Digital Commons Network^™

Mousebytes, An Open-Access High-Throughput Pipeline And Database For Rodent Touchscreen-Based Cognitive Assessment, Flavio H. Beraldo, Daniel Palmer, Sara Memar, David I. Wasserman, Wai Jane V. Lee, Shuai Liang, Samantha D. Creighton, Benjamin Kolisnyk, Matthew F. Cowan, Justin Mels, Talal S. Masood, Chris Fodor, Mohammed A. Al-Onaizi, Robert Bartha, Tom Gee, Lisa M. Saksida, Timothy J. Bussey, Stephen S. Strother, Vania F. Prado, Boyer D. Winters, Marco A.M. Prado

Medical Biophysics Publications

© 2019, eLife Sciences Publications Ltd. All rights reserved. Open Science has changed research by making data accessible and shareable, contributing to replicability to accelerate and disseminate knowledge. However, for rodent cognitive studies the availability of tools to share and disseminate data is scarce. Automated touchscreen-based tests enable systematic cognitive assessment with easily standardised outputs that can facilitate data dissemination. Here we present an integration of touchscreen cognitive testing with an open-access database public repository (mousebytes.ca), as well as a Web platform for knowledge dissemination (https://touchscreencognition.org). We complement these resources with the largest dataset of age-dependent high-level cognitive assessment of …

Genome-Wide Association Analysis Of Hippocampal Volume Identifies Enrichment Of Neurogenesis-Related Pathways, Emrin Horgusluoglu-Moloch, Shannon L. Risacher, Paul K. Crane, Derrek Hibar, Paul M. Thompson, Andrew J. Saykin, Kwangsik Nho, Michael W. Weiner, Paul Aisen, Ronald Petersen, Clifford R. Jack, William Jagust, John Q. Trojanowki, Arthur W. Toga, Laurel Beckett, Robert C. Green, John Morris, Leslie M. Shaw, Jeffrey Kaye, Joseph Quinn, Lisa Silbert, Betty Lind, Raina Carter, Sara Dolen, Lon S. Schneider, Sonia Pawluczyk, Mauricio Beccera, Liberty Teodoro, Bryan M. Spann, James Brewer, Helen Vanderswag, Adam Fleisher

Medical Biophysics Publications

© 2019, The Author(s). Adult neurogenesis occurs in the dentate gyrus of the hippocampus during adulthood and contributes to sustaining the hippocampal formation. To investigate whether neurogenesis-related pathways are associated with hippocampal volume, we performed gene-set enrichment analysis using summary statistics from a large-scale genome-wide association study (N = 13,163) of hippocampal volume from the Enhancing Neuro Imaging Genetics through Meta-Analysis (ENIGMA) Consortium and two year hippocampal volume changes from baseline in cognitively normal individuals from Alzheimer’s Disease Neuroimaging Initiative Cohort (ADNI). Gene-set enrichment analysis of hippocampal volume identified 44 significantly enriched biological pathways (FDR corrected p-value < 0.05), of which 38 pathways were related to neurogenesis-related processes including neurogenesis, generation of new neurons, neuronal development, and neuronal migration and differentiation. For genes highly represented in the significantly enriched neurogenesis-related pathways, gene-based association analysis identified TESC, ACVR1, MSRB3, and DPP4 as significantly associated with hippocampal volume. Furthermore, co-expression network-based functional analysis of gene expression data in the hippocampal subfields, CA1 and CA3, from 32 normal controls showed that distinct co-expression modules were mostly enriched in neurogenesis related pathways. Our results suggest that neurogenesis-related pathways may be enriched for hippocampal volume and that hippocampal volume may serve as a potential phenotype for the investigation of human adult neurogenesis.

