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Articles 18151 - 18180 of 27453
Full-Text Articles in Medicine and Health Sciences
Adenoviral Gene Therapy For Bladder Cancer, Roland W Herzog, Masataka Suzuki
Adenoviral Gene Therapy For Bladder Cancer, Roland W Herzog, Masataka Suzuki
Faculty, Staff and Students Publications
Enhanced by polyamide surfactant Syn3, intravesical administration of rAd-IFNα2b results in transduction of the virus into the bladder epithelium, resulting in the synthesis and expression of local IFNα2b cytokine. Upon secretion, IFNα2b binds to the IFNα receptor on bladder cancer and other cells, resulting in signaling via the JAK-STAT pathway. A plethora of induced IFN-stimulated genes containing IFN-sensitive response elements that contribute to activation of pathways restrict cancer growth.
Effects Of Protein-Coding Variants On Blood Metabolite Measurements And Clinical Biomarkers In The Uk Biobank, Abhishek Nag, Ryan S Dhindsa, Lawrence Middleton, Xiao Jiang, Dimitrios Vitsios, Eleanor Wigmore, Erik L Allman, Anna Reznichenko, Keren Carss, Katherine R Smith, Quanli Wang, Benjamin Challis, Dirk S Paul, Andrew R Harper, Slavé Petrovski
Effects Of Protein-Coding Variants On Blood Metabolite Measurements And Clinical Biomarkers In The Uk Biobank, Abhishek Nag, Ryan S Dhindsa, Lawrence Middleton, Xiao Jiang, Dimitrios Vitsios, Eleanor Wigmore, Erik L Allman, Anna Reznichenko, Keren Carss, Katherine R Smith, Quanli Wang, Benjamin Challis, Dirk S Paul, Andrew R Harper, Slavé Petrovski
Faculty, Staff and Students Publications
Genome-wide association studies (GWASs) have established the contribution of common and low-frequency variants to metabolic blood measurements in the UK Biobank (UKB). To complement existing GWAS findings, we assessed the contribution of rare protein-coding variants in relation to 355 metabolic blood measurements-including 325 predominantly lipid-related nuclear magnetic resonance (NMR)-derived blood metabolite measurements (Nightingale Health Plc) and 30 clinical blood biomarkers-using 412,393 exome sequences from four genetically diverse ancestries in the UKB. Gene-level collapsing analyses were conducted to evaluate a diverse range of rare-variant architectures for the metabolic blood measurements. Altogether, we identified significant associations (p < 1 × 10
Appeal Of Tobacco Quitline Services Among Low-Income Smokers, Lauren M Grimes, Rachel Garg, Olivia Weng, Jennifer M Wolff, Amy Mcqueen, Kelly M Carpenter, Matthew W Kreuter
Appeal Of Tobacco Quitline Services Among Low-Income Smokers, Lauren M Grimes, Rachel Garg, Olivia Weng, Jennifer M Wolff, Amy Mcqueen, Kelly M Carpenter, Matthew W Kreuter
2020-Current year OA Pubs
INTRODUCTION: State tobacco quitlines are delivering cessation assistance through an increasingly diverse range of channels. However, offerings vary from state to state, many smokers are unaware of what is available, and it is not yet clear how much demand exists for different types of assistance. In particular, the demand for online and digital cessation interventions among low-income smokers, who bear a disproportionate burden of tobacco-related disease, is not well understood.
METHODS: We examined interest in using 13 tobacco quitline services in a racially diverse sample of 1,605 low-income smokers in 9 states who had called a 2-1-1 helpline and participated …
Insights Into Pulmonary Phosphate Homeostasis And Osteoclastogenesis Emerge From The Study Of Pulmonary Alveolar Microlithiasis, Yasuaki Uehara, Steven L Teitelbaum, Et Al.
Insights Into Pulmonary Phosphate Homeostasis And Osteoclastogenesis Emerge From The Study Of Pulmonary Alveolar Microlithiasis, Yasuaki Uehara, Steven L Teitelbaum, Et Al.
