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Articles 27421 - 27450 of 77143

Full-Text Articles in Medical Specialties

Emt-Activated Secretory And Endocytic Vesicular Trafficking Programs Underlie A Vulnerability To Pi4k2a Antagonism In Lung Cancer, Xiaochao Tan, Guan-Yu Xiao, Shike Wang, Lei Shi, Yanbin Zhao, Xin Liu, Jiang Yu, William K Russell, Chad J Creighton, Jonathan M Kurie Apr 2023

Emt-Activated Secretory And Endocytic Vesicular Trafficking Programs Underlie A Vulnerability To Pi4k2a Antagonism In Lung Cancer, Xiaochao Tan, Guan-Yu Xiao, Shike Wang, Lei Shi, Yanbin Zhao, Xin Liu, Jiang Yu, William K Russell, Chad J Creighton, Jonathan M Kurie

Faculty, Staff and Students Publications

Hypersecretory malignant cells underlie therapeutic resistance, metastasis, and poor clinical outcomes. However, the molecular basis for malignant hypersecretion remains obscure. Here, we showed that epithelial-mesenchymal transition (EMT) initiates exocytic and endocytic vesicular trafficking programs in lung cancer. The EMT-activating transcription factor zinc finger E-box-binding homeobox 1 (ZEB1) executed a PI4KIIIβ-to-PI4KIIα (PI4K2A) dependency switch that drove PI4P synthesis in the Golgi and endosomes. EMT enhanced the vulnerability of lung cancer cells to PI4K2A small-molecule antagonists. PI4K2A formed a MYOIIA-containing protein complex that facilitated secretory vesicle biogenesis in the Golgi, thereby establishing a hypersecretory state involving osteopontin (SPP1) and other prometastatic ligands. …


The Association Between Caffeine Intake And The Colonic Mucosa-Associated Gut Microbiota In Humans-A Preliminary Investigation, Annie Dai, Kristi Hoffman, Anthony A Xu, Shawn Gurwara, Donna L White, Fasiha Kanwal, Albert Jang, Hashem B El-Serag, Joseph F Petrosino, Li Jiao Apr 2023

The Association Between Caffeine Intake And The Colonic Mucosa-Associated Gut Microbiota In Humans-A Preliminary Investigation, Annie Dai, Kristi Hoffman, Anthony A Xu, Shawn Gurwara, Donna L White, Fasiha Kanwal, Albert Jang, Hashem B El-Serag, Joseph F Petrosino, Li Jiao

Faculty, Staff and Students Publications

We examined the association between caffeine and coffee intake and the community composition and structure of colonic microbiota. A total of 34 polyp-free adults donated 97 colonic biopsies. Microbial DNA was sequenced for the 16S rRNA gene V4 region. The amplicon sequence variant was assigned using DADA2 and SILVA. Food consumption was ascertained using a food frequency questionnaire. We compared the relative abundance of taxonomies by low (<82.9 mg) vs. high (≥82.9 mg) caffeine intake and by never or <2 cups vs. 2 cups vs. ≥3 cups coffee intake. False discovery rate-adjusted p values (q values) <0.05 indicated statistical significance. Multivariable negative binomial regression models were used to estimate the incidence rate ratio and its 95% confidence interval of having a non-zero count of certain bacteria by intake level. Higher caffeine and coffee intake was related to higher alpha diversity (Shannon index p < 0.001), higher relative abundance of Faecalibacterium and Alistipes, and lower relative abundance of Erysipelatoclostridium (q values < 0.05). After adjustment of vitamin B2 in multivariate analysis, the significant inverse association between Erysipelatoclostridium count and caffeine intake remained statistically significant. Our preliminary study could not …


Rapid Profiling Of Dna Replication Dynamics Using Mass Spectrometry-Based Analysis Of Nascent Dna, Mohamed E Ashour, Andrea K Byrum, Alice Meroni, Jun Xia, Saurabh Singh, Roberto Galletto, Susan M Rosenberg, Alessandro Vindigni, Nima Mosammaparast Apr 2023

Rapid Profiling Of Dna Replication Dynamics Using Mass Spectrometry-Based Analysis Of Nascent Dna, Mohamed E Ashour, Andrea K Byrum, Alice Meroni, Jun Xia, Saurabh Singh, Roberto Galletto, Susan M Rosenberg, Alessandro Vindigni, Nima Mosammaparast