The Bin1 Rs744373 Snp Is Associated With Increased Tau-Pet Levels And Impaired Memory, Nicolai Franzmeier, Anna Rubinski, Julia Neitzel, Michael Ewers, Michael W. Weiner, Paul Aisen, Ronald Petersen, Clifford R. Jack, William Jagust, John Q. Trojanowski, Arthur W. Toga, Laurel Beckett, Robert C. Green, Andrew J. Saykin, John Morris, Leslie M. Shaw, Zaven Khachaturian, Greg Sorensen, Lew Kuller, Marcus Raichle, Steven Paul, Peter Davies, Howard Fillit, Franz Hefti, David Holtzman, Marek M. Mesulam, William Potter, Peter Snyder, Adam Schwartz, Tom Montine, Ronald G. Thomas, Michael Donohue

Medical Biophysics Publications

© 2019, The Author(s). The single nucleotide polymorphism (SNP) rs744373 in the bridging integrator-1 gene (BIN1) is a risk factor for Alzheimer’s disease (AD). In the brain, BIN1 is involved in endocytosis and sustaining cytoskeleton integrity. Post-mortem and in vitro studies suggest that BIN1-associated AD risk is mediated by increased tau pathology but whether rs744373 is associated with increased tau pathology in vivo is unknown. Here we find in 89 older individuals without dementia, that BIN1 rs744373 risk-allele carriers show higher AV1451 tau-PET across brain regions corresponding to Braak stages II–VI. In contrast, the BIN1 rs744373 SNP was not associated …

Multimodal Hippocampal Subfield Grading For Alzheimer’S Disease Classification, Kilian Hett, Vinh Thong Ta, Gwenaëlle Catheline, Thomas Tourdias, José V. Manjón, Pierrick Coupé, Michael W. Weiner, Paul Aisen, Ronald Petersen, Clifford R. Jack, William Jagust, John Q. Trojanowki, Arthur W. Toga, Laurel Beckett, Robert C. Green, Andrew J. Saykin, John Morris, Leslie M. Shaw, Zaven Khachaturian, Greg Sorensen, Maria Carrillo, Lew Kuller, Marc Raichle, Steven Paul, Peter Davies, Howard Fillit, Franz Hefti, Davie Holtzman, M. Marcel Mesulam, William Potter, Peter Snyder, Tom Montine

Medical Biophysics Publications

© 2019, The Author(s). Numerous studies have proposed biomarkers based on magnetic resonance imaging (MRI) to detect and predict the risk of evolution toward Alzheimer’s disease (AD). Most of these methods have focused on the hippocampus, which is known to be one of the earliest structures impacted by the disease. To date, patch-based grading approaches provide among the best biomarkers based on the hippocampus. However, this structure is complex and is divided into different subfields, not equally impacted by AD. Former in-vivo imaging studies mainly investigated structural alterations of these subfields using volumetric measurements and microstructural modifications with mean diffusivity …

3d Vessel-Wall Virtual Histology Of Whole-Body Perfused Mice Using A Novel Heavy Element Stain, P. Joy Dunmore-Buyze, Charmainne Cruje, Zengxuan Nong, Jason J. Lee, John A. Kiernan, J. Geoffrey Pickering, Maria Drangova

Medical Biophysics Publications

Virtual histology – utilizing high-resolution three-dimensional imaging – is becoming readily available. Micro-computed tomography (micro-CT) is widely available and is often coupled with x-ray attenuating histological stains that mark specific tissue components for 3D virtual histology. In this study we describe a new tri-element x-ray attenuating stain and perfusion protocol that provides micro-CT contrast of the entire vasculature of an intact mouse. The stain – derived from an established histology stain (Verhoeff’s) – is modified to enable perfusion through the vasculature; the attenuating elements of the stain are iodine, aluminum, and iron. After a 30-minute perfusion through the vasculature (10-minute …

Are Specific Learning Disorders Truly Specific, And Are They Disorders?, Lien Peters, Daniel Ansari

Brain and Mind Institute Researchers' Publications

© 2019 The Authors Specific learning disorders, such as dyslexia and dyscalculia, are frequently studied to inform our understanding of cognitive development, genetic mechanisms and brain function. In this Opinion Paper, we discuss limitations of this research approach, including the use of arbitrary criteria to select groups of children, heterogeneity within groups and overlap between domains of learning. By drawing on evidence from cognitive science, neuroscience and genetics, we propose an alternative, dimensional framework. We argue that we need to overcome the problems associated with a categorical approach by taking into account interacting factors at multiple levels of analysis that …

Altered Motor, Anxiety-Related And Attentional Task Performance At Baseline Associate With Multiple Gene Copies Of The Vesicular Acetylcholine Transporter And Related Protein Overexpression In Chat::Cre+ Rats, Craig P. Mantanona, Johan Alsiö, Joanna L. Elson, Beth M. Fisher, Jeffrey W. Dalley, Timothy Bussey, Ilse S. Pienaar

