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2019

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Center Lift Trailer Support Structure, Carson Corle, Anthony M. Hayes, Bryan A. Truax Jan 2019

Center Lift Trailer Support Structure, Carson Corle, Anthony M. Hayes, Bryan A. Truax

Williams Honors College, Honors Research Projects

Center lift pontoon trailers have a high center of gravity, therefore have the potential for the pontoon and trailer to tip while cornering. There is need for a component to stabilize the pontoon on the trailer while towing. Different concepts of a support system were sketched to determine the best option. The characteristics that were deemed important for the support system were narrowed down to determine the best concept and the connections of the best design were sketched in greater detail. The forces that the support system would have to withstand to stabilize the pontoon on the trailer were calculated. …


Interlaminar Damage Detection In Composite Materials, Hariharan Rangarajan Jan 2019

Interlaminar Damage Detection In Composite Materials, Hariharan Rangarajan

Williams Honors College, Honors Research Projects

Using ceramic matrix composites (CMCs) for high-temperature applications in jet engines increases durability and reduces weight and cooling requirements resulting in improved efficiency and fuel savings. Understanding, detecting, and monitoring different types of damage is essential to achieve optimal performance of CMC components. The Direct Current Potential Drop (DCPD) method is a non-destructive technique of estimating damage in composite materials.

DCPD technique works by measuring nodal potential differences when current is flown through the material. Direct current spreading in different woven and laminate composites is modeled to follow a ladder resistor network in which the nodal voltages decrease exponentially as …


The Wrist Brace Project, Nathan Nicholas Jan 2019

The Wrist Brace Project, Nathan Nicholas

Williams Honors College, Honors Research Projects

This paper outlines the engineering design process of creating a specialized wrist brace for a local child. This project was completed by a team of senior Biomedical Engineering students.


Synthesis Of Drug Encapsulated Chitosan-Heparin Based Nanoparticles And Release Study, Trent Richwine Jan 2019

Synthesis Of Drug Encapsulated Chitosan-Heparin Based Nanoparticles And Release Study, Trent Richwine

Williams Honors College, Honors Research Projects

The main objective of this honor’s project is to encapsulate drugs with different molecular weights inside of chitosan-heparin based nanoparticles (Cs-Hep NPs). Three different drugs with low (NNC), medium (IFN-γ), and large (BSA) molecular weights were chosen in order to compare all types of drugs and how they react with the nanoparticles. Analysis of particle size, zeta potential, and a release study was performed. The release took place over a 168-hour time period and liquid samples were taken throughout. The hypothesis was that the molecular weight of the drug will correlate to the physical properties of the nanoparticles. The results …


Burnout Syndrome In Critical Care Nurses, Katie Burke, Kelly Claridge, Mallory Bidlen Jan 2019

Burnout Syndrome In Critical Care Nurses, Katie Burke, Kelly Claridge, Mallory Bidlen

Williams Honors College, Honors Research Projects

Burnout syndrome among nurses, especially within the critical care setting, has been a persistent and increasingly prevalent problem in the healthcare field. This systematic review aims to explore the common causes of burnout among nurses associated with working in a critical care setting. Twenty-five peer-reviewed articles, published between the years of 2000 and 2018, were selected for analysis and synthesis using the databases PubMed and CINAHL. The group included research studies conducted in the United States, Spain, France, China and Iran with sample sizes ranging from 42 to 2,392 intensive care unit (ICU) nurses. The articles included in this review …


Absorption Calculator: A Cross-Platform Application For Portable Data Analysis, Annmarie Kolbl Jan 2019

Absorption Calculator: A Cross-Platform Application For Portable Data Analysis, Annmarie Kolbl

Williams Honors College, Honors Research Projects

Traditional spectrometers are expensive and non-portable, making them inaccessible to the public. This application will be used in conjunction with spectrometer hardware developed by Erie Open Systems. The hardware itself is 3D printed and, in addition to being portable, enables data to be collected easily. The purpose of this project is to create a cross-platform application capable of reading the output from the spectrometer hardware, calculating the absorbance levels of the sample against the control, and recording the data in tables stored on the cloud. The end result will be an application that runs on iOS and Android, and is …