Faculty, Staff and Students Publications

The primary method for probing DNA replication dynamics is DNA fiber analysis, which utilizes thymidine analog incorporation into nascent DNA, followed by immunofluorescent microscopy of DNA fibers. Besides being time-consuming and prone to experimenter bias, it is not suitable for studying DNA replication dynamics in mitochondria or bacteria, nor is it adaptable for higher-throughput analysis. Here, we present mass spectrometry-based analysis of nascent DNA (MS-BAND) as a rapid, unbiased, quantitative alternative to DNA fiber analysis. In this method, incorporation of thymidine analogs is quantified from DNA using triple quadrupole tandem mass spectrometry. MS-BAND accurately detects DNA replication alterations in both …


Parental Perceptions Of The Hpv Vaccine For Prevention Of Anogenital And Oropharyngeal Cancers, Beth I. Schwartz, Merissa Maccani, Shalini Bansal, Meghan Gannon Apr 2023

Parental Perceptions Of The Hpv Vaccine For Prevention Of Anogenital And Oropharyngeal Cancers, Beth I. Schwartz, Merissa Maccani, Shalini Bansal, Meghan Gannon

Department of Obstetrics and Gynecology Faculty Papers

Background and Objectives

Human papillomavirus (HPV) is implicated in the development of both anogenital and oropharyngeal cancers. Although HPV vaccination prevents the majority of anogenital and head and neck cancers (HNC), vaccination rates remain low, especially among males. Known barriers to vaccination are knowledge gaps and vaccine acceptability. The objective of this study is to explore parental knowledge, perceptions, and decision-making processes about HPV and HPV vaccination for both anogenital and HNC.

Methods

This qualitative study recruited parents of children and adolescents aged 8–18 to participate in semi-structured telephone interviews. Data were analyzed using thematic analyses, informed by an inductive …


Independent Reproduction Of The Flash Effect On The Gastrointestinal Tract: A Multi-Institutional Comparative Study, Anet Valdés Zayas, Neeraj Kumari, Kevin Liu, Denae Neill, Abagail Delahoussaye, Patrik Gonçalves Jorge, Reiner Geyer, Steven H Lin, Claude Bailat, François Bochud, Raphael Moeckli, Albert C Koong, Jean Bourhis, Cullen M Taniguchi, Fernanda G Herrera, Emil Schüler Apr 2023

Independent Reproduction Of The Flash Effect On The Gastrointestinal Tract: A Multi-Institutional Comparative Study, Anet Valdés Zayas, Neeraj Kumari, Kevin Liu, Denae Neill, Abagail Delahoussaye, Patrik Gonçalves Jorge, Reiner Geyer, Steven H Lin, Claude Bailat, François Bochud, Raphael Moeckli, Albert C Koong, Jean Bourhis, Cullen M Taniguchi, Fernanda G Herrera, Emil Schüler

Faculty, Staff and Student Publications

FLASH radiation therapy (RT) is a promising new paradigm in radiation oncology. However, a major question that remains is the robustness and reproducibility of the FLASH effect when different irradiators are used on animals or patients with different genetic backgrounds, diets, and microbiomes, all of which can influence the effects of radiation on normal tissues. To address questions of rigor and reproducibility across different centers, we analyzed independent data sets from The University of Texas MD Anderson Cancer Center and from Lausanne University (CHUV). Both centers investigated acute effects after total abdominal irradiation to C57BL/6 animals delivered by the FLASH …


Improving Resident Awareness And Documentation Of Abnormal Involuntary Movements In Psychiatric Patients On Antipsychotic Medications, Jocelyn Mccornack, Kelly Wurzel Apr 2023

Improving Resident Awareness And Documentation Of Abnormal Involuntary Movements In Psychiatric Patients On Antipsychotic Medications, Jocelyn Mccornack, Kelly Wurzel

View All Graduate Medical Education Content

No abstract provided.


Treating Opioid Use Disorder: One Shot At A Time, Shelly Haferkamp, Michael P. Kinney, Daniel Yang, Lindsey Cunningham, Anna Davey, Amy G Burns Apr 2023

Treating Opioid Use Disorder: One Shot At A Time, Shelly Haferkamp, Michael P. Kinney, Daniel Yang, Lindsey Cunningham, Anna Davey, Amy G Burns

View All Graduate Medical Education Content

No abstract provided.


