Medicine and Health Sciences Commons^™

Examining The Use Of Expressive Arts Therapies In Neurorehabilitation Treatment Planning, Rebecca J. Horner

Expressive Therapies Capstone Theses

Those undergoing neurorehabilitation after stroke and traumatic brain injury report a diminished sense of overall wellness. This paper examines the conceivable benefits of introducing expressive arts therapies, which is the therapeutic use and combination of the visual arts, movement, drama, music, writing and other intermodal creative processes, into physical therapy and neurorehabilitation treatment planning. Expressive arts therapies have the capacity to engage with an individual’s physical, emotional, social and spiritual states concurrently. They simultaneously offer the ability to promote an increased sense of well-being, address mind-body disconnects, and process trauma non-verbally.

The sections of this narrative literature review focus on …

Pharmacokinetics Of Single Feeding Of Cannabidiol In Cattle: A Pilot Study, Haley Cornette

Honors College Theses

Cannabidiol (CBD) is a substance that has been used in complementary medicine for many years. However, modern medicine has little knowledge of how this substance is utilized and metabolized in ruminant animals. Regulations on quality assurance and use in animals are lacking, and CBD supplementation in livestock is not approved. If CBD supplements can be shown to be safe and effective, detection in the animal will be important for determining regulation of use. A withdrawal period can then be established to allow time for deterioration of product to safe levels before livestock products enter human markets. This study sought to …

2d Respiratory Sound Analysis To Detect Lung Abnormalities, Rafia Sharmin Alice, Kc Santosh

SDSU Data Science Symposium

Abstract. In this paper, we analyze deep visual features from 2D data representation(s) of the respiratory sound to detect evidence of lung abnormalities. The primary motivation behind this is that visual cues are more important in decision-making than raw data (lung sound). Early detection and prompt treatments are essential for any future possible respiratory disorders, and respiratory sound is proven to be one of the biomarkers. In contrast to state-of-the-art approaches, we aim at understanding/analyzing visual features using our Convolutional Neural Networks (CNN) tailored Deep Learning Models, where we consider all possible 2D data such as Spectrogram, Mel-frequency Cepstral Coefficients …

Leveraging Bio-Inspired Molecules For Cancer Theranostics, Douglas S. Macpherson

Dissertations, Theses, and Capstone Projects

A variety of molecules can be radiolabeled and delivered to a cancer site for the purposes of diagnostics and therapy. Among the most promising of tumor targeting molecules are peptides and antibodies. These bio-inspired molecules can be designed and synthesized to target and respond to cancer cells based on the properties of those cells. Matrix metalloproteinase (MMP) enzymes are over-expressed by some metastatic cancers, in which they are responsible for the degradation and remodeling of the extracellular matrix. In recent years, MMPs have emerged as promising targets for enzyme-responsive diagnostic probes because oligopeptides can be designed to be selectively hydrolyzed …

Effects Of A Race Timer On The 3-Minute All-Out Test For Critical Power, Paul Mandell, Boe Burrus, Taylor Bloedon

Topics in Exercise Science and Kinesiology

Topics in Exercise Science and Kinesiology Volume 4: Issue 1, Article 2, 2023. The 3-min all-out cycling test (3MT) elicits valuable fitness metrics including V̇O_2peak, HR_max, Critical Power (CP), and Work Above End Power (WEP; equivalent to work prime; W’). Twelve (n = 12) healthy active males were recruited to participate in the current study on the effects of the implementation of a race timer on the 3MT. Participants completed a V̇O_2peak test and one 3MT familiarization trial before completing one standard 3MT and one 3MT with the presence of a countdown race timer in …

A Brief Overview Of Triple A Syndrome, Jamaal Khan

Mako: NSU Undergraduate Student Journal

Triple A Syndrome, also known as AAA Syndrome, is a rare autosomal recessive disorder caused by any mutation in the AAAS gene on chromosome 12q13, whose main function is to code for the WD-repeat family regulatory protein, ALADIN. It typically occurs as a group of diseases that are characterized by alacrima, Addison's disease, and achalasia. Alacrima can be defined by a decrease in the amount of tears produced while achalasia is nerve damage in the esophagus that can cause difficulty swallowing. Lastly, Addison's disease is the insufficient production of cortisol and aldosterone produced by the adrenal cortex. There is no …

