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Articles 3181 - 3210 of 14474

Full-Text Articles in Medicine and Health Sciences

Home-Based Virtual Culinary Nutrition Education Sessions For Amyotrophic Lateral Sclerosis Patients: Quantitative Experimental Pilot Study, Ciara N. Reistad, Mauricio Lobo Apr 2024

Home-Based Virtual Culinary Nutrition Education Sessions For Amyotrophic Lateral Sclerosis Patients: Quantitative Experimental Pilot Study, Ciara N. Reistad, Mauricio Lobo

Department of Nutrition Student Projects

Amyotrophic lateral sclerosis (ALS) impairs voluntary muscular activity and often results in malnutrition. The need for specialized dietary therapy for ALS-related illnesses is highlighted by recent research, but it also draws attention to the lack of targeted care and ongoing nutritional status monitoring. Technological developments like telehealth and chatbots hold potential for ALS patients’ nutritional monitoring. The pilot study examined the feasibility and impact of home-based virtual culinary nutrition education sessions on nutritional knowledge, dietary intake of energy (CHO), protein (PRO) and FAT, body mass index (BMI), and functional status assessed by ALSFRS-R scores in patients with Amyotrophic Lateral Sclerosis …


2024 North Texas Research Forum Program, Hca Healthcare Apr 2024

2024 North Texas Research Forum Program, Hca Healthcare

North Texas GME Research Forum 2024

No abstract provided.


Privileges, Immunities, And Affirmative Action In Medical Education, Gregory Curfman Apr 2024

Privileges, Immunities, And Affirmative Action In Medical Education, Gregory Curfman

Journal of Law and Health

In Students for Fair Admissions v. President & Fellows of Harvard College and Students for Fair Admissions v. University of North Carolina, the Supreme Court ruled that affirmative action in university admissions, in which an applicant of a particular race or ethnicity receives a plus factor, is unconstitutional. This ruling was based on both the Equal Protection Clause of the Fourteenth Amendment and Title VI of the Civil Rights Act of 1964. This article argues that a more natural fit as the basis for constitutional analysis would be a different clause in the Fourteenth Amendment, the Privileges or Immunities …


Academic Detailing As A Health Information Technology Implementation Method: Supporting The Design And Implementation Of An Emergency Department-Based Clinical Decision Support Tool To Prevent Future Falls, Hanna J Barton, Apoorva Maru, Margaret A Leaf, Daniel J Hekman, Douglas A Wiegmann, Manish N Shah, Brian W Patterson Apr 2024

Academic Detailing As A Health Information Technology Implementation Method: Supporting The Design And Implementation Of An Emergency Department-Based Clinical Decision Support Tool To Prevent Future Falls, Hanna J Barton, Apoorva Maru, Margaret A Leaf, Daniel J Hekman, Douglas A Wiegmann, Manish N Shah, Brian W Patterson

Faculty, Staff and Student Publications

BACKGROUND: Clinical decision support (CDS) tools that incorporate machine learning-derived content have the potential to transform clinical care by augmenting clinicians' expertise. To realize this potential, such tools must be designed to fit the dynamic work systems of the clinicians who use them. We propose the use of academic detailing-personal visits to clinicians by an expert in a specific health IT tool-as a method for both ensuring the correct understanding of that tool and its evidence base and identifying factors influencing the tool's implementation.

OBJECTIVE: This study aimed to assess academic detailing as a method for simultaneously ensuring the correct …


The Consequences Of A Career In Burn Surgery: An Economic Analysis To Aid Prospective Clinicians, Jeffrey E. Carter, Anastasiya Ivanko, Jonathan E. Schoen, Herb A. Phelan Iii, William L. Hickerson, Randy D. Kearns Apr 2024

The Consequences Of A Career In Burn Surgery: An Economic Analysis To Aid Prospective Clinicians, Jeffrey E. Carter, Anastasiya Ivanko, Jonathan E. Schoen, Herb A. Phelan Iii, William L. Hickerson, Randy D. Kearns

School of Medicine Faculty Publications

56th Annual Meeting of the American Burn Association, 2024; April 9 - April 12, 2024; Chicago, IL


2024 April 16 - Medical Student Education Committee Minutes, Medical Student Education Committee, East Tennessee State University Apr 2024

2024 April 16 - Medical Student Education Committee Minutes, Medical Student Education Committee, East Tennessee State University

Medical Student Education Committee Minutes

No abstract provided.