Brain and Mind Institute Researchers' Publications

© 2019, The Author(s). Transgenic rodents expressing Cre recombinase cell specifically are used for exploring mechanisms regulating behavior, including those mediated by cholinergic signaling. However, it was recently reported that transgenic mice overexpressing a bacterial artificial chromosome containing choline acetyltransferase (ChAT) gene, for synthesizing the neurotransmitter acetylcholine, present with multiple vesicular acetylcholine transporter (VAChT) gene copies, resulting in altered cholinergic tone and accompanying behavioral abnormalities. Since ChAT::Cre+ rats, used increasingly for understanding the biological basis of CNS disorders, utilize the mouse ChAT promotor to control Cre recombinase expression, we assessed for similar genotypical and phenotypical differences in such rats compared …

A Macaque Connectome For Large-Scale Network Simulations In Thevirtualbrain, Kelly Shen, Gleb Bezgin, Michael Schirner, Petra Ritter, Stefan Everling, Anthony R. Mcintosh

Brain and Mind Institute Researchers' Publications

© 2019, The Author(s). Models of large-scale brain networks that are informed by the underlying anatomical connectivity contribute to our understanding of the mapping between the structure of the brain and its dynamical function. Connectome-based modelling is a promising approach to a more comprehensive understanding of brain function across spatial and temporal scales, but it must be constrained by multi-scale empirical data from animal models. Here we describe the construction of a macaque (Macaca mulatta and Macaca fascicularis) connectome for whole-cortex simulations in TheVirtualBrain, an open-source simulation platform. We take advantage of available axonal tract-tracing datasets and enhance the existing …

Predator-Induced Fear Causes Ptsd-Like Changes In The Brains And Behaviour Of Wild Animals, Liana Y. Zanette, Emma C. Hobbs, Lauren E. Witterick, Scott A. Macdougall-Shackleton, Michael Clinchy

Brain and Mind Institute Researchers' Publications

© 2019, The Author(s). Predator-induced fear is both, one of the most common stressors employed in animal model studies of post-traumatic stress disorder (PTSD), and a major focus of research in ecology. There has been a growing discourse between these disciplines but no direct empirical linkage. We endeavoured to provide this empirical linkage by conducting experiments drawing upon the strengths of both disciplines. Exposure to a natural cue of predator danger (predator vocalizations), had enduring effects of at least 7 days duration involving both, a heightened sensitivity to predator danger (indicative of an enduring memory of fear), and elevated neuronal …

Consciousness-Specific Dynamic Interactions Of Brain Integration And Functional Diversity, Andrea I. Luppi, Michael M. Craig, Ioannis Pappas, Paola Finoia, Guy B. Williams, Judith Allanson, John D. Pickard, Adrian M. Owen, Lorina Naci, David K. Menon, Emmanuel A. Stamatakis

Brain and Mind Institute Researchers' Publications

Prominent theories of consciousness emphasise different aspects of neurobiology, such as the integration and diversity of information processing within the brain. Here, we combine graph theory and dynamic functional connectivity to compare resting-state functional MRI data from awake volunteers, propofol-anaesthetised volunteers, and patients with disorders of consciousness, in order to identify consciousness-specific patterns of brain function. We demonstrate that cortical networks are especially affected by loss of consciousness during temporal states of high integration, exhibiting reduced functional diversity and compromised informational capacity, whereas thalamo-cortical functional disconnections emerge during states of higher segregation. Spatially, posterior regions of the brain’s default mode …

Dynamics Of Drug Resistance: Optimal Control Of An Infectious Disease, Naveed Chehrazi, Lauren E. Cipriano, Eva A. Enns

Business Publications

Antimicrobial resistance is a significant public health threat. In the U.S. alone, 2 million people are infected and 23,000 die each year from antibiotic resistant bacterial infections. In many cases, infections are resistant to all but a few remaining drugs. We examine the case where a single drug remains and solve for optimal treatment policy for an SIS infectious disease model incorporating the effects of drug resistance. The problem is formulated as an optimal control problem with two continuous state variables, the disease prevalence and drug's "quality" (the fraction of infections that are drug-susceptible). The decision maker's objective is to …

