Review of cases of nosocomial Lassa fever in Nigeria: the high price of poor medical practice.

OBJECTIVE
To analyze two hospital outbreaks of Lassa fever in southern central Nigeria.
METHODS
Hospitals and clinics in city and rural areas of Imo State, Nigeria.
METHODS
Medical data had been reviewed in hospitals and clinics in each areas. Sufferers with presumed and laboratory confirmed Lassa fever had been recognized and contracts traced. Hospital employees, sufferers, and native residents had been questioned, data had been fastidiously reviewed, and serum samples had been taken. Serum samples had been assayed for antibody particular to Lassa virus, and isolates of Lassa virus had been obtained.
RESULTS
Amongst 34 sufferers with Lassa fever, together with 20 sufferers, six nurses, two surgeons, one doctor, and the son of a affected person, there have been 22 deaths (65% fatality fee). Eleven circumstances had been laboratory confirmed, 5 by isolation of virus. Most sufferers had been uncovered in hospitals (assault fee in sufferers in a single hospital 55%). Each outbreak hospitals had been inadequately geared up and staffed, with poor medical follow. Compelling, oblique proof revealed that parenteral drug rounds with sharing of syringes, performed by minimally educated and supervised employees, fuelled the epidemic amongst sufferers. Workers had been subsequently contaminated throughout emergency surgical procedure and whereas caring for nosocomially contaminated sufferers.
CONCLUSIONS
This outbreak illustrates the excessive worth exacted by the follow of contemporary drugs, significantly use of parenteral injections and surgical procedure, with out due consideration to good medical follow. Excessive precedence should be given to training of medical employees in growing international locations and to pointers for secure operation of clinics and hospitals. Failure to take action could have far reaching, pricey, and in the end devastating penalties.

Mouse beta Thromboglobulin (CXCL7/bTG) CLIA Kit

20-abx491403
  • EUR 9567.60
  • EUR 5095.20
  • EUR 1177.20
  • 10 × 96 tests
  • 5 × 96 tests
  • 96 tests

NAP-2 Antibody / CXCL7

R31872 100 ug
EUR 356.15
Description: Chemokine (C-X-C motif) ligand 7 (CXCL7), also known as NAP-2 or Pro-Platelet basic protein (PPBP), is a human gene. The protein encoded by this gene is a platelet-derived growth factor that belongs to the CXC chemokine family. This growth factor is a potent chemoattractant and activator of neutrophils. It has been shown to stimulate various cellular processes including DNA synthesis, mitosis, glycolysis, intracellular cAMP accumulation, prostaglandin E2 secretion, and synthesis of hyaluronic acid and sulfated glycosaminoglycan. It also stimulates the formation and secretion of plasminogen activator by synovial cells. Furthermore, the protein is an antimicrobial protein with bactericidal and antifungal activity.

CXCL7/NAP-2

PR27118 2 ug
EUR 229.2

Mouse Pro-Platelet Basic Protein (CXCL7) ELISA Kit

IMSPPBPKT each
EUR 702
Description: Mouse Pro-Platelet Basic Protein (CXCL7) ELISA Kit

Human NAP2(CXCL7)

90222-A 2 µg
EUR 130
Description: Recombinant NAP-2 is a disulfide-linked monomeric protein consisting of 71 amino acid residues and migrates as an approximately 8 kDa protein under non-reducing conditions and reducing conditions in SDS-PAGE. Optimized DNA sequence encoding Human NAP-2 (CXCL7) mature chain was expressed in E. coli.

Human NAP2(CXCL7)

90222-B 10 µg
EUR 205
Description: Recombinant NAP-2 is a disulfide-linked monomeric protein consisting of 71 amino acid residues and migrates as an approximately 8 kDa protein under non-reducing conditions and reducing conditions in SDS-PAGE. Optimized DNA sequence encoding Human NAP-2 (CXCL7) mature chain was expressed in E. coli.