2020-Current year OA Pubs
Pulmonary alveolar microlithiasis is an autosomal recessive lung disease caused by a deficiency in the pulmonary epithelial Npt2b sodium-phosphate co-transporter that results in accumulation of phosphate and formation of hydroxyapatite microliths in the alveolar space. The single cell transcriptomic analysis of a pulmonary alveolar microlithiasis lung explant showing a robust osteoclast gene signature in alveolar monocytes and the finding that calcium phosphate microliths contain a rich protein and lipid matrix that includes bone resorbing osteoclast enzymes and other proteins suggested a role for osteoclast-like cells in the host response to microliths. While investigating the mechanisms of microlith clearance, we found …
Prevalence And Management Of Sleep Disturbance In Adults With Primary Brain Tumours And Their Caregivers: A Systematic Review, Jason A. Martin, Nicolas H. Hart, Natalie Bradford, Fiona Naumann, Mark B. Pinkham, Elizabeth P. Pinkham, Justin J. Holland
Prevalence And Management Of Sleep Disturbance In Adults With Primary Brain Tumours And Their Caregivers: A Systematic Review, Jason A. Martin, Nicolas H. Hart, Natalie Bradford, Fiona Naumann, Mark B. Pinkham, Elizabeth P. Pinkham, Justin J. Holland
Research outputs 2022 to 2026
Purpose: The aims of this systematic review were to (1) examine the prevalence, severity, manifestations, and clinical associations/risk factors of sleep disturbance in primary brain tumour (PBT) survivors and their caregivers; and (2) determine whether there are any sleep-focused interventons reported in the literature pertaining to people affected by PBT. Methods: This systematic review was registered with the international register for systematic reviews (PROSPERO: CRD42022299332). PubMed, EMBASE, Scopus, PsychINFO, and CINAHL were electronically searched for relevant articles reporting sleep disturbance and/or interventions for managing sleep disturbance published between September 2015 and May 2022. The search strategy included terms focusing on …
Private Pete Fights Illiteracy At Fort Ontario: The Men In Charge, Christian Wright, Adrian Mandzy
Private Pete Fights Illiteracy At Fort Ontario: The Men In Charge, Christian Wright, Adrian Mandzy
2023 Celebration of Student Scholarship - Poster Presentations
From June of 1943 to February of 1944, the 1210th Special Training Unit at Fort Ontario in Oswego, New York taught pre-basic military training to thousands of illiterate, slow learning, and non-English-speaking soldiers in the United States Army. The training center at Fort Ontario conducted programs in disciplinary barracks, specialized military, technical, academic and vocational education.
Classification Of Road Objects Using Convolutional Neural Networks, Mann Patel, Heba Elgazzar
Classification Of Road Objects Using Convolutional Neural Networks, Mann Patel, Heba Elgazzar
2023 Celebration of Student Scholarship - Poster Presentations
Driving is the primary means of transportation for many people around the world. Whether the use is to assist human drivers or create autonomous driving, the use of machine learning can create safer road conditions. Drivers must consider other objects on the road, most commonly other vehicles and pedestrians. These three components, road signs, pedestrians, and vehicles, make up a large majority of objects that a driver will encounter when on the road. This research applies machine learning algorithms, specifically Convolutional Neural Networks (CNN), to classify these road objects. The goal is to create a classification model that can reliably …
Integrating Palliative Care In A Family Nurse Practitioner Curricula - Post Survey Data, Betty Lang, Susan Montgomery, Ellen P. Moore, Amanda Townsend
Integrating Palliative Care In A Family Nurse Practitioner Curricula - Post Survey Data, Betty Lang, Susan Montgomery, Ellen P. Moore, Amanda Townsend
MSN Project Data
There is a growing need to integrate Palliative Care in Family Nurse Practitioner (FNP) curricula. Due to increasing costs in an already overstretched healthcare system, a large portion of primary care is delivered by FNPs, often to older or sicker patients. Therefore, it is imperative that FNPs receive formal educational and professional preparation regarding palliative care resources. One of the Core concepts presented by The American Association of Colleges of Nursing's Essentials: Core Concepts for Professional Nursing Education (2021) is palliative care, as are hospice and supportive care. Graduate Competencies and Recommendations for Educating nursing Students (G-CARES) further describe advanced-level …
2023-03-01 Michiganoverview_Covidbedppe, Michigan Department Of Health & Human Services
2023-03-01 Michiganoverview_Covidbedppe, Michigan Department Of Health & Human Services
Michigan COVID-19 Hospital Data
Contains the tables Statewide Hospital Capacity Report for COVID-19, COVID-19 Metrics, Statewide Hospital Available PPE Tracking for COVID-19, as well as the tables PPE Days On Hand and Patient Census.
