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2018

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Articles 7741 - 7770 of 15442

Full-Text Articles in Medicine and Health Sciences

Torsion Of Ovarian Dysgerminoma In A Child: Role Of Computed Tomography., Kumail Khandwala, Jehanzeb Shahid, Naila Nadeem, Muhammad Usman Tariq Apr 2018

Torsion Of Ovarian Dysgerminoma In A Child: Role Of Computed Tomography., Kumail Khandwala, Jehanzeb Shahid, Naila Nadeem, Muhammad Usman Tariq

Department of Radiology

Dysgerminomas are malignant germ cell tumors of the ovary that most commonly occur in the adolescent population. Ovarian dysgerminomapresenting with complications like torsion is a rare entity in the pediatric age group. Cross-sectional imaging plays a crucial role in diagnosis, tumor staging before surgical resection, and for planning adjuvant chemotherapy. We report a case of a nine-year-old female who presented to the emergency room (ER) with abdominal distention and abdominal pain. Computed tomography scan revealed a large right-sided pelvic mass with areas of low attenuation, speckled calcification, peritumoral free fluid, and a twisted vascular pedicle that was likely originating from …


Métodos Y Tratamientos Para El Control De La Epidemia De Vih En Arica En Jóvenes / Methods And Treatments For The Control Of The Hiv Epidemic In Arica In Young People, Elizabeth Whidden Apr 2018

Métodos Y Tratamientos Para El Control De La Epidemia De Vih En Arica En Jóvenes / Methods And Treatments For The Control Of The Hiv Epidemic In Arica In Young People, Elizabeth Whidden

Independent Study Project (ISP) Collection

Research question: What methods of prevention and treatment of HIV are available to adolescents and young adults in Arica, and what problems exist in their access to these resources?

Background: Even though Chile is currently working very hard to combat a national problem with HIV, rates of HIV infection in Chile are the highest in Latin America. This increase in infection is most prevalent in young adults between the ages of 15 and 24. Arica, a city of 200,000 people in northern Chile, has the highest rates of HIV infection in the country, but it is unclear why this is …


Calcification Of The Stylohyoid Complex In Libyans, Galal Omami Apr 2018

Calcification Of The Stylohyoid Complex In Libyans, Galal Omami

Oral Health Practice Faculty Publications

Objective: To investigate the prevalence and pattern of calcification of the stylohyoid complex in Libyan population.

Material and methods: Archived digital panoramic radiographs of 3343 patients were collected; 181 images were excluded for underage or poor image quality. Thus, the images of 3162 patients (1081 men, 2081 women; women-to-men ratio, 2:1; age range, 16–68 years; mean age, 36.7 years) retrieved and assigned to one of four morphological patterns of the stylohyoid complex: regular, elongated, calcified, and undetected. Data were analyzed with the Χ2 test using SPSS (Chicago, IL, USA); P values lower than 0.05 were considered statistically significant.

Results: …


Analyzing The Differentiation Among State Medical Marijuana Policies By Examining State Policies & Trends, Richard Furlong Apr 2018

Analyzing The Differentiation Among State Medical Marijuana Policies By Examining State Policies & Trends, Richard Furlong

Political Science Theses and Capstones

Support for marijuana has been growing nationwide. This increased support has gained a lot of momentum since the late 1990s when California became the first state to legalize marijuana for medical use by enacting Proposition 215, or the Compassionate Use Act. Since the enactment of Proposition 215, 28 more states and the District of Columbia have legalized marijuana for medicinal use. I look into why states have begun to adopt these laws, and what makes these states differ throughout the country in the timeliness of their actions. I assembled data to examine a variety of state policies to attempt to …


Standardizing And Magnetizing Improvement Projects, Brittany Kyle Apr 2018

Standardizing And Magnetizing Improvement Projects, Brittany Kyle

Doctor of Nursing Practice (DNP) Projects

Abstract

Recent changes to healthcare reimbursement models have forced hospitals to improve their quality of care while reducing costs. John Muir Health has adopted the Performance Improvement philosophy to address these challenges. However, the current state for improvement project design is not standardized and does not guarantee that Magnet© standards will be followed. This design has caused confusion, inability to achieve project goals, and dissatisfaction among team members. The inability to achieve project goals has resulted in an ineffective use of resources and redundant work.

