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อิทธิพลของการเจ็บป่วยด้วยโรคไม่ติดต่อเรื้อรังที่มีต่อภาวะซึมเศร้าในประชากรไทยวัยกลางคนและวัยสูงอายุ, ปิยาภรณ์ นฤภัย

Chulalongkorn University Theses and Dissertations (Chula ETD)

การวิจัยนี้มีวัตถุประสงค์เพื่อศึกษาภาวะซึมเศร้าที่เกิดขึ้นในประชากรไทยวัยกลางคนและวัยสูงอายุ และอิทธิพลของการเจ็บป่วยด้วยโรคไม่ติดต่อเรื้อรัง รวมถึงปัจจัยที่มีผลต่อการมีภาวะซึมเศร้าของประชากรไทยวัยกลางคนและวัยสูงอายุ โดยกลุ่มตัวอย่างในการศึกษาคือประชากรที่มีอายุ 35 ปีบริบูรณ์ขึ้นไป ที่ตอบแบบสัมภาษณ์ด้วยตนเองจากโครงการสำรวจอนามัยและสวัสดิการ พ.ศ. 2564 และ วิเคราะห์ข้อมูลด้วยการถดถอยโลจิสติกทวิภาค (Binary logistic regression analysis)ผลการศึกษาพบว่า สัดส่วนของประชากรไทยวัยกลางคนที่มีภาวะซึมเศร้าน้อยกว่าวัยสูงอายุ และการเจ็บป่วยด้วยโรคไม่ติดต่อเรื้อรังมีความสัมพันธ์กับการมีภาวะซึมเศร้าของประชากรไทยทั้ง 2 ช่วงวัยอย่างมีนัยสำคัญทางสถิติที่ระดับ 0.05 โดยประชากรวัยกลางคนที่ป่วยเป็นโรคไม่ติดต่อเรื้อรังมีโอกาสที่จะมีภาวะซึมเศร้าสูงกว่าผู้ป่วยวัยสูงอายุ และปัจจัยที่มีอิทธิพลต่อการมีภาวะซึมเศร้าของผู้ป่วยโรคไม่ติดต่อเรื้อรังทั้งในวัยกลางคนและวัยสูงอายุ ได้แก่ สถานภาพการทำงาน จำนวนของโรคเรื้อรังที่เป็น การหยุดกิจวัตรประจำวันเนื่องจากการเจ็บป่วย วิธีการรักษาพยาบาล และค่ารักษาพยาบาล ในขณะที่ปัจจัยที่มีความสัมพันธ์กับการมีภาวะซึมเศร้าที่พบเฉพาะในผู้ป่วยวัยกลางคน ประกอบด้วย ศาสนา ระดับการศึกษา เขตที่อยู่อาศัย และค่าพาหนะไป-กลับเพื่อเดินทางไปรักษาพยาบาล และประเภทโรค นอกจากนี้ผลการศึกษาพบว่าปัจจัยที่มีความสัมพันธ์ต่อการมีภาวะซึมเศร้าที่พบเฉพาะผู้ป่วยวัยสูงอายุ ประกอบด้วย เพศ สวัสดิการค่ารักษาพยาบาล และจำนวนสมาชิกในครัวเรือน ดังนั้น การให้ความสำคัญกับจำนวนโรคไม่ติดต่อเรื้อรัง ประเภทโรคและการดูแลผู้ป่วยในแต่ละกลุ่มวัยให้เข้าถึงการรักษาและได้รับการรักษาอย่างมีประสิทธิภาพ และคำนึงถึงลักษณะทางประชากร เศรษฐกิจและสังคมที่แตกต่างกัน จึงเป็นมาตรการที่สำคัญที่จะช่วยป้องกันและลดปัญหาภาวะซึมเศร้าของประชากรไทยวัยกลางคนและวัยสูงอายุ

Defining Genetic Diversity Of Rhesus Macaque Fcγ Receptors With Long-Read Rna Sequencing., Haleigh E. Conley, Max M. He, David Easterhoff, Hélène Fradin Kirshner, Sarah L. Cocklin, Jacob Meyer, Taylor Hoxie, Madison Berry, Todd Bradley, William D. Tolbert, Marzena Pazgier, Georgia D. Tomaras, Joern E. Schmitz, Michael Anthony Moody, Kevin Wiehe, Justin Pollara