Medical School Watercooler Newsletter - March 1, 2023, Lindsey Lyle
Medical School Watercooler Newsletter - March 1, 2023, Lindsey Lyle
Watercooler Newsletter
This is the March 1, 2023 edition of the Frederick P. Whiddon College of Medicine's newsletter - Watercooler.
Contents include:
- Brain awareness week set for march 14-18
- Students collect thousands for menstrual products for those in need
- Meet the bands of Doc Rock
- Fundraisers to benefit USA student-run free clinic
Hutch Diverticulum: A Rare Congenital Urinary Bladder Diverticulum In An Elderly Male Patient., Dr Rudresh Hiremath, Dr Shwetha Poojari
Hutch Diverticulum: A Rare Congenital Urinary Bladder Diverticulum In An Elderly Male Patient., Dr Rudresh Hiremath, Dr Shwetha Poojari
Radiology Teaching Files
54 year old male patient presented with burning micturition and increased frequency of urination for the last two months. He also gives history of intermittent episodes of high grade fever with chills and rigors.
Mucocele Of The Appendix With Perforation., Sudha Kiran Das Dr., Vikram Patil Dr
Mucocele Of The Appendix With Perforation., Sudha Kiran Das Dr., Vikram Patil Dr
Radiology Teaching Files
45 year old gentleman, presented to the Emergency Department with right iliac fossa pain & fever.
It's Time To (Again) Recognize The Considerable Clinical And Public Health Significance Of Cardiorespiratory Fitness, Leonard A. Kaminsky, Mary T. Imboden, Cemal Ozemek
It's Time To (Again) Recognize The Considerable Clinical And Public Health Significance Of Cardiorespiratory Fitness, Leonard A. Kaminsky, Mary T. Imboden, Cemal Ozemek
Faculty Publications - Department of Kinesiology
In this issue of the Journal of the American College of Cardiology, Kokkinos et al5 studied the relationship of both a single CRF value, and change in CRF, with all-cause mortality in a large (n 1⁄4 93,060) sample from the ETHOS (Exercise Testing and Health Outcomes Study) cohort. In this cohort, CRF was estimated as the peak metabolic equivalents (METs) derived from the peak speed and grade obtained on a treadmill exercise test. The findings from the single measure of CRF showed, compared with the low-CRF group (w5 METs), reductions in mortality rate across each higher-CRF group in both those …
2023-03-01_Michiganoverview_Covidvaccinestats, Michigan Department Of Health & Human Services
2023-03-01_Michiganoverview_Covidvaccinestats, Michigan Department Of Health & Human Services
Michigan COVID-19 Vaccine Data
The COVID Vaccine Dashboard page was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus/resources/covid-19-vaccine/covid-19-dashboard.
First-dose tracker above is for entire Michigan Population. Coverage maps below are for age 5+.
Previously reported numbers of administered vaccine doses may change as new data are received. A possible lag in reporting vaccine doses will result in increases in numbers previously reported.
This report is created by the Michigan Department of Health and Human Services Division of Immunization from data reported to the Michigan Care Improvement Registry (MCIR).
The dashboard contained the tabs Primary Series Doses Administered, Primary Series Doses by Vaccine, …
Effect Of Xylitol Versus Sugar On Caries Risk, Alyssa Birmingham, Kailey Hart, Raissa Igihozo, Amanda Osmolski
Effect Of Xylitol Versus Sugar On Caries Risk, Alyssa Birmingham, Kailey Hart, Raissa Igihozo, Amanda Osmolski
Dental Hygiene Student Research Posters
The effect of xylitol versus sugar on caries risk is a rising trend in caries prevention. The dominant explanation for this trend is explained by xylitol’s ability to significantly decrease caries rates in recent studies. To answer the question, in adult patients, what is the effect of xylitol versus sugar on caries risk, we compared previous studies in a literature review. The limitations of these findings include the many intrinsic and extrinsic factors that influence plaque accumulation that were not considered. Further research is needed to determine if xylitol alone has caries-prevention qualities.