The objectives of this project were to standardize the way improvement projects are reviewed …


Cime Newsletter : April 2018, Cime Apr 2018

Cime Newsletter : April 2018, Cime

Centre for Innovation in Medical Education (CIME) Archives

- Practice 360º – Training 108 junior doctors from across Pakistan

- Hackers in Action Again!

- Palliative Care Simulation Workshop

- Simulation Workshops – Urology Week

- A ‘resilience awareness’ afternoon at CIME

- “Urinar” – A Webinar on Transurethral Resection of Bladder Tumor (TURBT) and LASER Surgery Workshop

- World Oral Health Day

- In Case You Missed!

- A New Arrival in CIME

- The Essex Bird’s Story


Palliative Surgical Gastrostomy Under Ultrasound‑Guided Bilateral Rectus Sheath Blocks In A Head And Neck Cancer Patient, Saima Rashid, Faisal Shamim,, Maha Khan, Robyna Khan Apr 2018

Palliative Surgical Gastrostomy Under Ultrasound‑Guided Bilateral Rectus Sheath Blocks In A Head And Neck Cancer Patient, Saima Rashid, Faisal Shamim,, Maha Khan, Robyna Khan

Department of Anaesthesia

No abstract provided.


Pharmacy Newsletter : April 2018, Pharmacy Department Apr 2018

Pharmacy Newsletter : April 2018, Pharmacy Department

Department of Pharmacy Archives

Content:

  • New Guidelines of Clostridium Difficile Infection (CDI
  • Botulinum Toxin Type –A: An Option to Treat Carpal Tunnel Syndrome (CTS)
  • Adverse Drug Reactions (ADR) Reporting Trend at AKUH – Year 2017
  • Medication Reconciliation: Step to Enter Patient Home Medication Entry


A Comprehensive Meta-Analysis Of Stem Cell Therapy For Chronic Angina, Rahman Shah, Samuel B. Latham, Sajjad A. Khan, Muhammad Shahreyar, Inyong Hwang, Ion S. Jovin Apr 2018

A Comprehensive Meta-Analysis Of Stem Cell Therapy For Chronic Angina, Rahman Shah, Samuel B. Latham, Sajjad A. Khan, Muhammad Shahreyar, Inyong Hwang, Ion S. Jovin

Section of Internal Medicine

Background: A substantial proportion of patients with coronary artery disease do not achieve complete revascularization and continue to experience refractory angina despite optimal medical therapy. Recently, stem cell therapy has emerged as a potential therapeutic option for these patients. However, findings of individual trials have been scrutinized because of their small sample sizes and lack of statistical power. Therefore, we conducted an updated comprehensive meta-analysis of available randomized controlled trials (RCTs) with the largest sample size ever reported on this subject.
Hypothesis: In patients with chronic angina stem cell therapy improves clinical outcomes.
Methods: Scientific databases and websites were searched …


Improving Communication Competency In Perioperative Nurse Managers, Philomena Whelan Apr 2018

Improving Communication Competency In Perioperative Nurse Managers, Philomena Whelan

Doctor of Nursing Practice (DNP) Projects

Abstract

Aim: This paper outlines the project planning, implementation and evaluation of a project aimed at improving the communication competency of perioperative nurse managers. Leadership development consisted of providing education and simulation practice to managers of the operating room (OR), pre and post anesthesia recovery (PACU) area and sterile processing (SPD). The goal was to improve the OR turnover time, cost per OR hour, patient access and the perception of the participants in their ability and willingness to speak up.

Background: The literature shows that training is needed to improve the ability of teams to understand the factors influencing the …


Loss Of Mecp2 In Adult 5-Ht Neurons Induces 5-Ht1a Autoreceptors, With Opposite Sex-Dependent Anxiety And Depression Phenotypes, Tristan J. Philippe, Faranak Vahid-Ansari, Zoe R. Donaldson, Brice Le François, Amin Zahrai, Valérie Turcotte-Cardin, Mireille Daigle, Jonathan James, René Hen, Zul Merali, Paul R. Albert Apr 2018

Loss Of Mecp2 In Adult 5-Ht Neurons Induces 5-Ht1a Autoreceptors, With Opposite Sex-Dependent Anxiety And Depression Phenotypes, Tristan J. Philippe, Faranak Vahid-Ansari, Zoe R. Donaldson, Brice Le François, Amin Zahrai, Valérie Turcotte-Cardin, Mireille Daigle, Jonathan James, René Hen, Zul Merali, Paul R. Albert