Manuscripts, Articles, Book Chapters and Other Papers

Fcγ receptors (FcγRs) are membrane-bound glycoproteins that bind to the fragment crystallizable (Fc) constant regions of IgG antibodies. Interactions between IgG immune complexes and FcγRs can initiate signal transduction that mediates important components of the immune response including activation of immune cells for clearance of opsonized pathogens or infected host cells. In humans, many studies have identified associations between FcγR gene polymorphisms and risk of infection, or progression of disease, suggesting a gene-level impact on FcγR-dependent immune responses. Rhesus macaques are an important translational model for most human health interventions, yet little is known about the breadth of rhesus macaque …

A Deeper Dive Into Food Insecurity Among Women Involved In The Criminal Justice System, Jessica Robles

Public Health Theses

Background: The U.S. has the highest incarceration rate globally and a recent study found that 91% of formerly incarcerated individuals report being food insecure. Given that, women have become the fastest-growing segment in the incarceration system. Women who are involved in the criminal justice system (WICJ) are more at risk for experiencing food insecurity and chronic diseases. Therefore, this study aims to contribute to existing knowledge on the overall health of WICJ by assessing the prevalence of food insecurity and the social determinants of health (SDOH) that may contribute to food insecurity.Objective: To provide information on the overall health of …

Chagas Disease Screening: Awareness, Practices And Perceived Barriers Among Health Care Providers In Connecticut, Erica J. Rayack

Public Health Theses

Background: An estimated 288,000 people in the United States are infected with Chagas disease. Despite published recommendations for health care providers, the neglected nature of this disease persists, in part due to gaps in knowledge and low levels of Chagas disease awareness among health care providers. A survey was emailed to health care providers to assess knowledge, screening practices and provider-perceived barriers to screening for Chagas disease.

Methods: The survey link was emailed to healthcare providers and department heads. Providers answered a series of questions categorized either as knowledge (K), practice (P), or perceived barriers (B), which were then scored …

Towards A Saliva-Based Pcr Test For The Detection Of Mpox, Russell J. Thomas

Public Health Theses

Current recommendations for the diagnosis of mpox (monkeypox) rely on lesion-swabs as the gold-standard specimen type even though many patients experience symptoms prior to lesion-onset. Earlier detection could bolster the mpox response by mitigating transmission and facilitating access to antiviral treatments. In this study, we validated five PCR assays and compared their detection of mpox virus DNA extracted from 30 saliva specimens collected into Spectrum SDNA-1000 tubes. We found the Logix Smart™ Mpox (2-Gene) RUO assay (Co-Diagnostics, Inc., Salt Lake City, UT) performed statistically significantly better than the other assays. Next, we tested five raw (unsupplemented) known-positive saliva samples in …

A Robust Bayesian Model Averaging Method For Basket Trials With Different Endpoints, Xueting Wang

Public Health Theses

Oncology drug research in the last few decades has been driven by the development of targeted agents. In the era of targeted therapies, basket trials are often used to test the antitumor activity of a novel treatment in multiple indications sharing the same genomic alteration. As patient population are further fragmented into biomarker-defined subgroups in basket trials, novel statistical methods are needed to facilitate cross-indication learning to improve the statistical power in basket trial design. Here we propose a robust Bayesian model averaging (rBMA) technique for the design and analysis of phase II basket trials. We consider the posterior distribution …

Hiv Treatment Patterns Across A Us Data Network: 2012-2021, Raechel Elizabeth Davis

Public Health Theses

IntroductionOnce-daily combination antiretroviral therapy is recognized as the standard treatment for people living with Human Immunodeficiency Virus (HIV) in the United States.1,2 Treatment strategies for HIV have changed substantially over the years, influenced by individual and clinical factors, new medication options, and changing clinical guidelines.1–3 Observational data sources provide a unique opportunity to characterize populations and provide insight into medication usage under real-world conditions that differ systematically from controlled trial scenarios.3,4 Methods We evaluated the treatment patterns and characteristics of 12288 individuals diagnosed with HIV and continuously treated with antiretroviral medications across four, US-based observational databases using the Observational Health …

“You Are Just Trying To Make It Work”: A Qualitative Exploration Of Healthcare Provider Implementation Considerations For Integrating Mental Health And Hiv Care In Central Uganda, Divya Gumudavelly

