to = triplets;=20 again suggesting that fetal load of genetic potential does = impact=20 mother's metabolism. These are just a few examples, and = there are=20 many more potential ways whereby the fetus can regulate=20 metabolism.

Slide 34.

There is a list of hormones, which are all secreted from = the=20 placenta, potentially the control from fetal genetic = variants, and=20 which influences mother's metabolism, affecting insulin = resistance=20 and mother's blood pressure, and which can therefore control = nutrients to the fetus. It is an area where we may see many = more=20 examples, and which may have relevance not only to birth = weight, but=20 also to risk of various gestational diseases in the = mother.

Slide 35.

Finally, how do these things affect the infant in early = postnatal=20 growth?

Slide 36.

We have seen the regulation of prenatal growth. In = postnatal=20 growth, nutrition obviously changes, and the nutrition is = supplied=20 by infant feeding, infant appetite, and parental choice of = feeding.=20 But the fetal genes remain the same, at least during early = infancy.=20 So it is no surprise then that the fetal genes which impact=20 antenatal growth also impact on postnatal growth.

Slide 37.

Here a severe deletion of IGF-I, very rare, led to a very = low=20 birth weight, 1.4 kg, but also very severely impaired = postnatal=20 growth. That was IGF-I.

Slide 38.

This is the Igf1 receptor (Igf1R), and again a = mutation=20 here also leads to low birth weight, 2.4 kg, and a very poor = postnatal growth pattern with a final height of 134 cm. = These are=20 rare mutations.

Slide 39.

Also copy number, chromosomal imbalances, which lead to = either=20 one copy of the Igf1R or three copies, also have = concordant=20 effects on growth. So presumably underexpression of = Igf1R=20 leads to low birth weight and poor postnatal growth, whereas = three=20 copies or overactive Igf1R leads to high birth = weight and=20 ongoing rapid postnatal growth.

Slide 40.

Similarly for Igf2, there is some evidence that = infants=20 with Beckwith-Wiedemann Syndrome are not only larger at = birth, but=20 they continue to grow rapidly, particularly in height,=20 postnatally.

Slide 41.

The exact opposite, at genetic level to the = Beckwith-Wiedemann=20 Syndrome is the Silver-Russell Syndrome, which is now = identified to=20 be due to Igf2 underexpression. This is, as you = know,=20 associated with low birth weight and also very poor infant = weight=20 gain and subsequent growth.

The effects of fetal genes certainly appear to continue = into=20 postnatal life, whereas the effect of the mother's = environment seems=20 to wear off.

Slide 42.

Here are data from the ALSPAC study. In red is the growth = trajectory of mothers who smoked during pregnancy. The = weight is=20 expressed as a standard deviation score, where at any age = from birth=20 to age 5, the population average is represented by this = horizontal=20 line through 0. You can see that the infants of mothers who = smoked=20 had lower birth weights, but caught up appropriately during = the=20 first year of life.

Slide 43.

We have already talked about birth order, so first-born = children=20 being smaller at birth, and again, they show a catch-up,=20 compensatory catch-up growth during the first year of = life.

Slide 44.

These are some preliminary data we have from our = Cambridge=20 cohort. On the right panel, this shows the correlation = coefficient=20 between mother's glucose level and the infant's skin folds = at birth.=20 And you can see a positive correlation, as we have shown = before,=20 between higher mother's glucose levels and larger skin folds = at=20 birth. But if you follow these infants up into the first 2 = years of=20 life, this association rapidly disappears, even by age 3 = months, as=20 these infants catch down in growth. In contrast, mother's = BMI=20 independent of glucose levels does not actually influence = skin folds=20 at birth. If we follow these infants up, we see a rapidly = emerging=20 correlations with mother's BMI.

Slide 45.

Another maternal trait that appears to have a rapid = effect on=20 growth in the early postnatal period is mother's age at = menarche.=20 Age at menarche is a highly heritable trait, and is strongly = associated with increased weight and BMI both in childhood = and adult=20 life. Mother's earlier age at menarche seems to confer a = more rapid=20 postnatal growth pattern, even particularly in the first 2 = years of=20 life. In contrast, in the lower panel shows infants of = mothers with=20 later menarche. They show the opposite pattern of = particularly slow=20 growth again in this crucial first 2 years of life.

Slide 46.

These are apparent transgenerational effects of maternal = traits,=20 and I suspect that the specific genes that influence these = traits=20 also are susceptibility genes for obesity. This is the=20 leptin-deficient mouse, who was identified about 10 to 15 = years=20 ago.

Slide 47.

This is the growth chart of a human individual with = leptin=20 deficiency. You can see a marked effect of leptin treatment = when=20 this child was age 5. But particularly, I want to point out = that the=20 period of most rapid deviation from the normal growth charts = is in=20 infancy, showing the marked effects of these appetite genes, = particularly on infant weight gain.

Slide 48.

Leptin deficiency is exceedingly rare, but the common = variation=20 that leads to obesity was reported last year, result from a=20 genome-wide association study. This was in the fatso gene, = or FTO.=20 You see remarkable data in nearly 40,000 individuals showing = a very=20 consistent increased effect on BMI. This study was largely = in=20 adults,

Slide 49.

but data from Lourdes Ib=C3=A1=C3=B1ez in Barcelona has = shown that this=20 gene particularly confers rapid growth, even in the first 2 = weeks of=20 life. There was no effect on birth weight, but the infants = who were=20 with the predisposing alleles for obesity put on more weight = in the=20 first 13 days of life. On DEXA scans at age 2 weeks of life, = these=20 infants were already fatter than infants with the wild type=20 allele.

Slide 50.

So to summarize the last area, fetal growth genes also = impact on=20 postnatal growth. The effects of the maternal-uterine = environment=20 largely appear to disappear during infancy, allowing = catch-up=20 growth. Then thirdly, further parental genetic effects do = impact on=20 postnatal weight gain and infant growth very soon after = birth. I=20 think that these concepts are robust, but the examples I was = showing=20 you so far are quite limited and we are unable yet to use = these for=20 prediction of which infants are going to have low birth = weight and=20 which infants are going to catch up postnatally.

Slide 51.

But you may have heard about the results of the = genome-wide=20 association scans, which really have revolutionized the = discovery of=20 common genetic variants. This is through genotyping, not = just=20 handfuls of SNPs at a time, but hundreds of thousands of = genetic=20 markers at a time. In this month's edition of Nature=20 Genetics, there is a report on 30 or 40 new genes for = adult=20 height, and a further 6 new genes for type 2 diabetes, and = many more=20 are on their way. So watch this space.

Slide 52.

Thank you very much to several of my colleagues at = Cambridge, and=20 to the ALSPAC team in Bristol. And thank you very much for = your=20 attention.

Go=20 to CME Test Questions = =C2=BB

Contents = of: Small=20 for Gestational Age: Issues in 2008=20

All sections of this activity = are=20 required for credit.

Genetic=20 Determinants of Size at BirthKen = K. Ong,=20 MD, PhD, MRCPCHAvailable As: = Slides/Audio = ;| Slides/Transcript=
Assessing=20 the Risk of Insulin Resistance and Metabolic = SyndromeClaire L=C3=A9vy-Marchal, MDAvailable As: Slides/Audio = ;| Slides/Transcript=
The=20 Treatment of Growth Failure in SGA ChildrenAnita Hokken-Koelega, MDAvailable As: Slides/Audio = ;| Slides/Transcript=
Panel=20 DiscussionAnita Hokken-Koelega, = MD; Ken K.=20 Ong, MD, PhD, MRCPCH; Claire L=C3=A9vy-Marchal, = MDAvailable As: Slides/Audio = ;| Slides/Transcript=

Go=20 to CME Test = Questions=20 =C2=BB

CME Information=20
Earn=20 CME Credit =C2=BB =

All material on this website is protected by = copyright, Copyright = =C2=A9 1994-2008=20 by Medscape. This website also contains material copyrighted by 3rd = parties.=20

