16 results on '"Michael P. Alexander"'
Search Results
2. Evaluation of the Integrated Pulmonary Index® during non-anesthesiologist sedation for percutaneous endoscopic gastrostomy
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Michael, Florian Alexander, Peveling-Oberhag, Jan, Herrmann, Eva, Zeuzem, Stefan, Bojunga, Jörg, and Friedrich-Rust, Mireen
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- 2021
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3. Donald T. Stuss: A Remembrance.
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Michael P. Alexander, Terence W. Picton, and Tim Shallice
- Published
- 2020
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4. Incorporating Human Beliefs and Behaviors into Wildlife Ecology
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McInturff, Michael Charles Alexander
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Ecology ,Wildlife conservation ,Environmental science ,fence ecology ,human-wildlife conflict ,large carnivores ,movement ecology ,predation risk ,socio-ecology - Abstract
Like much of the global biosphere, wildlife species have experienced rapid declines during the Anthropocene. Wildlife ecologists have responded to these crises by developing a range of technologies, techniques, and large datasets, which together have revolutionized the field, provided novel insights into the movements and behaviors of animals, and identified new risks and impacts to wildlife in a human-dominated world. While these advances have been vitally important, wildlife ecology has been slower to recognize and incorporate humans themselves into its new research domains. The chapters of this dissertation explore methods for better incorporating human behaviors, beliefs, actions, and infrastructure into the theories and approaches in wildlife ecology that have flourished in the last two decades. The research presented here demonstrates the importance of linking human beliefs and behaviors to wildlife ecology both by presenting novel findings and by showing the opportunities missed when narrow approaches are applied to complex socio-ecological problems.In Chapter 1, I provide a general introduction on the theories underlying this research, contextualize the research questions in light of the loss and recovery of large predators, and describe the research site where I collected much of the data for this dissertation. In Chapter 2, I apply the methods of movement ecology to some of the first fine-scale telemetry data collected on rifle hunters. I draw conclusions about their individual, site-level, and regional-level hunting behaviors and discuss the broad implications of these findings for hunting management. In Chapter 3, I examine livestock-predator conflict using approaches from both ecology and the social sciences. I describe a form of selection bias that is likely widespread but unreported due to the omission of social data from ecological models of conflict, and I offer guidelines for combining and translating ecological and social research on conflict. In Chapter 4, I explore the ecological impacts of one of the most globally widespread human constructions, the fence. I show for the first time the potential extent of fencing at large scales and discuss the wide variety of ecological effects of fences for both humans and ecosystems. I further highlight biases and gaps in fence research that have thus far limited a complete understanding of the environmental effects of these features. In Chapter 5, I conclude by making recommendations regarding how research might better incorporate human perceptions, decisions, and actions into ecology.
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- 2019
5. Donald T. Stuss: A Remembrance
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Tim Shallice, Terence W. Picton, and Michael P. Alexander
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Psychoanalysis ,Cognitive Neuroscience ,Neuropsychology ,Psychology - Abstract
A remembrance of Donald T. Stuss, PhD, OC, OOnt, FRSC, one of the giants of modern neuropsychology, died on September 3, 2019, of complications from pancreatic cancer after a short illness. He was 77.
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- 2020
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6. Subjective Cognitive Complaints in Concussion
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Alexandra Stillman, Michael P. Alexander, Karen Torres, Nancy Madigan, and Natasha Swan
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Adult ,Male ,030506 rehabilitation ,Emotions ,Neuropsychological Tests ,03 medical and health sciences ,Executive Function ,Young Adult ,0302 clinical medicine ,Cognition ,Concussion ,medicine ,Humans ,Generalizability theory ,Cognitive Dysfunction ,Depression (differential diagnoses) ,Brain Concussion ,Aged ,Aged, 80 and over ,Post-Concussion Syndrome ,Middle Aged ,medicine.disease ,humanities ,Female ,Neurology (clinical) ,0305 other medical science ,Psychology ,Cognition Disorders ,030217 neurology & neurosurgery ,Clinical psychology - Abstract
Studies of symptoms after concussion have been focused heavily on athletic and military populations; generalizability to "civilians" has not recently been demonstrated. We selected cognitive symptoms as an important target to assess because of impact on school and employment. We evaluated cognitive complaints in a highly symptomatic (Rivermead Post-Concussion Symptoms Questionnaire [PCSQ], mean [M] = 29.5) civilian sample (
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- 2019
7. Concussion: Evaluation and management
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William P. Meehan, Alexandra Stillman, Nancy Madigan, Michael P. Alexander, Alvaro Pascual-Leone, and Rebekah Mannix
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Sleep disorder ,medicine.medical_specialty ,business.industry ,MEDLINE ,Cognition ,General Medicine ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Concussion ,medicine ,Physical therapy ,Humans ,Headaches ,medicine.symptom ,business ,Brain Concussion ,030217 neurology & neurosurgery - Abstract
Concussion is a common problem often managed by nonneurologists. It is often accompanied by headaches, dizziness, sleep disturbance, psychiatric symptoms, and cognitive issues. Here, we outline how to evaluate and manage concussion, including treatment of the most common symptoms.