Benzodiazepine-Minimizing Protocol For Alcohol Withdrawal: A Comparative Analysis, Jennifer Gaston, Hsin-Fang Li, Emily J Cox, Caitlin Klamper, John F Wurzel Apr 2023

Benzodiazepine-Minimizing Protocol For Alcohol Withdrawal: A Comparative Analysis, Jennifer Gaston, Hsin-Fang Li, Emily J Cox, Caitlin Klamper, John F Wurzel

View All Graduate Medical Education Content

No abstract provided.


Code Status In The Inpatient Setting, Alyssa Harper, Travis Fisher, Marjorie Schoen, Caroline Pappas, Ian May Apr 2023

Code Status In The Inpatient Setting, Alyssa Harper, Travis Fisher, Marjorie Schoen, Caroline Pappas, Ian May

View All Graduate Medical Education Content

No abstract provided.


Preventing Chf Hospitalizations In Patients With Dementia, John Beale, Zoe Tartz, Jackson Harley, Tory Starzyk, Matthew Kennedy, Colleen Zimmermann Apr 2023

Preventing Chf Hospitalizations In Patients With Dementia, John Beale, Zoe Tartz, Jackson Harley, Tory Starzyk, Matthew Kennedy, Colleen Zimmermann

View All Graduate Medical Education Content

No abstract provided.


Breaking Barriers: Improving Care For Incarcerated Patients While Hospitalized, Spencer Steadman, Jordan Schroeder, Jacob Straus, Colton Berry Apr 2023

Breaking Barriers: Improving Care For Incarcerated Patients While Hospitalized, Spencer Steadman, Jordan Schroeder, Jacob Straus, Colton Berry

View All Graduate Medical Education Content

No abstract provided.


Improving Metabolic Monitoring During Transfers Of Care For Psychiatric Patients Discharged From The Inpatient Psychiatric Residency Service On An Antipsychotic Medication – Part 2, Allison Cohen, Anisha Boetel Apr 2023

Improving Metabolic Monitoring During Transfers Of Care For Psychiatric Patients Discharged From The Inpatient Psychiatric Residency Service On An Antipsychotic Medication – Part 2, Allison Cohen, Anisha Boetel

View All Graduate Medical Education Content

No abstract provided.


Identifying Systemic Errors In Refilling Insulin To Prevent Another Hospitalization: An Rca, John Butler, Mikayla Button, Jared Fincher, Rakin Solaiman, Michael Woodfin Apr 2023

Identifying Systemic Errors In Refilling Insulin To Prevent Another Hospitalization: An Rca, John Butler, Mikayla Button, Jared Fincher, Rakin Solaiman, Michael Woodfin

View All Graduate Medical Education Content

No abstract provided.


A Comprehensive Review Of Covid-19: Associated Endocrine Manifestations, Saif Khan Md, Maryam Karim Mbbs, Vasu Gupta, Heenam Goel Md, Rohit Jain Md Apr 2023

A Comprehensive Review Of Covid-19: Associated Endocrine Manifestations, Saif Khan Md, Maryam Karim Mbbs, Vasu Gupta, Heenam Goel Md, Rohit Jain Md

Articles

Coronavirus disease 2019 (COVID-19) has played a significant part in systematic damage, affecting lives and leading to significant mortality. The endocrine system is one of the systems affected by this pandemic outbreak. The relationship between them has been identified in previous and ongoing research. The mechanism through which severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) can achieve this is similar to that for organs that express angiotensin-converting enzyme 2 receptors, which is the primary binding site of the virus. Endocrine cells widely express angiotensin-converting enzyme 2 receptors and transmembrane serine protease 2, the primary mediators initiating the acute phase of the disease. …


Transition From Estimated Blood Loss To Quantitative Blood Loss In Labor And Delivery, Taylor K. Stewart, Brigette Schuman Apr 2023

Transition From Estimated Blood Loss To Quantitative Blood Loss In Labor And Delivery, Taylor K. Stewart, Brigette Schuman

View All Graduate Medical Education Content

No abstract provided.