Assessment Of Condylar Morphology In Various Facial Types-Cbct Study, Dr.Shruti Patil Apr 2024

Assessment Of Condylar Morphology In Various Facial Types-Cbct Study, Dr.Shruti Patil

Annual Research Symposium

Mandibular condyle being part of the TMJ complex, its volume and shape play a pivotal role in treatment stability and outcomes in orthodontic and orthognathic patients over long term periods. Different loading patterns would result in different morphology of the TMJ. The association with different facial types and understanding the relationship between condylar position, morphology and jaw base divergence is limited. This study’s objective is to assess the condylar structure which includes condylar height, width and height of the fossa in different jaw base divergences.

A cross-sectional study was conducted in which 90 patients undergoing Orthodontic treatment were selected and …


Barriers That Affect Equity In The Occupational Therapy Admissions Process: Student And Faculty Perspectives, Quinn P. Tyminski, Lenin Grajo Apr 2024

Barriers That Affect Equity In The Occupational Therapy Admissions Process: Student And Faculty Perspectives, Quinn P. Tyminski, Lenin Grajo

The Open Journal of Occupational Therapy

The use of holistic admissions in higher education has been demonstrated to increase the diversity of incoming student classes; yet, in occupational therapy (OT) research, admissions processes remain under-explored. This phenomenological study aimed to explore the process of OT admissions from the perspective of students, faculty, and staff at a single OT program with the goal to create a more inclusive, equitable, and holistic process. Focus groups were conducted with first-year students, and an online survey was sent to faculty to explore perspectives on the admissions process, necessary qualities for an OT graduate student, and suggestions for increasing inclusion and …


Wellness Research & Programming For Bodybuilders, Victoria Castillo, Karen Park, Kersten Laughlin Apr 2024

Wellness Research & Programming For Bodybuilders, Victoria Castillo, Karen Park, Kersten Laughlin

Spring 2024 Virtual OTD Capstone Symposium

This project explores the occupational impact on bodybuilders and wellness & program development for competitive bodybuilders. Phase one focuses on research to understand the occupational impact on bodybuilders during competition. Phase two, which focuses on program development, highlights the alignment to the objectives as they allow for the development of an educational program intended for bodybuilder coaches to help with health prevention and wellness with their bodybuilder clients.


Intouch Week Of April 15, 2024, New York Medical College Apr 2024

Integrative Assessment And Prediction Modeling For Injury Risk Mitigation In Division 1 Female Soccer Athletes: A Comprehensive Approach Utilizing Wearable Technology, Joseph Amitrano, Juqi Lin, Gina Lewandowski, Lauren Calabrese, Dhruv Seshadri Apr 2024

Integrative Assessment And Prediction Modeling For Injury Risk Mitigation In Division 1 Female Soccer Athletes: A Comprehensive Approach Utilizing Wearable Technology, Joseph Amitrano, Juqi Lin, Gina Lewandowski, Lauren Calabrese, Dhruv Seshadri

International Journal of Exercise Science: Conference Proceedings

There is a pressing need for effective injury prevention methods to mitigate time-loss injuries. This study aims to develop a predictive recovery model for Division 1 female soccer athletes by integrating physiological, biomechanical, and subjective wellbeing assessments. PURPOSE The growing popularity of women's sports, particularly soccer, has brought the critical issue of injury risk management. While existing literature underscores the importance of maintaining an optimal acute to chronic workload ratio (ACWR) to mitigate injury risks, there remains a gap in understanding additional predictive metrics for athlete health. This deficit is pronounced in the context of women's soccer, where research focusing …


Leveraging Wearable Technology For Physiological Modeling In Guiding Return To Play Protocols For Athletes Post-Acl Reconstruction Surgery, Dhruv Seshadri, Milad Zarrinfar, Marco Giuliani, Kevin Cahill, Joseph Amitrano Apr 2024

Leveraging Wearable Technology For Physiological Modeling In Guiding Return To Play Protocols For Athletes Post-Acl Reconstruction Surgery, Dhruv Seshadri, Milad Zarrinfar, Marco Giuliani, Kevin Cahill, Joseph Amitrano