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0px 0px } #rrlist { MARGIN-TOP: 11px; FONT-WEIGHT: bold; FONT-SIZE: 15px; LIST-STYLE-IMAGE: = url(http://images.medscape.com/pi/global/ornaments/check-box.gif); = MARGIN-BOTTOM: 0px } #rrlist LI { PADDING-BOTTOM: 13px } P.onlinestatement { FONT-WEIGHT: bold; FONT-SIZE: 15px; TEXT-ALIGN: center } #printsponsor { MARGIN-BOTTOM: 20px } #printsponsortitle { BORDER-RIGHT: #b22222 1px solid; BORDER-TOP: #b22222 1px solid; MARGIN: = 0px 0px -9px 14px; BORDER-LEFT: #b22222 1px solid; WIDTH: 175px; = BORDER-BOTTOM: #b22222 1px solid; POSITION: relative; BACKGROUND-COLOR: = #ffffff } #printsponsortitle H3 { PADDING-RIGHT: 7px; PADDING-LEFT: 7px; FONT-WEIGHT: bold; FONT-SIZE: = 13px; PADDING-BOTTOM: 3px; MARGIN: 0px; COLOR: #b22222; PADDING-TOP: = 3px; FONT-FAMILY: Verdana, sans-serif; TEXT-ALIGN: center } #printsponsorbg { BORDER-RIGHT: #b22222 1px solid; PADDING-RIGHT: 14px; BORDER-TOP: = #b22222 1px solid; PADDING-LEFT: 14px; PADDING-BOTTOM: 14px; = BORDER-LEFT: #b22222 1px solid; PADDING-TOP: 7px; BORDER-BOTTOM: #b22222 = 1px solid } #printsponsorbg H4 { PADDING-RIGHT: 0px; PADDING-LEFT: 0px; FONT-SIZE: 17px; PADDING-BOTTOM: = 0px; MARGIN: 0px 0px 3px; PADDING-TOP: 9px } #notes { BORDER-TOP: #969696 1px solid; MARGIN-BOTTOM: 30px; PADDING-TOP: 7px } .leftalignimage { PADDING-RIGHT: 0px; PADDING-LEFT: 0px; FLOAT: left; PADDING-BOTTOM: = 0px; MARGIN: 0px 10px 20px 0px; PADDING-TOP: 0px } #toc { BORDER-RIGHT: #c9dee7 3px solid; PADDING-RIGHT: 0px; BORDER-TOP: = #c9dee7 3px solid; PADDING-LEFT: 0px; PADDING-BOTTOM: 0px; MARGIN: 0px = 0px 15px; BORDER-LEFT: #c9dee7 3px solid; WIDTH: 159px; PADDING-TOP: = 0px; BORDER-BOTTOM: #c9dee7 3px solid; BACKGROUND-COLOR: #fff } #toc H5 { PADDING-RIGHT: 0px; PADDING-LEFT: 0px; FONT-WEIGHT: bold; FONT-SIZE: = 0.9em; PADDING-BOTTOM: 5px; MARGIN: 0px 5px; TEXT-TRANSFORM: uppercase; = PADDING-TOP: 5px; BORDER-BOTTOM: #b3b3b3 double; FONT-FAMILY: Verdana, = sans-serif } #cmeinfo { BORDER-RIGHT: #fff 1px solid; PADDING-RIGHT: 0px; PADDING-LEFT: 0px; = PADDING-BOTTOM: 8px; MARGIN: 0px 0px 15px; BORDER-LEFT: #e3e3e3 1px = solid; PADDING-TOP: 3px } .cmeinfonavlist { PADDING-RIGHT: 3px; PADDING-LEFT: 3px; FONT-SIZE: 13px; PADDING-BOTTOM: = 5px; MARGIN: 0px; PADDING-TOP: 5px; LIST-STYLE-TYPE: none; = BACKGROUND-COLOR: #fff; TEXT-ALIGN: left } .cmeinfonavlist LI { PADDING-RIGHT: 0px; PADDING-LEFT: 0px; FONT-WEIGHT: bold; = PADDING-BOTTOM: 5px; PADDING-TOP: 0px } .cmeinfonavlist LI A { BORDER-RIGHT: #c9dee7 2px solid; PADDING-RIGHT: 4px; = BACKGROUND-POSITION: left top; BORDER-TOP: #c9dee7 2px solid; DISPLAY: = block; PADDING-LEFT: 4px; FONT-SIZE: 13px; BACKGROUND-IMAGE: = url(http://images.medscape.com/pi/1024/article/bg_cmebtn.gif); = PADDING-BOTTOM: 3px; BORDER-LEFT: #c9dee7 2px solid; PADDING-TOP: 4px; = BORDER-BOTTOM: #c9dee7 2px solid; BACKGROUND-REPEAT: repeat-x } .cmeinfonavlist LI A:link { FONT-SIZE: 13px } .cmeinfonavlist LI A:visited { FONT-SIZE: 13px } .cmeinfonavlist LI A:hover { FONT-SIZE: 13px; BACKGROUND-IMAGE: none; BACKGROUND-COLOR: #ffce87 } .cmeinfonavlist LI A:active { FONT-SIZE: 13px } #cmeinfo H6 { PADDING-RIGHT: 5px; PADDING-LEFT: 5px; FONT-SIZE: 13px; PADDING-BOTTOM: = 2px; MARGIN: 0px; COLOR: #cc0000; PADDING-TOP: 0px; FONT-FAMILY: arial, = sans-serif; BACKGROUND-COLOR: #fff } #cmeinfo P { PADDING-RIGHT: 5px; PADDING-LEFT: 5px; FONT-SIZE: 11px; PADDING-BOTTOM: = 8px; MARGIN: 0px; PADDING-TOP: 0px; BACKGROUND-COLOR: #fff } .cmeinfonavlist P#expiredstatement { PADDING-RIGHT: 0px; PADDING-LEFT: 0px; FONT-WEIGHT: normal; = PADDING-BOTTOM: 8px; PADDING-TOP: 0px } A.posttest:link { FONT-WEIGHT: bold; FONT-SIZE: 13px; MARGIN: 0px; COLOR: #cc0000 } A.posttest:visited { FONT-WEIGHT: bold; FONT-SIZE: 13px; MARGIN: 0px; COLOR: #cc0000 } A.posttest:hover { FONT-WEIGHT: bold; FONT-SIZE: 13px; MARGIN: 0px; COLOR: #cc0000 } A.posttest:active { FONT-WEIGHT: bold; FONT-SIZE: 13px; MARGIN: 0px; COLOR: #cc0000 } UL.articlenavlist { PADDING-RIGHT: 0px; PADDING-LEFT: 0px; FONT-WEIGHT: bold; FONT-SIZE: = 0.9em; PADDING-BOTTOM: 0px; MARGIN: 0px; PADDING-TOP: 0px; = LIST-STYLE-TYPE: none; BACKGROUND-COLOR: #fff } UL.articlenavlist LI { PADDING-RIGHT: 4px; PADDING-LEFT: 5px; PADDING-BOTTOM: 4px; = PADDING-TOP: 4px } UL.articlenavlist LI B { PADDING-RIGHT: 0px; BACKGROUND-POSITION: left top; PADDING-LEFT: 8px; = BACKGROUND-IMAGE: = url(http://images.medscape.com/pi/global/ornaments/bg_nav_highlight.gif);= PADDING-BOTTOM: 0px; PADDING-TOP: 0px; BACKGROUND-REPEAT: no-repeat; = BACKGROUND-COLOR: #fff; TEXT-DECORATION: none } UL.articlenavlist LI A { BACKGROUND-COLOR: #fff; TEXT-DECORATION: none } UL.articlenavlist LI A:link { TEXT-DECORATION: none } UL.articlenavlist LI A:visited { TEXT-DECORATION: none } UL.articlenavlist LI A:hover { BACKGROUND-COLOR: #fff; TEXT-DECORATION: underline } UL.articlenavlist LI A:active { TEXT-DECORATION: none } UL.articlenavlist2 { PADDING-RIGHT: 0px; BORDER-TOP: #c9dee7 1px solid; PADDING-LEFT: 0px; = FONT-SIZE: 0.8em; PADDING-BOTTOM: 0px; MARGIN: 0px; PADDING-TOP: 0px; = LIST-STYLE-TYPE: none; BACKGROUND-COLOR: #fff } UL.articlenavlist2 LI { PADDING-RIGHT: 4px; PADDING-LEFT: 5px; PADDING-BOTTOM: 4px; = PADDING-TOP: 4px } UL.articlenavlist2 LI B { PADDING-RIGHT: 0px; BACKGROUND-POSITION: left top; PADDING-LEFT: 8px; = FONT-WEIGHT: normal; BACKGROUND-IMAGE: = url(http://images.medscape.com/pi/global/ornaments/bg_nav_highlight.gif);= PADDING-BOTTOM: 0px; PADDING-TOP: 0px; BACKGROUND-REPEAT: no-repeat; = BACKGROUND-COLOR: #fff; TEXT-DECORATION: none } UL.articlenavlist2 LI A { BACKGROUND-COLOR: #fff; TEXT-DECORATION: none } UL.articlenavlist2 LI A:link { TEXT-DECORATION: none } UL.articlenavlist2 LI A:visited { TEXT-DECORATION: none } UL.articlenavlist2 LI A:hover { BACKGROUND-COLOR: #fff; TEXT-DECORATION: underline } UL.articlenavlist2 LI A:active { TEXT-DECORATION: none } #trackerwidget { BORDER-RIGHT: #b3b3b3 1px solid; PADDING-RIGHT: 0px; BORDER-TOP: = #b3b3b3 1px solid; PADDING-LEFT: 0px; PADDING-BOTTOM: 7px; MARGIN: 0px = 0px 15px; BORDER-LEFT: #b3b3b3 1px solid; WIDTH: 120px; PADDING-TOP: = 0px; BORDER-BOTTOM: #b3b3b3 1px solid; BACKGROUND-COLOR: #f3f3f3 } #trackerwidget H5 { PADDING-RIGHT: 5px; PADDING-LEFT: 5px; FONT-WEIGHT: bold; FONT-SIZE: = 0.9em; PADDING-BOTTOM: 5px; MARGIN: 0px; COLOR: #000000; PADDING-TOP: = 5px; BORDER-BOTTOM: #b3b3b3 1px solid; FONT-FAMILY: Verdana, sans-serif; = BACKGROUND-COLOR: #ffffff } #currentcredits { PADDING-RIGHT: 5px; PADDING-LEFT: 5px; FONT-WEIGHT: bold; = PADDING-BOTTOM: 5px; PADDING-TOP: 5px } #trackerwidget A { PADDING-RIGHT: 0px; PADDING-LEFT: 