Dynamic Fecal Microbiota Transfer From Mice With Western Diet-Induced Severe Colitis And Colon Tumorigenesis Did Not Exacerbate Colitis Symptoms Or Colon Tumorigenesis In Recipient Mice Fed Either The Ain93g Diet Or The Total Western Diet, Abby D. Benninghoff

Browse all Datasets

Consumption of the total Western diet (TWD) in mice has been shown to increase gut inflammation, promote colon tumorigenesis, and alter the fecal microbiome composition in mice as com-pared to mice fed a healthy diet, AIN93G (AIN). However, it is unclear whether the gut micro-biome contributes directly to colitis-associated CRC in this model. The objective of this study was to determine whether dynamic fecal microbiota transfer (FMT) from host mice fed either AIN or TWD basal diets would alter colitis symptoms or colitis-associated CRC in recipient mice, which were fed either AIN or TWD directly using a 2x2 factorial experiment …

Proceedings Of The 22nd International Conference Of Public Health Sciences

Journal of Health Research

Chulalongkorn University has its own vision to be a world-class national university that generates the knowledge and innovation necessary for the creative and sustainable transformation of Thai society. In order to accomplish this vision, Chulalongkorn University has been supporting every Faculties, Institutes, Colleges and etc. within the university to conduct academic activities including in-class teaching, research, and conferences as we have today. The College of Public Health Sciences is the academic entity that emphasizes the teaching-learning on graduate level in the field of public health and public health sciences. It utilizes a mechanism to combine research both in public health …

The Effects Of Acute Rauwolscine (Α-Yohimbine) Ingestion On Repeated Wingate Sprint Performance In Healthy Males, Megan E. Barnes, Tyler Williams, Camryn R. Cowan, Brenden A. Torres, W. Tanner Clark, Rebecca R. Rogers, Luke R. Harms, Christopher G. Ballmann

Topics in Exercise Science and Kinesiology

Topics in Exercise Science and Kinesiology Volume 4: Issue 1, Article 1, 2023. Background: Rauwolscine (RW), also known as α-Yohimbine, is an α-2-adrenergic receptor antagonist which possesses sympathomimetic properties. RW is commercially sold in pre-workout and energy supplements. However, the ergogenic potential of RW has not been determined. The purpose of this study was to investigate the effects of acute RW supplementation on repeated sprint performance. Methods: Healthy male participants (n=12) completed 3 × 15-second Wingate anaerobic tests (WAnT) separated by 2 minutes of active recovery. Blood lactate (La) was collected before exercise (Pre) and immediately following exercise …

Abdominal Aortic Aneurysm: Natural History, Pathophysiology And Translational Perspectives, Giulio Accarino, Antonio Nicola Giordano, Martina Falcone, Adriana Celano, Maria Giovanna Vassallo, Giovanni Fornino, Umberto Marcello Bracale, Carmine Vecchione, Gennaro Galasso

Translational Medicine @ UniSa

An abdominal aortic aneurysm (AAA) is a degenerative pathology that affects the infrarenal segment of the aorta, leading to its progressive dilatation and eventually rupture. The infrarenal segment is involved in 80% of the aortic aneurisms, and represents alone 30% of all aneurysms. The natural history of the disease is characterized by the progressive increase of the aortic diameter associated with proportionally higher risk of rupture, particularly for cases with diameter greater than 5.5 cm. In case of rupture the mortality rate is very high, independently from the endovascular or surgical treatment. The most important risk factors are older age, …

Gm Allotypes And Covid-19. A Pilot Study Performed On Sicilian Patients, Mattia Emanuela Ligotti, Anna Calabrò, Giulia Accardi, Anna Aiello, Calogero Caruso, Claudia Colomba, Danilo Di Bona, Giovanni Duro, Aryan M Namboodiri, Antonino Tuttolomondo, Janardan P Pandey, Giuseppina Candore

Translational Medicine @ UniSa

Several studies suggest that genetic variants that influence the onset, maintenance and resolution of the immune response might be fundamental in predicting the evolution of COVID-19. In the present paper, we analysed the distribution of GM allotypes (the genetic markers of immunoglobulin γ chains) in symptomatic and asymptomatic COVID-19 patients and in healthy controls, all born and residing in Sicily. Indeed, the role played by GM allotypes in immune responses and infection control is well known. Our findings show that the GM23 allotype is significantly reduced in healthy controls. Interestingly, in a previous study, Sicilians carrying the GM23 allotype were …

Translating The Results Of A Selective Decontamination Of The Digestive Tract Trial Into Efficacious Real-Life Interventions, Ornella Piazza, Giovanni Boccia, Carolina Ciacci, Francesco De Caro, Amelia Filippelli, Gianluigi Franci, Pasquale Pagliano

Translational Medicine @ UniSa

No Abstract for this article type.