International Journal of Exercise Science: Conference Proceedings

There is a clinical need to quantify return to play when assessing athletes’ post-surgery. This study aims at developing physiological models to predict recovery time post-Anterior Cruciate Ligament (ACL) surgery in Division 1 Football players by integration of physiological and subjective data. PURPOSE Amidst the pressure to excel in top athletic competitions, athletes frequently endure ligamentous injuries, notably ACL tears. Yet, there's no standard method for quantifying return-to-play post-ACL reconstruction, leaving rehabilitation without an objective measure to assess athletes' readiness. Holistic assessment integrating physiological and subjective measurements can facilitate return prediction. METHODS This case study evaluates two Division 1 football …


Comparing The Effect Of N-95 Vs Surgical Mask Use On Resting Metabolic Data Changes, Robert Steinberg, Alexander Rothstein, Amerigo Rossi, Alyssa Hillian, Joanne Difrancisco-Donoghue Apr 2024

Comparing The Effect Of N-95 Vs Surgical Mask Use On Resting Metabolic Data Changes, Robert Steinberg, Alexander Rothstein, Amerigo Rossi, Alyssa Hillian, Joanne Difrancisco-Donoghue

International Journal of Exercise Science: Conference Proceedings

Face masks reduce the spread of viral respiratory particles, however, their impact on respiratory physiology requires further research. Previous studies reported negative changes in gas exchange data when wearing a surgical mask, however, breath-by-breath data has not been analyzed. PURPOSE: To compare physiological changes when wearing an N95 mask and surgical mask at rest. Variables measured include oxygen consumption (VO2), carbon dioxide ventilation (VC02), respiratory exchange ratio (RER), heart rate (HR), respiratory rate (RR), minute ventilation (MV), and discomfort. METHODS: 42 subjects ages 18-55 (19 men; age 22.98±3.83) were recruited. Exclusion criteria was a history of metabolic disease/claustrophobia. Respiratory and …


Responsiveness Of The Sit-To-Stand Test To Measure Lower Body Power, Jose Antonio Tan Apr 2024

Responsiveness Of The Sit-To-Stand Test To Measure Lower Body Power, Jose Antonio Tan

International Journal of Exercise Science: Conference Proceedings

Muscle power declines at a faster rate and demonstrates a stronger association with physical function than strength, emphasizing the growing importance of assessing muscle power. The Sit-to-Stand (STS) test is a novel test to measure lower body power that is valid and reliable, while also being portable and affordable. However, its responsiveness to change or longitudinal validity is unknown. PURPOSE: To examine the responsiveness to change of the Sit-to-Stand test in comparison to the pneumatic leg press in measuring lower body power. METHOD: 23 community-living adults, aged 50-80, were recruited. Participants underwent a full body strength training workout twice a …


Knee Injuries In Nfl Lineman -- A Correlation With Bmi, Michael Lem Md, John Bianchi Do, Austin Irwin, Robert J. Farrell Md, Cole Siegenfeld Apr 2024

Knee Injuries In Nfl Lineman -- A Correlation With Bmi, Michael Lem Md, John Bianchi Do, Austin Irwin, Robert J. Farrell Md, Cole Siegenfeld

International Journal of Exercise Science: Conference Proceedings

Knee Injuries in NFL Linemen - Correlation with BMI

Dr. Michael Lem, MD; Dr. John Bianchi, DO; Austin Irwin, OMS II; Dr. Robert Farrell, MD; Cole Siegenfeld, OMS II

Purpose:

Knee injuries are among the most common injuries suffered in the NFL which in turn can decrease a player's playing time in a given season and thus negatively impact future performance. Understanding characteristics like BMI can help modify and identify players at risk for knee injuries.

Methods and Study Design:

Data collected for this study was extracted from the official NFL database of injuries.