Volunteer Tool Kit, Lydia Brooks Jan 2019

Volunteer Tool Kit, Lydia Brooks

Williams Honors College, Honors Research Projects

The Williams Syndrome Association is a nonprofit organization that helps raise funds and awareness about Williams syndrome. Williams syndrome is a disorder that is not very well known and has a lot of unique challenges associated with it. Individuals with Williams syndrome have serious health concerns and tend to be extremely friendly, outgoing, and empathetic. The Williams Syndrome Association is dedicated to raising funds to aid research, creating awareness for the disorder, and providing support to families that are affected by the disorder. The association recruits volunteers to put on an annual Walk for Williams Syndrome in their area. These …


Systematic Review Of Sensory Integrations With Autism Spectrum Disorder, Cierra Simmons Jan 2019

Systematic Review Of Sensory Integrations With Autism Spectrum Disorder, Cierra Simmons

Williams Honors College, Honors Research Projects

Autism Spectrum Disorder is a developmental disorder that can affect communication and behavior. In children a sensory diet is utilized in order to address these issues. Research has been completed over the years looking into the effects of different sensory integrations on classroom behavior and participation. This is a comparison study of various integrations including, but not limited to, vestibular swinging, therapy balls, and therapy cushions. It is often up to an Occupational Therapist to create a sensory diet for each student on a caseload. The purpose of this study was to discover if there is one treatment that can …


#Blacklivesmatter: How A Hashtag Maintains A Movement: A Content Analysis Of The Black Lives Matter Hashtag On Twitter, Ashleigh Grimes Jan 2019

#Blacklivesmatter: How A Hashtag Maintains A Movement: A Content Analysis Of The Black Lives Matter Hashtag On Twitter, Ashleigh Grimes

Master's Theses and Doctoral Dissertations

American society is consumed by social media; thus, digital activism is becoming a prevalent way of advocating for and establishing social progress. The purpose of this study was to identify the frequency of engagement with the hashtag #BlackLivesMatter by Twitter users. The data collection consisted of tweets shared between the time frame of July 17, 2014, to August 17, 2014. The methodology used was content analysis, which included the examination of the volume of Twitter tweets collected from this time frame. This research adds to the impending design of a social movement structure that includes online social movements. The present …


Unravelling The D1r-D2r Heteromer, Margaret M. Champion Jan 2019

Unravelling The D1r-D2r Heteromer, Margaret M. Champion

Master's Theses and Doctoral Dissertations

Dopamine receptors D1R and D2R form a heterooligomeric complex with signaling properties distinct from the individual receptors. Aberrant expression of this protein-protein complex is linked to the etiology of various neuropsychiatric diseases. Formation of the D1R-D2R heteromer is thought to be dependent upon electrostatic interactions occurring between the carboxyl tail of D1R and the third intracellular loop of D2R. Using this interaction site as template, I synthesized several peptides designed to disrupt the minimal area of the D1R-D2R interaction interface and tested these using whole cell lysates of human brain tissue and dopamine receptor constructs. I report that a synthetic …


Examining The Interaction Of Academic Optimism, Enabling School Structures, Middle Level Practices, And Academic Achievement, Vikki Wandmacher Jan 2019

Examining The Interaction Of Academic Optimism, Enabling School Structures, Middle Level Practices, And Academic Achievement, Vikki Wandmacher

Master's Theses and Doctoral Dissertations

This study focused on young adolescent development, middle grades education, and the underlying supporting structures that assist students in achieving academically. Results were examined through the lens of Bandura’s social cognitive theory, and a big picture view of the interplay of beliefs, behavior, and environmental influences emerged. The study examined three ideas: (a) the level of academic optimism (AO), enabled school structure (ESS), middle level strategy implementation, and academic achievement; (b) how the implementation of middle level strategies and School to Watch (STW) status affected the level of AO, and ESS; and (c) how the factors of AO, ESS, STW …


“It’S Like A Big Freaking Fake Circus”: An Exploration Of Intersectionality And Women’S Experiences In Higher Education Fundraising, Daniel Mathis Spadafore Jan 2019

“It’S Like A Big Freaking Fake Circus”: An Exploration Of Intersectionality And Women’S Experiences In Higher Education Fundraising, Daniel Mathis Spadafore