5px; FONT-SIZE: 11px; PADDING-BOTTOM: = 0px; PADDING-TOP: 0px; TEXT-DECORATION: none } #trackerwidget A:hover { TEXT-DECORATION: underline } #multiarticlelist { DISPLAY: block; Z-INDEX: 200; POSITION: absolute } #multiarticlelist DIV.inactive { VISIBILITY: hidden; POSITION: absolute } #multiarticlelist DIV.active { BORDER-RIGHT: #ccccdd 1px solid; PADDING-RIGHT: 10px; = BACKGROUND-POSITION: left top; PADDING-LEFT: 5px; BACKGROUND-IMAGE: = url(http://images.medscape.com/pi/global/ornaments/multiarticle_top.gif);= VISIBILITY: visible; PADDING-BOTTOM: 0px; MARGIN: -1px 0px 0px -416px; = BORDER-LEFT: #ccccdd 2px solid; WIDTH: 606px; PADDING-TOP: 5px; = BORDER-BOTTOM: #ccccdd 2px solid; BACKGROUND-REPEAT: no-repeat; = POSITION: absolute; BACKGROUND-COLOR: #f3f7ff } #multiarticlelist OL { PADDING-RIGHT: 0px; PADDING-LEFT: 0px; LIST-STYLE-POSITION: outside; = PADDING-BOTTOM: 0px; MARGIN: 0px 0px 0px 30px; PADDING-TOP: 0px; = LIST-STYLE-TYPE: decimal } #multiarticlelist LI { PADDING-RIGHT: 0px; PADDING-LEFT: 0px; PADDING-BOTTOM: 15px; MARGIN: = 0px; COLOR: #666666; PADDING-TOP: 0px } #multiarticlelist A { PADDING-RIGHT: 0px; DISPLAY: inline; PADDING-LEFT: 0px; FONT-SIZE: = 13px; PADDING-BOTTOM: 0px; BORDER-TOP-STYLE: none; PADDING-TOP: 0px; = BORDER-RIGHT-STYLE: none; BORDER-LEFT-STYLE: none; BACKGROUND-COLOR: = #f3f7ff; BORDER-BOTTOM-STYLE: none } .requiredstatement { PADDING-RIGHT: 0px; PADDING-LEFT: 0px; FONT-WEIGHT: bold; = PADDING-BOTTOM: 0px; MARGIN: 0px 0px 10px; COLOR: #cc0000; PADDING-TOP: = 0px } A#programlink { DISPLAY: block; FONT-WEIGHT: bold; MARGIN: 0px 0px 5px } #multiarticlelistbtm { BORDER-RIGHT: #b3b3b3 1px solid; PADDING-RIGHT: 15px; BORDER-TOP: = #b3b3b3 1px solid; PADDING-LEFT: 5px; PADDING-BOTTOM: 3px; MARGIN: 0px = 0px 15px; BORDER-LEFT: #b3b3b3 1px solid; PADDING-TOP: 3px; = BORDER-BOTTOM: #b3b3b3 1px solid; BACKGROUND-COLOR: #f3f7ff } #multiarticlelistbtm OL { PADDING-RIGHT: 0px; PADDING-LEFT: 0px; LIST-STYLE-POSITION: outside; = PADDING-BOTTOM: 0px; MARGIN: 0px 0px 0px 30px; PADDING-TOP: 0px; = LIST-STYLE-TYPE: decimal } #multiarticlelistbtm LI { PADDING-RIGHT: 0px; PADDING-LEFT: 0px; PADDING-BOTTOM: 15px; MARGIN: = 0px; COLOR: #666666; PADDING-TOP: 0px } .tocintrop { MARGIN-TOP: 7px; DISPLAY: block; FONT-SIZE: 12px } #multiarticletoc { BORDER-RIGHT: #c9dee7 double; PADDING-RIGHT: 10px; BORDER-TOP: #c9dee7 = double; PADDING-LEFT: 5px; PADDING-BOTTOM: 5px; MARGIN: 10px 0px 15px; = BORDER-LEFT: #c9dee7 double; PADDING-TOP: 5px; BORDER-BOTTOM: #c9dee7 = double; BACKGROUND-COLOR: #e5f1f6 } #multiarticletoc OL { PADDING-RIGHT: 0px; PADDING-LEFT: 0px; LIST-STYLE-POSITION: outside; = PADDING-BOTTOM: 0px; MARGIN: 0px 0px 0px 30px; PADDING-TOP: 5px; = LIST-STYLE-TYPE: decimal } #multiarticletoc LI { PADDING-RIGHT: 0px; PADDING-LEFT: 0px; PADDING-BOTTOM: 15px; MARGIN: = 0px; COLOR: #666666; PADDING-TOP: 0px } #multiarticletoc UL { PADDING-RIGHT: 0px; PADDING-LEFT: 0px; LIST-STYLE-POSITION: outside; = PADDING-BOTTOM: 0px; MARGIN: 0px 0px 0px 21px; PADDING-TOP: 5px; = LIST-STYLE-TYPE: none } #multiarticletoc UL A { FONT-WEIGHT: bold; FONT-SIZE: 13px } #multiarticletoc SPAN.version A { FONT-WEIGHT: normal; FONT-SIZE: 11px } #parenttoc { CLEAR: both; PADDING-RIGHT: 0px; PADDING-LEFT: 0px; Z-INDEX: 100; = PADDING-BOTTOM: 0px; MARGIN: -6px; WIDTH: 500px; PADDING-TOP: 0px; = POSITION: relative; BACKGROUND-COLOR: #ffffff } #parenttocnav { BORDER-RIGHT: #96b5d5 1px dashed; BORDER-TOP: #96b5d5 1px dashed; = MARGIN: 0px 0px 10px; BORDER-LEFT: #96b5d5 1px dashed; WIDTH: 100%; = BORDER-BOTTOM: #96b5d5 1px dashed; BACKGROUND-COLOR: #ffffff } #parenttocnav H5 { PADDING-RIGHT: 0px; PADDING-LEFT: 0px; FONT-SIZE: 10px; PADDING-BOTTOM: = 0px; MARGIN: 4px 3px 0px; PADDING-TOP: 0px } #navcells { WIDTH: 100% } #navcells TD { BORDER-RIGHT: #ceddf1 1px solid; BORDER-TOP: #ceddf1 1px solid; = FONT-SIZE: 12px; BORDER-LEFT: #ceddf1 1px solid; BORDER-BOTTOM: #ceddf1 = 1px solid; BACKGROUND-COLOR: #eaf1ff } #navcells A { PADDING-RIGHT: 5px; DISPLAY: block; PADDING-LEFT: 5px; PADDING-BOTTOM: = 2px; WIDTH: 94%; PADDING-TOP: 2px; HEIGHT: 100%; BACKGROUND-COLOR: = #eaf1ff } #navcells A:link { PADDING-RIGHT: 5px; DISPLAY: block; PADDING-LEFT: 5px; PADDING-BOTTOM: = 2px; WIDTH: 94%; PADDING-TOP: 2px; HEIGHT: 100% } #navcells A:visited { PADDING-RIGHT: 5px; DISPLAY: block; PADDING-LEFT: 5px; PADDING-BOTTOM: = 2px; WIDTH: 94%; PADDING-TOP: 2px; HEIGHT: 100% } #navcells A:hover { BACKGROUND-COLOR: #ffffff } #navcells A:active { PADDING-RIGHT: 5px; DISPLAY: block; PADDING-LEFT: 5px; PADDING-BOTTOM: = 2px; WIDTH: 94%; PADDING-TOP: 2px; HEIGHT: 100% } #parenttoc H3 { PADDING-RIGHT: 0px; BORDER-TOP: #b3b3b3 1px solid; PADDING-LEFT: 5px; = FONT-SIZE: 13px; PADDING-BOTTOM: 2px; MARGIN: 0px 0px 10px; PADDING-TOP: = 2px; BORDER-BOTTOM: #b3b3b3 1px dashed; FONT-FAMILY: Verdana, sans-serif } #parenttoc H4 { PADDING-RIGHT: 0px; BORDER-TOP: #b6b6b6 1px dashed; PADDING-LEFT: 0px; = FONT-SIZE: 12px; PADDING-BOTTOM: 2px; MARGIN: 0px 0px 5px 5px; COLOR: = #303030; PADDING-TOP: 2px; BORDER-BOTTOM: #b6b6b6 1px dashed; = FONT-FAMILY: Verdana, sans-serif } UL.conferenceparentlist { PADDING-RIGHT: 5px; LIST-STYLE: none none outside; PADDING-LEFT: 5px; = PADDING-BOTTOM: 10px; MARGIN: 0px; PADDING-TOP: 0px } UL.conferenceparentlist LI { PADDING-BOTTOM: 7px } #floatingrightcolumn { PADDING-RIGHT: 0px; PADDING-LEFT: 12px; Z-INDEX: 50; FLOAT: right; = PADDING-BOTTOM: 12px; WIDTH: 300px; PADDING-TOP: 0px; BACKGROUND-COLOR: = #ffffff } #articletoolbox { MARGIN: 0px; WIDTH: 100%; BORDER-BOTTOM: #fff 8px solid } #articletoolboxborder { BORDER-RIGHT: #bfbfbf 1px solid; PADDING-RIGHT: 0px; BORDER-TOP: = #bfbfbf 1px solid; PADDING-LEFT: 5px; PADDING-BOTTOM: 4px; BORDER-LEFT: = #bfbfbf 1px solid; PADDING-TOP: 4px; BORDER-BOTTOM: #bfbfbf 1px solid } #articletoollist { PADDING-RIGHT: 0px; LIST-STYLE: none none outside; PADDING-LEFT: 0px; = FONT-SIZE: 11px; PADDING-BOTTOM: 0px; MARGIN: 0px; PADDING-TOP: 0px } #articleprint { PADDING-RIGHT: 0px; DISPLAY: inline; PADDING-LEFT: 0px; FONT-SIZE: = 11px; PADDING-BOTTOM: 0px; MARGIN: 0px 10px 0px 0px; PADDING-TOP: 0px } #printwith { PADDING-RIGHT: 0px; DISPLAY: inline; PADDING-LEFT: 0px; FONT-SIZE: = 11px; PADDING-BOTTOM: 0px; MARGIN: 0px 10px 0px 0px; PADDING-TOP: 0px } #printwithout { PADDING-RIGHT: 0px; DISPLAY: inline; PADDING-LEFT: 0px; FONT-SIZE: = 11px; PADDING-BOTTOM: 0px; MARGIN: 0px 10px 0px 0px; PADDING-TOP: 0px } #articleemail { PADDING-RIGHT: 0px; DISPLAY: inline; PADDING-LEFT: 0px; FONT-SIZE: = 11px; PADDING-BOTTOM: 0px; MARGIN: 0px 10px 0px 0px; PADDING-TOP: 0px } #submitquestion { PADDING-RIGHT: 