Digital Commons Network^™

Higher Dose Oral Fluconazole For The Treatment Of Aids-Related Cryptococcal Meningitis (Hiflac)--Report Of A5225, A Multicentre, Phase I/Ii, Two-Stage, Dose-Finding, Safety, Tolerability And Efficacy Randomised, Amphotericin B-Controlled Trial Of The Aids Clinical Trials Group, Umesh G. Lalloo, David B. Clifford, Et Al.

2020-Current year OA Pubs

BACKGROUND: The WHO recommended 1200mg/day of fluconazole (FCZ) in the induction phase of cryptococcal meningitis (CM) in HIV prior to 2018 in regions where amphotericin-B (AMB) was unavailable. A 2-stage AMB-controlled, dose-escalation study to determine the maximum tolerated dose and the safety/efficacy of an induction-consolidation strategy of higher doses FCZ (1200mg-2000mg/day), adjusted for weight and renal function (eGFR)in adults with CM was undertaken.

METHODS: In Stage-1, three induction doses of FCZ (1200mg/day, 1600mg/day and 2000mg/day) were tested in sequential cohortsand compared with AMB in a 3:1 ratio. A particular dose was not tested in Stage 2 if there were significant …

Imputation Of Missing Values For Cochlear Implant Candidate Audiometric Data And Potential Applications, Cole Pavelchek, Andrew P. Michelson, Amit Walia, Amanda Ortmann, Jacques Herzog, Craig A. Buchman, Matthew A. Shew

2020-Current year OA Pubs

OBJECTIVE: Assess the real-world performance of popular imputation algorithms on cochlear implant (CI) candidate audiometric data.

METHODS: 7,451 audiograms from patients undergoing CI candidacy evaluation were pooled from 32 institutions with complete case analysis yielding 1,304 audiograms. Imputation model performance was assessed with nested cross-validation on randomly generated sparse datasets with various amounts of missing data, distributions of sparsity, and dataset sizes. A threshold for safe imputation was defined as root mean square error (RMSE) <10dB. Models included univariate imputation, interpolation, multiple imputation by chained equations (MICE), k-nearest neighbors, gradient boosted trees, and neural networks.

RESULTS: Greater quantities of missing data were associated with worse performance. Sparsity in audiometric data is not uniformly distributed, as inter-octave frequencies are less commonly …

Online Health Information For Penile Prosthesis Implants Lacks Quality And Is Unreadable To The Average Us Patient, Benjamin Plambeck, Jinfeng Jiang, Jesus Perez, Brittany E. Wordekemper, David Fu, Alexandra Colvin, Christopher M. Deibert

2020-Current year OA Pubs

BACKGROUND: Online health information (OHI) has become widely accessible and affects patient decisions regarding their healthcare. The purpose of this study was to assess the readability, quality, and accuracy of information available to patients online about penile prosthesis implants (PPIs).

METHODS: We performed a Google search using the keywords "penile implant" and "penile prosthesis." The first 30 search results for both terms were analyzed, and advertisements, news articles, duplicates, and videos were excluded. Websites were categorized as institutional, commercial, and personal/patient support. Readability of each website was determined using the Flesch-Kincaid grade level (FKGL) readability formula within the readable tool. …

Sex-Related Differences In Premature Cardiovascular Disease In Familial Hypercholesterolemia, Anandita Agarwala, Elena Deych, Laney K Jones, Amy C Sturm, Karen Aspry, Zahid Ahmad, Christie M Ballantyne, Anne C Goldberg

2020-Current year OA Pubs

BACKGROUND: Familial hypercholesterolemia (FH) is associated with an increased prevalence of premature atherosclerotic cardiovascular disease (ASCVD), however, little is known about sex-specific differences in premature ASCVD and its risk factors.

OBJECTIVE: The present study seeks to assess the burden and risk factors for premature ASCVD among men and women with FH.

METHODS: In this study we retrospectively examined sex-specific differences in ASCVD prevalence, risk factor burdens, and lipid treatment outcomes in 782 individuals with clinically or genetically confirmed FH treated in 5 U.S. lipid and genetics clinics. A generalized linear model using Binomial distribution with random study site effect and …

Simulation-Free Radiation Therapy: An Emerging Form Of Treatment Planning To Expedite Plan Generation For Patients Receiving Palliative Radiation Therapy, Joshua P Schiff, Tianyu Zhao, Yi Huang, Baozhou Sun, Geoffrey D Hugo, Matthew B Spraker, Christopher D Abraham

2020-Current year OA Pubs

PURPOSE: Herein we report the clinical and dosimetric experience for patients with metastases treated with palliative simulation-free radiation therapy (SFRT) at a single institution.