Master's Theses and Doctoral Dissertations

Women in higher education fundraising navigate the broad forces of sexism and racism in society and their profession, a profession in which they are being paid less than their male counterparts and are under-represented in leadership roles, despite being the majority of fundraising professionals. This study provided a platform for women in higher education fundraising to tell their stories and to explain, in their own words, how they navigated a traditionally White patriarchal system of philanthropy, interacted with fundraising prospects and donors, and experienced the fundraising profession. The research questions included:

• What do women say are their lived experiences …


Concussion's Impact On Learning: The Need For Return-To-Learn Protocols For Hospital And School Collaboration, Anne E. Crylen Jan 2019

Concussion's Impact On Learning: The Need For Return-To-Learn Protocols For Hospital And School Collaboration, Anne E. Crylen

Master's Theses and Doctoral Dissertations

Over half million children with traumatic brain injuries (TBI) pass through United States emergency departments each year. While there is Return-to-Play legislation in all 50 states, in response to sports-related concussion, there are very few Return-to-Learn protocols in place in the nation’s public schools. Concussion is a mild form of TBI; the vast spectrum of TBI makes it a complex disability, which may involve intensive physical rehabilitation and cognitive therapy. The primary purpose of this qualitative case study was to examine the collaboration between educational and medical providers at one high school in Michigan to illuminate the process of school …


Compression Set Improvement Of Thermoplastic Vulcanizates For High Temperature Tubing, Mitchell Valaitis Jan 2019

Compression Set Improvement Of Thermoplastic Vulcanizates For High Temperature Tubing, Mitchell Valaitis

Williams Honors College, Honors Research Projects

It was hypothesized that increasing the curative level of the fluorocarbon rubber (FKM) used in manufacturing of thermoplastic vulcanizate (TPV) materials would decrease the compression set values of the TPV enough for it to be suitable as a flexible, lightweight alternative to high operating temperature thermoset rubber tubing currently being used for power steering hose. First, promising TPV formulations were identified by varying the polyamide (PA) and FKM used in a Brabender mixer. Four different types of polyamide and four different types of FKM were investigated, with two of the FKM types and one polyamide type identified as being promising. …


Assessment Of Sex-Related Differences Of The Osteocyte Lacunar-Canalicular Network Across The Human Lifespan Using Synchrotron Micro-Computed Tomography, Linda Muakkassa Jan 2019

Assessment Of Sex-Related Differences Of The Osteocyte Lacunar-Canalicular Network Across The Human Lifespan Using Synchrotron Micro-Computed Tomography, Linda Muakkassa

Williams Honors College, Honors Research Projects

Osteocytes, the most ubiquitous bone cell type, are responsible for bone maintenance and communication as well as mechanotransduction. Osteocytes reside in spaces within the bone matrix called lacunae, which are used as a proxy for the cells themselves in X-ray imaging. Previous studies have revealed that lacunar volume was reduced in females with increasing age, thus likely contributing to bone frailty and diseases such as osteoporosis. The implications of diseases caused by changes in the bone osteocyte lacunar-canalicular network are not yet fully understood. Since much of the past research revolved around gross bone morphology, this study investigated age and …


The Second Wind, Jacob Heiss, Logan Neidert Jan 2019

The Second Wind, Jacob Heiss, Logan Neidert

Williams Honors College, Honors Research Projects

The Second Wind device is a set of sensors and a data processing unit capable of recording data necessary to conduct a simplified version of a complex cardiopulmonary stress test (CPET). This data includes VO2, VCO2, ventilation, and pulse oximetry data. VO2 and VCO2 are the percent, by volume, of oxygen and carbon dioxide in the patient's breath, spirometry is the measure of air flow, and the pulse oximetry data includes heart rate (HR) and percent oxygen in the blood (SpO2). In addition, the device was designed to be portable, so this test could be run from patients’ homes or …


Signs Of Growth And Healing: Health Care And Science, Richard J. Fehring Jan 2019

Signs Of Growth And Healing: Health Care And Science, Richard J. Fehring

College of Nursing Faculty Research and Publications

MY ESSAY ON THE HISTORY OF Catholic Natural Family Planning (NFP) scientists (chapter 8 in this volume) ended with discussing scientists who were active during the papacy of John Paul II (1979-2005). This present essay continues with the time period from approximately 2000 to 2018 and, indeed, into the future. My purpose here, however, is to delineate signs of growth and healing in health care and science related to NFP and not to focus on individual NFP scientists. Given that purpose, recent trends in NFP science and historical factors that influence NFP science can provide us with signs of growth …