Brain and Mind Institute

The 5-HT1A autoreceptor mediates feedback inhibition of serotonin (5-HT) neurons, and is implicated in major depression. The human 5-HT1A gene (HTR1A) rs6295 risk allele prevents Deaf1 binding to HTR1A, resulting in increased 5-HT1A autoreceptor transcription. Since chronic stress alters HTR1A methylation and expression, we addressed whether recruitment of methyl-binding protein MeCP2 may alter Deaf1 regulation at the HTR1A locus. We show that MeCP2 enhances Deaf1 binding to its HTR1A site and co-immunoprecipitates with Deaf1 in cells and brain tissue. Chromatin immunoprecipitation assays showed Deaf1-dependent recruitment of MeCP2 to the mouse HTR1A promoter, and MeCP2 modulated human and mouse HTR1A gene …


Genetic Variants In Hsd17b3, Smad3, And Ipo11 Impact Circulating Lipids In Response To Fenofibrate In Individuals With Type 2 Diabetes, Daniel M. Rotroff, Sonja S. Pijut, Skylar W. Marvel, John R. Jack, Tammy M. Havener, Aurora Pujol, Agatha Schluter, Gregory A. Graf, Henry N. Ginsberg, Hetal S. Shah, He Gao, Mario-Luca Morieri, Alessandro Doria, Josyf C. Mychaleckyi, Howard L. Mcleod, John B. Buse, Michael J. Wagner, Alison A. Motsinger-Reif, Accord/Accordion Investigators Apr 2018

Genetic Variants In Hsd17b3, Smad3, And Ipo11 Impact Circulating Lipids In Response To Fenofibrate In Individuals With Type 2 Diabetes, Daniel M. Rotroff, Sonja S. Pijut, Skylar W. Marvel, John R. Jack, Tammy M. Havener, Aurora Pujol, Agatha Schluter, Gregory A. Graf, Henry N. Ginsberg, Hetal S. Shah, He Gao, Mario-Luca Morieri, Alessandro Doria, Josyf C. Mychaleckyi, Howard L. Mcleod, John B. Buse, Michael J. Wagner, Alison A. Motsinger-Reif, Accord/Accordion Investigators

Pharmaceutical Sciences Faculty Publications

Individuals with type 2 diabetes (T2D) and dyslipidemia are at an increased risk of cardiovascular disease. Fibrates are a class of drugs prescribed to treat dyslipidemia, but variation in response has been observed. To evaluate common and rare genetic variants that impact lipid responses to fenofibrate in statin‐treated patients with T2D, we examined lipid changes in response to fenofibrate therapy using a genomewide association study (GWAS). Associations were followed‐up using gene expression studies in mice. Common variants in SMAD3 and IPO11 were marginally associated with lipid changes in black subjects (P < 5 × 10‐6). Rare variant and gene expression changes …


Be Careful, Little Eyes, Susan Allen Apr 2018

Be Careful, Little Eyes, Susan Allen

Lake Union Herald

No abstract provided.


What’S Wrong With My School?, Asia Kirkland Apr 2018

What’S Wrong With My School?, Asia Kirkland

Lake Union Herald

No abstract provided.


Resolution Of Symptomatic Secondary Empty Sella Syndrome Following Lumbar-Peritoneal Shunt., Waseem Mehmood Nizamani, Mubbashira Siddiqui, Sehrish Nizar Ali Momin, Waqas Muhammad, Rashid Jooma Apr 2018

Resolution Of Symptomatic Secondary Empty Sella Syndrome Following Lumbar-Peritoneal Shunt., Waseem Mehmood Nizamani, Mubbashira Siddiqui, Sehrish Nizar Ali Momin, Waqas Muhammad, Rashid Jooma

Department of Radiology

Background: Post‑surgical empty sella is related to the removal of pituitary tumors either from the transcranial or transphenoidal route, rendering diaphragma sellae incompetent at the end of the procedure. This subsequently leads to herniation of the third ventricle and optic apparatus into the empty sella. Studies have shown that in 50% of the cases, individuals with primary and secondary empty sella syndrome have developed defects in the visual fields. Benign increased intracranial pressure, cerebrospinal rhinorrhea, papilledema, and abnormalities affecting visual acuity may also occur as a result of empty sella.