The Role Of Year And Animal Origin On Key Determinants Of Ewe Longevity, Audrey Burton, Annika Weaver, Rebekah Mills, Flint Herrelson, Patricia Harrelson
The Role Of Year And Animal Origin On Key Determinants Of Ewe Longevity, Audrey Burton, Annika Weaver, Rebekah Mills, Flint Herrelson, Patricia Harrelson
2023 Celebration of Student Scholarship - Poster Presentations
The MSU sheep flock is an Innovation Flock in the Sheep GEMS project through the University of Nebraska-Lincoln. The Sheep GEMS project is a national, multi-breed project that is focused on evaluating different sheep breeds and their longevity in different climates. As a participant, we collect/send raw data that is compiled. Our preliminary data from the 2022 (Year 1) and 2023 (Year 2) lambing season has been included. We collected measurements from Katahdin ewes (n = 38; 1-4.5 years old). We measured fecal egg counts (FEC), FAMACHA scores, body condition scores (BCS), teat and udder scores. Using the MIXED procedures …
Affective Depression Mediates Ptsd To Suicide In A Sample Of Treatment-Seeking First Responders, James Whitworth, Jeanine Galusha, Jose Carbajal, Warren Ponder, Donna Schuman
Affective Depression Mediates Ptsd To Suicide In A Sample Of Treatment-Seeking First Responders, James Whitworth, Jeanine Galusha, Jose Carbajal, Warren Ponder, Donna Schuman
Faculty Publications
Objective: The aim of this study was to examine the associations of comorbid
posttraumatic stress disorder (PTSD), affective or somatic depression, and
suicide among first responders (FRs). Method: We used baseline data from
FRs (N = 232) who sought services at a nonprofit mental health agency specializing
in treating trauma exposed FRs. We conducted two PROCESS simple
mediation models with PTSD as the predictor, affective depression and somatic
depression as the mediators, and suicidality as the dependent variable.
Results: Affective depression significantly mediated the relationship between
PTSD and suicidality, whereas somatic depression did not. The direct effect …
Ada Code Of Ethics (March 2023), American Dental Association
Ada Code Of Ethics (March 2023), American Dental Association
Code of Ethics
The ADA Code of Ethics has three main components: The Principles of Ethics, the Code of Professional Conduct and the Advisory Opinions. Contents may also include: Amendment to ADA Principles of Ethics and Code of Professional Conduct and Insert for the ADA Principles of Ethics and Code of Professional Conduct. The most current issue is available on the ADA’s website.
From Bali Beaches To Breathwork: A Comparative Analysis On Yoga Tourism Strategies Used By Bali’S Destination Marketing Organizations, Brooke R. Findlay
From Bali Beaches To Breathwork: A Comparative Analysis On Yoga Tourism Strategies Used By Bali’S Destination Marketing Organizations, Brooke R. Findlay
Experience Industry Management
Strategic marketing is crucial for the success of tourist destinations. When potential tourists research a location before visiting, they commonly click through the websites of various Destination Marketing Organizations (DMOs). This paper compares the marketing efforts of two (DMOs), the Bali Tourism Board (BTB) and Wonderful Indonesia, focusing on their use of social media and websites in promoting yoga tourism in Bali. Yoga tourism is an element of wellness tourism that attracts yogis from all over the world to practice yoga in spiritual locations. Bali increasingly grows in numbers of yoga tourists each season and is now a world-renowned yoga …
Caring For Your Employees, Lance Plunkett Jd, Llm
Caring For Your Employees, Lance Plunkett Jd, Llm
The New York State Dental Journal
Employment laws are rapidly expanding worker opportunities and rights complicating dentists' ability to hire and retain employees in a competitive job market.
College Of Health Sciences Newsletter, College Of Health Sciences, Old Dominion University
College Of Health Sciences Newsletter, College Of Health Sciences, Old Dominion University
Ellmer College of Health Sciences Newsletters
March 2023 issue of Old Dominion University's College of Health Sciences Newsletter.