Restrictive Ventilatory Patterns In Residents Of Continuing Care Retirement Communities, Christine R. Kovach, Murad H. Taani, Crystal-Rae Waltons, Sheryl Kelber, Irwin Margolis Jan 2019

Restrictive Ventilatory Patterns In Residents Of Continuing Care Retirement Communities, Christine R. Kovach, Murad H. Taani, Crystal-Rae Waltons, Sheryl Kelber, Irwin Margolis

College of Nursing Faculty Research and Publications

Restrictive ventilatory patterns (RVPs) in older adults may contribute to morbidity and decreased quality of life. The purpose of this study was to begin to understand (a) the number of older adults residing in Continuing Care Retirement Communities with RVPs, (b) factors associated with RVP, and (c) whether RVP is associated with ambulation level. This descriptive study was conducted at three sites. RVP was evident in 34 of the 65 participants (52%), and 33 (97%) of these were either moderate or severely restricted. Dementia, dyspnea, kyphosis, and lower muscle strength were significant predictors of RVP. Eighty percent of the nonambulatory …


Effect Of Implementing Discharge Readiness Assessment In Adult Medical-Surgical Units On 30-Day Return To Hospital The Readi Randomized Clinical Trial, Marianne E. Weiss, Olga Yakusheva, Kathleen L. Bobay, Linda L. Costa, Ronda G. Hughes, Susan A. Nuccio, Morris Hamilton, Sarah J. Bahr, Danielle M. Siclovan, James Bang Jan 2019

Effect Of Implementing Discharge Readiness Assessment In Adult Medical-Surgical Units On 30-Day Return To Hospital The Readi Randomized Clinical Trial, Marianne E. Weiss, Olga Yakusheva, Kathleen L. Bobay, Linda L. Costa, Ronda G. Hughes, Susan A. Nuccio, Morris Hamilton, Sarah J. Bahr, Danielle M. Siclovan, James Bang

College of Nursing Faculty Research and Publications

Importance: The downward trend in readmissions has recently slowed. New enhancements to hospital readmission reduction efforts are needed. Structured assessment of patient readiness for discharge has been recommended as an addition to discharge preparation standards of care to assist with tailoring of risk-mitigating actions.

Objective: To determine the effect of unit-based implementation of readiness evaluation and discharge intervention protocols on readmissions and emergency department or observation visits.

Design, Setting, and Participants: The Readiness Evaluation and Discharge Interventions (READI) cluster randomized clinical trial conducted in medical-surgical units of 33 Magnet hospitals between September 15, 2014, and March 31, 2017, included all …


Integrating Research And Quality Improvement Using Teamstepps: A Health Team Communication Project To Improve Hospital Discharge, Joseph Beiler, Kristi Opper, Marianne E. Weiss Jan 2019

Integrating Research And Quality Improvement Using Teamstepps: A Health Team Communication Project To Improve Hospital Discharge, Joseph Beiler, Kristi Opper, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Purpose/Objectives:

The purpose of this article is to describe an innovative approach to the integration of quality improvement and research processes. A project with the objective of improving health team communication about hospital discharge provides an exemplar case.

Description of the Project/Program:

The TeamSTEPPS 10-step action planning guide provided the structure for planning, developing, and evaluating a redesign of interprofessional health team communication to improve hospital discharge led by 2 clinical nurse specialists. The redesign involved development of processes for team bedside rounding, registered nurse bedside shift reports, and briefing tools to support the rounding processes.

Outcome:

Using the TeamSTEPPS …


Effects Of Positive Thinking On Dementia Caregivers’ Burden And Care-Recipients’ Behavioral Problems, Abir K. Bekhet, Mauricio Garnier-Villarreal Jan 2019

Effects Of Positive Thinking On Dementia Caregivers’ Burden And Care-Recipients’ Behavioral Problems, Abir K. Bekhet, Mauricio Garnier-Villarreal

College of Nursing Faculty Research and Publications

Most dementia care is provided at home by family members. This caregiving places an additional burden on the family members, which can negatively impact their physical and psychological well-being. The caregivers’ burden can also contribute to behavioral problems in the care-recipients. The purpose of this study was to examine the mediating/moderating effects of positive thinking (PT) on the relationship between caregivers’ burden (embarrassment/anger, patient’s dependency, and self-criticism) and their care-recipients’ behavioral problems (memory, depression, and disruption) in a sample of 100 dementia caregivers. Results indicated that caregivers’ embarrassment, self-criticism, and perception of patient dependency predicts depression in care-recipients, and these …