Case Description: This case report discusses a rare treatment …


Language Profiles Of Children Who Have Experienced Complex Trauma And Fetal Alcohol Spectrum Disorders, Christel G. Ciolino Apr 2018

Language Profiles Of Children Who Have Experienced Complex Trauma And Fetal Alcohol Spectrum Disorders, Christel G. Ciolino

Masters Theses

Children who experience maltreatment and children with Fetal Alcohol Spectrum Disorders (FASD) have similar neurological differences and are at risk for language impairments. However, limited research has been conducted to analyze their specific skill sets. To address this limitation, retrospective data from the Children’s Trauma Assessment Center of Southwest Michigan were analyzed. The linguistic profiles of 79 children with histories of varying numbers of traumatic experiences and comorbid FASD statues are compared in the areas of semantics, syntax, pragmatics, and social communication. Individuals had high pass rates on the CELF-5 Screening Test and high overall scores on the Pragmatic Protocol-Revised …


Access To Mental Health Care For Depression Among Latina Women In Adams County, Alison P. Lauro Apr 2018

Access To Mental Health Care For Depression Among Latina Women In Adams County, Alison P. Lauro

Student Publications

This research project focused on what barriers prevent Latina women in Adams County from accessing mental health care. A survey was distributed to 52 women over several weeks. These participants, particularly immigrant and undocumented women, have lower rates of health insurance, low incomes, and limited transportation, and the county does not have accessible, Spanish speaking mental health professionals, which makes it nearly impossible for these women to access mental healthcare in the county.


Jack Peirs, Third Ypres, And Control, Jonathan Tracey Apr 2018

Jack Peirs, Third Ypres, And Control, Jonathan Tracey

Student Publications

During the First World War, British officers, primarily upper class, struggled to adapt to trauma within the boundaries of social expectations. Viewing the combat experience and letters of Jack Peirs during the battle of Passchendaele offers insight into how officers experienced the war, explained it to their families, and coped with trauma.


Attitudes Toward Contraception Among Fourth Wave College-Aged Women, Caroline L. Lewis Apr 2018

Attitudes Toward Contraception Among Fourth Wave College-Aged Women, Caroline L. Lewis

Student Publications

This research examines how college-aged women today view contraception in comparison to the ways it has been viewed by previous generations of women, as well as what they view the future of contraception in the United States to look like. This has been done through a lens of political action and advocacy, which has defined the fight for access to contraception and reproductive justice throughout history. In light of the recent threats on contraception and the corresponding responsive social movements, such as the Women’s March, women in the United States are shifting their views on the matter, but what actions …


Ring And Peg Simulation For Minimally Invasive Surgical Robot, Evan Brown Apr 2018

Ring And Peg Simulation For Minimally Invasive Surgical Robot, Evan Brown

Department of Mechanical and Materials Engineering: Dissertations, Theses, and Student Research

Surgical procedures utilizing minimally invasive laparoscopic techniques have shown less complications, better cosmetic results, and less time in the hospital than conventional surgery. These advantages are partially offset by inherent difficulties of the procedures which include an inverted control scheme, instrument clashing, and loss of triangulation. Surgical robots have been designed to overcome the limitations, the Da Vinci being the most widely used. A dexterous in vivo, two-armed robot, designed to enter an insufflated abdomen with a limited insertion profile and expand to perform a variety of operations, has been created as a less expensive, versatile alternative to the Da …


Food Insecurity, Social Networks And Symptoms Of Depression Among Men And Women In Rural Uganda: A Cross-Sectional, Population-Based Study, Jessica M. Perkins, Viola N. Nyakato, Bernard Kakuhikire, Alexander C. Tsai, Sv Subramanian, David Bangsberg, Nicholas A. Christakis Apr 2018

Food Insecurity, Social Networks And Symptoms Of Depression Among Men And Women In Rural Uganda: A Cross-Sectional, Population-Based Study, Jessica M. Perkins, Viola N. Nyakato, Bernard Kakuhikire, Alexander C. Tsai, Sv Subramanian, David Bangsberg, Nicholas A. Christakis

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective: To assess the association between food insecurity and depression symptom severity stratified by sex, and test for evidence of effect modification by social network characteristics.