0px; DISPLAY: inline; PADDING-LEFT: 0px; FONT-SIZE: = 11px; PADDING-BOTTOM: 0px; MARGIN: 0px 10px 0px 0px; PADDING-TOP: 0px } #articlediscussion { PADDING-RIGHT: 0px; DISPLAY: inline; PADDING-LEFT: 0px; FONT-SIZE: = 11px; PADDING-BOTTOM: 0px; MARGIN: 0px 10px 0px 0px; PADDING-TOP: 0px } #articledownload { PADDING-RIGHT: 0px; DISPLAY: inline; PADDING-LEFT: 0px; FONT-SIZE: = 11px; PADDING-BOTTOM: 0px; MARGIN: 0px 10px 0px 0px; PADDING-TOP: 0px } #abstractordertext { PADDING-RIGHT: 0px; DISPLAY: inline; PADDING-LEFT: 0px; FONT-SIZE: = 11px; PADDING-BOTTOM: 0px; MARGIN: 0px 10px 0px 0px; PADDING-TOP: 0px } #abstractviewonline { PADDING-RIGHT: 0px; DISPLAY: inline; PADDING-LEFT: 0px; FONT-SIZE: = 11px; PADDING-BOTTOM: 0px; MARGIN: 0px 10px 0px 0px; PADDING-TOP: 0px } #articlerating { PADDING-RIGHT: 0px; DISPLAY: inline; PADDING-LEFT: 0px; FONT-SIZE: = 11px; PADDING-BOTTOM: 0px; MARGIN: 0px 10px 0px 0px; PADDING-TOP: 0px } .version { FONT-SIZE: 11px; MARGIN-LEFT: 15px } #versionlist { PADDING-RIGHT: 5px; BORDER-TOP: #bfbfbf 1px solid; PADDING-LEFT: 5px; = FONT-SIZE: 11px; PADDING-BOTTOM: 4px; PADDING-TOP: 4px; BORDER-BOTTOM: = #bfbfbf 1px solid; TEXT-ALIGN: right } #emailtoolbox { DISPLAY: none; MARGIN: 0px 0px 14px } #emailtoolboxtitle { BORDER-RIGHT: #b3b3b3 1px solid; BORDER-TOP: #b3b3b3 1px solid; MARGIN: = 0px 0px -9px 14px; BORDER-LEFT: #b3b3b3 1px solid; WIDTH: 125px; = BORDER-BOTTOM: #b3b3b3 1px solid; POSITION: relative; BACKGROUND-COLOR: = #ffffff } #emailtoolboxtitle H6 { PADDING-RIGHT: 7px; PADDING-LEFT: 7px; FONT-WEIGHT: bold; FONT-SIZE: = 15px; PADDING-BOTTOM: 3px; MARGIN: 0px; COLOR: #003366; PADDING-TOP: = 3px; FONT-FAMILY: arial, sans-serif; TEXT-ALIGN: center } #emailtoolboxbg { BORDER-RIGHT: #b3b3b3 1px solid; PADDING-RIGHT: 14px; BORDER-TOP: = #b3b3b3 1px solid; PADDING-LEFT: 14px; PADDING-BOTTOM: 7px; BORDER-LEFT: = #b3b3b3 1px solid; PADDING-TOP: 7px; BORDER-BOTTOM: #b3b3b3 1px solid; = BACKGROUND-COLOR: #eeeeee } #emailconfirmation { DISPLAY: none; FONT-WEIGHT: bold; FONT-SIZE: 15px; WIDTH: 350px; COLOR: = #ff3300 } #downloadtoolbox { DISPLAY: none; MARGIN: 0px 0px 14px } #downloadtoolboxtitle { BORDER-RIGHT: #b3b3b3 1px solid; BORDER-TOP: #b3b3b3 1px solid; MARGIN: = 0px 0px -9px 14px; BORDER-LEFT: #b3b3b3 1px solid; WIDTH: 165px; = BORDER-BOTTOM: #b3b3b3 1px solid; POSITION: relative; BACKGROUND-COLOR: = #ffffff } #downloadtoolboxtitle H6 { PADDING-RIGHT: 7px; PADDING-LEFT: 7px; FONT-WEIGHT: bold; FONT-SIZE: = 15px; PADDING-BOTTOM: 3px; MARGIN: 0px; COLOR: #003366; PADDING-TOP: = 3px; FONT-FAMILY: arial, sans-serif; TEXT-ALIGN: center } #downloadtoolboxbg { BORDER-RIGHT: #b3b3b3 1px solid; PADDING-RIGHT: 14px; BORDER-TOP: = #b3b3b3 1px solid; PADDING-LEFT: 14px; PADDING-BOTTOM: 7px; BORDER-LEFT: = #b3b3b3 1px solid; PADDING-TOP: 7px; BORDER-BOTTOM: #b3b3b3 1px solid; = BACKGROUND-COLOR: #eeeeee } .closebtn { FONT-SIZE: 11px; TEXT-ALIGN: right } .emailtoolinput TD { PADDING-RIGHT: 0px; PADDING-LEFT: 0px; PADDING-BOTTOM: 0px; WIDTH: = 450px; PADDING-TOP: 7px } .emailtoolinput TD INPUT { WIDTH: 450px } .emailtoolinput TD TEXTAREA { WIDTH: 450px } #ratingtoolbox { DISPLAY: none; MARGIN: 0px 0px 14px } #ratingtoolboxtitle { BORDER-RIGHT: #b3b3b3 1px solid; BORDER-TOP: #b3b3b3 1px solid; MARGIN: = 0px 0px -9px 14px; BORDER-LEFT: #b3b3b3 1px solid; WIDTH: 125px; = BORDER-BOTTOM: #b3b3b3 1px solid; POSITION: relative; BACKGROUND-COLOR: = #ffffff } #ratingtoolboxtitle H6 { PADDING-RIGHT: 7px; PADDING-LEFT: 7px; FONT-WEIGHT: bold; FONT-SIZE: = 15px; PADDING-BOTTOM: 3px; MARGIN: 0px; COLOR: #003366; PADDING-TOP: = 3px; FONT-FAMILY: arial, sans-serif; TEXT-ALIGN: center } #ratingtoolboxbg { BORDER-RIGHT: #b3b3b3 1px solid; PADDING-RIGHT: 14px; BORDER-TOP: = #b3b3b3 1px solid; PADDING-LEFT: 14px; PADDING-BOTTOM: 7px; BORDER-LEFT: = #b3b3b3 1px solid; PADDING-TOP: 7px; BORDER-BOTTOM: #b3b3b3 1px solid; = BACKGROUND-COLOR: #eeeeee } .star { PADDING-RIGHT: 0px; BACKGROUND-POSITION: 0px 0px; PADDING-LEFT: 0px; = BACKGROUND-IMAGE: = url(http://images.medscape.com/pi/global/ornaments/rating-star.gif); = PADDING-BOTTOM: 0px; MARGIN: 0px; PADDING-TOP: 0px; BACKGROUND-REPEAT: = no-repeat } #ratingthanks { DISPLAY: none } #ratingthanks2 { DISPLAY: none } #ratearticleform { PADDING-RIGHT: 0px; DISPLAY: inline; PADDING-LEFT: 0px; PADDING-BOTTOM: = 0px; MARGIN: 0px; PADDING-TOP: 0px } #ratearticleform FORM { PADDING-RIGHT: 0px; DISPLAY: inline; PADDING-LEFT: 0px; PADDING-BOTTOM: = 0px; MARGIN: 0px; PADDING-TOP: 0px } #ratearticleform2 { PADDING-RIGHT: 0px; DISPLAY: inline; PADDING-LEFT: 0px; PADDING-BOTTOM: = 0px; MARGIN: 0px; PADDING-TOP: 0px } #ratearticleform2 FORM { PADDING-RIGHT: 0px; DISPLAY: inline; PADDING-LEFT: 0px; PADDING-BOTTOM: = 0px; MARGIN: 0px; PADDING-TOP: 0px } 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BORDER-TOP: #ffffff 1px solid; = BORDER-LEFT: #ffffff 1px solid; COLOR: #ff6600; BORDER-BOTTOM: #ffffff = 1px solid } A.inpagenav:visited { BORDER-RIGHT: #ffffff 1px solid; BORDER-TOP: #ffffff 1px solid; = BORDER-LEFT: #ffffff 1px solid; COLOR: #ff6600; BORDER-BOTTOM: #ffffff = 1px solid } A.inpagenav:hover { BORDER-RIGHT: #ffffff 1px solid; BORDER-TOP: #ffffff 1px solid; = BORDER-LEFT: #ffffff 1px solid; COLOR: #cc0000; BORDER-BOTTOM: #ffffff = 1px solid } A.inpagenav:active { BORDER-RIGHT: #ffffff 1px solid; BORDER-TOP: #ffffff 1px solid; = BORDER-LEFT: #ffffff 1px solid; COLOR: #ff6600; BORDER-BOTTOM: #ffffff = 1px solid } .figtable { FONT-SIZE: 13px; MARGIN: 0px 0px 20px; BACKGROUND-COLOR: #eeeeee } .thumbcell { PADDING-RIGHT: 10px; PADDING-LEFT: 0px; PADDING-BOTTOM: 0px; = PADDING-TOP: 0px } .slidetable { FONT-SIZE: 13px; MARGIN: 0px 0px 20px; BACKGROUND-COLOR: transparent } .datatable { BORDER-RIGHT: #d3d3d3 1px solid; BORDER-TOP: #d3d3d3 1px solid; = FONT-SIZE: 13px; MARGIN: 0px 0px 20px; BORDER-LEFT: #d3d3d3 1px solid; = BORDER-BOTTOM: #d3d3d3 1px solid; BACKGROUND-COLOR: #f3f3f3 } .datatable TD { BORDER-RIGHT: #ffffff 1px solid; PADDING-RIGHT: 4px; BORDER-TOP: = #ffffff 1px solid; PADDING-LEFT: 4px; PADDING-BOTTOM: 4px; BORDER-LEFT: = #ffffff 1px solid; PADDING-TOP: 4px; BORDER-BOTTOM: #ffffff 1px solid; = TEXT-ALIGN: left } #contentbodymoblie .slidetable .thumbcell { DISPLAY: none } .flashvid { MARGIN: 0px 0px 20px; TEXT-ALIGN: center } P#topten { PADDING-RIGHT: 0px; PADDING-LEFT: 0px; FONT-SIZE: 13px; PADDING-BOTTOM: = 0px; MARGIN: 5px 0px 0px; PADDING-TOP: 0px } P#topten2 { PADDING-RIGHT: 0px; PADDING-LEFT: 0px; FONT-SIZE: 13px; PADDING-BOTTOM: = 0px; MARGIN: 5px 0px 0px; PADDING-TOP: 0px } P#eventdate { PADDING-RIGHT: 0px; PADDING-LEFT: 0px; FONT-SIZE: 