Parsing The Effects Of Demography, Climate And Management On Recurrent Brucellosis Outbreaks In Elk, Gavin C. Cotterill, Paul C. Cross, Jerod A. Merkle, Jared D. Rogerson, Brandon M. Scurlock, Johan T. Du Toit

Wildland Resources Faculty Publications

1. Zoonotic pathogens can harm human health and well‐being directly or by impacting livestock. Pathogens that spillover from wildlife can also impair conservation efforts if humans perceive wildlife as pests. Brucellosis, caused by the bacterium Brucella abortus, circulates in elk and bison herds of the Greater Yellowstone Ecosystem and poses a risk to cattle and humans. Our goal was to understand the relative effects of climatic drivers, host demography and management control programmes on disease dynamics.
2. Using >20 years of serologic, demographic and environmental data on brucellosis in elk, we built stochastic compartmental models to assess the influences of climate forcing, …

Alumni Journal - Volume 90, Number 3, Loma Linda University School Of Medicine

Alumni Journal, School of Medicine

Editorials
2 | Guest Editorial: Tiffany C. Priester '04
4 | From the President
7 | From the Dean

News
8 | This and That
10 | APC Preview
12 | School of Medicine News
14 | Students
15 | Wedding Announcements
16 | Alumni News

Missions
18 | Missions Feature - inspiring stories from the mission field

Features
45 | Alumni Spotlight - Lloyd Rudy Broomes '66
46 | Canadian Rockies Alumni Trip
50 | Department Report: Otolaryngology
53 | The Storm of Our Shores [Book review]

In Memoriam
53 | Featured Obituary - Stanley G. Sturges '55
54 …

The Effects Of Dry Needling In The Management Of Sub-Acromial Impingement Syndrome: A Case Report, Kaitlyn Radice, Lindsey Bramlette, Kristin Fenstermaker

Miami, Fall 2019

The purpose of this study was to evaluate the effectivness of dry needling to an active trigger point in the anterior deltoid musculature in conjunction with physical therapy. This case study presents a 77-year-old male with traumatic pull into flexion injury. In addition to being given RTC and postural musculature strengthening exercises, PROM, joint mobilization, and soft tissue mobilization, dry needling was performed at week 2 and week 4 of treatment.

From this case study, we can conclude that TrP-DN to an active TrPin the anterior deltoid can yield statistically significant improvements in ROM, strength, pain, and functional abilities when …

Physical Therapy Management Of Stress Urinary Incontinence In The Pediatric Population: A Case Study, Debra Dy, Maureen Egizii

Miami, Fall 2019

The purpose of this study was to determine if external pelvic floor examination and treatment can be an effective, non-invasive intervention for urinary incontinence in the pediatric population. The case study examines the effectiveness of exercise therapy for an 11-year-old female with pelvic floor dysfunction. This case demonstrates that pelvic floor strengthening exercises can help to resolve incontinence symptoms without the implementation of internal examination or treatment. Although commonly used to address incontinence in adults, pelvic floor physical therapy may also be an effective, non-invasive intervention option for children who are experiencing urinary incontinence.

Treatment Of Phantom Limb Pain And Knee Flexion Contracture Due To Transtibial Amputation: A Case Study, Kristin Smead, Donna Leigel

Miami, Fall 2019

This case study evaluated the effectiveness of a combination of visual mirror therapy for phantom limb pain desensitization in conjunction with a physical therapy regimen of therapeutic exercise, short-wave diathermy, and gait training in a 66-year-old male with left lower extremity amputation.

Through a combination of mirror therapy, short-wave diathermy over the hamstring musculature, and therapeutic exercise, the patient displayed an overall improvement in left lower limb knee flexion contracture and a reduction in perceived phantom limb pain.The patient can now tolerate full weight bearing through this extremity from an improved fit of the prosthesis socket. Throughout the course of …

Committee Reports & Updates

NASIG Newsletter

No abstract provided.

December 2019 Full Issue

NASIG Newsletter

No abstract provided.