Academic Experiences Of International Students At Eastern Michigan University, Denice Gravenstijn Jan 2019

Academic Experiences Of International Students At Eastern Michigan University, Denice Gravenstijn

Master's Theses and Doctoral Dissertations

International students who move to the United States to study can experience both positive and negative challenges during the process of achieving their educational goals at the higher educational institutions they are enrolled in. This study explored how academic experiences of international students from different racial/or ethnic groups may or may not differ from each other. For this qualitative study, fourteen international graduate students of diverse backgrounds enrolled in the Winter and/or Summer 2018 semesters at Eastern Michigan University (EMU) were interviewed. The results of this study show that there are differences as well as similarities in the academic experiences …


Response Shift After A 4-Week Multimodal Intervention For Chronic Ankle Instability, Cameron J. Powden, Matthew C. Hoch, Beth E. Jamali, Johanna M. Hoch Jan 2019

Response Shift After A 4-Week Multimodal Intervention For Chronic Ankle Instability, Cameron J. Powden, Matthew C. Hoch, Beth E. Jamali, Johanna M. Hoch

Rehabilitation Sciences Faculty Publications

Context The accurate evaluation of self-reported changes in function throughout the rehabilitation process is important for determining patient progression. Currently, how a response shift (RS) may affect the accuracy of self-reported functional assessment in a population with chronic ankle instability (CAI) is unknown.

Objective To examine the RS in individuals with CAI after a 4-week multimodal rehabilitation program.

Design Controlled laboratory study.

Setting Laboratory.

Patients or Other Participants Twenty adults (5 men, 15 women; age = 24.35 ± 6.95 years, height = 169.29 ± 10.10 cm, mass = 70.58 ± 12.90 kg) with self-reported CAI participated. Inclusion criteria were at …


The 20-M Shuttle Run: Assessment And Interpretation Of Data In Relation To Youth Aerobic Fitness And Health, Grant R. Tomkinson, Justin J. Lang, Joel Blanchard, Luc A. Léger, Mark S. Tremblay Jan 2019

The 20-M Shuttle Run: Assessment And Interpretation Of Data In Relation To Youth Aerobic Fitness And Health, Grant R. Tomkinson, Justin J. Lang, Joel Blanchard, Luc A. Léger, Mark S. Tremblay

Education, Health & Behavior Studies Faculty Publications

Cardiorespiratory fitness (CRF) is a good summative measure of the body’s ability to perform continuous, rhythmic, dynamic, large-muscle group physical activity, and exercise. In children, CRF is meaningfully associated with health, independent of physical activity levels, and it is an important determinant of sports and athletic performance. Although gas-analyzed peak oxygen uptake is the criterion physiological measure of children’s CRF, it is not practical for population-based testing. Field testing offers a simple, cheap, practical alternative to gas analysis. The 20-m shuttle run test (20mSRT)—a progressive aerobic exercise test involving continuous running between 2 lines 20 m apart in time to …


A 4-Week Multimodal Intervention For Individuals With Chronic Ankle Instability: Examination Of Disease-Oriented And Patient-Oriented Outcomes, Cameron J. Powden, Johanna M. Hoch, Beth E. Jamali, Matthew C. Hoch Jan 2019

A 4-Week Multimodal Intervention For Individuals With Chronic Ankle Instability: Examination Of Disease-Oriented And Patient-Oriented Outcomes, Cameron J. Powden, Johanna M. Hoch, Beth E. Jamali, Matthew C. Hoch

Rehabilitation Sciences Faculty Publications

Context Individuals with chronic ankle instability (CAI) experience disease- and patient-oriented impairments that contribute to both immediate and long-term health detriments. Investigators have demonstrated the ability of targeted interventions to improve these impairments. However, the combined effects of a multimodal intervention have not been evaluated for their effects on a multidimensional profile of health.

Objective To examine the effects of a 4-week rehabilitation program on disease- and patient-oriented impairments associated with CAI.

Design Controlled laboratory study.

Setting Laboratory.