Public Health Theses

There is a growing push to integrate mental health services within HIV care in urban Uganda. Amidst HIV clinics becoming comprehensive healthcare centers, there is a critical need to understand how providers can better adopt and implement mental health specific protocols in HIV practice. Semi-structured interviews were conducted with 16 healthcare providers at two different HIV care centers to understand current practices, routines, barriers, and facilitators to implementing mental health care services within HIV care. Abductive thematic analysis, drawing from Consolidated Framework for Implementation Research (CFIR) and Theoretical Domains Framework (TDF) frameworks, was used in conjunction with constructivist grounded theory …

Optimization Of An Elisa-Based Leptospirosis Diagnostic, Kevin Yuhang Zhao

Public Health Theses

Leptospirosis is an infectious zoonotic disease responsible for about 1 million cases annually. Issues in early diagnosis is a major contributor towards poor health outcomes. Current tests for diagnosis, such as whole-cell ELISA-based diagnostics or the microscopic agglutination test (MAT), importantly lack sensitivity during acute-phase disease. Therefore, creating an ELISA-based diagnostic, which is generally cheaper and easier to perform than the MAT, using highly-conserved targets, that has high sensitivity towards acute-phase disease, would be desirable. This study first attempted to optimize protocols for diagnosis, and next applied the optimized protocol against epitopes derived from hamsters vaccinated with a multi-recombinant protein …

Effect Of Digital Public Health Campaigns By The World Health Organization On Self-Reported Behavior, Recall/Knowledge, And Attitude Toward Interventions Related To Covid-19: A Meta-Analysis, Zili Zhou

Public Health Theses

The COVID-19 pandemic highlighted the need for effective scientific communication. The success of public health interventions are largely dependent on public knowledge and behavior. With the global rise of social media usage, as well as the increased prevalence of social media advertisement campaigns, the platforms present a tool with the potential to be utilized by public health authorities to deliver information and influence broad populations within a short period of time. From 2020 to 2022, the World Health Organization conducted 58 social media campaigns, totaling 176 brand-lift studies, in partnership with Meta on the subject of COVID-19. The campaigns conveyed …

The Undercurrents Of Disease In Armed Conflict: An Analysis Of Aggregate National Dstb And Mdr/Xdr Tb Screening & Diagnosis Trends During The 2022 War In Ukraine, Sakina Erika Reames

Public Health Theses

​​Tuberculosis (TB) is the second leading cause of death by an infectious disease worldwide after COVID-19. Extensive efforts have been made for decades to tackle this disease through bolstering healthcare systems especially in countries experiencing a disproportionate burden of TB. Ukraine is considered by the WHO to be one of the 30 high burden countries in the world with a notably high burden of MDR TB. In addition, Ukraine has the second largest HIV epidemic in Eastern Europe and Central Asia as well as the fifth largest number of extensive drug resistant cases in the world. Ukraine has made extensive …

Vector Status Of Aedes Albopictus In Connecticut: Analyses Of Invasion Pattern, Geographic Distribution, And Disease Risk, Meredith Bagger

Public Health Theses

Introduction: Aedes albopictus is a highly successful invasive mosquito. Its presence and expansion into Connecticut have implications for human and animal health. The factors limiting Ae. albopictus spread and risk by the pathogens it carries have not been previously examined. Methods: This study leveraged data from the Connecticut Mosquito and Arbovirus Surveillance Program during 2006-2022 and a project designed to characterize mosquito-borne filarial parasite species in Connecticut from 2020-2021. We examined correlations between mosquito abundance and winter temperature as well as land use. We described the arboviruses detected in Ae. albopictus collections and calculated the risk of Ae. albopictus transmitting …

Primary Liver Cancer In China From 2000-2020: Evolution Of Epidemiology, Clinical Disease, And Therapy, Wanqing Chi

Public Health Theses

Background & Aims: China contributed to 49% of all liver cancer deaths worldwide in 2020. We sought to investigate the relationship between clinical characteristics, antiviral therapy (ART), and multiple risk factors that affect the prognosis of primary liver cancer (PLC) patients over time to highlight proper chronic liver disease management.Methods: We identified 1322 PLC patients diagnosed between 2000 to 2020 in a major academic teaching hospital in Shanghai, China. We used descriptive epidemiology to characterize the evolution of liver cancer in China, and Cox proportional hazard models and Kaplan-Meier survival analysis to assess the relationship between evolving ART and survival …