An Investigation Into The Relationships Between Bullying, Discrimination, Burnout And Patient Safety In Nurses And Midwives: Is Burnout A Mediator?, Judith Johnson, Lorraine Cameron, Lucy Mitchinson, Mayur Parmar, Gail Opio-Te, Gemma Louch, Angela Grange

HPD Articles

BACKGROUND: Bullying and discrimination may be indirectly associated with patient safety via their contribution to burnout, but research has yet to establish this. AIMS: The aims of this study were to investigate the relationships between workplace bullying, perceived discrimination, levels of burnout and patient safety perceptions in nurses and midwives and to assess whether bullying and discrimination were more frequently experienced by Black, Asian and minority ethnic than White nurses and midwives. METHODS: In total, 528 nurses and midwives were recruited from four hospitals in the United Kingdom to complete a cross-sectional survey between February and March 2017. The survey …

Implementation Of Ventilator Bundle For Prevention Of Ventilator-Associated Pneumonia In Pediatric Intensive Care Unit, Abd-Elaleem Elgendy, Ahmed Y. Alsawah, Mahmoud M. Al-Shahat, Mohamed F. Alsoda, Mohammad A. M. Abboud, Sherif M. K. Reda

Journal of Medicine in Scientific Research

Background Ventilator-associated pneumonia (VAP) is associated with increased morbidity and mortality in pediatric intensive care unit (PICU) patients. Objective The aim was to examine the effect of adherence to VAP prevention bundle on the incidence of VAP in PICU. Patients and methods A prospective comparative study was conducted in Al-Hussein University Hospital on all patients admitted and ventilated in PICU in a year from September 2017 until September 2018. They were divided into two groups: the first group included patients admitted to PICU after implementation of the study, comprising 43 patients as cases, and the second group included patients admitted …

The Use Of Gonadotropin-Releasing Hormone Antagonist In Women Undergoing Intrauterine Insemination, Bassem Sobhy, M Yousef Elsemary

Journal of Medicine in Scientific Research

Background Intrauterine insemination (IUI) is considered to be a very popular treatment procedure that is used for many infertile women worldwide. Aim The aim was to evaluate whether the addition of gonadotropin-releasing hormone antagonist would improve the clinical pregnancy rate in women undergoing IUI. Materials and methods A prospective study was performed at El-Galaa Maternity Teaching Hospital where 124 women with primary or secondary infertility were subjected to controlled ovarian stimulation with human menopausal gonadotropin (74–150 IU/day) only (control group, n=62) or to human menopausal gonadotropin (75–150 IU/day) plus Cetrorelix (0.25 mg/day, starting when the leading follicle was ≥16 mm; …

Determinants Of Infarction Patterns In Posterior Cerebral Circulation, Ahmed H. T Badr Ahmed, Mohamed M. Fouad, Ramez R. Moustafa, Taha K. Alloush

Journal of Medicine in Scientific Research

Background Ischemic stroke is defined as focal or global neurological dysfunction lasting longer than 24 h or leading to death that is caused by vascular insult, either stricture or occlusion of a specific vascular territory. Aim of the study This study aimed to determine the relationship between different risk factors and different infarction patterns in posterior circulation such single small lacunar lesion, single large lesion, and multiple scattered lesions. Patients and methods This study included 60 patients recruited from the stroke unit of Ain Shams University and El Sahel Teaching Hospitals during the period from April to October 2018 with …

Omental Flap Harvested Through Transdiaphragmatic Approach At The Same Sternotomy Incision For Poststernotomy Mediastinitis: A New Approach, Waleed El-Awady

Journal of Medicine in Scientific Research

Background The surgical treatment of poststernotomy mediastinitis is still a challenge and associated with high mortality. Conservative treatment and various surgical procedures are sometimes inadequate and need more aggressive treatment. Omental flap improves control of infection and prognosis, but harvesting is an additional procedure with its associated morbidity and trauma. Patients and methods A total of 14 patients had omental flap, which was harvested through a diaphragmatic opening at the lower part of the same sternotomy incision, without additional laparotomy incision or extension of sternotomy incision into the upper abdomen or even laparoscopically. The mean age of the patients was …

Engagement With Project Echo To Increase Medication-Assisted Treatment In Rural Primary Care, Julie Salvador, Snehal Bhatt, Rebecca Fowler, Jerrilyn Ritz, Regina James, Vanessa Jacobsohn, Heidi Rishel Brakey, Andrew L Sussman

Project ECHO Bibliography

OBJECTIVE: The purpose of this study was to understand the barriers and facilitators that affect engagement with Project ECHO (Extension for Community Healthcare Outcomes) to implement medication-assisted treatment (MAT) in primary care settings.