METHODS AND MATERIALS: SFRT was performed at a single institution. Multiple fractionation regimens were used. Diagnostic imaging was used for treatment planning. Patient characteristics as well as planning and treatment time points were collected. A matched cohort of patients with conventional computed tomography simulation radiation therapy (CTRT) was acquired to evaluate for differences in planning and treatment time. SFRT dosimetry was evaluated to determine the fidelity of SFRT. Descriptive statistics were calculated on all variables and …

Leveraging Health Infrastructure To Optimize Hpv Vaccination For Adolescents In Zambia: Protocol For An Implementation Study, Sam Miti, Thembekile Shato, Comfort Asante, Ana Baumann, Gershom Chongwe, Patricia M. Bobo, Michelle I. Silver, Jean M. Hunleth

2020-Current year OA Pubs

BACKGROUND: Cervical cancer is the leading cause of cancer death in Zambia, where HIV prevalence is also high (11.3%). HIV heightens the risk of developing and dying from cervical cancer. The human papillomavirus (HPV) vaccine can prevent 90% of cervical cancers, and in Zambia is recommended for adolescent girls ages 14-15 years, including those with HIV. Currently they mainly deliver HPV vaccination via school-based campaigns, which may exclude the most vulnerable adolescents-those out-of-school or who irregularly attend. Adolescents living with HIV (ALHIV) are more likely to have these vulnerabilities. Further, school-based campaigns are not tailored to the WHO-recommended HPV vaccination …

Cytosolic Epcam Cooperates With H-Ras To Regulate Epithelial To Mesenchymal Transition Through Zeb1, Fatma A. Omar, Taylor C. Brown, William E. Gillanders, Timothy P. Fleming, Michael A. Smith, Ross M. Bremner, Narendra V. Sankpal

2020-Current year OA Pubs

Next generation sequencing of human cancer mutations has identified novel therapeutic targets. Activating Ras oncogene mutations play a central role in oncogenesis, and Ras-driven tumorigenesis upregulates an array of genes and signaling cascades that can transform normal cells into tumor cells. In this study, we investigated the role of altered localization of epithelial cell adhesion molecule (EpCAM) in Ras-expressing cells. Analysis of microarray data demonstrated that Ras expression induced EpCAM expression in normal breast epithelial cells. Fluorescent and confocal microscopy showed that H-Ras mediated transformation also promoted epithelial-to-mesenchymal transition (EMT) together with EpCAM. To consistently localize EpCAM in the cytosol, …

Diastolic Dysfunction Criteria And Heart Failure Readmission In Patients With Heart Failure And Reduced Ejection Fraction, Steven J. Lavine, Danielle Kelvas

2020-Current year OA Pubs

No abstract provided.

#Orthotwitter: Relationship Between Author Twitter Utilization And Academic Impact In Orthopaedic Surgery, Ryan T Halvorson, Sachin Allahabadi, Nicolas Cevallos, Aidan J. Foley, Kelsey Collins, Abel Torres Espin, Brian T. Feeley, Nirav K. Pandya, Jeannie F. Bailey

2020-Current year OA Pubs

Background #OrthoTwitter has evolved to disseminate findings and engage the public. However, the academic impact of Twitter utilization in orthopaedic surgery is unknown. Questions/purposes The purpose of the study was to evaluate relationships between the author and manuscript Twitter activity and citations. Methods Manuscripts in 17 orthopaedic journals from 2018 were identified. Citations, online mentions, impact factors, and subspecialties were obtained. H-index and Twitter account details for authors were obtained for a subset of manuscripts. Relationships between Twitter activity and citations were evaluated. Results 2,473/4,224 (58.5%) manuscripts were mentioned on Twitter (n=29,958 mentions), with Twitter manuscripts cited more frequently (median …