Developing, Implementing, And Evaluating A Clinical Dashboard To Improve The Efficiency And Ease Of Tracking Institute For Healthcare Improvement Ihi Age-Friendly 4ms Framework Data., Margaret Parniawski Nsn, Ne-Bc, Kenneth Forte, Denis Mohess Md, Ray Wauthier Bsn, Erica Zerl Ssa, Edward Ostrowski Msn Apr 2023

Developing, Implementing, And Evaluating A Clinical Dashboard To Improve The Efficiency And Ease Of Tracking Institute For Healthcare Improvement Ihi Age-Friendly 4ms Framework Data., Margaret Parniawski Nsn, Ne-Bc, Kenneth Forte, Denis Mohess Md, Ray Wauthier Bsn, Erica Zerl Ssa, Edward Ostrowski Msn

Posters

The purpose of this study was to describe a user-centered development, implementation and preliminary evaluation of clinical dashboards to track Age-Friendly 4M Framework Data.


Ua12/2/2 Talisman: Surreal Issue No. 14, Wku Student Affairs Apr 2023

Ua12/2/2 Talisman: Surreal Issue No. 14, Wku Student Affairs

WKU Administration Documents

Spring 2023 Talisman:

  • Broekema, Gabi. Surrealism
  • Hunter, Leah. Surreal
  • Cox, Samantha. Surrealism
  • Plescia, Audrey. Horoscopes
  • Booth, Pandora. Dreamscapes
  • Ousley, Rachael. Body & Soul – Yoga, Susan Tutino
  • Coles, Jack. Tool for the Future – Artificial Intelligence
  • Sandlin, Ellie. Altered Minds – Drug Experimentation
  • Neidlinger, Heather. Little Dipper
  • White, Peyton. Pure Adrenaline – Rodeo, Skateboarding, Boxing, Rock Climbing
  • Plescia, Audrey. The Hill is Haunted
  • Richer, Cailyn. Threads of Expression – Fashion
  • Jefferson, Reginald. Momentum
  • Bruck, Lasikka. At Death’s Door – Yenni Gonzalez, Zoe Avery, Hannah Smith
  • Meyers, Jeffrey. Voice in Movement – Theatre & Dance, National Dance Education Association
  • Surreal Playlist


Spontaneous Rupture Of A Previously Asymptomatic Giant Angiomyolipoma, Reed Ritterbusch Apr 2023

Spontaneous Rupture Of A Previously Asymptomatic Giant Angiomyolipoma, Reed Ritterbusch

View All Graduate Medical Education Content

Northwest Research Symposium Day of Presentations 2023


Outcomes Associated With Allogeneic Hematopoietic Stem Cell Transplantation For Relapsed And Refractory Hodgkin Lymphoma In The Era Of Novel Agents., Muhammad Salman Faisal, Walter Hanel, Timothy Voorhees, Rui Li, Ying Huang, Abdullah Khan, David Bond, Yazeed Sawalha, John Reneau, Lapo Alinari, Robert Baiocchi, Beth Christian, Kami Maddocks, Yvonne Efebera, Sam Penza, Ayman Saad, Jonathan Brammer, Marcos Delima, Samantha Jaglowski, Narendranath Epperla Apr 2023

Outcomes Associated With Allogeneic Hematopoietic Stem Cell Transplantation For Relapsed And Refractory Hodgkin Lymphoma In The Era Of Novel Agents., Muhammad Salman Faisal, Walter Hanel, Timothy Voorhees, Rui Li, Ying Huang, Abdullah Khan, David Bond, Yazeed Sawalha, John Reneau, Lapo Alinari, Robert Baiocchi, Beth Christian, Kami Maddocks, Yvonne Efebera, Sam Penza, Ayman Saad, Jonathan Brammer, Marcos Delima, Samantha Jaglowski, Narendranath Epperla

Oncology Articles

BACKGROUND: Relapsed or refractory Hodgkin lymphoma (R/R HL) is a challenging disease with limited treatment options beyond brentuximab vedotin and checkpoint inhibitors. Herein we present the time-trend analysis of R/R HL patients who received allogeneic hematopoietic cell transplantation (allo-HCT) at our center from 2001-2017.

METHODS: The patients were divided into two distinct treatment cohorts: era1 (2001-2010), and era2 (2011-2017). The primary endpoint was overall survival (OS). Secondary endpoints included progression-free survival (PFS), non-relapse mortality (NRM), and cumulative incidence of acute and chronic graft versus host disease (GVHD).