Burmese Pythons In Florida: A Synthesis Of Biology, Impacts, And Management Tools, Jacquelyn C. Guzy, Bryan G. Falk, Brian J. Smith, Johnd David Willson, Robert N. Reed, Nicholas G. Aumen, Michael L. Avery, Ian A. Bartoszek, Earl Campbell, Michael S. Cherkiss, Natalie M. Claunch, Andrea F. Currylow, Tylan Dean, Jeremy Dixon, Richard Engeman, Sarah Funck, Rebekah Gibble, Kodiak C. Hengstebeck, John S. Humphrey, Margaret E. Hunter, Jillian M. Josimovich, Jennifer Ketterlin, Michael Kirkland, Frank J. Mazzotti, Robert Mccleery, Melissa A. Miller, Matthew Mccollister, M. Rockwell Parker, Shannon E. Pittman, Michael Rochford, Christina Romagosa, Art Roybal, Ray W. Snow, Mckayla M. Spencer, J. Hardin Waddle, Any A. Yackel Adams, Kristen M. Hart

USDA Wildlife Services - Staff Publications

Burmese pythons (Python molurus bivittatus) are native to southeastern Asia, however, there is an established invasive population inhabiting much of southern Florida throughout the Greater Everglades Ecosystem. Pythons have severely impacted native species and ecosystems in Florida and represent one of the most intractable invasive-species management issues across the globe. The difficulty stems from a unique combination of inaccessible habitat and the cryptic and resilient nature of pythons that thrive in the subtropical environment of southern Florida, rendering them extremely challenging to detect. Here we provide a comprehensive review and synthesis of the science relevant to managing invasive …

Enhancing The Quality Of Life For Senior Citizens: A Facilitator’S Guidebook For Mindful Music And Movement, Shannon Sexton

Mindfulness Studies Theses

Music appreciation and enjoyment enhance well-being throughout the lifespan. The challenges and constraints that people experience as they age can lead to lack of access to music, decreased physical activity, and fewer avenues for creative expression. Group music and movement interventions created for older populations offer opportunities for social connection and improved quality of life. Mindful practices add further benefit when combined with these interventions. Current available programs are scarce and most often do not encompass mixed modalities. In addition, the benefits of these programs do not show long-term sustainability. The purpose of this thesis is to explore the effects …

Predicting If Lung Cancer Will Relapse—The Role Of Neutrophil/Lymphocyte Ratio, Abigail Chan, Søren Bentzen, Amit Rout, Kenneth Miller

Hematology/Oncology and Stem Cell Therapy

Objective/Background: Baseline neutrophil/lymphocyte ratio (NLR), a surrogate marker for systemic inflammation and immunosuppression, is a well-studied prognostic marker in nonsmall cell lung cancer (NSCLC). This study tests if interim NLR is prognostic in NSCLC patients in remission. Methods: This single-center, retrospective cohort study analyzed 131 NSCLC patients treated from 2010 to 2015 who achieved complete remission. NLR was calculated at baseline and from the first available blood sample during remission. Kaplan–Meier estimates of overall survival (OS) and time to recurrence were compared using the log-rank test for trend. Multivariable analysis was conducted using the Cox proportional hazards model. Results: Of …

Impact Of Pre-Transplant Induction Therapy On Outcomes Of Patients Who Undergo Autologous Stem Cell Transplantation For Mantle Cell Lymphoma In First Complete Remission, Omar Albanyan, Samer Alkassis, Seongho Kim, Andrew Kin, Asif Alavi, Lois Ayash, Voravit Ratanatharathorn, Dipenkumar Modi, Joseph P. Uberti, Abhinav Deol

Hematology/Oncology and Stem Cell Therapy

Mantle cell lymphoma is a rare subtype of non-Hodgkin’s lymphoma with poor prognosis and continue to be challenging to treat. The choice of first line induction regimen remains a topic of debate due paucity of clinical trials. We retrospectively evaluated 66 patients diagnosed with mantle cell lymphoma who achieved first complete response after induction chemotherapy followed by autologous stem cell transplant. Treatment groups were divided into lowintensity versus high-intensity regimens. Our data showed the intensity of induction regimen does not impact posttransplant outcomes of mantle cell lymphoma who underwent autologous stem cell transplant in first complete response.