The Association Of Radiation Dose With Overall Survival For Patients Treated With Prostate Stereotactic Body Radiation Therapy, Michael R. Waters, Neal Andruska, Benjamin W. Fischer-Valuck, Temitope Agabalogun, Randall J. Brenneman, Hiram Gay, Jeff M. Michalski, Brian Baumann

2020-Current year OA Pubs

Introduction Stereotactic body radiation therapy (SBRT) for prostate adenocarcinoma (PCa) has demonstrated excellent biochemical recurrence-free survival, with studies showing improved BRFS with higher-dose SBRT. However, current studies have been underpowered to evaluate the relationship of SBRT dose to overall survival (OS). In this retrospective study using the National Cancer Database (NCDB), we hypothesize that, given the low alpha/beta ratio of PCa, a relatively small increase in the dose-per-fraction would be associated with improved survival outcomes for intermediate-risk PCa (IR-PCa) comparing 36.25 Gy/5 fx [biologically equivalent dose (BEDα/β = 1.5 = 211.46 Gy vs. 35 Gy (BED1.5 = 198.33 Gy)]. Materials …

Testing Of A Novel Questionnaire Of Household Exposure To Wood Smoke, Paula M. Meek, Sarah J. Schmiege, Akshay Sood, Hans Petersen, Rodrigo Vazquez-Guillamet, Hammad Irshad, Jacob Mcdonald, Yohannes Tesfaigzi

2020-Current year OA Pubs

Household air pollution from wood smoke (WS), contributes to adverse health effects in both low- and high-income countries. However, measurement of WS exposure has been limited to expensive in-home monitoring and lengthy face-to-face interviews. This paper reports on the development and testing of a novel, self-report nine-item measure of WS exposure, called the Household Exposure to Wood Smoke (HEWS). A sample of 149 individuals using household wood stoves for heating from western states in the U.S., completed the HEWS during the winter months (November to March) of 2013 through 2016 with 30 subjects having in-home particle monitoring. Hard copy or …

Association Of Hospital Centrality In Inter-Hospital Patient-Sharing Networks With Patient Mortality And Length Of Stay, Regan W. Bergmark, Ginger Jin, Robert S. Semco, Marc Santolini, Margaret A. Olsen, Amar Dhand

2020-Current year OA Pubs

OBJECTIVE: The interdependence of hospitals is underappreciated in patient outcomes studies. We used a network science approach to foreground this interdependence. Specifically, within two large state-based interhospital networks, we examined the relationship of a hospital's network position with in-hospital mortality and length of stay.

METHODS: We constructed interhospital network graphs using data from the Healthcare Cost and Utilization Project and the American Hospital Association Annual Survey for Florida (2014) and California (2011). The exposure of interest was hospital centrality, defined as weighted degree (sum of all ties to a given hospital from other hospitals). The outcomes were in-hospital mortality and …

Innovations In Hematopoietic Stem-Cell Mobilization: A Review Of The Novel Cxcr4 Inhibitor Motixafortide, Zachary D. Crees, Michael P. Rettig, John F. Dipersio

2020-Current year OA Pubs

Hematopoietic stem-cell transplantation (HCT) and stem-cell-based gene therapies rely on the ability to collect sufficient CD34+ hematopoietic stem and progenitor cells (HSPCs), typically

Anti-Fibrotic Therapy And Lung Transplant Outcomes In Patients With Idiopathic Pulmonary Fibrosis, Todd L. Astor, Hilary J. Goldberg, Laurie D. Snyder, Andrew Courtwright, Ramsey Hachem, Tahuanty Pena, Lorenzo Zaffiri, Gerard J. Criner, Marie M. Budev, Tany Thaniyavarn, Thomas B. Leonard, Shaun Bender, Aliaa Barakat, Janis L. Breeze, Peter Lacamera

2020-Current year OA Pubs

BACKGROUND: It is unclear whether continuing anti-fibrotic therapy until the time of lung transplant increases the risk of complications in patients with idiopathic pulmonary fibrosis.

OBJECTIVES: To investigate whether the time between discontinuation of anti-fibrotic therapy and lung transplant in patients with idiopathic pulmonary fibrosis affects the risk of complications.