METHODS: A 12-session weekly curriculum was delivered to participating primary care providers and clinic staff (N=24 participants from 13 clinics). Participants completed attendance logs and a qualitative interview in order to identify factors that influence engagement in the ECHO sessions and the potential integration of MAT.

RESULTS: Primary care providers and staff valued the ECHO sessions, but overall attendance was low and variable. Participants generally valued the …

Distance Education To Improve The Quality Of Asthma Treatment In Primary Health Care, Rudi Roman, Karine Margarites Lima, Maria Angela Fontoura Moreira, Roberto Umpierre, Lisiane Hauser, Dimitris V. Rados, Alvaro Vigo, Marcelo Goncalves, Sotero Serrate Mengue

Project ECHO Bibliography

Objective: The mere dissemination of standard care recommendations has been insufficient to improve clinical results in patients with asthma. The objective of the present study was to evaluate the clinical effectiveness of a multifaceted asthma distance education for primary care providers. Methods: Cluster randomized controlled trial. Full primary care teams were included if they had access to telehealth support and free basic asthma treatment. Before randomization, selected teams indicated asthma patients between 5-45 years old for inclusion. The intervention group received three interactive online sessions, printed educational material, reminders, booklet for patients, and frequent stimulus to use consulting services. The …

Oral Development And Breastfeeding: An Assessment Of The Lactation Care Provider Approach, Robin Gatlin

Dental Hygiene ETDs

Breastfeeding influences the infant’s oral development in many ways. Lactation care providers work closely with the mother-infant pair and may be the first to provide information on oral health. The purpose of this study is to assess lactation care provider’s perception, attitude and behavior on the relationship between breastfeeding and oral development; including oral malocclusion, breathing patterns, tethered oral tissues and dental caries. A survey sent to lactation care providers who are members of The United States Lactation Consultant Association. A total of 12 members participated in the survey. Of that, 11 were International Board Certified Lactation Consultants (IBCLCs) and …

The Effects Of Seed-Applied Fluopyram On Root Penetration And Development Of Meloidogyne Incognita On Cotton And Soybean, Tracy Hawk

Graduate Theses and Dissertations

Plant-parasitic nematodes are major pests of cotton and soybean in Arkansas, and across the Southern United States. These nematodes cause more than $3 billion worth of crop losses each year, in part due to lack of available control tactics, such as nematicides. Fluopyram has recently been registered as a seed-treatment nematicide in agronomic crops. The toxicity of fluopyram against Meloidogyne incognita infection has been reported, however, information on root protection provided by fluopyram against Meloidogyne incognita is lacking. The first objective of this research was to evaluate the effect seed-applied fluopyram had on nematode development, root galling, and reproduction on …

Use Of Aerial Imagery And Novel Experimental Design To Determine The Distribution Of Foliar Diseases On Soybean And Improve Efficiency Of Product Testing, Mckayla Patterson

Graduate Theses and Dissertations

Soybeans are grown on approximately 1.3 million ha in Arkansas generating an estimated $1.7 billion annually. Foliar diseases on soybean can result in economic losses. Growers spend significant time and money on disease scouting via crop consultants and often (subsequent) fungicide applications. Fungicide trials are often arranged in small plots designs. In these scenarios, spatial variability of foliar disease is minimized. While it is advantageous to minimize variance outside of treatment differences, another limitation with many small plot trials is ample disease pressure or having only lower severity. Within a commercial production field, soil types and disease severities vary. Logically, …

Cytotoxicity And Mutagenicity Of Disinfection Byproduct Mixtures Formulated Using Free Chlorine And Monochloramine, Yonas Ghebremedhin

Graduate Theses and Dissertations

Bioassays have been used extensively to assess various toxicity endpoints of drinking water disinfection byproducts (DBPs), but an emphasis on single compounds prevails. In this research, DBP mixtures were assessed using a cytotoxicity test with Chinese Hamster Ovary (CHO) cells and an Ames fluctuation test with Salmonella typhimurium TA-98 and TA-100 with and without S9 rat liver homogenate. Seven whole mixture DBP concentrates were formulated using reconstituted natural organic matter (NOM) extracts from the Upper Mississippi River using scaled disinfectant dosing protocols with free chlorine and monochloramine in the presence and absence of added bromide. DBPs were identified by gas …

Opal's Muse, Ronda Crawford

The Prairie Light Review

No abstract provided.