CXCL7 Recombinant Protein

91-045 0.05 mg
EUR 821.4
Description: Human Chemokine (C-X-C motif) Ligand 7 (CXCL7), also known as neutrophil activating peptide 2 (NAP-2), is a member of the CXC chemokines containing an ELR domain (Glu-Leu-Arg tripeptide motif). Similar to other ELR domain containing CXC chemokines, such as IL-8 and the GRO proteins, CXCL7 binds CXCR2, chemoattracts and activates neutrophils. CXCL7, Connective Tissue Activating Protein III (CTAPIII) and beta thrombogulin ( beta TG), are proteolytically processed carboxylterminal fragments of platelet basic protein (PBP) which is found in the alphagranules of human platelets. Although CTAPIII, beta TG, and PBP represent amino-terminal extended variants of NAP2 and possess the same CXC chemokine domains, these proteins do not exhibit CXCL7/NAP2 activity. CXCL7 induces cell migration through the G-protein-linked receptor CXCR-2.

CXCL7 Recombinant Protein

92-388 0.05 mg
EUR 437.1
Description: Human Chemokine (C-X-C motif) Ligand 7 (CXCL7), also known as neutrophil activating peptide 2 (NAP-2), is a member of the CXC chemokines containing an ELR domain (Glu-Leu-Arg tripeptide motif). Similar to other ELR domain containing CXC chemokines, such as IL-8 and the GRO proteins, CXCL7 binds CXCR2, chemoattracts and activates neutrophils. CXCL7, Connective Tissue Activating Protein III (CTAPIII) and beta thrombogulin ( beta TG), are proteolytically processed carboxylterminal fragments of platelet basic protein (PBP) which is found in the alphagranules of human platelets. Although CTAPIII, beta TG, and PBP represent amino-terminal extended variants of NAP2 and possess the same CXC chemokine domains, these proteins do not exhibit CXCL7/NAP2 activity. CXCL7 induces cell migration through the G-protein-linked receptor CXCR-2.

NAP-2 Antibody / CXCL7 / PPBP

RQ4113 100 ug
EUR 356.15
Description: Chemokine (C-X-C motif) ligand 7 (CXCL7), also known as NAP2 or Pro-Platelet basic protein (PPBP), is a human gene. The protein encoded by this gene is a platelet-derived growth factor that belongs to the CXC chemokine family. This growth factor is a potent chemoattractant and activator of neutrophils. It has been shown to stimulate various cellular processes including DNA synthesis, mitosis, glycolysis, intracellular cAMP accumulation, prostaglandin E2 secretion, and synthesis of hyaluronic acid and sulfated glycosaminoglycan. It also stimulates the formation and secretion of plasminogen activator by synovial cells. Furthermore, the protein is an antimicrobial protein with bactericidal and antifungal activity.

NAP-2/CXCL7, Rat

HY-P7269 50ug
EUR 639.6

NAP-2, CXCL7, rat

RC352-18 2ug
EUR 125.26

NAP-2/CXCL7, Human

HY-P7268 50ug
EUR 639.6

NAP-2, CXCL7, human

RC312-18 2ug
EUR 125.26

Human CXCL7 ELISA Kit

LF-EK50893 1×96T
EUR 777.6

CXCL7 ELISA KIT|Human

EF001450 96 Tests
EUR 826.8

ELISA kit for Mouse ?TG/PBP/CXCL7/NAP2 (Thromboglobulin, Beta)

E-EL-M1269 1 plate of 96 wells
EUR 640.8
Description: A sandwich ELISA kit for quantitative measurement of Mouse ?TG/PBP/CXCL7/NAP2 (Thromboglobulin, Beta) in samples from Serum, Plasma, Cell supernatant

Human CXCL7 Antibody (Biotin Conjugate)

32852-05121 150 ug
EUR 442.8

ELISA kit for Human CXCL7

EK5304 96 tests
EUR 663.6
Description: Enzyme-linked immunosorbent assay kit for quantification of Human CXCL7 in samples from serum, plasma, tissue homogenates and other biological fluids.

Recombinant Rat NAP-2/CXCL7

RECXP-0701 10ug Ask for price

Human CXCL7 AssayLite Antibody (RPE Conjugate)

32852-05151 150 ug
EUR 513.6

Human CXCL7 AssayLite Antibody (APC Conjugate)

32852-05161 150 ug
EUR 513.6

Human CXCL7 AssayMax ELISA Kit

EC2270-1 96 Well Plate
EUR 572.4

Human CXCL7 PicoKine ELISA Kit

EK0729 96 wells
EUR 510
Description: For quantitative detection of human CXCL7 in cell culture supernates, cell lysates, serum and plasma (heparin, EDTA).