11px; PADDING-BOTTOM: = 0px; MARGIN: -10px 0px 10px; PADDING-TOP: 0px } P#postingdate { PADDING-RIGHT: 0px; PADDING-LEFT: 0px; FONT-SIZE: 11px; PADDING-BOTTOM: = 0px; MARGIN: 0px 0px 10px; PADDING-TOP: 0px 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TEXT-TRANSFORM: uppercase; BORDER-LEFT: #b3b3b3 1px = solid; PADDING-TOP: 5px; BORDER-BOTTOM: #b3b3b3 double; = BACKGROUND-COLOR: #f3f3f3; TEXT-ALIGN: left } #sponsoradborder { BORDER-RIGHT: #b3b3b3 1px solid; PADDING-RIGHT: 5px; PADDING-LEFT: 5px; = PADDING-BOTTOM: 5px; BORDER-LEFT: #b3b3b3 1px solid; PADDING-TOP: 5px; = BORDER-BOTTOM: #b3b3b3 1px solid; BACKGROUND-COLOR: #f3f3f3 } #sponsorlistings A { FONT-WEIGHT: bold; TEXT-ALIGN: left } #sponsorlistings P A { FONT-WEIGHT: normal; TEXT-ALIGN: left } #sponsorlistings P { PADDING-RIGHT: 0px; PADDING-LEFT: 0px; FONT-SIZE: 12px; PADDING-BOTTOM: = 5px; MARGIN: 0px; PADDING-TOP: 0px; BACKGROUND-COLOR: #f3f3f3; = TEXT-ALIGN: left } #sponsorlistings UL { PADDING-RIGHT: 0px; PADDING-LEFT: 22px; PADDING-BOTTOM: 5px; MARGIN: = 0px; PADDING-TOP: 0px; LIST-STYLE-TYPE: circle; BACKGROUND-COLOR: = #f3f3f3; TEXT-ALIGN: left } #sponsorlistings UL LI { PADDING-RIGHT: 0px; PADDING-LEFT: 0px; PADDING-BOTTOM: 7px; MARGIN: = 0px; PADDING-TOP: 0px; TEXT-ALIGN: left } #sponsorlistings LI A { FONT-WEIGHT: normal; TEXT-ALIGN: left } #newslettersignupbox { MARGIN: 0px 0px 15px } #newslettersignuptitle H6 { BORDER-RIGHT: #b3b3b3 1px solid; PADDING-RIGHT: 5px; BORDER-TOP: = #b3b3b3 1px solid; PADDING-LEFT: 5px; FONT-SIZE: 1em; PADDING-BOTTOM: = 4px; MARGIN: 0px; TEXT-TRANSFORM: uppercase; BORDER-LEFT: #b3b3b3 1px = solid; PADDING-TOP: 5px; BORDER-BOTTOM: #b3b3b3 double; = BACKGROUND-COLOR: #f3f3f3; TEXT-ALIGN: left } #newslettersignupborder { BORDER-RIGHT: #b3b3b3 1px solid; PADDING-RIGHT: 5px; PADDING-LEFT: 5px; = PADDING-BOTTOM: 5px; BORDER-LEFT: #b3b3b3 1px solid; PADDING-TOP: 5px; = BORDER-BOTTOM: #b3b3b3 1px solid; BACKGROUND-COLOR: #f3f3f3 } .newsletterrow { CLEAR: both; WIDTH: 194px } .signupicon { FLOAT: left; WIDTH: 15px; TEXT-ALIGN: left } .newsletterlisting { FLOAT: right; WIDTH: 179px; PADDING-TOP: 2px; TEXT-ALIGN: left } .newsletterlisting A { DISPLAY: block } #supporterbadge { BORDER-RIGHT: #b3b3b3 1px solid; PADDING-RIGHT: 0px; BORDER-TOP: = #b3b3b3 1px solid; PADDING-LEFT: 0px; PADDING-BOTTOM: 5px; MARGIN: 0px = 0px 15px; BORDER-LEFT: #b3b3b3 1px solid; PADDING-TOP: 5px; = BORDER-BOTTOM: #b3b3b3 1px solid; BACKGROUND-COLOR: #ffffff; TEXT-ALIGN: = center } #cmeproviders { BORDER-RIGHT: #b3b3b3 1px solid; PADDING-RIGHT: 8px; BORDER-TOP: = #b3b3b3 1px solid; PADDING-LEFT: 8px; PADDING-BOTTOM: 0px; MARGIN: 0px = 0px 15px; BORDER-LEFT: #b3b3b3 1px solid; PADDING-TOP: 8px; = BORDER-BOTTOM: #b3b3b3 1px solid; BACKGROUND-COLOR: #ffffff } #cmeproviders P { PADDING-RIGHT: 0px; PADDING-LEFT: 0px; FONT-SIZE: 11px; PADDING-BOTTOM: = 8px; MARGIN: 0px; PADDING-TOP: 0px } .providerlogo { FLOAT: left; MARGIN: 0px 5px 5px 0px } #sectionnav { PADDING-RIGHT: 0px; BORDER-TOP: #666666 1px solid; PADDING-LEFT: 0px; = FONT-SIZE: 13px; PADDING-BOTTOM: 0px; MARGIN: 0px; PADDING-TOP: 2px } #previoussection { FONT-WEIGHT: bold; FONT-SIZE: 13px; FLOAT: left; MARGIN-BOTTOM: 20px; = MARGIN-RIGHT: 116px; TEXT-ALIGN: left } #currentsection { FONT-WEIGHT: bold; FONT-SIZE: 13px; FLOAT: left; MARGIN-BOTTOM: 20px; = MARGIN-RIGHT: 16px; TEXT-ALIGN: left } #nextsection { FONT-WEIGHT: bold; FONT-SIZE: 13px; FLOAT: right; MARGIN-BOTTOM: 20px; = WIDTH: 225px } P#citation { PADDING-RIGHT: 5px; PADDING-LEFT: 5px; FONT-SIZE: 11px; PADDING-BOTTOM: = 5px; MARGIN: 0px 0px 15px; PADDING-TOP: 5px; BACKGROUND-COLOR: #eeeeee } #authoraffiliations { PADDING-RIGHT: 0px; LIST-STYLE: none none outside; PADDING-LEFT: 0px; = PADDING-BOTTOM: 0px; MARGIN: 0px 0px 20px; PADDING-TOP: 0px } .subheadinglink { PADDING-RIGHT: 0px; PADDING-LEFT: 0px; FONT-SIZE: 15px; PADDING-BOTTOM: = 7px; PADDING-TOP: 0px } .abstracttable { FONT-SIZE: 11px; MARGIN: 0px 0px 10px; FONT-FAMILY: arial, sans-serif } .abstracttable TH { BORDER-RIGHT: #999999 1px solid; BORDER-TOP: #999999 1px solid; = FONT-SIZE: 12px; BORDER-LEFT: #999999 1px solid; COLOR: #003366; = FONT-FAMILY: arial, sans-serif; TEXT-ALIGN: left } .abstracttable TD { BORDER-RIGHT: 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13px; PADDING-BOTTOM: = 6px; MARGIN: 0px 0px 10px; PADDING-TOP: 0px; BORDER-BOTTOM: #b3b3b3 = double; FONT-FAMILY: Verdana, sans-serif } #tabs { PADDING-RIGHT: 0px; BACKGROUND-POSITION: left bottom; PADDING-LEFT: = 0px; Z-INDEX: 2; BACKGROUND-IMAGE: = url(http://images.medscape.com/pi/global/ornaments/tab-empty.gif); = PADDING-BOTTOM: 0px; MARGIN: 0px 0px 10px; PADDING-TOP: 0px; = BACKGROUND-REPEAT: repeat-x; POSITION: relative } #tablist { PADDING-RIGHT: 0px; PADDING-LEFT: 0px; Z-INDEX: 2; PADDING-BOTTOM: 0px; = MARGIN: 0px; PADDING-TOP: 0px; POSITION: relative } .casetabon { PADDING-RIGHT: 0px; PADDING-LEFT: 0px; FONT-SIZE: 13px; BACKGROUND: = url(http://images.medscape.com/pi/global/ornaments/bg_casenav_left.gif) = no-repeat left top; PADDING-BOTTOM: 0px; PADDING-TOP: 0px; = BORDER-BOTTOM: #fff 1px solid } .tabonlink { PADDING-RIGHT: 10px; DISPLAY: block; PADDING-LEFT: 0px; FONT-WEIGHT: = bold; BACKGROUND: = url(http://images.medscape.com/pi/global/ornaments/bg_casenav_right_on.gi= f) no-repeat right top; PADDING-BOTTOM: 3px; MARGIN: 0px 0px 0px 5px; = COLOR: #000000; PADDING-TOP: 4px } .casetabon B { PADDING-RIGHT: 10px; DISPLAY: block; PADDING-LEFT: 0px; FONT-WEIGHT: = bold; BACKGROUND: = url(http://images.medscape.com/pi/global/ornaments/bg_casenav_right_on.gi= f) no-repeat right top; PADDING-BOTTOM: 3px; MARGIN: 0px 0px 0px 5px; = COLOR: #000000; PADDING-TOP: 4px } .casetaboff { PADDING-RIGHT: 0px; PADDING-LEFT: 0px; FONT-SIZE: 13px; BACKGROUND: = url(http://images.medscape.com/pi/global/ornaments/bg_casenav_left.gif) = no-repeat left top; PADDING-BOTTOM: 0px; PADDING-TOP: 0px; = BORDER-BOTTOM: #b3b3b3 1px solid } .tabofflink { PADDING-RIGHT: 10px; DISPLAY: block; PADDING-LEFT: 0px; BACKGROUND: = url(http://images.medscape.com/pi/global/ornaments/bg_casenav_right_off.g= if) no-repeat right top; PADDING-BOTTOM: 3px; MARGIN: 0px 0px 0px 5px; = CURSOR: hand; COLOR: #105781; PADDING-TOP: 4px } .casetaboff A { PADDING-RIGHT: 10px; DISPLAY: block; PADDING-LEFT: 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Medscape physician members have an = opportunity to earn CME credits for Internet Point of Care (PoC) through = self directed learning on topics relevant to clinical care. Physicians = participate in a 3 step learning cycle to receive a half (0.5) AMA = PRA Category 1 credit.