Reported knee injuries for offensive and …


Bioinformatics To Guide Musculoskeletal Modeling: A Retrospective Study From Olympic Water Polo Athletes, Dhruv Seshadri, Tony Del Vecchio, Hayley Whitney, Tim Gabbett Apr 2024

Bioinformatics To Guide Musculoskeletal Modeling: A Retrospective Study From Olympic Water Polo Athletes, Dhruv Seshadri, Tony Del Vecchio, Hayley Whitney, Tim Gabbett

International Journal of Exercise Science: Conference Proceedings

GNYACSM Original Research Abstract

Bioinformatics to Guide Musculoskeletal Modeling: A Retrospective Study from Olympic Water Polo Athletes

DEL VECCHIO TONY, WHITNEY HAYLEY, GABBETT TIM

Seshadri Lab; Bioengineering; Lehigh University; Bethlehem, PA

Category: Masters

Advisor / Mentor: Seshadri, Dhruv [email protected]

ABSTRACT

There is a pressing need for effective injury prevention methods to mitigate time-loss injuries. This study aims to develop a robust injury risk assessment model for water polo athletes by assessing the interplay between load-response metrics, and leveraging artificial intelligence to forecast wellness based on prior assessments.

PURPOSE

Water polo athletes present with upper extremity injuries in the hip, knee, …


Effectiveness Of Mobile Health Sedentary Time Interventions In Older Adults: A Systematic Review And Meta-Analysis, Siqing Chen, Lili Yang, Carol Ewing Garber Facsm, Matthew Stults-Kolehmainen Facsm, Chenchen Wang, Yuting Yang, Qiao Yuan Apr 2024

Effectiveness Of Mobile Health Sedentary Time Interventions In Older Adults: A Systematic Review And Meta-Analysis, Siqing Chen, Lili Yang, Carol Ewing Garber Facsm, Matthew Stults-Kolehmainen Facsm, Chenchen Wang, Yuting Yang, Qiao Yuan

International Journal of Exercise Science: Conference Proceedings

mHealth is the provision of health care and health information through mobile electronic devices.The prevalence of sedentary behaviors (SB) among older adults is increasing, underscoring the urgent need for effective mHealth interventions. Evidence of the effectiveness of mHealth in older adults is unclear. PURPOSE: The study aims to 1) explore the effects of mHealth interventions on reducing SB; and 2) examine the influence of potential moderators on mHealth interventions' effectiveness by analyzing subgroups according to participants' characteristics and intervention specifics. METHODS: A systematic review and meta-analysis of randomized controlled trials were conducted. A literature search was conducted using multiple databases …


Perceived Recovery States And Physical Fitness In Reserve Officers’ Training Corps Cadets, Lianne Emanuel, Jessie Hirsch, James Bodendorf, Amy Loin, Gregory Ioannides, Aliya Catanzarita, Joseph Schnatter, Isaac Stein, Tarek Harhash, Sean Kane, Julianne Rung, Katie Sell Apr 2024

Perceived Recovery States And Physical Fitness In Reserve Officers’ Training Corps Cadets, Lianne Emanuel, Jessie Hirsch, James Bodendorf, Amy Loin, Gregory Ioannides, Aliya Catanzarita, Joseph Schnatter, Isaac Stein, Tarek Harhash, Sean Kane, Julianne Rung, Katie Sell

International Journal of Exercise Science: Conference Proceedings

Reserve Officers’ Training Corps (ROTC) cadets are challenged mentally, emotionally, and physically with the physical fitness requirements (e.g., Army Combat Fitness Test or ACFT) required within their military science curriculum. Common physical fitness tests such as those for strength, power, and balance can provide insight into the recovery and readiness status of tactical athletes. PURPOSE: The purpose of this study was to explore the relationship between scores on the Short Recovery and Stress Scale (SRSS) and performance on a physical fitness test battery assessing balance, mobility, body composition, muscular strength, and power in collegiate ROTC cadets. METHODS: Seventeen …


Heart Rate Response To Maximal Exercise In A Participant With C8 Spinal Cord Injury, Jessie Hirsch, Alex Rothstein, Norbert Holowat Jr, Michele Aquino, Amerigo Rossi, John P. Handrakis Apr 2024

Heart Rate Response To Maximal Exercise In A Participant With C8 Spinal Cord Injury, Jessie Hirsch, Alex Rothstein, Norbert Holowat Jr, Michele Aquino, Amerigo Rossi, John P. Handrakis

International Journal of Exercise Science: Conference Proceedings

Motor, sensory, and autonomic dysfunction are a common sequela after spinal cord injury (SCI) and typically impair cardiovascular responses to exercise. However, some individuals with cervical SCI (tetraplegia) and “complete” motor and sensory injury (AIS A) demonstrate the ability to increase heart rate (HR) above the limit achievable by vagal withdrawal alone (~110 bpm). PURPOSE: The purpose of this test was to highlight the unexpected HR response to a continuous graded exercise test. (GXT) in a wheelchair athlete with tetraplegia. METHODS: A 26-year-old male with tetraplegia after a SCI (classification neurological level of injury (NLI) C8, AIS A) …