Recombinant Human NAP-2 (CXCL7)

HECXP-0701 10ug Ask for price

Human CXCL7 AssayLite Antibody (FITC Conjugate)

32852-05141 150 ug
EUR 513.6

Human CXCL7 AssayLite Antibody (PerCP Conjugate)

32852-05171 150 ug
EUR 565.2

Neutrophil Activating Protein-2 (CXCL7) Antibody

20-abx137035
  • EUR 427.20
  • EUR 627.60
  • 0.5 mg
  • 1 mg

Nori® Canine CXCL7 ELISA Kit

GR115398 96-well
EUR 461

Nori Equine CXCL7/NAP2 ELISA Kit

GR106909 96-well
EUR 461

Rat PPBP/CXCL7 PicoKine ELISA Kit

EK0731 96 wells
EUR 510
Description: For Quantitative Detection of rat CXCL7 in cell culture supernates, serum and plasma (heparin, EDTA).

NAP-2/CXCL7 (CHO-expressed), Human

HY-P7267 50ug
EUR 596.4

Human Chemokine Ligand CXCL7 ELISA Kit

IHUCXCL7KT each
EUR 890
Description: Human Chemokine Ligand CXCL7 ELISA Kit

Recombinant Human CXCL7/NAP-2 Protein

RP00829 10 μg
EUR 265.2

ThymusChemokine‑1/CXCL7 (CHO-expressed), Rat

HY-P7301 10ug
EUR 349.2

Nori® Human CXCL7-NAP2 ELISA Kit

GR106282 96-well
EUR 461

Neutrophil Activating Protein-2 (CXCL7) Protein

20-abx261559
  • EUR 393.60
  • EUR 4101.60
  • EUR 276.00
  • 10 ug
  • 1 mg
  • 2 µg

Neutrophil Activating Protein-2 (CXCL7) Protein

20-abx261561
  • EUR 393.60
  • EUR 4101.60
  • EUR 276.00
  • 10 ug
  • 1 mg
  • 2 µg

Human CXCL7(Platelet basic protein) ELISA Kit

EH0007 96T
EUR 681.12
Description: Method of detection: Double Antibody, Sandwich ELISA;Reacts with: Homo sapiens;Sensitivity: 9.375pg/ml

Human CXCL7 EZ-Set™ ELISA Kit (DIY Antibody Pairs)

EZ0729 5 plates/kit
EUR 321.6
Description: For the development of sandwich ELISA kit to measure human CXCL7 in cell culture supernates, cell lysates, tissue homogenates, serum and plasma (heparin, EDTA).

Human CXCL7 Recombinant Protein Tag Free Lyophilized

IHUCXCL7RTFLY50UG each
EUR 988
Description: Human CXCL7 Recombinant Protein Tag Free Lyophilized

Recombinant Rat Neutrophil Activating Protein-2 (CXCL7)

7-02065 2µg Ask for price

Recombinant Rat Neutrophil Activating Protein-2 (CXCL7)

7-02066 10µg Ask for price

Recombinant Rat Neutrophil Activating Protein-2 (CXCL7)

7-02067 1mg Ask for price

Rabbit Anti Mouse Cxcl1 Polyclonal Antibody

CPBT-65100RM 0.1 mg
EUR 1057.2

Rat Platelet Basic Protein / CXCL7 (PPBP) ELISA Kit

abx255841-96tests 96 tests
EUR 801.6

Pig Platelet Basic Protein / CXCL7 (PPBP) ELISA Kit

abx511493-96tests 96 tests
EUR 1093.2

Recombinant Human Neutrophil Activating Protein-2 (CXCL7)

7-02059 2µg Ask for price

Recombinant Human Neutrophil Activating Protein-2 (CXCL7)

7-02060 10µg Ask for price

Recombinant Human Neutrophil Activating Protein-2 (CXCL7)

7-02061 1mg Ask for price

Human Neutrophil Activating Protein-2 (CXCL7), (Recombinant)

22060606-1 2 µg
EUR 146.42

Rat Pro-Platelet Basic Protein (CXCL7) ELISA Kit

IRTPPBPKT each
EUR 702
Description: Rat Pro-Platelet Basic Protein (CXCL7) ELISA Kit