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- 2017
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8. Independent, Community-Based Aerobic Exercise Training for People With Moderate-to-Severe Traumatic Brain Injury
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Ernest V. Gervino, Bonnie Wong, Michael P. Alexander, Alvaro Pascual-Leone, and Jennifer M. Devine
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Adult ,Male ,medicine.medical_specialty ,Traumatic brain injury ,medicine.medical_treatment ,Poison control ,Physical Therapy, Sports Therapy and Rehabilitation ,Suicide prevention ,03 medical and health sciences ,0302 clinical medicine ,Physical medicine and rehabilitation ,Brain Injuries, Traumatic ,Injury prevention ,Heart rate ,medicine ,Humans ,Aerobic exercise ,Prospective Studies ,Exercise ,Trauma Severity Indices ,Rehabilitation ,business.industry ,Heart rate monitor ,030229 sport sciences ,Middle Aged ,medicine.disease ,Exercise Therapy ,Physical therapy ,Patient Compliance ,Female ,business ,030217 neurology & neurosurgery - Abstract
Objective To determine whether people with moderate-to-severe traumatic brain injury (TBI) can adhere to a minimally supervised, community-based, vigorous aerobic exercise program. Design Prospective trial. Setting Young Men's Christian Association (YMCA) facilities. Participants Community-dwelling volunteers (N=10; 8 men, 2 women; age range, 22–49y) 6 to 15 months after moderate-to-severe TBI. Intervention Participants received memberships to local YMCAs and brief orientations to exercise. They were then asked to independently complete ≥12 weeks of ≥3 training sessions per week, performed at 65% to 85% of maximum heart rate for ≥30 minutes per session. Participants could self-select exercise modality, provided they met intensity and duration targets. Programmable heart rate monitors captured session intensity and duration. Main Outcome Measures Independence with equipment and facility use and compliance with training goals (session frequency, duration, intensity, total weeks of training). Results All participants achieved independence with equipment and facility use. All met at least 2 of 4 training goals; half met all 4 goals. Participants averaged (±SD) 3.3±0.7 sessions per week for 13 weeks (range, 6–24). Average ± SD session duration was 62±23 minutes, of which 51±22 minutes occurred at or above individuals' heart rate training targets. Conclusions People in recovery from moderate-to-severe TBI can, with minimal guidance, perform vigorous, community-based exercise. This suggests that decentralized exercise may be logistically and economically sustainable after TBI, expanding its potential therapeutic utility and rendering longer-duration exercise studies more feasible.