Design: A population-based cross-sectional study. The nine-item Household Food Insecurity Access Scale captured food insecurity. Five name generator questions elicited network ties. A sixteen-item version of the Hopkins Symptom Checklist for Depression captured depression symptom severity. Linear regression was used to estimate the association between food insecurity and depression symptom severity while adjusting for potential confounders and to test for potential network moderators.

Setting: In-home survey interviews in south-western Uganda. Subjects: All adult residents …


Wright State University's Symposium Of Student Research, Scholarship & Creative Activities From Friday April 13, 2018, Wright State University Apr 2018

Wright State University's Symposium Of Student Research, Scholarship & Creative Activities From Friday April 13, 2018, Wright State University

Celebration of Undergraduate & Graduate Research, Scholarship, and Creative Activities Materials

The student abstract booklet is a compilation of abstracts from students' oral and poster presentations at Wright State University's Symposium of Student Research, Scholarship & Creative Activities on April 13, 2018.


The Emerging Issue Of Hepatitis C Virus In The United States And In West Virginia, Alberto Coustasse Dr.Ph. Md,Mba, Mph, Maggie Phillips Rn, Bsn, Mha, Jumana Abboud Mha, Neha Botre Mha, David P. Paul Iii Apr 2018

The Emerging Issue Of Hepatitis C Virus In The United States And In West Virginia, Alberto Coustasse Dr.Ph. Md,Mba, Mph, Maggie Phillips Rn, Bsn, Mha, Jumana Abboud Mha, Neha Botre Mha, David P. Paul Iii

Management Faculty Research

Introduction:

Hepatitis C virus (HCV) is one of the most significant public health problems currently facing the U.S., Especially in West Virginia. If it is undetected and left untreated, the likelihood of sustaining a treatment response decreases. While early identification has been identified as a critical focus in trying to obtain better health outcomes, new drug treatments appear promising, although somewhat expensive. West Virginia, a predominantly rural state, is beginning to face a mounting financial crisis due to HCV.

Purpose of the Study:

The purpose of this study was to examine the effects of early identification and treatment for patients …


Dental Students' Skills Assessments: Comparisons Of Daily Clinical Grades And Clinical And Laboratory Assessments, Elizangela Bertoli, Kristy Pepper Lawson, Susan S. Bishop Apr 2018

Dental Students' Skills Assessments: Comparisons Of Daily Clinical Grades And Clinical And Laboratory Assessments, Elizangela Bertoli, Kristy Pepper Lawson, Susan S. Bishop

Oral Health Practice Faculty Publications

The aim of this study was to compare the daily clinical grades of third-year dental students during routine clinical activities involving direct and indirect operative procedures to clinical and laboratory assessments. The authors compared students’ daily clinical grades to graded clinical assessments and compared daily clinical grades to laboratory assessments at one U.S. dental school. A total of 50 third-year students (participation rate: 98%) participated in this study during the school year of 2014–15. The study analyzed the students’ daily clinical grades and graded assessments during regular clinical activities and two laboratory examinations. The results found no statistically significant differences …


Menopausal-Related Symptoms In Women One Year After Breast Cancer Surgery., Melissa Mazor, Kathryn Lee, Anand Dhruva, Janine K Cataldo, Steven M Paul, Michelle Melisko, Betty J Smoot, Jon D Levine, Charles Elboim, Yvette P Conley, Christine Miaskowksi Apr 2018

Menopausal-Related Symptoms In Women One Year After Breast Cancer Surgery., Melissa Mazor, Kathryn Lee, Anand Dhruva, Janine K Cataldo, Steven M Paul, Michelle Melisko, Betty J Smoot, Jon D Levine, Charles Elboim, Yvette P Conley, Christine Miaskowksi

Articles, Abstracts, and Reports

CONTEXT: Approximately 60% to 100% of women with breast cancer experience at least one menopausal-related symptom. Little is known about associations between menopausal status and symptoms in women 12 months after breast cancer surgery.

OBJECTIVES: The purpose of this study was to evaluate for differences in occurrence, severity, and distress of symptoms between pre- and postmenopausal women 12 months after breast cancer surgery.