RESULTS: Among the 51 patients included in the study, 29 were in era1, …


Kearns-Sayre Syndrome: Two Case Reports And A Review For The Primary Care Physician., Chad Richmond, Leonard Powell, Zachary D. Brittingham, Alison Mancuso Apr 2023

Kearns-Sayre Syndrome: Two Case Reports And A Review For The Primary Care Physician., Chad Richmond, Leonard Powell, Zachary D. Brittingham, Alison Mancuso

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Kearns-Sayre syndrome (KSS) is a mitochondrial encephalopathic disorder. Because mitochondria are ubiquitous organelles that are present in almost every human tissue, their dysfunction can affect nearly any organ system and give rise to a wide range of clinical characteristics. 1: As is the case with most diseases associated with mitochondrial DNA (mtDNA) mutations, the clinical features of KSS were defined before modern molecular genetic classifications emerged. 2: The exact prevalence of KSS is unknown; however, estimates place it at about 1:100,000 people. Although it is a rather rare syndrome, the ability to recognize or consider KSS as part of a …


Bronchiolitis: Hypertonic Saline, Children's Mercy Kansas City Apr 2023

Bronchiolitis: Hypertonic Saline, Children's Mercy Kansas City

Clinical Critically Appraised Topics

No abstract provided.


Staff And Provider Education On Diabetic Foot Exams And Foot Care Using The Ophelia Process, Shasta Pickens Apr 2023

Staff And Provider Education On Diabetic Foot Exams And Foot Care Using The Ophelia Process, Shasta Pickens

Doctoral Projects

Diabetes mellitus continues to grow in global prevalence and consumes an increasing amount of healthcare resources. Persons that live in disadvantaged groups have a higher prevalence due to a lack of understanding and access to care. Diabetes is one of the leading causes of chronic disease and limb loss worldwide. Diabetes foot care is essential, as diabetes can be dangerous to patients’ feet.

The purpose of this doctoral project was to increase diabetic foot care education and foot exams for staff and providers in a federally qualified health center (FQHC). Many people in this rural community do not understand the …


The Distribution Of Cardiovascular Risk Factors And The Association With Cadre Amongst Healthcare Workers At A Tertiary University Hospital In Nairobi City, Kenya, Emma Andrea Khabure Apr 2023

The Distribution Of Cardiovascular Risk Factors And The Association With Cadre Amongst Healthcare Workers At A Tertiary University Hospital In Nairobi City, Kenya, Emma Andrea Khabure

Master of Medicine in Family Medicine

Introduction: According to the World Health Organization (WHO), non-communicable diseases such as stroke, contribute to about 70% of the top ten causes of mortality in the world. The growing burden of Cardiovascular (CVD) risk factors has also been noted to affect the health workforce. According to the Ministry of Health in Kenya employing the WHO STEPS survey, 27% of Kenyans are either overweight or obese. Few studies have been done in Kenya to highlight the prevalence and impact of cardiovascular risk factors amongst healthcare workers. The variety of findings and paucity of data bring about the need to evaluate this …


Psychology University Students’ Mental Health Status During Covid-19 Pandemic In Karachi, Pakistan, Aisha Noorullah, Mubarak Mansoor, Ayesha Zahid Apr 2023

Psychology University Students’ Mental Health Status During Covid-19 Pandemic In Karachi, Pakistan, Aisha Noorullah, Mubarak Mansoor, Ayesha Zahid

Department of Psychiatry

Purpose: The COVID-19 pandemic has brought challenges in various domains of life but for low and middle-income country university students very demanding situations have emerged. University students’ psychological well-being has always been an area of concern worldwide and higher rates of anxiety and depression have been extensively reported among this cohort.
Objective: To determine the frequency of depressive symptoms, anxiety symptoms, and quality of sleep and the association of sleep quality and personality traits with anxiety and depressive symptoms among university students in Karachi, Pakistan in the context of the pandemic COVID-19.
Method: This web-based cross-sectional study was conducted among …


Comparative Medicaid Policy Analysis Related To Maternal And Infant Birth Outcomes In South Carolina, Cassidy L. Lena Apr 2023