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- 2016
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9. Transabdominal ultrasonography to reduce the burden of X‐ray imaging in prophylactic pancreatic stent localization after ERCP—A prospective trial
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Michael, Florian Alexander, Gerber, Ludmilla, Weiler, Nina, Hunyady, Peter Marton, Abedin, Nada, de la Vera, Anna‐Lena Laguna, Stoffers, Philipp, Filmann, Natalie, Zeuzem, Stefan, Bojunga, Jörg, Friedrich‐Rust, Mireen, and Dultz, Georg
- Abstract
Before performing endoscopy to remove prophylactic pancreatic stents placed in patients with high risk of post‐endoscopic retrograde cholangiopancreatography pancreatitis (PEP), X‐ray imaging is recommended to confirm the stents position in the pancreatic duct. The aim of the present study was to investigate the feasibility of prophylactic pancreatic stent detection by transabdominal ultrasonography, to reduce the burden of X‐ray imaging, which is currently the golden standard. All patients who received a pancreatic stent for PEP prophylaxis were included in the present prospective trial. First, stent position was determined by transabdominal ultrasonography. Afterwards, it was verified by X‐ray imaging. Retained stents were removed by esophagogastroduodenoscopy. Dislocated stents needed no further intervention. Fourty‐one patients were enrolled in this study. All prophylactic pancreatic stents were straight 6 cm long 5 Fr stents with external flap. All stents were removed between day 1 and 10 (median: 3 days) in all cases. In 34 of 41 cases (83.0%), the pancreatic stent was still in place on the day of examination. Twenty‐nine of 34 (85.3%) stents were detected correctly by transabdominal ultrasonography. Overlying gas prevented visualization of the pancreas in 3/41 (7.3%) cases. Sensitivity of sonographic detection of the stent was 93.5% (29/31). Six of seven stents were determined correctly as dislocated by ultrasonography. Here, specificity was 85.7%. A positive predictive value of 96.7% (29/30) was examined. The negative predictive value was 75.0% (6/8). Transabdominal ultrasonography detects the majority of prophylactic pancreatic stents. Thereby, it helps to identify patients with an indication for endoscopy sufficiently. X‐ray imaging could subsequently be omitted in about 70% of examinations, reducing the radiation exposure for the patient and the endoscopy staff.
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- 2021
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10. The effect of focal cortical frontal and posterior lesions on recollection and familiarity in recognition memory
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Natasha Kovacevic, Fuqiang Gao, Sandra E. Black, Michael P. Alexander, Michael L. Schwartz, Brian Levine, and Vessela Stamenova
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Dorsum ,Adult ,Male ,medicine.medical_specialty ,Cognitive Neuroscience ,Experimental and Cognitive Psychology ,Audiology ,Hippocampus ,050105 experimental psychology ,03 medical and health sciences ,Judgment ,0302 clinical medicine ,Focal lesion ,Parietal Lobe ,medicine ,Humans ,0501 psychology and cognitive sciences ,Recognition memory ,Aged ,Brain network ,Cued recall ,Brain Mapping ,Recall ,05 social sciences ,Recognition, Psychology ,Middle Aged ,Temporal Lobe ,Frontal Lobe ,Neuropsychology and Physiological Psychology ,Frontal lobe ,Temporal Regions ,Mental Recall ,Female ,Psychology ,030217 neurology & neurosurgery ,Cognitive psychology - Abstract
Recognition memory can be subdivided into two processes: recollection (a contextually rich memory) and familiarity (a sense that an item is old). The brain network supporting recognition encompasses frontal, parietal and medial temporal regions. Which specific regions within the frontal lobe are critical for recollection vs. familiarity, however, are unknown; past studies of focal lesion patients have yielded conflicting results. We examined patients with focal lesions confined to medial polar (MP), right dorsal frontal (RDF), right frontotemporal (RFT), left dorsal frontal (LDF), temporal, and parietal regions and matched controls. A series of words and their humorous definitions were presented either auditorily or visually to all participants. Recall, recognition, and source memory were tested at 30 min and 24 h delay, along with “remember/know” judgments for recognized items. The MP, RDF, temporal and parietal groups were impaired on subjectively reported recollection; their intact recognition performance was supported by familiarity. None of the groups were impaired on cued recall, recognition familiarity or source memory. These findings suggest that the MP and RDF regions, along with parietal and temporal regions, are necessary for subjectively-reported recollection, while the LDF and right frontal ventral regions, as those affected in the RTF group, are not.