Prevalence And Genetic Determinants Of Vancomycin Resistance Of Clostridioides Difficile Isolates In Connecticut, Zeyu Fu

Public Health Theses

AbstractIntroduction: The emergence of vancomycin-resistant strains of C. difficile has become a growing concern, as it can lead to treatment failure and increased morbidity and mortality. In this study, we aimed to investigate the prevalence and mechanisms of vancomycin resistance in C. difficile isolates in Connecticut from patients with confirmed C. difficile infection at Yale New Haven Hospital. Methods: We collected 89 stool samples from patients with confirmed C. difficile infection, isolated C. difficile, and performed susceptibility testing on the isolates using the E-strip test method. Isolates with an MIC value below 4 μg/ml were classified as susceptible and isolates …

Attribution Of Febrile Illness To Circulating Respiratory Viruses In The United States, July 2016 - March 2023, Lily Kitfield-Vernon

Public Health Theses

Background: SARS-CoV-2, an emerging epidemic respiratory virus, has circulated in the United States since early 2020. The dynamics of Influenza (flu) and Respiratory Syncytial Virus (RSV) have shifted, causing atypical timing and levels of illness across the country and in particular age groups. Fever, recorded on at-home bluetooth-enabled thermometers, is a promising new tool with which to monitor respiratory disease. Quantifying the proportion of fever attributable to these three viruses, at a particular time or within a particular age group, would strengthen the collective understanding of viral circulation in the U.S., and enable the use of fever data in the …

Protection Against Cholera From Killed Whole-Cell Oral Cholera (Kocv) Vaccines: Systematic Review And Meta-Regression Of Randomized Control Trials And Observational Studies, Helena Hojeong Kwon

Public Health Theses

Introduction: Although killed whole-cell oral cholera vaccines (kOCVs) are widely used as a part of cholera control strategy, mixed evidence around the vaccine induced protection remains.Objectives: The primary objective of this systematic review was to update estimates of kOCV protection: vaccine efficacy and effectiveness. A secondary objective was to estimate the waning dynamic of kOCV protection by duration of follow-up. Methods: On August 15th, 2022, we searched for randomized control trials and observational studies that reported kOCV protection in low- and middle-income countries on PubMed, EMBASE, Scopus, ISI Web of Science, and The Cochrane Review Library with a start date …

Drivers Of Global Waterborne Disease Transmission Following Extreme Precipitation Events: A Systematic Review, Claire Latendresse

Public Health Theses

Precipitation events such as hurricanes, typhoons, and heavy rainfall can have devastating impacts on water and sanitation infrastructure around the world and have led to large-scale waterborne outbreaks. As climate change amplifies the frequency and intensity of extreme weather events, it is also triggering an increase in waterborne disease transmission. This master’s thesis consists of a systematic review of academic literature pertaining to extreme precipitation events and the pathways by which they trigger waterborne outbreaks.

A systematic review of the literature in PubMed was conducted to identify waterborne disease outbreaks associated with extreme precipitation. The initial search yielded 3,248 results …

The Ethical And Legal Considerations Of Ai-Driven Healthcare In Infectious Diseases, Natalie Makableh

Public Health Theses

Artificial intelligence (AI) has been rapidly growing in the healthcare sector, with the potential to improve patient outcomes, increase efficiency, and reduce costs. However, as with any technological advancement, AI-driven healthcare presents ethical and legal challenges that must be addressed to ensure the responsible and beneficial use of the technology. To the best of our knowledge this is the first study to examine the ethical and legal considerations of using AI technology in healthcare, with a particular focus on infectious diseases. With the growing use of AI in healthcare, it is crucial to evaluate its potential benefits and challenges in …

Knowledge, Attitudes, And Practices (Kap) About Lassa Fever Prevention And Control: A Survey Of Three Rural Communities In Central Liberia-Epidemiology Of Microbial Diseases, Joseph Gibson Jepru Lewis

Public Health Theses

Introduction: Since the discovery of Lassa fever in 1969 in Nigeria, the disease has become endemic in many West African countries. An estimated 500,000 cases of Lassa fever virus occur each year, leading to approximately 5,000 deaths annually. Liberia continues to record outbreaks almost every subsequent year in regions once considered non-endemic. With no effective vaccines, many studies have underscored the importance for residents in Lassa-endemic regions to have good knowledge and good prevention practices in place to prevent Lassa fever.