Human Platelet Basic Protein / CXCL7 (PPBP) ELISA Kit

abx252283-96tests 96 tests
EUR 801.6

Neutrophil Activating Protein-2 (CXCL7), 95 a.a. Protein

20-abx260678
  • EUR 393.60
  • EUR 4101.60
  • EUR 276.00
  • 10 ug
  • 1 mg
  • 2 µg

Recombinant (E.Coli) Human Neutrophil Activating Protein-2 (CXCL7)

RP-1008 10 ug
EUR 343.2

Human Thromboglobulin, Beta (bTG/PBP/CXCL7/NAP2) CLIA Kit

abx197774-96tests 96 tests
EUR 990

Human CXCL7 Recombinant Protein C-6 His Tag Lyophilized

IHUCXCL7RC6HISLY50UG each
EUR 479
Description: Human CXCL7 Recombinant Protein C-6 His Tag Lyophilized

Mouse Anti-Human CXCL13 monoclonal antibody, clone JID662

CABT-L2832-100uL500uL 100 uL, 500 uL
EUR 602.4

PRICE: software program for the focused meeting of elements of (Meta) genomic sequence information.

  • Low-cost DNA sequencing applied sciences have expanded the position for direct nucleic acid sequencing within the evaluation of genomes, transcriptomes, and the metagenomes of complete ecosystems.

 

  • Human and machine comprehension of such giant datasets might be simplified by way of synthesis of sequence fragments into lengthy, contiguous blocks of sequence (contigs), however a lot of the progress within the discipline of meeting has centered on genomes in isolation quite than metagenomes.

 

  • Right here, we current software program for paired-read iterative contig extension (PRICE), a method for centered meeting of specific nucleic acid species utilizing advanced metagenomic information as enter.

Anti-CD11c/Integrin alpha X antibody

PAab01412 100 ug
EUR 426

Human Integrin Alpha X (ITGaX) Protein

20-abx166474
  • EUR 760.80
  • EUR 326.40
  • EUR 2281.20
  • EUR 895.20
  • EUR 543.60
  • 100 ug
  • 10 ug
  • 1 mg
  • 200 ug
  • 50 ug

Human Integrin alpha- X, ITGAX ELISA KIT

ELI-13625h 96 Tests
EUR 988.8

Integrin Alpha X (CD11c) Antibody

abx200116-100ug 100 ug
EUR 477.6

Integrin Alpha X (CD11c) Antibody

20-abx200679
  • EUR 309.60
  • EUR 410.40
  • 100 ug
  • 500 ug

Integrin Alpha X (ITGaX) Antibody

20-abx104960
  • EUR 493.20
  • EUR 159.60
  • EUR 1378.80
  • EUR 678.00
  • EUR 376.80
  • 100 ug
  • 10 ug
  • 1 mg
  • 200 ug
  • 50 ug

Integrin Alpha X (CD11c) Antibody

abx216334-100ug 100 ug
EUR 526.8

Integrin Alpha X (CD11c) Antibody

abx139631-01mg 0.1 mg
EUR 444

Integrin Alpha X (ITGAX) Antibody

20-abx322638
  • EUR 526.80
  • EUR 393.60
  • 100 ul
  • 50 ul

Integrin Alpha X (CD11c) Antibody

abx411892-50ug 50 ug
EUR 811.2

Integrin Alpha X (ITGAX) Antibody

abx330439-100ul 100 ul
EUR 510

Integrin Alpha X (ITGAX) Antibody

20-abx113189
  • EUR 878.40
  • EUR 477.60
  • 150 ul
  • 50 ul

Integrin Alpha X (ITGAX) Antibody

abx033098-400ul 400 ul
EUR 627.6

Integrin Alpha X (ITGAX) Antibody

abx033098-80l 80 µl
EUR 343.2

Integrin Alpha X (ITGaX) Antibody

20-abx129411
  • EUR 510.00
  • EUR 159.60
  • EUR 1412.40
  • EUR 693.60
  • EUR 393.60
  • 100 ug
  • 10 ug
  • 1 mg
  • 200 ug
  • 50 ug

Integrin Alpha X (ITGAX) Antibody

20-abx124171
  • EUR 493.20
  • EUR 710.40
  • EUR 218.40
  • EUR 376.80
  • 100 ul
  • 200 ul
  • 20 ul
  • 50 ul