Comparative Medicaid Policy Analysis Related To Maternal And Infant Birth Outcomes In South Carolina, Cassidy L. Lena

Senior Theses

The United States despite being one of the most industrialized and wealthiest nations in the world, has the worst maternal and child health outcomes of any industrialized nation. The rates of maternal morbidity, mortality, and infant mortality have been increasing within the past decade, when many causes of death for this population are preventable. This study conducted a literature review on Medicaid policies and associated programs between three states (South Carolina, North Carolina, and California) in order to gain background information. Secondly, a comparative Medicaid policy analysis was completed using the Centers for Disease Control and Prevention [CDC] framework, which …


Factors Associated With Sun Protection Behaviors Among Childhood Cancer Survivors, Melissa Fluehr, Gary Kwok, Jerod L. Stapleton, Margaret Masterson, Katie A. Devine Apr 2023

Factors Associated With Sun Protection Behaviors Among Childhood Cancer Survivors, Melissa Fluehr, Gary Kwok, Jerod L. Stapleton, Margaret Masterson, Katie A. Devine

UK CARES Faculty Publications

Background: Childhood cancer survivors (CCS) are at increased risk of developing skin cancer. Engaging in sun-protective behaviors may ameliorate that risk, but prior work shows that survivors engage in suboptimal levels of sun-protective behaviors. Guided by the Health Belief Model (HBM), this study evaluated factors associated with sun-protective behavior among CCS.

Methods: This is a secondary analysis of a survey study of 94 adult survivors of childhood cancer recruited from a long-term follow-up clinic. Participants reported their sun protection habits, skin type/ sensitivity, barriers to sun protection, and perceived severity and susceptibility of getting skin cancer. Descriptive statistics were used …


The Importance Of Translationally Evaluating Steroid Hormone Contributions To Substance Use, Erin E. Maher, Ashley Strzelecki, Jessica J. Weafer, Cassandra D. Gipson Apr 2023

The Importance Of Translationally Evaluating Steroid Hormone Contributions To Substance Use, Erin E. Maher, Ashley Strzelecki, Jessica J. Weafer, Cassandra D. Gipson

Markey Cancer Center Faculty Publications

Clinically, women appear to be more susceptible to certain aspects of substance use disorders (SUDs). The steroid hormones 17β-estradiol (E2) and progesterone (Pg) have been linked to women-specific drug behaviors. Here, we review clinical and preclinical studies investigating how cycling ovarian hormones affect nicotine-, cocaine-, and opioid-related behaviors. We also highlight gaps in the literature regarding how synthetic steroid hormone use may influence drug-related behaviors. In addition, we explore how E2 and Pg are known to interact in brain reward pathways and provide evidence of how these interactions may influence drug-related behaviors. The synthesis of this review demonstrates the critical …


Elevation Of Cannabis Knowledge: Higher Learning, Savannah Marie Patterson, Anisha Boetel Apr 2023

Elevation Of Cannabis Knowledge: Higher Learning, Savannah Marie Patterson, Anisha Boetel

Articles, Abstracts, and Reports

No abstract provided.


Discrepancies In Age-Based Medication Dosing, Chad Ruger, Anne Keeling, Sera Jacob, Cassidy Macarthur Apr 2023

Discrepancies In Age-Based Medication Dosing, Chad Ruger, Anne Keeling, Sera Jacob, Cassidy Macarthur

Articles, Abstracts, and Reports

No abstract provided.


Identification Of Acute Pathological Heart Rate Variability Variance Using Wearable Technology And Novel Predictive Software: A Multi-Disciplinary Collaboration Between St Luke’S Rehabilitation And Eastern Washington University, Trevor Mordhorst, Sanmeet Kaur, Dan Tappan, Dillon Dalton, Otto Bucholz, Katrina Taylor, Garth Babcock, Alicia Hegie, Frank Jackson Apr 2023

Identification Of Acute Pathological Heart Rate Variability Variance Using Wearable Technology And Novel Predictive Software: A Multi-Disciplinary Collaboration Between St Luke’S Rehabilitation And Eastern Washington University, Trevor Mordhorst, Sanmeet Kaur, Dan Tappan, Dillon Dalton, Otto Bucholz, Katrina Taylor, Garth Babcock, Alicia Hegie, Frank Jackson

Articles, Abstracts, and Reports

No abstract provided.