Methods: A cross-sectional data extracted from a longitudinal, observational, cohort study conducted using voluntary participant self-reported and study visits …

Demographics Of Hospitalized Covid-19 And Influenza Cases In Connecticut During The 2021-2022 Influenza Season: Is There Evidence Of Viral Interference?, Molly Mclaughlin

Public Health Theses

Since the COVID pandemic began in March 2020, the epidemiology of influenza has changeddramatically in the United States. During the 2021-2022 influenza season in Connecticut, only 262 hospitalized influenza cases were recorded in New Haven and Middlesex Counties from October 2021-June 2022, while there are usually well over 1,000 cases in a single season. While the decline in influenza cases could be due to preventive measures adopted early in the pandemic, viral interference could also be to blame. Viral interference is the process by which infection with one virus transiently protects against infection by another virus via a generalized immune …

The Impact Of The Covid-19 Pandemic On Non-Typhoidal Salmonella Incidence And Exposures In Connecticut, 2015-2022, Adeline Morris

Public Health Theses

Background: During 2020, Salmonella incidence decreased by 22% in the United States.1 At the same time, many common activities were reduced or restricted, including travel and eating food prepared at restaurants or events, which are known risk factors for Salmonella infection. Methods: A descriptive analysis using Salmonella surveillance data collected in Connecticut between 2015 to 2022 was performed to characterize the changes in travel and outside food exposures. Frequencies of exposures were compared before the pandemic, during the pandemic, and after the vaccine was implemented and restrictions eased. Rate ratios of observed to expected cases were calculated to explore trends …

Impact Of The Covid-19 Outbreak On Mental Health And Public Practices In Rural Communities In China, Wenxin Liang

Public Health Theses

Coronavirus disease (COVID-19) has significant impact on people’s mental health. However, no nationwide study has investigated the mental health among rural residents during the COVID-19 outbreak in China. This study was aimed to investigate the impact of the COVID-19 outbreak on the mental health and public practices for controlling and preventing the COVID-19 in rural communities in China. An anonymous online survey was sent to participants through WeChat, the most widely used Chinese social-networking app, from March 2 to 11, 2020. We recruited 4607 individuals from 11 representative provinces in mainland China. The analytical sample was 2159 rural residents. The …

Indirect Effects Of Covid-19 Vaccination Against Sars-Cov-2 Omicron: Rapid Review & Meta-Analysis, Brett Anthony Martini

Public Health Theses

Background: First identified in Wuhan, China in late 2019, the infectious viral disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has affected millions of lives worldwide and poses the largest public health crisis in the past century. The development and deployment of vaccines have been a key public health measure to mitigate the subsequent harm associated with the viral infection. Despite the mRNA vaccine platform being in development for 15+ years, the mass vaccination campaigns were the first large-scale use of this technology, leaving much to be learned about their effectiveness and longevity. Mass vaccination campaigns influence …

Epidemiology Of Human Hookworm (Necator Americanus) Infection In Rural Ghana: Investigating Host-Parasite Factors That Mediate Infection, Savanna Randi

Public Health Theses

Abstract

Introduction: Hookworms are soil-transmitted helminths (STHs) that cause significant morbidity in high-risk populations, posing a global health concern in locations of rural poverty [1-5]. While there have been ventures by the World Health Organization to eliminate hookworms in Africa by 2030, there is variability in the effectiveness of current chemotherapy regimens. Studies have shown that benzimidazole anthelmintics have reduced effectiveness, and people living in endemic areas are quickly reinfected [6]. Critical gaps remain in understanding parasite-host interactions within communities, further challenging successful disease control. A study initiated in 2022 investigated the epidemiology of human hookworm infection in Beposo, Ghana. …

Antibiotic Prophylaxis For Prevention Of Surgical Site Infections In Orthopedic Surgery, Edwin Ruiz Fuentes

Public Health Theses

Background: In the past decades, there has been an increase in the proportion of orthopedic surgical site infections (SSIs) caused by gram-negative bacilli in various healthcare settings. SSI prevention guidelines suggest that gentamicin can be added to prophylactic antibiotic treatment to target gram-negative bacilli. However, the effectiveness of this strategy remains to be confirmed in orthopedic surgery.