Integrin Alpha X (ITGAX) Antibody

20-abx339188
  • EUR 493.20
  • EUR 360.00
  • 100 ul
  • 50 ul

Integrin Alpha X (ITGAX) Antibody

20-abx339189
  • EUR 493.20
  • EUR 360.00
  • 100 ul
  • 50 ul

Integrin Alpha X (CD11c) Antibody

abx413008-01mg 0.1 mg
EUR 526.8

Integrin Alpha X (CD11c) Antibody

abx413011-25ug 25 ug
EUR 326.4

Integrin Alpha X (CD11c) Antibody

abx413356-2ml 2 ml
EUR 727.2

Integrin Alpha X (CD11c) Antibody

abx413688-02mg 0.2 mg
EUR 678

Integrin Alpha X (CD11c) Antibody

abx413691-01mg 0.1 mg
EUR 526.8

Integrin Alpha X (CD11c) Antibody

abx413694-25ug 25 ug
EUR 326.4

Integrin Alpha X (CD11c) Antibody

abx415362-01mg 0.1 mg
EUR 543.6

Integrin Alpha X (CD11c) Antibody

abx414593-01mg 0.1 mg
EUR 910.8

Integrin Alpha X (CD11c) Antibody

abx413004-025mg 0.25 mg
EUR 678

Integrin Alpha X (ITGaX) Polyclonal Antibody (Human)

4-PAB159Hu01
  • EUR 286.80
  • EUR 2869.20
  • EUR 717.60
  • EUR 358.80
  • EUR 253.20
  • 100ul
  • 10ml
  • 1ml
  • 200ul
  • 20ul
Description: A Rabbit polyclonal antibody against Human Integrin Alpha X (ITGaX)

CD11c/Integrin alpha X ELISA KIT|Human

EF008489 96 Tests
EUR 826.8

Alpha V Beta 5 Integrin, Peptide Aptamer, unlabeled

AP-301-U 5 mg Ask for price

Alpha V Beta 5 Integrin, Peptide Aptamer, Biotinylated

AP-301-B 1 mg Ask for price

Alpha V Beta 5 Integrin, Peptide Aptamer, FITC labelled

AP-301-F 1 mg Ask for price

Mouse Integrin alpha-X (Itgax)

1-CSB-BP874106MO1
  • EUR 1008.00
  • EUR 398.40
  • EUR 2604.00
  • EUR 1362.00
  • EUR 1894.80
  • EUR 564.00
  • 100ug
  • 10ug
  • 1MG
  • 200ug
  • 500ug
  • 50ug
Description: Recombinant Mouse Integrin alpha-X(Itgax),partial expressed in Baculovirus

Integrin Alpha X (ITGaX) Polyclonal Antibody (Human), PE

4-PAB159Hu01-PE
  • EUR 344.40
  • EUR 3012.00
  • EUR 860.40
  • EUR 430.80
  • EUR 230.40
  • 100ul
  • 10ml
  • 1ml
  • 200ul
  • 20ul
Description: A Rabbit polyclonal antibody against Human Integrin Alpha X (ITGaX). This antibody is labeled with PE.

Integrin Alpha X (CD11c) Antibody (PE)

abx200118-100tests 100 tests
EUR 794.4

Integrin Alpha X (CD11c) Antibody (PE)

20-abx200676
  • EUR 326.40
  • EUR 276.00
  • 100 ug
  • 25 ug

Integrin Alpha X (CD11c) Antibody (PE)

abx139633-100tests 100 tests
EUR 577.2

Integrin Alpha X (ITGaX) Polyclonal Antibody (Human), APC

4-PAB159Hu01-APC
  • EUR 399.60
  • EUR 3735.60
  • EUR 1046.40
  • EUR 507.60
  • EUR 258.00
  • 100ul
  • 10ml
  • 1ml
  • 200ul
  • 20ul
Description: A Rabbit polyclonal antibody against Human Integrin Alpha X (ITGaX). This antibody is labeled with APC.

Integrin Alpha X (ITGaX) Polyclonal Antibody (Human), Cy3

4-PAB159Hu01-Cy3
  • EUR 483.60
  • EUR 4930.80
  • EUR 1345.20
  • EUR 627.60
  • EUR 294.00
  • 100ul
  • 10ml
  • 1ml
  • 200ul
  • 20ul
Description: A Rabbit polyclonal antibody against Human Integrin Alpha X (ITGaX). This antibody is labeled with Cy3.