Patients or Other Participants Twenty adults (5 males, 15 females; age = 24.35 ± 6.95 years, height = 169.29 ± 10.10 cm, …


Resting Cerebral Blood Flow After Exercise Training In Mild Cognitive Impairment, Alfonso J. Alfini, Lauren R. Weiss, Kristy A. Nielson, Matthew D. Verber, J. Carson Smith Jan 2019

Resting Cerebral Blood Flow After Exercise Training In Mild Cognitive Impairment, Alfonso J. Alfini, Lauren R. Weiss, Kristy A. Nielson, Matthew D. Verber, J. Carson Smith

Psychology Faculty Research and Publications

Background:

Exercise training has been associated with greater cerebral blood flow (CBF) in cognitively normal older adults (CN). Alterations in CBF, including compensatory perfusion in the prefrontal cortex, may facilitate changes to the brain’s neural infrastructure.

Objective:

To examine the effects of a 12-week aerobic exercise intervention on resting CBF and cognition in CN and those with mild cognitive impairment (MCI). We hypothesized individuals with MCI (vs. CN) would exhibit greater whole brain CBF at baseline and that exercise would mitigate these differences. We also expected CBF changes to parallel cognitive improvements.

Methods:

Before and after a 12-week exercise intervention, …


National Survey: Developing A Common Approach To Grading Of Practice In Pre-Registration Midwifery, Ml Fisher, Heather Bower, Samantha Chenery-Morris, Frances Galloway, Judith Jackson, Susan Way, M Fisher Jan 2019

National Survey: Developing A Common Approach To Grading Of Practice In Pre-Registration Midwifery, Ml Fisher, Heather Bower, Samantha Chenery-Morris, Frances Galloway, Judith Jackson, Susan Way, M Fisher

School of Nursing and Midwifery

This paper presents the final phase of a national project exploring grading of practice in programmes leading to registration as a midwife in the United Kingdom. The aim was to develop a generic framework for grading practice, enhancing standardisation while enabling flexibility in application of current and new educational standards. A mixed method on-line survey considered existing practice assessment tools, factors contributing to robust and reliable assessment and perceptions of two assessment tools developed by the research team: a ‘Lexicon Framework’ and ‘Rubric’, which were tested through scenarios. Participants included 170 midwifery and nursing academics, clinicians and students, representing 20 …


Professional Knowledges For Early Childhood Education And Care, Vjg Campbell Barr Jan 2019

Professional Knowledges For Early Childhood Education And Care, Vjg Campbell Barr

School of Law, Humanities and Social Sciences

This article proposes reconceptualizing professional knowledge in early childhood education and care (ECEC) as knowledges, incorporating phronesis (practical wisdom), techne (skill), and episteme (pure knowledge). Conceptualizing professional knowledge in the plural broadens perspectives on the professional knowledge base and opens up a discussion of how different forms of knowledge are acquired. Drawing on Bernstein, the author identifies ECEC as requiring horizontal and vertical constructs of knowledge that have different structures and legitimization processes. While phronesis is presented as being a part of ECEC professional knowledges, the discussion explores the difficulties in defining phronesis, because of the variable ways it is …


Evaluating The Acceptability Of Assistive Robots For Early Detection Of Mild Cognitive Impairment, Matteo Luperto, Marta Romeo, Francesca Lunardini, Nicola Basilico, Carlo Abbate, Ray Jones, Angelo Cangelosi, Simona Ferrante, N. Alberto Borghese Jan 2019

Evaluating The Acceptability Of Assistive Robots For Early Detection Of Mild Cognitive Impairment, Matteo Luperto, Marta Romeo, Francesca Lunardini, Nicola Basilico, Carlo Abbate, Ray Jones, Angelo Cangelosi, Simona Ferrante, N. Alberto Borghese

School of Nursing and Midwifery

No abstract provided.


Optimising Feedback For Early Career Professionals: A Scoping Review And New Framework, Karen Mattick, Nicola Brennan, Simon Briscoe, Chrysanthi Papoutsi, Mark Pearson Jan 2019

Optimising Feedback For Early Career Professionals: A Scoping Review And New Framework, Karen Mattick, Nicola Brennan, Simon Briscoe, Chrysanthi Papoutsi, Mark Pearson

Peninsula Medical School

No abstract provided.