Best Screening: Introducing The Neonatal Assessment Visual European Grid To Nicus In Tennessee, Gabrielle Sledge Apr 2024

Best Screening: Introducing The Neonatal Assessment Visual European Grid To Nicus In Tennessee, Gabrielle Sledge

OTD Capstone Projects

Blind Early Services Tennessee (BEST) is an early intervention agency that serves children ages 0-5 with visual impairments across Tennessee. BEST serves over 200 children and families across the state offering early intervention (BEST Start), parent empowerment (BEST Advocate), and family support (BEST Together) programming. The purpose of this project was to assist in the implementation of an early identification initiative (BEST Screening) using the Neonatal Assessment Visual European Grid (NAVEG). The NAVEG is a newborn vision screening shown to identify neurological risk for visual impairments. The long-term goal of this program is to promote the screening and early identification …


Health Professional Students Receiving Osteopathic Manipulative Treatment: An Interdisciplinary And Interprofessional Activity To Improve Attitudes Towards Osteopathic Medicine And Interprofessional Collaboration, Nicole Neiman, Justinas Joksas, Erica Sickel, Anne Marie Zeller Apr 2024

Health Professional Students Receiving Osteopathic Manipulative Treatment: An Interdisciplinary And Interprofessional Activity To Improve Attitudes Towards Osteopathic Medicine And Interprofessional Collaboration, Nicole Neiman, Justinas Joksas, Erica Sickel, Anne Marie Zeller

Research Day

No abstract provided.


Evaluation Of Seizure Recognition And First Aid Training Course And Improving Self-Efficacy Related To Medical Emergencies In Mississippi, Anna Katherine Herrington, Collin Earl Wayne Crawson, Daniel Robert Zuckerman Apr 2024

Evaluation Of Seizure Recognition And First Aid Training Course And Improving Self-Efficacy Related To Medical Emergencies In Mississippi, Anna Katherine Herrington, Collin Earl Wayne Crawson, Daniel Robert Zuckerman

Honors Theses

Within recent years, there has been increased attention to the growing physician shortage across the United States. This shortage has placed substantial strain upon regions of lower healthcare access, particularly those of rural regions such as much of the state of Mississippi. As rural healthcare providers are placed under more strenuous conditions, they encounter issues of increased patient volume, lack of a trauma team, or adequate transportation to higher-level care facilities. These issues may exacerbate the present inequities in cost of living, access to adequate healthcare, and the distress caused by these concerns. Individuals with epilepsy are one cohort with …


Perceived Recovery States And Physical Fitness In Reserve Officers’ Training Corps Cadets, Lianne Emanuel, Jessie Hirsch, James Bodendorf, Amy Loin, Gregory Ioannides, Aliya Catanzarita, Tarek Harhash, Joseph Schnatter, Isaac Stein, Sean Kane, Julianne Rung, Katie Sell Apr 2024

Perceived Recovery States And Physical Fitness In Reserve Officers’ Training Corps Cadets, Lianne Emanuel, Jessie Hirsch, James Bodendorf, Amy Loin, Gregory Ioannides, Aliya Catanzarita, Tarek Harhash, Joseph Schnatter, Isaac Stein, Sean Kane, Julianne Rung, Katie Sell

International Journal of Exercise Science: Conference Proceedings

Reserve Officers’ Training Corps (ROTC) cadets are challenged mentally, emotionally, and physically with the physical fitness requirements (e.g., Army Combat Fitness Test or ACFT) required within their military science curriculum. Common physical fitness tests such as those for strength, power, and balance can provide insight into the recovery and readiness status of tactical athletes. PURPOSE: The purpose of this study was to explore the relationship between scores on the Short Recovery and Stress Scale (SRSS) and performance on a physical fitness test battery assessing balance, mobility, body composition, muscular strength, and power in collegiate ROTC cadets. METHODS: Seventeen ROTC cadets …


Effects Of Electrical Exercise On Self-Reported Depression And Quality Of Life In Those With Spinal Cord Injury, Aj Barber, Eric Heidorn, John Mcdaniel, Cody S. Dulaney Apr 2024