Promising Effect Of Pdl1 Inhibitors In The Front-Line Management Of Primary Aggressive Central Nervous System Lymphoma: A Case Report, Rasha El-Tawab, Abdulaziz Hamada, Rehab Elhagracy, Karen Pinto, Salem Alshemmari

Hematology/Oncology and Stem Cell Therapy

Primary central nervous system lymphoma (PCNSL) is a rare lymphoma that involves the central nervous system. The standard treatment involves chemotherapy with high-dose methotrexate. To the best of our knowledge, this is the first reported case of employing checkpoint inhibitor, nivolumab, alone to treat a patient with PCNSL who could not tolerate the induction therapy. In aggressive cases of PCNSL where chemotherapy may become futile, stand-alone checkpoint inhibitors should be considered as the front-line treatment protocol.

Predictors And Management Of Relapse To Axicabtagene Ciloleucel In Patients With Aggressive B-Cell Lymphoma, Jose Vicente Forero-Forero, Paula A. Lengerke-Diaz, Eider Moreno-Cortes, Megan Melody, Zaid Abdel Rahman, Allison C. Rosenthal, Mohamed A. Kharfan-Dabaja, Januario E. Castro

Hematology/Oncology and Stem Cell Therapy

Objective/background: Despite the success of chimeric antigen receptor (CAR) T-cell therapy in patients with aggressive non-Hodgkin lymphoma (aNHL), some patients still fail treatment, and their prognosis is dismal. Methods: We performed a retrospective study of aNHL patients treated with axicabtagene ciloleucel (axi-cel) at two Mayo Clinic centers between 2018 and 2020. We evaluated predictive factors, toxicities, and responses to salvage regimens after CAR T-cell therapy. Results: Thirty-four patients received axi-cel with a median length of hospitalization of 14 days. Cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome of any grade occurred in 91% and 41% of patients, respectively. …

Immune Checkpoint Inhibitor-Induced Pneumonitis: Incidence, Clinical Characteristics, And Outcomes, Harsha Banavasi, Seongho Kim, Samer Alkassis, Asil Daoud, Amir Laktineh, Misako Nagasaka, Ammar Sukari, Ayman O. Soubani

Hematology/Oncology and Stem Cell Therapy

Background: Immune checkpoint inhibitors (ICIs) are the newest class of anticancer drugs. Pneumonitis is increasingly being recognized as a potential complication of these agents. Methods: We conducted a retrospective study of patients who received ICIs at a comprehensive cancer center. We collected data on demographics, type of malignancy, type of ICI agent, incidence of pneumonitis up to 6 weeks after receiving ICI agent, clinical characteristics, and risk factors for overall survival in patients who develop pneumonitis. Results: A total of 654 patients received ICIs during the study period. The most common type of cancer for which ICI was given was …

Changes In Heme Levels During Acute Vaso-Occlusive Crisis In Sickle Cell Anemia, Evilazio Cunha Cardoso, Pedro Vieira Silva-Neto, Bidossessi Wilfried Hounkpe, Francine Chenou, Cintia Cristina Mateus Xerez Albuquerque, Nadja Pinto Garcia, Alexander Leonardo Silva-Junior, Adriana Malheiro, Purim Cesar, Franciele De Lima, Erich V. De Paula, Nelson Abrahim Fraiji

Hematology/Oncology and Stem Cell Therapy

Objective/Background: Sickle cell anemia (SCA) is associated with increased levels of extracellular heme, which is a key mediator of inflammation in this condition. Despite abundant evidence supporting this concept in cell and animal models, few studies addressed the association between heme levels and the development and severity of acute vaso-occlusive crises (VOC) in humans. Methods: A cross-sectional study was conducted in patients with acute VOC. Total extracellular heme levels were measured in both plasma and serum at admission and after convalescence, and correlated with other clinical and laboratory markers of SCA severity. Results: A total of 28 episodes of VOC …