Mglu5 Inhibition In The Basolateral Amygdala Prevents Estrous Cycle-Dependent Changes In Cue-Induced Cocaine Seeking, Claire M. Corbett, Emily N. D. Miller, Jessica A. Loweth
Mglu5 Inhibition In The Basolateral Amygdala Prevents Estrous Cycle-Dependent Changes In Cue-Induced Cocaine Seeking, Claire M. Corbett, Emily N. D. Miller, Jessica A. Loweth
Rowan-Virtua School of Osteopathic Medicine Departmental Research
Drug associated cues are a common relapse trigger for individuals recovering from cocaine use disorder. Sex and ovarian hormones influence patterns of cocaine use and relapse vulnerability, with studies indicating that females show increased cue-induced craving and relapse vulnerability compared to males. In a rodent model of cocaine craving and relapse vulnerability, cue-induced cocaine seeking behavior following weeks of withdrawal from extended-access cocaine self-administration is higher in females in the estrus stage of the reproductive (estrous) cycle (Estrus Females) compared to both Males and females in all other stages (Non-Estrus Females). However, the neuronal substrates and cellular mechanisms underlying these …
Impact Of Emr/Ehr And Computer Decision Support Systems On Nursing Homes And Long-Term Care, Wendy Trzyna, Brian Cox, Alberto Coustasse
Impact Of Emr/Ehr And Computer Decision Support Systems On Nursing Homes And Long-Term Care, Wendy Trzyna, Brian Cox, Alberto Coustasse
Management Faculty Research
Long-Term Care (LTCs) facilities and nursing homes have been an essential part of the healthcare industry to meet the needs of older adults. However, Electronic Medical Records (EMRs/ EHR within LTC facilities and nursing homes have lagged more than in other healthcare sectors. This research analyzed the impact of implementing EMR/EHR and Computerized Decision Support Systems within LTC facilities and nursing homes. In nursing homes and LTC facilities where EMR/EHR has been implemented, patient outcomes improved by reduced pressure ulcers and increased identification of patients at risk for malnutrition and falls. Integration of CDSSs with EMR/EHR improved documentation and prescribing …
Closed-System Transfer Devices Reduce Exposure To Contaminants, Ken Maxik, Craig Kimble, Alberto Coustasse
Closed-System Transfer Devices Reduce Exposure To Contaminants, Ken Maxik, Craig Kimble, Alberto Coustasse
Management Faculty Research
Closed-system transfer devices (CSTDs) are used during the preparation of hazardous drugs (HDs) as a mechanism to reduce the transfer of drugs or vapors into the environment. When evaluating these systems, pharmacists should consider which drugs in the pharmacy would benefit the safety of health care workers and patients using the systems. Medication types include neoplastic agents, such as bleomycin, cisplatin, and methotrexate, and other agents, such as cyclosporine, oxytocin, and progesterone.
Relationship Between The Hospital Readmission Reduction Program And Readmissions, Postoperative Complications, And Cost, Cary A. Blick, Blake P. Williams, Drake T. Myers, Joshua Pomranke, Sarah M. Clemente, Alberto Coustasse
Relationship Between The Hospital Readmission Reduction Program And Readmissions, Postoperative Complications, And Cost, Cary A. Blick, Blake P. Williams, Drake T. Myers, Joshua Pomranke, Sarah M. Clemente, Alberto Coustasse
Management Faculty Research
Hospital readmissions have contributed significantly to rising healthcare costs in the United States. To curb rising costs, the Centers for Medicare and Medicaid Services introduced the Hospital Readmissions Reduction Program (HRRP), a penalty-based program designed to decrease healthcare costs. This research aims to determine if the HRRP has successfully reduced healthcare costs and increased quality outcomes associated with total knee arthroplasty (TKA) or total hip arthroplasty (THA) as defined by a reduction in readmission rates, postoperative complications, and overall costs. Although a positive correlation has been shown between outcomes and costs post-HRRP, more research is needed to tease out the …
Disparities In Access To Cancer Diagnostics In Asean Member Countries, Nicole Rose I. Alberto, Isabelle Rose I. Alberto, Corinna Victoria M. Puyat, Maria Alexandra R. Antonio, Frances Dominique V. Ho, Edward Christopher Dee, Brandon A. Mahal, Michelle Ann B. Eala
Disparities In Access To Cancer Diagnostics In Asean Member Countries, Nicole Rose I. Alberto, Isabelle Rose I. Alberto, Corinna Victoria M. Puyat, Maria Alexandra R. Antonio, Frances Dominique V. Ho, Edward Christopher Dee, Brandon A. Mahal, Michelle Ann B. Eala