Effects Of Electrical Exercise On Self-Reported Depression And Quality Of Life In Those With Spinal Cord Injury, Aj Barber, Eric Heidorn, John Mcdaniel, Cody S. Dulaney

International Journal of Exercise Science: Conference Proceedings

One of the most common psychological disorders that occur as a result of spinal cord injury (SCI) is depression along with reductions in quality of life. Moreover, depression is correlated with quality of life. It is increasingly apparent that exercise offers an accessible and non-pharmacological intervention to ease depressive symptoms and improve quality of life. Unfortunately, access to meaningful exercise options remains challenging to those with mobility impairments such as those seen with SCI. PURPOSE: The purpose of this study was to assess the chronic engagement of home-based electrical stimulation exercise (ESE) on self-reported depression and quality of life …


Effects Of Electrical Exercise And Affect On Self-Reported Anxiety In Those With Spinal Cord Injury, John Zimmerman, Eric Heidorn, John Mcdaniel, Cody S. Dulaney Apr 2024

Effects Of Electrical Exercise And Affect On Self-Reported Anxiety In Those With Spinal Cord Injury, John Zimmerman, Eric Heidorn, John Mcdaniel, Cody S. Dulaney

International Journal of Exercise Science: Conference Proceedings

Those who have incurred a spinal cord injury (SCI) have severe and immediate changes to their lifestyle. Those with SCI have reported reduced levels of positive affect and no change in negative affect compared to controls. Also, those with SCI may have reduced opportunities for engaging in meaningful exercise either due to mobility or equipment access limitations. PURPOSE: The purpose of this study was to assess the chronic engagement of home-based electrical stimulation exercise (ESE) on self-reported anxiety and positive and negative affect. METHODS: 9 individuals with ASIA A or B SCI were recruited for this study. Participants …


Poster Abstracts For 14th Annual University Of Dayton And Miami Valley Hospital Healthcare Symposium, Udayton Apr 2024

Poster Abstracts For 14th Annual University Of Dayton And Miami Valley Hospital Healthcare Symposium, Udayton

Pre-Health Resource Center Campus Communications

No abstract provided.


Typhlitis In A Neutropenic Patient, Alice He Bs, Wern Lynn Ng Md, Lay She Ng Md, Si Yuan Khor Md, Chandi Garg Md Apr 2024

Typhlitis In A Neutropenic Patient, Alice He Bs, Wern Lynn Ng Md, Lay She Ng Md, Si Yuan Khor Md, Chandi Garg Md

Tower Health Research Day

No abstract provided.


Li-Fraumeni Syndrome And The Benefits Of Annual Comprehensive Screening: A Pancreatic Adenocarcinoma Case, Alice He Bs, Wern Lynn Ng Md, Faith Seltun Do, Lay She Ng Md, Si Yuan Khor Md, Elham Nasrollahi Md, Chandi Garg Md, Rong Rong Ge Md Apr 2024

Li-Fraumeni Syndrome And The Benefits Of Annual Comprehensive Screening: A Pancreatic Adenocarcinoma Case, Alice He Bs, Wern Lynn Ng Md, Faith Seltun Do, Lay She Ng Md, Si Yuan Khor Md, Elham Nasrollahi Md, Chandi Garg Md, Rong Rong Ge Md

Tower Health Research Day

No abstract provided.


Do Nsaids' Decrease Union Rates Following Joint Arthrodesis? A Meta-Analysis, Emerson Rowe, Julian Takagi-Stewart, Asif Ilyas, Sina Ramtin Apr 2024

Do Nsaids' Decrease Union Rates Following Joint Arthrodesis? A Meta-Analysis, Emerson Rowe, Julian Takagi-Stewart, Asif Ilyas, Sina Ramtin

Tower Health Research Day

No abstract provided.


Sixty-Two Percent Of Abstracts From The American Association Of Hand Surgery Annual Meeting 2017-2020 Are Later Published, Tyson Stoker, Benjamin Millar, Lilah Fones, Asif Ilyas Apr 2024

Sixty-Two Percent Of Abstracts From The American Association Of Hand Surgery Annual Meeting 2017-2020 Are Later Published, Tyson Stoker, Benjamin Millar, Lilah Fones, Asif Ilyas

Tower Health Research Day

No abstract provided.