The 3 steps include:

Search = Medscape: Identify a clinical question by entering a search term
Learn: Review information sources = (search results)
Complete Action Plan: Briefly document how you = will implement learning in clinical practice

These = activities will be recorded in your CME Tracker with the 3 step = documentation available in print format on your certificate and CME = Tracker.

CANCEL CONTINUE »

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The 3 steps include:

Search = Medscape: Identify a clinical question by entering a search term
Learn: Review information sources = (search results)
Complete Action Plan: Briefly document how you = will implement learning in clinical practice

These = activities will be recorded in your CME Tracker with the 3 step = documentation available in print format on your certificate and CME = Tracker.

CLOSE";=0A= incompletealert =3D "

Please note that in order to earn = AMA/PRA category 1 credit, you must first read at least one article from = your list of search results.

The 3 steps include:

Search = Medscape: Identify a clinical question by entering a search term
Learn: Review information sources = (search results)
Complete Action Plan: Briefly document how you = will implement learning in clinical practice

These = activities will be recorded in your CME Tracker with the 3 step = documentation available in print format on your certificate and CME = Tracker.

CLOSE";=0A= emptydiv =3D "

";=0A= if (idname =3D=3D "whatissearchcme") {=0A= changeDivcmesearch('cmesearchalert', searchalert);=0A= }else if (idname =3D=3D "incompletealert") {=0A= changeDivcmesearch('cmesearchalert', incompletealert); =0A= } else if (idname =3D=3D "clearsearchcmealert") {=0A= changeDivcmesearch('cmesearchalert', emptydiv);=0A= }=0A= }=0A= =0A= /* Invites Functions */=0A= function showinvite(state, layerid) {=0A= if (document.getElementById) {=0A= var contentlayer =3D document.getElementById(layerid);=0A= setElementClass(contentlayer, state);=0A= movelayers(layerid);=0A= }=0A= }=0A= function showwhatthis(state) {=0A= if (document.getElementById) {=0A= var contentlayer =3D document.getElementById("whatthisp");=0A= setElementClass(contentlayer, state);=0A= }=0A= }=0A= =0A= /* POM Ad functions */=0A= function playPOMswf() {=0A= var flashid =3D document.getElementById("flashcontent300x600s");=0A= setElementClass(flashid, 'inactive');=0A= var flashid2 =3D document.getElementById("flashcontent300x600");=0A= setElementClass(flashid2, 'active');=0A= PlayFlashMovie("POMFlashAd"); =0A= }=0A= function addjscript(onepx) {=0A= if (document.getElementById("hidden1x1")) {=0A= var onepx2 =3D document.getElementById("hidden1x1").value;=0A= var newDiv =3D document.createElement("div");=0A= newDiv.setAttribute("id", "1x1enlargepx");=0A= newDiv.innerHTML =3D " $3D\"\"$ ";=0A= if (document.getElementById("1x1enlargepx")) {=0A= addjscript2();=0A= }=0A= else {=0A= var my_div =3D document.getElementById("endofpomad");=0A= my_div.parentNode.insertBefore(newDiv, my_div);=0A= addjscript2();=0A= }=0A= }=0A= else {=0A= var newDiv =3D document.createElement("div");=0A= newDiv.setAttribute("id", "1x1enlargepx");=0A= newDiv.innerHTML =3D " $3D\"\"$ ";=0A= if (document.getElementById("1x1enlargepx")) {=0A= addjscript2();=0A= }=0A= else {=0A= var my_div =3D document.getElementById("endofpomad");=0A= my_div.parentNode.insertBefore(newDiv, my_div);=0A= addjscript2();=0A= }=0A= }=0A= }=0A= function addjscript2() {=0A= var flashid =3D document.getElementById("pomad");=0A= setElementClass(flashid, 'showmovie');=0A= movelayers("pomad");=0A= setTimeout("PlayFlashMovie('POMFlashLayer');",1);=0A= }=0A= function removePOMadlayer() {=0A= StopFlashMovie("POMFlashLayer");=0A= RewindFlashMovie("POMFlashAd");=0A= var flashid =3D document.getElementById("pomad");=0A= setElementClass(flashid, 'hidemovie');=0A= PlayFlashMovie("POMFlashAd");=0A= RewindFlashMovie("POMFlashLayer");=0A= }=0A= function removePOMadlayerstatic() {=0A= StopFlashMovie("POMFlashLayer");=0A= var flashid =3D document.getElementById("pomad");=0A= setElementClass(flashid, 'hidemovie');=0A= RewindFlashMovie("POMFlashLayer");=0A= }=0A= =0A= function StopFlashMovie(passmovieid)=0A= {=0A= var flashMovie=3DgetFlashMovieObject(passmovieid);=0A= flashMovie.StopPlay();=0A= }=0A= =0A= function PlayFlashMovie(passmovieid)=0A= {=0A= var flashMovie=3DgetFlashMovieObject(passmovieid);=0A= flashMovie.Play();=0A= //embed.nativeProperty.anotherNativeMethod();=0A= }=0A= =0A= function RewindFlashMovie(passmovieid)=0A= {=0A= var flashMovie=3DgetFlashMovieObject(passmovieid);=0A= flashMovie.Rewind();=0A= }=0A= =0A= function getFlashMovieObject(movieName)=0A= {=0A= if (window.document[movieName]) =0A= {=0A= return window.document[movieName];=0A= }=0A= if (navigator.appName.indexOf("Microsoft Internet")=3D=3D-1)=0A= {=0A= if (document.embeds && document.embeds[movieName])=0A= return document.embeds[movieName]; =0A= }=0A= else // if (navigator.appName.indexOf("Microsoft Internet")!=3D-1)=0A= {=0A= return document.getElementById(movieName);=0A= }=0A= }=0A= /* Functions for Scrolling Feature Widget */=0A= function autoscrollwidget(passfeatnum) {=0A= var listel =3D new Array();=0A= listel =3D = document.getElementById('featurewidgetcontent').getElementsByTagName('li'= );=0A= document.getElementById('featnuminput').value =3D passfeatnum;=0A= var featnum =3D document.getElementById('featnuminput').value;=0A= if (document.getElementById('loopinput').value < "2") {=0A= if (featnum =3D=3D "0") {=0A= setElementClass(listel[0], 'active');=0A= document.getElementById('featwidgetled1').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgeton.gif";=0A= setElementClass(listel[1], 'inactive');=0A= document.getElementById('featwidgetled2').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgetoff.gif";=0A= setElementClass(listel[2], 'inactive');=0A= document.getElementById('featwidgetled3').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgetoff.gif";=0A= timeset =3D setTimeout("autoscrollwidget(1)",3000);=0A= }=0A= else if (featnum =3D=3D "1") {=0A= setElementClass(listel[0], 'inactive');=0A= document.getElementById('featwidgetled1').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgetoff.gif";=0A= setElementClass(listel[1], 'active');=0A= document.getElementById('featwidgetled2').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgeton.gif";=0A= setElementClass(listel[2], 'inactive');=0A= document.getElementById('featwidgetled3').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgetoff.gif";=0A= timeset =3D setTimeout("autoscrollwidget(2)",3000);=0A= }=0A= else if (featnum =3D=3D "2") {=0A= setElementClass(listel[0], 'inactive');=0A= document.getElementById('featwidgetled1').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgetoff.gif";=0A= setElementClass(listel[1], 'inactive');=0A= document.getElementById('featwidgetled2').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgetoff.gif";=0A= setElementClass(listel[2], 'active');=0A= document.getElementById('featwidgetled3').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgeton.gif";=0A= var looptime =3D (document.getElementById('loopinput').value * 1) + 1;=0A= document.getElementById('loopinput').value =3D looptime;=0A= timeset =3D setTimeout("autoscrollwidget(0)",3000);=0A= }=0A= }=0A= else {=0A= scrollwidgetto0();=0A= }=0A= }=0A= function scrollwidgetfrw() {=0A= clearTimeout(timeset);=0A= var listel =3D new Array();=0A= listel =3D = document.getElementById('featurewidgetcontent').getElementsByTagName('li'= );=0A= var featnum =3D document.getElementById('featnuminput').value;=0A= if (featnum =3D=3D "0") {=0A= setElementClass(listel[0], 'inactive');=0A= document.getElementById('featwidgetled1').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgetoff.gif";=0A= setElementClass(listel[1], 'active');=0A= document.getElementById('featwidgetled2').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgeton.gif";=0A= setElementClass(listel[2], 'inactive');=0A= document.getElementById('featwidgetled3').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgetoff.gif";=0A= document.getElementById('featnuminput').value =3D "1";=0A= }=0A= else if (featnum =3D=3D "1") {=0A= setElementClass(listel[0], 'inactive');=0A= document.getElementById('featwidgetled1').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgetoff.gif";=0A= setElementClass(listel[1], 'inactive');=0A= document.getElementById('featwidgetled2').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgetoff.gif";=0A= setElementClass(listel[2], 'active');=0A= document.getElementById('featwidgetled3').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgeton.gif";=0A= document.getElementById('featnuminput').value =3D "2";=0A= }=0A= else if (featnum =3D=3D "2") {=0A= setElementClass(listel[0], 'active');=0A= document.getElementById('featwidgetled1').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgeton.gif";=0A= setElementClass(listel[1], 'inactive');=0A= document.getElementById('featwidgetled2').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgetoff.gif";=0A= setElementClass(listel[2], 'inactive');=0A= document.getElementById('featwidgetled3').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgetoff.gif";=0A= document.getElementById('featnuminput').value =3D "0";=0A= }=0A= }=0A= function scrollwidgetbck() {=0A= clearTimeout(timeset);=0A= var listel =3D new Array();=0A= listel =3D = document.getElementById('featurewidgetcontent').getElementsByTagName('li'= );=0A= var featnum =3D document.getElementById('featnuminput').value;=0A= if (featnum =3D=3D "0") {=0A= setElementClass(listel[0], 'inactive');=0A= document.getElementById('featwidgetled1').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgetoff.gif";=0A= setElementClass(listel[1], 'inactive');=0A= document.getElementById('featwidgetled2').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgetoff.gif";=0A= setElementClass(listel[2], 'active');=0A= document.getElementById('featwidgetled3').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgeton.gif";=0A= document.getElementById('featnuminput').value =3D "2";=0A= }=0A= else if (featnum =3D=3D "1") {=0A= setElementClass(listel[0], 'active');=0A= document.getElementById('featwidgetled1').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgeton.gif";=0A= setElementClass(listel[1], 'inactive');=0A= document.getElementById('featwidgetled2').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgetoff.gif";=0A= setElementClass(listel[2], 'inactive');=0A= document.getElementById('featwidgetled3').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgetoff.gif";=0A= document.getElementById('featnuminput').value =3D "0";=0A= }=0A= else if (featnum =3D=3D "2") {=0A= setElementClass(listel[0], 'inactive');=0A= document.getElementById('featwidgetled1').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgetoff.gif";=0A= setElementClass(listel[1], 'active');=0A= document.getElementById('featwidgetled2').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgeton.gif";=0A= setElementClass(listel[2], 'inactive');=0A= document.getElementById('featwidgetled3').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgetoff.gif";=0A= document.getElementById('featnuminput').value =3D "1";=0A= }=0A= }=0A= =0A= function scrollwidgetto0() {=0A= clearTimeout(timeset);=0A= var listel =3D new Array();=0A= listel =3D = document.getElementById('featurewidgetcontent').getElementsByTagName('li'= );=0A= setElementClass(listel[0], 'active');=0A= document.getElementById('featwidgetled1').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgeton.gif";=0A= setElementClass(listel[1], 'inactive');=0A= document.getElementById('featwidgetled2').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgetoff.gif";=0A= setElementClass(listel[2], 'inactive');=0A= document.getElementById('featwidgetled3').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgetoff.gif";=0A= document.getElementById('featnuminput').value =3D "0";=0A= }=0A= function scrollwidgetto1() {=0A= clearTimeout(timeset);=0A= var listel =3D new Array();=0A= listel =3D = document.getElementById('featurewidgetcontent').getElementsByTagName('li'= );=0A= setElementClass(listel[0], 'inactive');=0A= document.getElementById('featwidgetled1').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgetoff.gif";=0A= setElementClass(listel[1], 'active');=0A= document.getElementById('featwidgetled2').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgeton.gif";=0A= setElementClass(listel[2], 'inactive');=0A= document.getElementById('featwidgetled3').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgetoff.gif";=0A= document.getElementById('featnuminput').value =3D "1";=0A= }=0A= function scrollwidgetto2() {=0A= clearTimeout(timeset);=0A= var listel =3D new Array();=0A= listel =3D = document.getElementById('featurewidgetcontent').getElementsByTagName('li'= );=0A= setElementClass(listel[0], 'inactive');=0A= document.getElementById('featwidgetled1').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgetoff.gif";=0A= setElementClass(listel[1], 'inactive');=0A= document.getElementById('featwidgetled2').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgetoff.gif";=0A= setElementClass(listel[2], 'active');=0A= document.getElementById('featwidgetled3').src =3D = "http://images.medscape.com/pi/features/scrollbox/icon-widgeton.gif";=0A= document.getElementById('featnuminput').value =3D "2";=0A= }=0A= /* Utility Function For Showing Hidden Layer */=0A= function showcontent(state, layerid) {=0A= if (document.getElementById) {=0A= var contentlayer =3D document.getElementById(layerid);=0A= setElementClass(contentlayer, state);=0A= movelayers(layerid);=0A= }=0A= }=0A= /* Utility Function For Showing Hidden Layer */=0A= function invitereminder(state, layerid) {=0A= if (document.getElementById) {=0A= var contentlayer =3D document.getElementById(layerid);=0A= setElementClass(contentlayer, state);=0A= movelayers(layerid);=0A= }=0A= }=0A= =0A= /* Utility Function Move Layers */=0A= function movelayers(num)=0A= {=0A= if (window.innerHeight)=0A= {=0A= pos =3D window.pageYOffset=0A= }=0A= else if (document.documentElement && document.documentElement.scrollTop)=0A= {=0A= pos =3D document.documentElement.scrollTop=0A= }=0A= else if (document.body)=0A= {=0A= pos =3D document.body.scrollTop=0A= }=0A= =0A= if (pos < theTop)=0A= {=0A= pos =3D theTop;=0A= }=0A= else=0A= {=0A= pos +=3D 75;=0A= }=0A= =0A= if (pos =3D=3D old)=0A= {=0A= document.getElementById(num).style.top =3D (pos + 'px');=0A= 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application/octet-stream Content-Transfer-Encoding: quoted-printable Content-Location: http://www.medscape.com/files/scripts/hp-pulldown.js function goToUrl(myUrl)=0A= {=0A= if (myUrl!=3D"")=0A= {=0A= parent.location.href=3DmyUrl;=0A= }=0A= }=0A= ------=_NextPart_000_0079_01C903AE.1BF28040 Content-Type: application/octet-stream Content-Transfer-Encoding: quoted-printable Content-Location: http://www.medscape.com/files/scripts/popup.js function resizeWin(newLoc, newHeight, newWidth) {=0A= newWin =3D = open("",newLoc,"scrollbars=3Dyes,resizable=3Dyes,height=3D" + newHeight = + ",width=3D" + newWidth);=0A= }=0A= ------=_NextPart_000_0079_01C903AE.1BF28040 Content-Type: application/octet-stream Content-Transfer-Encoding: quoted-printable Content-Location: http://www.medscape.com/files/scripts/swfobject.js /**=0A= * SWFObject v1.4.4: Flash Player detection and embed - = http://blog.deconcept.com/swfobject/=0A= *=0A= * SWFObject is (c) 2006 Geoff Stearns and is released under the MIT = License:=0A= * http://www.opensource.org/licenses/mit-license.php=0A= *=0A= * **SWFObject is the SWF embed script formerly known as FlashObject. = The name was changed for=0A= * legal reasons.=0A= */=0A= if(typeof deconcept =3D=3D "undefined") var deconcept =3D new Object();=0A= if(typeof deconcept.util =3D=3D "undefined") deconcept.util =3D new = Object();=0A= if(typeof deconcept.SWFObjectUtil =3D=3D "undefined") = deconcept.SWFObjectUtil =3D new Object();=0A= deconcept.SWFObject =3D function(swf, id, w, h, ver, c, = useExpressInstall, quality, xiRedirectUrl, redirectUrl, detectKey){=0A= if (!document.getElementById) { return; }=0A= this.DETECT_KEY =3D detectKey ? detectKey : 'detectflash';=0A= this.skipDetect =3D deconcept.util.getRequestParameter(this.DETECT_KEY);=0A= this.params =3D new Object();=0A= this.variables =3D new Object();=0A= this.attributes =3D new Array();=0A= if(swf) { this.setAttribute('swf', swf); }=0A= if(id) { this.setAttribute('id', id); }=0A= if(w) { this.setAttribute('width', w); }=0A= if(h) { this.setAttribute('height', h); }=0A= if(ver) { this.setAttribute('version', new = deconcept.PlayerVersion(ver.toString().split("."))); }=0A= this.installedVer =3D deconcept.SWFObjectUtil.getPlayerVersion();=0A= if(c) { this.addParam('bgcolor', c); }=0A= var q =3D quality ? quality : 'high';=0A= this.addParam('quality', q);=0A= this.setAttribute('useExpressInstall', useExpressInstall);=0A= this.setAttribute('doExpressInstall', false);=0A= var xir =3D (xiRedirectUrl) ? xiRedirectUrl : window.location;=0A= this.setAttribute('xiRedirectUrl', xir);=0A= this.setAttribute('redirectUrl', '');=0A= if(redirectUrl) { this.setAttribute('redirectUrl', redirectUrl); }=0A= }=0A= deconcept.SWFObject.prototype =3D {=0A= setAttribute: function(name, value){=0A= this.attributes[name] =3D value;=0A= },=0A= getAttribute: function(name){=0A= return this.attributes[name];=0A= },=0A= addParam: function(name, value){=0A= this.params[name] =3D value;=0A= },=0A= getParams: function(){=0A= return this.params;=0A= },=0A= addVariable: function(name, value){=0A= this.variables[name] =3D value;=0A= },=0A= getVariable: function(name){=0A= return this.variables[name];=0A= },=0A= getVariables: function(){=0A= return this.variables;=0A= },=0A= getVariablePairs: function(){=0A= var variablePairs =3D new Array();=0A= var key;=0A= var variables =3D this.getVariables();=0A= for(key in variables){=0A= variablePairs.push(key +"=3D"+ variables[key]);=0A= }=0A= return variablePairs;=0A= },=0A= getSWFHTML: function() {=0A= var swfNode =3D "";=0A= if (navigator.plugins && navigator.mimeTypes && = navigator.mimeTypes.length) { // netscape plugin architecture=0A= if (this.getAttribute("doExpressInstall")) { = this.addVariable("MMplayerType", "PlugIn"); }=0A= swfNode =3D '

';=0A= } else { // PC IE=0A= if (this.getAttribute("doExpressInstall")) { = this.addVariable("MMplayerType", "ActiveX"); }=0A= swfNode =3D '