Ateneo School of Medicine and Public Health Publications
Diagnostics, including laboratory tests, medical and nuclear imaging, and molecular testing, are essential in the diagnosis and management of cancer to optimize clinical outcomes. With the continuous rise in cancer mortality and morbidity in the Association of Southeast Asian Nations (ASEAN), there exists a critical need to evaluate the accessibility of cancer diagnostics in the region so as to direct multifaceted interventions that will address regional inequities and inadequacies in cancer care. This paper identifies existing gaps in service delivery, health workforce, health information systems, leadership and governance, and financing and how these contribute to disparities in access to cancer …
Geriatric Emergency Departments As Laboratories For Innovation, Brian W. Patterson, Manish N. Shah
Geriatric Emergency Departments As Laboratories For Innovation, Brian W. Patterson, Manish N. Shah
Journal of Geriatric Emergency Medicine
n/a for editorial
Measuring Ground Surface Elevation Changes In A Slow-Moving Colluvial Landslide Using Combinations Of Regional Airborne Lidar, Uav Lidar And Uav Photogrammetric Surveys, Sarah E. Johnson, William C. Haneberg, L. Sebastian Bryson, Matthew M. Crawford
Measuring Ground Surface Elevation Changes In A Slow-Moving Colluvial Landslide Using Combinations Of Regional Airborne Lidar, Uav Lidar And Uav Photogrammetric Surveys, Sarah E. Johnson, William C. Haneberg, L. Sebastian Bryson, Matthew M. Crawford
UK CARES Faculty Publications
Slow-moving, chronically destructive landslides are projected to grow in number globally in response to precipitation increases from climate change, and land disturbances from wildfire, mining and construction. In the Cincinnati and northern Kentucky metropolitan area, USA, landslides develop in colluvium that covers the steep slopes along the Ohio River and its tributaries. Here we quantify elevation changes in a slow-moving colluvial landslide over 14 years using county- wide lidar, uncrewed aerial vehicle (UAV) structure-from-motion (SfM) surveys and a UAV lidar survey. Because the technology and quality differ between surveys, the challenge was to calculate a threshold of detectable change for …
Improving Adolescent Contraceptive Care In The South: Policy Brief, Center For Applied Reasearch And Evaluation In Women's Health, East Tennessee State University
Improving Adolescent Contraceptive Care In The South: Policy Brief, Center For Applied Reasearch And Evaluation In Women's Health, East Tennessee State University
Center for Applied Research and Evaluation (CARE) in Women's Health Issue Briefs
Youth-friendly, person-centered contraceptive care (YFPCCC) improves the quality of care that youth receive. Research shows that clinic characteristics that support youth-friendly, person-centered care,like confidentiality and consent policies and trained providers, contribute to high quality contraceptive care for youth. As such, establishing or strengthening clinic policies requiring training and confidentiality will support a clinic’s capacity to provide YFPCCC. Understanding Southern safety-net clinics’ characteristics supporting YFPCCC and Southern youths’ perceptions of their care can highlight areas where policies may need to be established or strengthened.
Differences In Startle And Prepulse Inhibition In Contactin-Associated Protein-Like 2 Knock-Out Rats Are Associated With Sex-Specific Alterations In Brainstem Neural Activity, Alice Zheng, Kaela E Scott, Ashley L Schormans, Rajkamalpreet Mann, Brian L Allman, Susanne Schmid
Differences In Startle And Prepulse Inhibition In Contactin-Associated Protein-Like 2 Knock-Out Rats Are Associated With Sex-Specific Alterations In Brainstem Neural Activity, Alice Zheng, Kaela E Scott, Ashley L Schormans, Rajkamalpreet Mann, Brian L Allman, Susanne Schmid
Anatomy and Cell Biology Publications
The contactin-associated protein-like 2 (CNTNAP2) gene encodes for the CASPR2 protein, which plays an essential role in neurodevelopment. Mutations in CNTNAP2 are associated with neurodevelopmental disorders, including autism spectrum disorder and schizophrenia. Rats with a loss of function mutation in the Cntnap2 gene show increased acoustic startle response (ASR) and decreased prepulse inhibition (PPI). The neural basis of this altered auditory processing in Cntnap2 knock-out rats is currently unknown. Auditory brainstem recordings previously revealed no differences between the genotypes. The next step is to investigate brainstem structures outside of the primary auditory pathway that mediate ASR and PPI, which are …