Diagnosis And Treatment Of Subcutaneous Panniculitis-Like T-Cell Lymphoma: A Systematic Literature Review, Dunya Yunus Alsomali, Nasir Bakshi, Mohamed Kharfan-Dabaja, Riad El Fakih, Mahmoud Aljurf

Hematology/Oncology and Stem Cell Therapy

Objectives: The aim of this systematic review is to investigate different diagnostic methods and the available treatment options for subcutaneous panniculitis-like T-cell lymphoma (SPTCL). Methods: We searched PubMed, Web of Science, SCOPUS, EBSCO, and CINAHL Plus for published case reports of SPTCL. From each record, we extracted data of the diagnostic methods, immunohistochemical profile, clinical characteristics, and the treatment approaches provided. Data were summarized and narratively synthesized to highlight the various diagnostic methods and treatment options of SPTCL. Results: Our literature search yielded 1293 unique citations. Following screening, nine articles reporting a total of 15 cases were included in this …

Cross Fire: Daratumumab-Based Therapies Are Standard Of Care In Newly Diagnosed Multiple Myeloma, Neha Korde, Saad Z. Usmani

Hematology/Oncology and Stem Cell Therapy

There is no abstract.

Current Status And Future Perspectives On The Internet Of Things In Oncology, Ibrahim N. Muhsen, Omar W. Rasheed, Eiad A. Habib, Rakan K. Alsaad, Mohannad K. Maghrabi, Md A. Rahman, Douglas Sicker, William A. Wood, Muhammad S. Beg, Anthony D. Sung, Shahrukh K. Hashmi

Hematology/Oncology and Stem Cell Therapy

The Internet of Things (IoT) has penetrated many aspects of everyday human life. The use of IoT in healthcare has been expanding over the past few years. In this review, we highlighted the current applications of IoT in the medical literature, along with the challenges and opportunities. IoT use mainly involves sensors and wearables, with potential applications in improving the quality of life, personal health monitoring, and diagnosis of diseases. Our literature review highlights that the current main application studied in the literature is physical activity tracking. In addition, we discuss the current technologies that would help IoT-enabled devices achieve …

Efficacy And Safety Of Recombinant Thrombomodulin For The Prophylaxis Of Veno-Occlusive Complication In Allogeneiccit Hematopoietic Stem Cell Transplantation: A Systematic Review And Meta-Analysis, Richi Kashyap, Faiz Anwer, Muhammad Areeb Iqbal, Farhan Khalid, Anam Khan, Muhammad Ashar Ali, Muhammad Yasir Anwar, Anamika Chaudhary, Ali Jaan

Hematology/Oncology and Stem Cell Therapy

Background: Hepatic veno-occlusive disease (VOD), also termed as sinusoidal obstruction syndrome (SOS), is a lethal complication after hematopoietic stem cell transplantation (HSCT). Various factors put patients undergoing allogeneic HSCT at an increased risk for VOD. Thrombomodulin (TM) is an important factor which has a wide range of effects, including anticoagulant, anti-inflammatory, angiogenic, and protective effect, on endothelial cells. It plays a role in preventing excessive coagulation and thrombosis by binding with thrombin and inhibiting the coagulation cascade. There are a limited number of options for the prevention of this fatal complication. Recombinant thrombomodulin (rTM), an endothelial anticoagulant co-factor,

as prophylactic …

Strange Bedfellows: Npm1 Mutations In Acute Promyelocytic Leukemia, Stephen E. Langabeer

Hematology/Oncology and Stem Cell Therapy

No Abstract for this article type

Outcome Of Myeloma Patients With Covid-19 On Active Lenalidomide-Based Therapy: Does Lenalidomide Protect From Severe Covid-19?, Imran K. Tailor, Nawal F. Alshehry, Syed Z. Zaidi, Mohammed A. Marei, Ibraheem H. Motabi, Mansour Alfayez, Syed Y. Altaf

Hematology/Oncology and Stem Cell Therapy

No abstract for this article type.