";=0A= }=0A= return swfNode;=0A= },=0A= write: function(elementId){=0A= if(this.getAttribute('useExpressInstall')) {=0A= // check to see if we need to do an express install=0A= var expressInstallReqVer =3D new deconcept.PlayerVersion([6,0,65]);=0A= if (this.installedVer.versionIsValid(expressInstallReqVer) && = !this.installedVer.versionIsValid(this.getAttribute('version'))) {=0A= this.setAttribute('doExpressInstall', true);=0A= this.addVariable("MMredirectURL", = escape(this.getAttribute('xiRedirectUrl')));=0A= document.title =3D document.title.slice(0, 47) + " - Flash Player = Installation";=0A= this.addVariable("MMdoctitle", document.title);=0A= }=0A= }=0A= if(this.skipDetect || this.getAttribute('doExpressInstall') || = this.installedVer.versionIsValid(this.getAttribute('version'))){=0A= var n =3D (typeof elementId =3D=3D 'string') ? = document.getElementById(elementId) : elementId;=0A= n.innerHTML =3D this.getSWFHTML();=0A= return true;=0A= }else{=0A= if(this.getAttribute('redirectUrl') !=3D "") {=0A= document.location.replace(this.getAttribute('redirectUrl'));=0A= }=0A= }=0A= return false;=0A= }=0A= }=0A= =0A= /* ---- detection functions ---- */=0A= deconcept.SWFObjectUtil.getPlayerVersion =3D function(){=0A= var PlayerVersion =3D new deconcept.PlayerVersion([0,0,0]);=0A= if(navigator.plugins && navigator.mimeTypes.length){=0A= var x =3D navigator.plugins["Shockwave Flash"];=0A= if(x && x.description) {=0A= PlayerVersion =3D new = deconcept.PlayerVersion(x.description.replace(/([a-zA-Z]|\s)+/, = "").replace(/(\s+r|\s+b[0-9]+)/, ".").split("."));=0A= }=0A= }else{=0A= // do minor version lookup in IE, but avoid fp6 crashing issues=0A= // see = http://blog.deconcept.com/2006/01/11/getvariable-setvariable-crash-intern= et-explorer-flash-6/=0A= try{=0A= var axo =3D new ActiveXObject("ShockwaveFlash.ShockwaveFlash.7");=0A= }catch(e){=0A= try {=0A= var axo =3D new ActiveXObject("ShockwaveFlash.ShockwaveFlash.6");=0A= PlayerVersion =3D new deconcept.PlayerVersion([6,0,21]);=0A= axo.AllowScriptAccess =3D "always"; // throws if player version < = 6.0.47 (thanks to Michael Williams @ Adobe for this code)=0A= } catch(e) {=0A= if (PlayerVersion.major =3D=3D 6) {=0A= return PlayerVersion;=0A= }=0A= }=0A= try {=0A= axo =3D new ActiveXObject("ShockwaveFlash.ShockwaveFlash");=0A= } catch(e) {}=0A= }=0A= if (axo !=3D null) {=0A= PlayerVersion =3D new = deconcept.PlayerVersion(axo.GetVariable("$version").split(" = ")[1].split(","));=0A= }=0A= }=0A= return PlayerVersion;=0A= }=0A= deconcept.PlayerVersion =3D function(arrVersion){=0A= this.major =3D arrVersion[0] !=3D null ? parseInt(arrVersion[0]) : 0;=0A= this.minor =3D arrVersion[1] !=3D null ? parseInt(arrVersion[1]) : 0;=0A= this.rev =3D arrVersion[2] !=3D null ? parseInt(arrVersion[2]) : 0;=0A= }=0A= deconcept.PlayerVersion.prototype.versionIsValid =3D function(fv){=0A= if(this.major < fv.major) return false;=0A= if(this.major > fv.major) return true;=0A= if(this.minor < fv.minor) return false;=0A= if(this.minor > fv.minor) return true;=0A= if(this.rev < fv.rev) return false;=0A= return true;=0A= }=0A= /* ---- get value of query string param ---- */=0A= deconcept.util =3D {=0A= getRequestParameter: function(param) {=0A= var q =3D document.location.search || document.location.hash;=0A= if(q) {=0A= var pairs =3D q.substring(1).split("&");=0A= for (var i=3D0; i < pairs.length; i++) {=0A= if (pairs[i].substring(0, pairs[i].indexOf("=3D")) =3D=3D param) {=0A= return pairs[i].substring((pairs[i].indexOf("=3D")+1));=0A= }=0A= }=0A= }=0A= return "";=0A= }=0A= }=0A= /* fix for video streaming bug */=0A= deconcept.SWFObjectUtil.cleanupSWFs =3D function() {=0A= if (window.opera || !document.all) return;=0A= var objects =3D document.getElementsByTagName("OBJECT");=0A= for (var i=3D0; i < objects.length; i++) {=0A= objects[i].style.display =3D 'none';=0A= for (var x in objects[i]) {=0A= if (typeof objects[i][x] =3D=3D 'function') {=0A= objects[i][x] =3D function(){};=0A= }=0A= }=0A= }=0A= }=0A= // fixes bug in fp9 see = http://blog.deconcept.com/2006/07/28/swfobject-143-released/=0A= deconcept.SWFObjectUtil.prepUnload =3D function() {=0A= __flash_unloadHandler =3D function(){};=0A= __flash_savedUnloadHandler =3D function(){};=0A= if (typeof window.onunload =3D=3D 'function') {=0A= var oldUnload =3D window.onunload;=0A= window.onunload =3D function() {=0A= deconcept.SWFObjectUtil.cleanupSWFs();=0A= oldUnload();=0A= }=0A= } else {=0A= window.onunload =3D deconcept.SWFObjectUtil.cleanupSWFs;=0A= }=0A= }=0A= if (typeof window.onbeforeunload =3D=3D 'function') {=0A= var oldBeforeUnload =3D window.onbeforeunload;=0A= window.onbeforeunload =3D function() {=0A= deconcept.SWFObjectUtil.prepUnload();=0A= oldBeforeUnload();=0A= }=0A= } else {=0A= window.onbeforeunload =3D deconcept.SWFObjectUtil.prepUnload;=0A= }=0A= /* add Array.push if needed (ie5) */=0A= if (Array.prototype.push =3D=3D null) { Array.prototype.push =3D = function(item) { this[this.length] =3D item; return this.length; }}=0A= =0A= /* add some aliases for ease of use/backwards compatibility */=0A= var getQueryParamValue =3D deconcept.util.getRequestParameter;=0A= var FlashObject =3D deconcept.SWFObject; // for legacy support=0A= var SWFObject =3D deconcept.SWFObject;=0A= ------=_NextPart_000_0079_01C903AE.1BF28040 Content-Type: application/octet-stream Content-Transfer-Encoding: quoted-printable Content-Location: http://as.medscape.com/js.ng/transactionid%3D1219308588290&site%3D1&pos%3D901&affiliate%3D1&pf%3D10&usp%3D60&ct%3Dmy&artid%3D577681&spon%3Dcme&ssp%3D34 document.write('');=0A= if ("html" =3D=3D "html"){ =0A= document.bgColor =3D 'transparent';=0A= }=0A= document.write('