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- 2016
11. A Corticosteroid Gene Therapy Combination Strategy to Maximize Intramuscular-Mediated Delivery in Postischemic Myocardium
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Charles R. Bridges, Michael G. Katz, Andrew P. Kendle, Anthony S. Fargnoli, and Michael P. Alexander
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Pathology ,medicine.medical_specialty ,medicine.medical_treatment ,Genetic enhancement ,Transgene ,Heart Ventricles ,Genetic Vectors ,Anti-Inflammatory Agents ,Myocardial Ischemia ,Gene Expression ,Bioinformatics ,Injections, Intramuscular ,chemistry.chemical_compound ,Transduction (genetics) ,Drug Delivery Systems ,Adrenal Cortex Hormones ,Genes, Reporter ,Transduction, Genetic ,medicine ,Humans ,Myocardial infarction ,Methylprednisolone Hemisuccinate ,Images in Gene and Cell Therapy ,Genetics (clinical) ,Microscopy, Confocal ,business.industry ,Growth factor ,Myocardium ,Gene Transfer Techniques ,Genetic Therapy ,medicine.disease ,Vascular endothelial growth factor ,Clinical trial ,chemistry ,Stem cell ,business ,Plasmids - Abstract
Achieving sufficient plasmid delivery is a key unresolved problem in postischemic myocardium for the latest clinical trials whose main objective is to rapidly upregulate potent regenerative mechanisms within a tight therapeutic window (i.e., within 48 hr). The well-documented impediments for efficient plasmid trafficking and subsequent transduction include anatomical-scale, cardiac disease-related comorbidities, and localized immune responses following the acute myocardial infarction event. An appreciation of delivery challenges originated from the first-in-human cardiac surgery gene therapy trial,1 which featured direct intramuscular (IM) injection of adenovirus encoding the vascular endothelial growth factor. Long-term follow-up of this phase I trial yielded no clear evidence of efficacy, likely because of a limited, transient expression profile—but it provided an impetus for improvements in vector, target, and clinical delivery strategies. Since then, numerous regenerative trials such as the stromal cell-derived growth factor 1 have generated significant interest. These strategies seek to repair myocardium through the chemoattraction of endogenous stem cell lineages shortly after myocardial infarction.2 In contrast to viral vector-mediated transgenes, these approaches offer rapid onset gene overexpression through high-dose, yet low-risk vector plasmids. The IM route is attractive for this emerging therapeutic class because of its clinical feasibility through both surgical (Fig. 1A) and catheter-based delivery techniques, but is limited by transfer inefficiency. Despite technical modifications of needle-based delivery in myocardium, these problems persist: poor retention, inconsistent performance per site, and the highly focal resultant delivery profiles. This results in the demand for more injections, thus increasing the risk for additional injury in already-compromised myocardium.3 In addition, recent trial results suggest that the predominant intracoronary infusion route may be even less efficient in patients with significant coronary disease, thus renewing interest in IM delivery. Therefore, a shift toward improvement in the delivery profile featuring clinically applicable drug combination approaches has been explored as a means to increase efficiency per injection site.4
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- 2015
12. Some Neurobehavioral Aspects of Closed Head Injury
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Michael P. Alexander
- Subjects
medicine.medical_specialty ,Physical medicine and rehabilitation ,business.industry ,Closed head injury ,medicine ,medicine.disease ,Psychiatry ,business - Published
- 2015
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13. Mild traumatic brain injury
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Douglas I, Katz, Sara I, Cohen, and Michael P, Alexander
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Depressive Disorder ,Brain Injuries ,Headache ,Consciousness Disorders ,Humans ,Cognition Disorders - Abstract
Mild traumatic brain injury (TBI) is common but accurate diagnosis and defining criteria for mild TBI and its clinical consequences have been problematic. Mild TBI causes transient neurophysiologic brain dysfunction, sometimes with structural axonal and neuronal damage. Biomarkers, such as newer imaging technologies and protein markers, are promising indicators of brain injury but are not ready for clinical use. Diagnosis relies on clinical criteria regarding depth and duration of impaired consciousness and amnesia. These criteria are particularly difficult to confirm at the least severe end of the mild TBI continuum, especially when relying on subjective, retrospective accounts. The postconcussive syndrome is a controversial concept because of varying criteria, inconsistent symptom clusters and the evidence that similar symptom profiles occur with other disorders, and even in a proportion of healthy individuals. The clinical consequences of mild TBI can be conceptualized as two multidimensional disorders: (1) a constellation of acute symptoms that might be termed early phase post-traumatic disorder (e.g., headache, dizziness, imbalance, fatigue, sleep disruption, impaired cognition), that typically resolve in days to weeks and are largely related to brain trauma and concomitant injuries; (2) a later set of symptoms, a late phase post-traumatic disorder, evolving out of the early phase in a minority of patients, with a more prolonged (months to years), sometimes worsening set of somatic, emotional, and cognitive symptoms. The later phase disorder is highly influenced by a variety of psychosocial factors and has little specificity for brain injury, although a history of multiple concussions seems to increase the risk of more severe and longer duration symptoms. Effective early phase management may prevent or limit the later phase disorder and should include education about symptoms and expectations for recovery, as well as recommendations for activity modifications. Later phase treatment should be informed by thoughtful differential diagnosis and the multiplicity of premorbid and comorbid conditions that may influence symptoms. Treatment should incorporate a hierarchical, sequential approach to symptom management, prioritizing problems with significant functional impact and effective, available interventions (e.g., headache, depression, anxiety, insomnia, vertigo).