METHODS: We assessed intra-operative and post-transplant complications among patients with idiopathic pulmonary fibrosis who underwent lung transplant and had been treated with nintedanib or pirfenidone continuously for ⩾ 90 days at listing. Patients were grouped according to whether they had a shorter (⩽ 5 medication half-lives) or longer (> 5 …

Open-Source Statistical And Data Processing Tools For Wide-Field Optical Imaging Data In Mice, Lindsey M. Brier, Joseph P. Culver

2020-Current year OA Pubs

SIGNIFICANCE: Wide-field optical imaging (WOI) can produce concurrent hemodynamic and cell-specific calcium recordings across the entire cerebral cortex in animal models. There have been multiple studies using WOI to image mouse models with various environmental or genetic manipulations to understand various diseases. Despite the utility of pursuing mouse WOI alongside human functional magnetic resonance imaging (fMRI), and the multitude of analysis toolboxes in the fMRI literature, there is not an available open-source, user-friendly data processing and statistical analysis toolbox for WOI data.

AIM: To assemble a MATLAB toolbox for processing WOI data, as described and adapted to combine techniques from …

Bacterial Species And Antimicrobial Resistance Differ Between Catheter And Non-Catheter-Associated Urinary Tract Infections: Data From A National Surveillance Network, Stéphanie D'Incau, Andrew Atkinson, Lorenz Leitner, Andreas Kronenberg, Thomas M Kessler, Jonas Marschall

2020-Current year OA Pubs

OBJECTIVE: To investigate clinically relevant microbiological characteristics of uropathogens and to compare patients with catheter-associated urinary tract infections (CAUTIs) to those with non-CAUTIs.

METHODS: All urine cultures from the calendar year 2019 of the Swiss Centre for Antibiotic Resistance database were analyzed. Group differences in the proportions of bacterial species and antibiotic-resistant isolates from CAUTI and non-CAUTI samples were investigated.

RESULTS: Data from 27,158 urine cultures met the inclusion criteria.

CONCLUSION: CAUTI pathogens were more often resistant to recommended empirical antibiotics than non-CAUTI pathogens. This finding emphasizes the need for urine sampling for culturing before initiating therapy for CAUTI and …

Regulation Of The Volume-Regulated Anion Channel Pore-Forming Subunit Lrrc8a In The Intrahippocampal Kainic Acid Model Of Mesial Temporal Lobe Epilepsy, Manolia R. Ghouli, Carrie R. Jonak, Rajan Sah, Todd A. Fiacco, Devin K. Binder

2020-Current year OA Pubs

Volume-regulated anion channels (VRACs) are a group of ubiquitously expressed outwardly-rectifying anion channels that sense increases in cell volume and act to return cells to baseline volume through an efflux of anions and organic osmolytes, including glutamate. Because cell swelling, increased extracellular glutamate levels, and reduction of the brain extracellular space (ECS) all occur during seizure generation, we set out to determine whether VRACs are dysregulated throughout mesial temporal lobe epilepsy (MTLE), the most common form of adult epilepsy. To accomplish this, we employed the IHKA experimental model of MTLE, and probed for the expression of LRRC8A, the essential pore-forming …

Patterns Of Utilization And Clinical Adoption Of 0.35 Tesla Mr-Guided Radiation Therapy In The United States - Understanding The Transition To Adaptive, Ultra-Hypofractionated Treatments, Michael D Chuong, Lauren E Henke, Et Al.

2020-Current year OA Pubs

PURPOSE/OBJECTIVE: Magnetic resonance-guided radiation therapy (MRgRT) utilization is rapidly expanding worldwide, driven by advanced capabilities including continuous intrafraction visualization, automatic triggered beam delivery, and on-table adaptive replanning (oART). Our objective was to describe patterns of 0.35Tesla(T)-MRgRT (MRIdian) utilization in the United States (US) among early adopters of this novel technology.

MATERIALS/METHODS: Anonymized administrative data from all US MRIdian treatment systems were extracted for patients completing treatment from 2014 to 2020. Detailed treatment information was available for all MRIdian linear accelerator (linac) systems and some cobalt systems.

RESULTS: Seventeen systems at 16 centers delivered 5736 courses and 36,389 fractions (fraction details …

Substance Use Treatment Utilization Among Women With And Without Human Immunodeficiency Virus, Ayako W Fujita, Aditi Ramakrishnan, Et Al.