\n'); ------=_NextPart_000_0079_01C903AE.1BF28040 Content-Type: application/octet-stream Content-Transfer-Encoding: quoted-printable Content-Location: http://www.medscape.com/files/scripts/articletools.js var theTop =3D 75;=0Dvar old =3D theTop;=0D=0Dwindow.onload =3D = function() {=0D hidearticletools();=0D hidecontent();=0D = hiddenlayers();=0D}=0D=0Dfunction hidearticletools()=0D{=0D if = (document.getElementById('emailtoolbox')) {=0D = document.getElementById('emailtoolbox').style.display =3D "none";=0D = }=0D if (document.getElementById('ratingtoolbox')) {=0D = document.getElementById('ratingtoolbox').style.display =3D "none";=0D = }=0D if (document.getElementById('emailconfirmation')) {=0D = document.getElementById('emailconfirmation').style.display =3D = "none";=0D }=0D if (document.getElementById('ratingthanks')) {=0D = document.getElementById('ratingthanks').style.display =3D "none";=0D = }=0D if (document.getElementById('ratingthanks2')) {=0D = document.getElementById('ratingthanks2').style.display =3D "none";=0D = }=0D if (document.getElementById('synonymskeywords')) {=0D = document.getElementById('synonymskeywords').style.display =3D "none";=0D = }=0D}=0D=0Dfunction hidecontent()=0D{=0D if = (document.getElementById('references')) {=0D = document.getElementById('references').style.display =3D "none";=0D = document.getElementById('references').style.top =3D '75px';=0D = document.getElementById('references').style.left =3D '150px';=0D = document.getElementById('references').style.position =3D "absolute";=0D = document.getElementById('references').style.zIndex =3D 500;=0D }=0D = if (document.getElementById('suggestedreading')) {=0D = document.getElementById('suggestedreading').style.display =3D "none";=0D = document.getElementById('suggestedreading').style.top =3D '75px';=0D = document.getElementById('suggestedreading').style.left =3D '150px';=0D = document.getElementById('suggestedreading').style.position =3D = "absolute";=0D = document.getElementById('suggestedreading').style.zIndex =3D 500; =0D = }=0D if (document.getElementById('relatedlinkswin')) {=0D = document.getElementById('relatedlinkswin').style.display =3D "none";=0D = document.getElementById('relatedlinkswin').style.top =3D '75px';=0D = document.getElementById('relatedlinkswin').style.left =3D '150px';=0D = document.getElementById('relatedlinkswin').style.position =3D = "absolute";=0D document.getElementById('relatedlinkswin').style.zIndex = =3D 500; =0D }=0D if (document.getElementById('cmeinformation')) = {=0D document.getElementById('cmeinformation').style.display =3D = "none";=0D document.getElementById('cmeinformation').style.top =3D = '75px';=0D document.getElementById('cmeinformation').style.left =3D = '150px';=0D document.getElementById('cmeinformation').style.position = =3D "absolute";=0D = document.getElementById('cmeinformation').style.zIndex =3D 500; =0D = }=0D if (document.getElementById('authordisclosures')) {=0D = document.getElementById('authordisclosures').style.display =3D = "none";=0D document.getElementById('authordisclosures').style.top =3D = '75px';=0D document.getElementById('authordisclosures').style.left =3D = '150px';=0D = document.getElementById('authordisclosures').style.position =3D = "absolute";=0D = document.getElementById('authordisclosures').style.zIndex =3D 500; = =0D }=0D}=0D=0Dfunction showcontent(tent) {=0D if = (document.getElementById(tent).style.display =3D=3D "none") {=0D = hidecontent();=0D document.getElementById(tent).style.display =3D = "block";=0D document.getElementById(tent).style.height =3D "auto";=0D = movelayers(tent);=0D } else {=0D = document.getElementById(tent).style.display =3D "none";=0D = }=0D}=0D=0Dfunction movecontent(tent)=0D{=0D if (window.innerHeight)=0D = {=0D pos =3D window.pageYOffset=0D }=0D else if = (document.documentElement && document.documentElement.scrollTop)=0D {=0D = pos =3D document.documentElement.scrollTop=0D }=0D else if = (document.body)=0D {=0D pos =3D document.body.scrollTop=0D }=0D =0D if = (pos < theTop)=0D {=0D pos =3D theTop;=0D }=0D else=0D {=0D pos = +=3D 75;=0D }=0D =0D if (pos =3D=3D old)=0D {=0D = document.getElementById(tent).style.top =3D (pos + 'px');=0D = document.getElementById(tent).style.left =3D '150px';=0D }=0D else=0D = {=0D old =3D pos;=0D movelayers(tent);=0D }=0D}=0D=0D=0Dfunction = hiddenlayers() {=0D var displaystr =3D null;=0D var stylestr =3D = null;=0D=0D for(n =3D1; n < 100; n++){=0D if(n <10)=0D displaystr =3D = 'hiddenlayer0' + n;=0D else=0D displaystr =3D 'hiddenlayer' + n;=0D = stylestr =3D document.getElementById(displaystr);=0D if(stylestr !=3D = null) {=0D stylestr.style.display =3D "none";=0D stylestr.style.top = =3D '75px';=0D stylestr.style.left =3D '150px';=0D = stylestr.style.position =3D "absolute";=0D stylestr.style.zIndex =3D = 500;=0D } =0D else=0D break;=0D }=0D}=0D=0Dfunction = showlayers(num) {=0D if (document.getElementById(num).style.display = =3D=3D "none") {=0D hiddenlayers();=0D = document.getElementById(num).style.display =3D "block";=0D = document.getElementById(num).style.height =3D "auto";=0D = movelayers(num);=0D } else {=0D = document.getElementById(num).style.display =3D "none";=0D = }=0D}=0D=0Dfunction movelayers(num)=0D{=0D if (window.innerHeight)=0D = {=0D pos =3D window.pageYOffset=0D }=0D else if = (document.documentElement && document.documentElement.scrollTop)=0D {=0D = pos =3D document.documentElement.scrollTop=0D }=0D else if = (document.body)=0D {=0D pos =3D document.body.scrollTop=0D }=0D =0D if = (pos < theTop)=0D {=0D pos =3D theTop;=0D }=0D else=0D {=0D pos = +=3D 75;=0D }=0D =0D if (pos =3D=3D old)=0D {=0D = document.getElementById(num).style.top =3D (pos + 'px');=0D = document.getElementById(num).style.left =3D '150px';=0D }=0D else=0D = {=0D old =3D pos;=0D movelayers(num);=0D }=0D}=0D=0Dfunction = showemailtoolbox()=0D{=0D if = (document.getElementById('emailtoolbox').style.display =3D=3D "none")=0D = {=0D document.getElementById('emailtoolbox').style.display =3D = "block";=0D if (document.getElementById('ratingtoolbox')) {=0D = document.getElementById('ratingtoolbox').style.display =3D "none";=0D = }=0D }=0D else=0D {=0D = document.getElementById('emailtoolbox').style.display =3D "none";=0D = }=0D =0D}=0D=0Dfunction confirmsent()=0D{=0D if = (document.getElementById('emailconfirmation').style.display =3D=3D = "none")=0D {=0D = document.getElementById('emailconfirmation').style.display =3D = "block";=0D document.getElementById('emailform').style.display =3D = "none";=0D return false;=0D }=0D}=0D=0Dfunction = showratingtoolbox()=0D{=0D if = (document.getElementById('ratingtoolbox').style.display =3D=3D = "none")=0D {=0D document.getElementById('ratingtoolbox').style.display = =3D "block";=0D if (document.getElementById('emailtoolbox')) {=0D = document.getElementById('emailtoolbox').style.display =3D "none";=0D = }=0D }=0D else=0D {=0D = document.getElementById('ratingtoolbox').style.display =3D "none";=0D = }=0D =0D}=0D=0D/* Multi Nav Btn */=0D=0Dfunction = togglearticlelist(state) {=0D if (document.getElementById) {=0D var = multiarticlebtn =3D document.getElementById("multiarticlebtn");=0D = multiarticlebtn.setAttribute("href", "#"); // get rid of the href=0D = var menu =3D = document.getElementById("multiarticlelist").firstChild;=0D// Make sure = the firstChild is an HTML tag and nothing else=0D while (menu.nodeType = !=3D 1) { //nodeType 1 is HTML element=0D menu =3D menu.nextSibling; = // assign next sibling instead=0D }=0D = setElementClass(multiarticlebtn, state);=0D setElementClass(menu, = state);=0D if (document.getElementById("searchType")) {=0D if (state = =3D=3D "active") { =0D = document.getElementById("searchType").style.visibility =3D "hidden";=0D = } else {=0D document.getElementById("searchType").style.visibility = =3D "visible";=0D }=0D }=0D }=0D}=0D=0Dfunction = getElementClass(element) {=0D if (element.getAttribute("class")) {=0D = return element.getAttribute("class");=0D } else if = (element.getAttribute("className")) {=0D return = element.getAttribute("className");=0D }=0D}=0D=0Dfunction = setElementClass(element, classValue) {=0D if = (element.setAttribute("class", classValue)) {=0D = element.setAttribute("class", classValue);=0D } else if = (element.setAttribute("className", classValue)) {=0D = element.setAttribute("className", classValue);=0D }=0D}=0D=0D=0D/* = Script For Rate Form 1 */=0Dfunction overstars1()=0D{=0D = document.getElementById('star1').style.backgroundPosition=3D'0px = -16px';=0D}=0Dfunction offstars1()=0D{=0D = document.getElementById('star1').style.backgroundPosition=3D'0px = 0px';=0D}=0D=0Dfunction overstars2()=0D{=0D = document.getElementById('star1').style.backgroundPosition=3D'0px = -16px';=0D = document.getElementById('star2').style.backgroundPosition=3D'0px = -16px';=0D}=0Dfunction offstars2()=0D{=0D = document.getElementById('star1').style.backgroundPosition=3D'0px = 0px';=0D = document.getElementById('star2').style.backgroundPosition=3D'0px = 0px';=0D}=0D=0Dfunction overstars3()=0D{=0D = document.getElementById('star1').style.backgroundPosition=3D'0px = -16px';=0D = document.getElementById('star2').style.backgroundPosition=3D'0px = -16px';=0D = document.getElementById('star3').style.backgroundPosition=3D'0px = -16px';=0D}=0Dfunction offstars3()=0D{=0D = document.getElementById('star1').style.backgroundPosition=3D'0px = 0px';=0D = document.getElementById('star2').style.backgroundPosition=3D'0px = 0px';=0D = document.getElementById('star3').style.backgroundPosition=3D'0px = 0px';=0D}=0D=0Dfunction overstars4()=0D{=0D = document.getElementById('star1').style.backgroundPosition=3D'0px = -16px';=0D = document.getElementById('star2').style.backgroundPosition=3D'0px = -16px';=0D = document.getElementById('star3').style.backgroundPosition=3D'0px = -16px';=0D = document.getElementById('star4').style.backgroundPosition=3D'0px = -16px';=0D}=0Dfunction offstars4()=0D{=0D = document.getElementById('star1').style.backgroundPosition=3D'0px = 0px';=0D = document.getElementById('star2').style.backgroundPosition=3D'0px = 0px';=0D = document.getElementById('star3').style.backgroundPosition=3D'0px = 0px';=0D = document.getElementById('star4').style.backgroundPosition=3D'0px = 0px';=0D}=0D=0Dfunction overstars5()=0D{=0D = document.getElementById('star1').style.backgroundPosition=3D'0px = -16px';=0D = document.getElementById('star2').style.backgroundPosition=3D'0px = -16px';=0D = document.getElementById('star3').style.backgroundPosition=3D'0px = -16px';=0D = document.getElementById('star4').style.backgroundPosition=3D'0px = -16px';=0D = document.getElementById('star5').style.backgroundPosition=3D'0px = -16px';=0D}=0Dfunction offstars5()=0D{=0D = document.getElementById('star1').style.backgroundPosition=3D'0px = 0px';=0D = document.getElementById('star2').style.backgroundPosition=3D'0px = 0px';=0D = document.getElementById('star3').style.backgroundPosition=3D'0px = 0px';=0D = document.getElementById('star4').style.backgroundPosition=3D'0px = 0px';=0D = document.getElementById('star5').style.backgroundPosition=3D'0px = 0px';=0D}=0D=0Dfunction ratingthankyou()=0D{=0D if = (document.getElementById('ratingthanks').style.display =3D=3D "none")=0D = {=0D document.getElementById('ratingthanks').style.display =3D = "inline";=0D document.getElementById('ratearticleform').style.display = =3D "none";=0D return false;=0D }=0D}=0D=0D/* Script For Rate Form 2 = */=0Dfunction overstars1two()=0D{=0D = document.getElementById('star1two').style.backgroundPosition=3D'0px = -16px';=0D}=0Dfunction offstars1two()=0D{=0D = document.getElementById('star1two').style.backgroundPosition=3D'0px = 0px';=0D}=0D=0Dfunction overstars2two()=0D{=0D = document.getElementById('star1two').style.backgroundPosition=3D'0px = -16px';=0D = document.getElementById('star2two').style.backgroundPosition=3D'0px = -16px';=0D}=0Dfunction offstars2two()=0D{=0D = document.getElementById('star1two').style.backgroundPosition=3D'0px = 0px';=0D = document.getElementById('star2two').style.backgroundPosition=3D'0px = 0px';=0D}=0D=0Dfunction overstars3two()=0D{=0D = document.getElementById('star1two').style.backgroundPosition=3D'0px = -16px';=0D = document.getElementById('star2two').style.backgroundPosition=3D'0px = -16px';=0D = document.getElementById('star3two').style.backgroundPosition=3D'0px = -16px';=0D}=0Dfunction offstars3two()=0D{=0D = document.getElementById('star1two').style.backgroundPosition=3D'0px = 0px';=0D = document.getElementById('star2two').style.backgroundPosition=3D'0px = 0px';=0D = document.getElementById('star3two').style.backgroundPosition=3D'0px = 0px';=0D}=0D=0Dfunction overstars4two()=0D{=0D = document.getElementById('star1two').style.backgroundPosition=3D'0px = -16px';=0D = document.getElementById('star2two').style.backgroundPosition=3D'0px = -16px';=0D = document.getElementById('star3two').style.backgroundPosition=3D'0px = -16px';=0D = document.getElementById('star4two').style.backgroundPosition=3D'0px = -16px';=0D}=0Dfunction offstars4two()=0D{=0D = document.getElementById('star1two').style.backgroundPosition=3D'0px = 0px';=0D = document.getElementById('star2two').style.backgroundPosition=3D'0px = 0px';=0D = document.getElementById('star3two').style.backgroundPosition=3D'0px = 0px';=0D = document.getElementById('star4two').style.backgroundPosition=3D'0px = 0px';=0D}=0D=0Dfunction overstars5two()=0D{=0D = document.getElementById('star1two').style.backgroundPosition=3D'0px = -16px';=0D = document.getElementById('star2two').style.backgroundPosition=3D'0px = -16px';=0D = document.getElementById('star3two').style.backgroundPosition=3D'0px = -16px';=0D = document.getElementById('star4two').style.backgroundPosition=3D'0px = -16px';=0D = 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+"harCode(256)).toUpperCase();s.em=3D(i=3D=3D'%C4%80'?2:(i=3D=3D'%U0100'?= 1:0))}" +"s.un=3Dun;s.uns();s.vl_l=3D'charSet,visitorNamespace,cookieDomainPeriod= " +"s,cookieLifetime,visitVariableProvider,pageName,pageURL,referrer,cu" +"rrencyCode,purchaseID';s.vl_t=3Ds.vl_l+',channel,server,pageType,camp" +"aign,state,zip,events,products,linkName,linkType';for(var n=3D1;n<51;" +"n++)s.vl_t+=3D',prop'+n+',eVar'+n+',hier'+n;s.vl_g=3Ds.vl_t+',trackDown= " +"loadLinks,trackExternalLinks,trackInlineStats,linkLeaveQueryString," +"linkDownloadFileTypes,linkExternalFilters,linkInternalFilters,linkN" +"ames';if(pg)s.gl(s.vl_g);if(!ss){s.wds();s.ca()}}", l=3Dwindow.s_c_il,n=3Dnavigator,u=3Dn.userAgent,v=3Dn.appVersion,e=3Dv.in= dexOf( 'MSIE = '),m=3Du.indexOf('Netscape6/'),a,i,s;if(l)for(i=3D0;i0){a=3DparseInt(i=3Dv.substring(e +5));if(a>3)a=3DparseFloat(i)}else = if(m>0)a=3DparseFloat(u.substring(m+10) );else a=3DparseFloat(v);if(a>=3D5&&v.indexOf('Opera')<0&&u.indexOf( 'Opera')<0){eval(c);return new s_c(un,pg,ss)}else s=3Ds_c2f(c);return s( un,pg,ss)} if (s_not_pageview=3D=3D"n") {var = s_code=3Ds_md.t();if(s_code)document.write(s_code);} ------=_NextPart_000_0079_01C903AE.1BF28040--