Use Of Checkpoint Inhibitors In Gray Zone Lymphoma, Yensy Mariana Zelaya Rosales, Juliene Lima Mesquita, Yhasmine Delles Oliveira Garcia, Fernando Ricardo Fernandes Paz, Naiana Castelo Branco Campos, Joa˜O Paulo De Vasconcelos Leita˜O, Francisco Da´Rio Rocha Filho, Ricardo Vale Albino Oliveira Filho, Rome´Lia Pinheiro Gonc¸Alves Lemes, Fernando Barroso Duarte

Hematology/Oncology and Stem Cell Therapy

Checkpoint inhibitors, cancer immunotherapies, are the new forms of treatment for gray zone lymphoma, a rare subtype that combines the characteristics of both Hodgkin and non-Hodgkin disease forms. Programmed cell death protein 1/programmed cell death ligand 1 (PD-L1/PD-1) and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) modulate the immune system function. Immunological checkpoints can be stimulatory or inhibitory, and tumors can use these checkpoints to protect against immune system attacks. This is a case report of a difficult diagnosis and describes the most current treatment using checkpoint inhibitors, through the review of the clinical record of a patient diagnosed with gray area …

High Expression Of Long Noncoding Rna Norad Is Associated With Poor Clinical Outcomes In Non-M3 Acute Myeloid Leukemia Patients, Mohammad Masoud Eslami, Mina Soufizomorrod, Mohammad Ahmadvand

Hematology/Oncology and Stem Cell Therapy

Objective/Background: Dysregulation of long noncoding RNA NORAD has been identified in human solid tumors. However, the expression profile of NORAD and its clinical implications in acute myeloid leukemia (AML) is unclear. The current study aimed to explore the NORAD expression status and its clinical significance in non-M3 AML patients. Methods: NORAD expression was evaluated in 60 de novo non-M3 AML patients and 49 healthy individuals using quantitative reverse transcription–polymerase chain reaction method. The correlation between NORAD transcription levels and clinicopathologic characteristics was statistically studied. Results: Compared with the healthy controls, NORAD was consistently higher in non-M3 AML patients (p = …

Prophylactic Pretransplant Ganciclovir To Reduce Cytomegalovirus Infection After Hematopoietic Stem Cell Transplantation, Daniel R. Reed, Gina R. Petroni, Melissa West, Caroline Jones, Abeer Alfaraj, Paige G. Williams, Kathlene Degregory, Kyle Grose, Sandra Monson, Indumathy Varadarajan, Leonid Volodin, Gerald R. Donowitz, Tamila L. Kindwall-Keller, Karen K. Ballen

Hematology/Oncology and Stem Cell Therapy

Objective/Background: Cytomegalovirus (CMV) reactivation remains a serious complication after allogeneic hematopoietic cell transplantation (HCT) occurring in approximately 60–70% of CMV-seropositive HCT recipients. CMV reactivation leads to adverse outcomes including end-organ damage, graft-versus-host disease, and graft failure. Methods: Ganciclovir was administered pretransplant at 5 mg/kg twice daily intravenously from the start of conditioning to Day T-2 to CMV-seropositive patients receiving their first allogeneic HCT. CMV DNA was monitored weekly until at least Day 100 posttransplant. Results: A total of 109 consecutive patients were treated, median age 57 (range 20–73) years. Of these, 36 (33%) patients had a CMV reactivation within the …

Azacitidine Maintenance Therapy Postallogeneic Stem Cell Transplantation In Poorrisk Acute Myeloid Leukemia, Amany R. Keruakous, Jennifer Holter-Chakrabarty, Sarah A. Schmidt, Mohamad O. Khawandanah, George Selby, Carrie Yuen

Hematology/Oncology and Stem Cell Therapy

Objective/Background: Allogeneic hematopoietic stem cell transplant (HSCT) is the potential curative modality for poor-risk acute myeloid leukemia (AML), relapse remains the main reason for transplant failure. Early-phase studies showed azacitidine is safe for post-transplant maintenance therapy in AML. Methods: We performed a single institutional prospective cohort study to evaluate the benefit of azacitidine maintenance therapy following allogeneic HSCT in poor-risk AML. The main objective of this study is to generate a hypothesis aiming to optimize post-transplantation outcomes in poor-risk AML. Forty-nine adults with poor-risk AML who underwent allogeneic HSCT were evaluated in a nonrandomized prospective cohort fashion. Thirty-one participants received …