2020-Current year OA Pubs

BACKGROUND: Substance use (SU) contributes to poor health outcomes, yet limited data exist to inform strategies to optimize SU treatment among persons with human immunodeficiency virus (HIV). We describe SU and SU treatment utilization among women with and without HIV in the Women's Interagency HIV Study (WIHS).

METHODS: We included data from women enrolled in WIHS from 2013 to 2020. Current SU was self-reported, nonmedical use of drugs in the past year, excluding use of only marijuana. SU treatment utilization was self-reported use of a drug treatment program in the past year. Multivariable regression models were used to investigate associations …

Expanded Analysis Of High-Grade Astrocytoma With Piloid Features Identifies An Epigenetically And Clinically Distinct Subtype Associated With Neurofibromatosis Type 1, Patrick J Cimino, Sonika Dahiya, Et Al.

2020-Current year OA Pubs

High-grade astrocytoma with piloid features (HGAP) is a recently recognized glioma type whose classification is dependent on its global epigenetic signature. HGAP is characterized by alterations in the mitogen-activated protein kinase (MAPK) pathway, often co-occurring with CDKN2A/B homozygous deletion and/or ATRX mutation. Experience with HGAP is limited and to better understand this tumor type, we evaluated an expanded cohort of patients (n = 144) with these tumors, as defined by DNA methylation array testing, with a subset additionally evaluated by next-generation sequencing (NGS). Among evaluable cases, we confirmed the high prevalence CDKN2A/B homozygous deletion, and/or ATRX mutations/loss in this tumor …

A Randomized Implementation Trial To Increase Adoption Of Evidence-Informed Consent Practices, Erin D Solomon, Jessica Mozersky, Melody Goodman, Meredith V Parsons, Kari A Baldwin, Annie B Friedrich, Jenine K Harris, James M Dubois

2020-Current year OA Pubs

INTRODUCTION: Several evidence-informed consent practices (ECPs) have been shown to improve informed consent in clinical trials but are not routinely used. These include optimizing consent formatting, using plain language, using validated instruments to assess understanding, and involving legally authorized representatives when appropriate. We hypothesized that participants receiving an implementation science toolkit and a social media push would have increased adoption of ECPs and other outcomes.

METHODS: We conducted a 1-year trial with clinical research professionals in the USA (

RESULTS: Participants who engaged more with the toolkit were more likely to have tried to implement an ECP during the trial …

Live-Sky Gnss Signal Processing Using A Dual-Polarized Antenna Array For Multipath Mitigation, Eric Hahn, Sanjeev Gunawardena, Chris Bartone

Faculty Publications

Excerpt: Multipath results from reflections of Global navigation satellite signals (GNSS) signals arriving at a receiver that are delayed with respect to the desired line-of-sight (LOS) signals. The delayed signals distort the received LOS signals, thereby causing pseudorange and carrier phase measurement errors. Traditional multipath mitigation techniques include antenna gain pattern shaping (primarily to reduce ground multipath) and correlator gating techniques (such as narrow correlator and double-delta correlator [1]).

Sovereign Wealth Funds, Corporate Governance, And Corporate Performance, Feiyu Liu

Graduate Theses, Dissertations, and Problem Reports (ETD)

This dissertation comprises three chapters regarding the impact of sovereign wealth fund (SWF) investments on target firms’ corporate governance, cost of debt, and corporate social responsibility performance.

The first chapter is entitled “The Corporate Governance Consequences of Small Shareholdings: Evidence from Sovereign Wealth Fund Cross-Border Investments.” This chapter shows that firms’ corporate governance decrease following SWF cross-border investments. This impact holds for small SWF cross-border equity investments only, and is stronger for firms that are weakly governed and for those located in jurisdictions with weak shareholder protection. The negative relation is more pronounced when SWFs’ home countries have lower-quality investor …

Learning Representations For Novelty And Anomaly Detection, Ranya Almohsen

Graduate Theses, Dissertations, and Problem Reports (ETD)

The problem of novelty or anomaly detection refers to the ability to automatically

identify data samples that differ from a notion of normality. Techniques

that address this problem are necessary in many applications, like in medical

diagnosis, autonomous driving, fraud detection, or cyber-attack detection, just to

mention a few. The problem is inherently challenging because of the openness of

the space of distributions that characterize novelty or outlier data points. This is

often matched with the inability to adequately represent such distributions due

to the lack of representative data.