Methods: A retrospective cohort study was conducted to investigate the association between antibiotic prophylaxis with adjunctive gentamicin and SSI rates in orthopedic surgeries. 5,571 patients who underwent hip, knee, spine, and hip fracture surgeries between January 2019 and July 2021 at Yale-New Haven …

Characterizing Populations Living Near Concentrated Animal Feeding Operations: Implications For Health Equity And Environmental Justice, Leah Salzano

Public Health Theses

Current literature has highlighted that concentrated animal feeding operations (CAFOS) are associated with adverse health outcomes among populations living in close proximity to the farms and that, in certain states, vulnerable populations may be disproportionately exposed to CAFOs. However, none of the existing studies have assessed the sociodemographic makeup of areas highly exposed to CAFOs across a diverse geographic range. Using locations of CAFOs across six states with robust operations, we conducted logistic regression models assessing the likelihood of high exposure vs. low exposure at the census tract level for each 10% increase in sociodemographic variables (percent unemployed, percent minority, …

From Theory To Practice: Zoonotic Spillover, One Health And The Role Of Local Indigenous Communities, Pranav Prabhu Savanur

Public Health Theses

This paper discusses the impact of zoonotic spillovers on public health and the need for a One Health approach to preventing future pandemics. Zoonotic spillovers occur when pathogens are transmitted from animals to humans, facilitated by anthropogenic land changes, migration or trade, increased human-animal contact, and poor biosafety. However, anthropogenic land use change is the primary driver for zoonotic spillovers. Most emerging infectious diseases in humans are of zoonotic origin, and the impact of these spillovers on public health is significant. The paper emphasizes the need to prevent spillover events for primary pandemic prevention, which requires a coordinated and collaborative …

Compassion-Based Resilience Training (Cbrt) For Frontline Healthcare Workers In Contact With Covid-19 Patients, Michael Perez Sosa

Dissertations and Theses

Objectives: The COVID-19 pandemic has had deleterious consequences for the mental health of frontline healthcare workers worldwide. One systemic review of the literature found high prevalence rates of anxiety (67.55%), depression (58.89%), and stress (62.99%) reported by this population (Vizheh et al., 2020). Additionally, high rates of burnout and symptoms associated with trauma have also been ubiquitous during the pandemic for frontline healthcare workers. The purpose of this study is to investigate Compassion-Based Resilience Training (CBRT) as a remotely delivered intervention for frontline healthcare workers in contact with COVID-19 patients to reduce symptoms associated with stress, depression, anxiety, burnout, and …

The Nexus Of Climate Change And Human Rights: An Examination Of How Social, Political, And Environmental Impacts Of Climate Change Jeopardize The Protection Of Human Rights In The African Sahel, Camden R. Malone

Dissertations and Theses

Climate change is a threat multiplier by its driving forces of environmental stress and scarcity. In the developing world, countries are hit hardest and most frequently by the effects of climate change, such as severe floods, droughts, and desertification. In this thesis, I argue that existing models for the umbrella-term of climate-security underemphasize dimensions of human security through exclusion of HR violations linked to climate such as subjection to food/water stress, compromised health, displacement, and violent conflict. Therefore, the climate-security paradigm should be recast to pay closer attention to its consequences related to human rights protection, which I refer to …

Major Biotic Stresses Affecting Maize Production In Kenya And Their Implications For Food Security, Faith Njeri Njeru, Angeline Wambua, Edward Muge, Geert Haesaert, Jan Gettemans, Gerald Misinzo

All Rsif Scholars' Publications

Maize (Zea mays L.) is a staple food for many households in sub-Saharan Africa (SSA) and also contributes to the gross domestic product (GDP). However, the maize yields reported in most SSA countries are very low and this is mainly attributed to biotic and abiotic stresses. These stresses have been exacerbated by climate change which has led to long periods of drought or heavy flooding and the emergence of new biotic stresses. Few reports exist which compile the biotic stresses affecting maize production in SSA. Here, five major biotic stresses of maize in Kenya are presented which are attributed to …