- Published
- 2015
14. Mild traumatic brain injury
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Sara I Cohen, Douglas I. Katz, and Michael P. Alexander
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medicine.medical_specialty ,Pediatrics ,Traumatic brain injury ,Amnesia ,Cognition ,Rivermead post-concussion symptoms questionnaire ,medicine.disease ,Concussion ,Physical therapy ,medicine ,Anxiety ,medicine.symptom ,Psychology ,Psychosocial ,Depression (differential diagnoses) - Abstract
Mild traumatic brain injury (TBI) is common but accurate diagnosis and defining criteria for mild TBI and its clinical consequences have been problematic. Mild TBI causes transient neurophysiologic brain dysfunction, sometimes with structural axonal and neuronal damage. Biomarkers, such as newer imaging technologies and protein markers, are promising indicators of brain injury but are not ready for clinical use. Diagnosis relies on clinical criteria regarding depth and duration of impaired consciousness and amnesia. These criteria are particularly difficult to confirm at the least severe end of the mild TBI continuum, especially when relying on subjective, retrospective accounts. The postconcussive syndrome is a controversial concept because of varying criteria, inconsistent symptom clusters and the evidence that similar symptom profiles occur with other disorders, and even in a proportion of healthy individuals. The clinical consequences of mild TBI can be conceptualized as two multidimensional disorders: (1) a constellation of acute symptoms that might be termed early phase post-traumatic disorder (e.g., headache, dizziness, imbalance, fatigue, sleep disruption, impaired cognition), that typically resolve in days to weeks and are largely related to brain trauma and concomitant injuries; (2) a later set of symptoms, a late phase post-traumatic disorder, evolving out of the early phase in a minority of patients, with a more prolonged (months to years), sometimes worsening set of somatic, emotional, and cognitive symptoms. The later phase disorder is highly influenced by a variety of psychosocial factors and has little specificity for brain injury, although a history of multiple concussions seems to increase the risk of more severe and longer duration symptoms. Effective early phase management may prevent or limit the later phase disorder and should include education about symptoms and expectations for recovery, as well as recommendations for activity modifications. Later phase treatment should be informed by thoughtful differential diagnosis and the multiplicity of premorbid and comorbid conditions that may influence symptoms. Treatment should incorporate a hierarchical, sequential approach to symptom management, prioritizing problems with significant functional impact and effective, available interventions (e.g., headache, depression, anxiety, insomnia, vertigo).
- Published
- 2015
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15. Little cheer for Scots business.
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Michael Blackley; Alexander Butler
- Abstract
SCOTTISH firms are facing an economic crisis as the country heads into recession despite a freeze on rates, business leaders have warned. [ABSTRACT FROM PUBLISHER]
- Published
- 2022
16. Infectious Trigger for Autoimmune Encephalitis: A Case Report and Literature Review
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Sahar, Najmus, Michael Nurre, Alexander, and Q. Simon, Ryan
- Abstract
Herpes simplex virus 1 infection is a common cause of encephalitis (HSVE) in the United States. Post-HSVE development of N-methyl-D-aspartate receptor (NMDAR) antibodies resulting in autoimmune encephalitis is a rare complication, primarily affecting children and young adults. Anti-NMDAR develops 1–4 weeks after HSVE, manifesting as choreoathetosis and/or orofacial dyskinesia in children and psychiatric symptoms in young adults. We describe a case of a 61-year-old male who presented with agitation, behavioral changes, and confusion eight months after being treated for HSVE. Extensive investigation was unrevealing except for cerebrospinal fluid lymphocytic pleocytosis, a positive anti-NMDAR Ab titer 1 : 64, and imaging changes consistent with postviral encephalitis suggestive of HSV-induced anti-NMDAR encephalitis. Aggressive therapy resulted in limited success and persistent neurologic deficits. The unique features of this case are the old age of the patient and preceding HSVE which triggered this autoimmune process. Physicians should consider anti-NMDAR encephalitis in the differentials for relapsing patients after HSVE.
- Published
- 2019
- Full Text
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