In this dissertation we address the challenge above by making several …

Enhancing The Forensic Comparison Process Of Common Trace Materials Through The Development Of Practical And Systematic Methods, Meghan Nicole Prusinowski

Graduate Theses, Dissertations, and Problem Reports (ETD)

An ongoing advancement in forensic trace evidence has driven the development of new and objective methods for comparing various materials. While many standard guides have been published for use in trace laboratories, different areas require a more comprehensive understanding of error rates and an urgent need for harmonizing methods of examination and interpretation. Two critical areas are the forensic examination of physical fits and the comparison of spectral data, which depend highly on the examiner’s judgment.

The long-term goal of this study is to advance and modernize the comparative process of physical fit examinations and spectral interpretation. This goal is …

Not A Do-Or-Die Affair: Freelance Journalists In Nigeria And Ethical Dilemmas, Tolulope O. Olasoji

Graduate Theses, Dissertations, and Problem Reports (ETD)

This study explores the ethical dilemmas Nigerian freelance journalists face and their implications for their work. It will use in-depth interviews with select freelance journalists. Several studies have established that ethical concerns are rife in—and indeed the bane of—journalism in Nigeria. However, these pieces of research reflect the reality across conventional newsrooms, where, ideally, there is some organizational structure and support. No scholarly attention has been given to freelance journalists, otherwise known as entrepreneurial journalists, due to their autonomous nature, to understand the ethical dilemmas they may be entangled in primarily. This study seeks to address this gap in research. …

Synergies Between Residents: Evaluating Support And Concerns Of Recreation And Tourism Economic Development Within The Monongahela National Forest Region, Morgan R. Martin

Graduate Theses, Dissertations, and Problem Reports (ETD)

Tourism has continually been presented as a growing economic sector around the world. Having become an area of increased interest for diversifying rural economies, tourism is an attractive alternative to the declining traditional economic engines of rural communities like agriculture, forestry, and mining. Rural destinations have become increasingly attractive to outside visitors who seek to pursue activities embedded within the local culture and distinctive attractive assets available in rural regions. The USDA has recognized the increasing importance of recreation and tourism economies as an emerging or priority area of national need and an effective means for rural development. Even with …

A Program Evaluation Of The West Virginia University Health Science Center Interprofessional Education First-Year Curriculum, Kathryn Lynn Smalley

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: The Interprofessional Education (IPE) First-Year Program was started at the West Virginia University Health Sciences Center in 2013 with the goal of providing participants introductory knowledge of the IPE Core Competencies as defined by the Interprofessional Education Collaborative (IPEC). This program transfers 16 different disciplines out of their isolated educational silos and allows them to learn about, for, and with one another. Participants are introduced to foundational knowledge through several didactic sessions over the course of an academic year. Although the program has been increasingly incorporated by many health sciences disciplines since its inception, it has never officially …

Development Of A Model Sustainability Management Plan For The City Of Morgantown, West Virginia, Caitlyn Elizabeth Lewis

Graduate Theses, Dissertations, and Problem Reports (ETD)

This report has been prepared to demonstrate the research for a model planning document with a focus on sustainability in Morgantown, WV. It discusses the role of three categories in the context of sustainability and proposes a design solution for selected areas of concern throughout the City of Morgantown in order to demonstrate opportunities for a sustainable approach toward resolution for city officials.

The City of Morgantown, West Virginia, is a college town along the Monongahela River with a backstory of industrialism that is echoed by many other places in Appalachia. However, distinctively, in Morgantown 25,000 college students populate the …

Comparison Of Skeletal Class Iii Malocclusion Facial-Shape Subtypes Between Caucasian, African American, And Hispanic Populations, Rachel Katherine Huffman

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Comparison of Skeletal Class III Malocclusion Facial-Shape Subtypes Between

Caucasian, African American, and Hispanic Populations

Rachel K. Huffman, DMD

Introduction: The development of a skeletal Class III malocclusion (Cl III) is complex as it can arise from the overgrowth of the mandible, undergrowth of the maxilla, or a combination of the two. To understand the heterogeneity of this trait clinically, studies have been conducted using facial shape analysis (e.g., Geometric morphometrics (GeoMorph)) of Caucasian and Asian populations to learn more about the principal shapes. Little is known, however, about the predominant principal shape components of Cl III within African …