Integrin Alpha X (ITGaX) Polyclonal Antibody (Human), HRP

4-PAB159Hu01-HRP
  • EUR 366.00
  • EUR 3256.80
  • EUR 926.40
  • EUR 459.60
  • EUR 243.60
  • 100ul
  • 10ml
  • 1ml
  • 200ul
  • 20ul
Description: A Rabbit polyclonal antibody against Human Integrin Alpha X (ITGaX). This antibody is labeled with HRP.

Human Integrin Alpha X / CD11C (ITGAX) ELISA Kit

abx259467-96tests 96 tests
EUR 1093.2

Integrin Alpha X (CD11c) Antibody (APC)

abx200119-100tests 100 tests
EUR 1178.4

Integrin Alpha X (CD11c) Antibody (APC)

20-abx200672
  • EUR 376.80
  • EUR 260.40
  • 100 ug
  • 25 ug

Integrin Alpha X (CD11c) Antibody (APC)

abx139634-100tests 100 tests
EUR 577.2

Integrin Alpha X (CD11c) Antibody (RPE)

abx413009-100tests 100 tests
EUR 710.4

Integrin Alpha X (CD11c) Antibody (RPE)

abx413010-25tests 25 tests
EUR 376.8

Integrin Alpha X (CD11c) Antibody (RPE)

abx413692-100tests 100 tests
EUR 710.4

Integrin Alpha X (CD11c) Antibody (RPE)

abx413693-25tests025ml 25 tests (0.25 ml)
EUR 376.8

Integrin Alpha X (ITGaX) Polyclonal Antibody (Human), FITC

4-PAB159Hu01-FITC
  • EUR 344.40
  • EUR 3012.00
  • EUR 860.40
  • EUR 430.80
  • EUR 230.40
  • 100ul
  • 10ml
  • 1ml
  • 200ul
  • 20ul
Description: A Rabbit polyclonal antibody against Human Integrin Alpha X (ITGaX). This antibody is labeled with FITC.

Integrin Alpha X (CD11c) Antibody (FITC)

abx200117-100tests 100 tests
EUR 477.6

Integrin Alpha X (CD11c) Antibody (FITC)

20-abx200675
  • EUR 343.20
  • EUR 276.00
  • EUR 376.80
  • 100 ug
  • 25 ug
  • 500 ug

Integrin Alpha X (CD11c) Antibody (FITC)

abx139635-100tests 100 tests
EUR 510

Integrin Alpha X (CD11c) Antibody (FITC)

abx413007-01mg 0.1 mg
EUR 610.8

Integrin Alpha X (CD11c) Antibody (FITC)

abx413689-01mg 0.1 mg
EUR 610.8
  • We describe the meeting technique applied by PRICE and supply examples of its utility to the sequence of specific genes, transcripts, and virus genomes from advanced multicomponent datasets, together with an meeting of the BCBL-1 pressure of Kaposi’s sarcoma-associated herpesvirus. PRICE is open-source and obtainable without spending a dime obtain.

 

Taxes and subsidies are more and more being thought of as potential coverage devices to incentivize shoppers to enhance their meals and beverage consumption patterns and associated well being outcomes. This examine supplied a scientific overview of current U.S. research on the worth elasticity of demand for sugar-sweetened drinks (SSBs), quick meals, and fruit and veggies, in addition to the direct associations of costs/taxes with physique weight outcomes. Primarily based on the current literature, the worth elasticity of demand for SSBs, quick meals, fruit and veggies was estimated to be -1.21, -0.52, -0.49 and -0.48, respectively.

 

The research that linked soda taxes to weight outcomes confirmed minimal impacts on weight; nevertheless, they had been primarily based on current state-level gross sales taxes that had been comparatively low. Greater fast-food costs had been related to decrease weight outcomes significantly amongst adolescents, suggesting that elevating costs would probably affect weight outcomes.

 

Decrease fruit and vegetable costs had been usually discovered to be related to decrease physique weight outcomes amongst each low-income kids and adults, suggesting that subsidies that would scale back the price of fruit and veggies for lower-socioeconomic populations could also be efficient in lowering weight problems. Pricing devices ought to proceed to be thought of and evaluated as potential coverage devices to deal with public well being dangers.