METHODS: Women with breast cancer (n = 327) completed the Menopausal Symptoms Scale, which evaluated the occurrence, severity, and distress of 46 common menopausal-related symptoms. Regression analyses were used to evaluate between-group differences in the seven symptoms …


A Test Of Multisession Automatic Action Tendency Retraining To Reduce Alcohol Consumption Among Young Adults In The Context Of A Human Laboratory Paradigm., Robert F Leeman, Christine Nogueira, Reinout W Wiers, Janna Cousijn, Kelly Serafini, Kelly S Demartini, John A Bargh, Stephanie S O'Malley Apr 2018

A Test Of Multisession Automatic Action Tendency Retraining To Reduce Alcohol Consumption Among Young Adults In The Context Of A Human Laboratory Paradigm., Robert F Leeman, Christine Nogueira, Reinout W Wiers, Janna Cousijn, Kelly Serafini, Kelly S Demartini, John A Bargh, Stephanie S O'Malley

Articles, Abstracts, and Reports

BACKGROUND: Young adult heavy drinking is an important public health concern. Current interventions have efficacy but with only modest effects, and thus, novel interventions are needed. In prior studies, heavy drinkers, including young adults, have demonstrated stronger automatically triggered approach tendencies to alcohol-related stimuli than lighter drinkers. Automatic action tendency retraining has been developed to correct this tendency and consequently reduce alcohol consumption. This study is the first to test multiple iterations of automatic action tendency retraining, followed by laboratory alcohol self-administration.

METHODS: A total of 72 nontreatment-seeking, heavy drinking young adults ages 21 to 25 were randomized to automatic …


Oncolog, Volume 63, Number 04, April 2018, Joe Munch, Bryan Tutt, Sarah Bronson Apr 2018

Oncolog, Volume 63, Number 04, April 2018, Joe Munch, Bryan Tutt, Sarah Bronson

OncoLog MD Anderson's Report to Physicians (All issues) Archives

  • Hunger Training Helps Manage Weight, May Reduce Cancer Risk: Clinical Trial tests weight loss strategy to reduce cancer risk in obese participants
  • Re-Irradiation for Recurrent Head and Neck cancer: Stereotactic techniques enable re-irradiation of unresectable tumors
  • Dermoscopy for Early Detection of Melanoma. Other Skin Cancers: MD Anderson physicians train clinicians in underserved areas to use dermoscopy, which can help avoid unnecessary biopsy
  • HOUSE CALL: Alcohol-Related cancers-Drinking alcohol increases risk of several types of cancer


Jails Are Not Treatment Centers, Michael Henning, Rachel Mattick, Cali Turbes Apr 2018

Jails Are Not Treatment Centers, Michael Henning, Rachel Mattick, Cali Turbes

Master of Social Work Student Policy Advocacy Briefs

Currently, in Minnesota alone, there are more individuals with severe mental illness being incarcerated than hospitalized. Blue Earth County's Yellow Line Project (YLP) reported that 83.7% of individuals screened positive for mental illness prior to being booked into jail . Not only does incarcerating individuals with mental illness fill our jails, it prolongs mental illness and time spent away from treatment. Jail diversion programs divert individuals with mental health disorders from the criminal justice system and into appropriate treatment when applicable. For those individuals ineligible for diversion from the criminal justice system, care coordination would be ideal to assist in …


Opportunities And Obstacles For Deep Learning In Biology And Medicine, Travers Ching, S Joshua Swamidass, Et Al Apr 2018

Opportunities And Obstacles For Deep Learning In Biology And Medicine, Travers Ching, S Joshua Swamidass, Et Al

2010-2019 OA Pubs

Deep learning describes a class of machine learning algorithms that are capable of combining raw inputs into layers of intermediate features. These algorithms have recently shown impressive results across a variety of domains. Biology and medicine are data-rich disciplines, but the data are complex and often ill-understood. Hence, deep learning techniques may be particularly well suited to solve problems of these fields. We examine applications of deep learning to a variety of biomedical problems-patient classification, fundamental biological processes and treatment of patients-and discuss whether deep learning will be able to transform these tasks or if the biomedical sphere poses unique …


Low Subfrontal Dural Opening For Anterior Clinoid Meningioma, Michael R. Chicoine Apr 2018

Low Subfrontal Dural Opening For Anterior Clinoid Meningioma, Michael R. Chicoine

2010-2019 OA Pubs

No abstract provided.