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1. High frequency of diabetic ketoacidosis at diagnosis of type 1 diabetes in Italian children: A nationwide longitudinal study, 2004-2013

Author

Cherubini, Valentino, Skrami, Edlira, Ferrito, Lucia, Zucchini, Stefano, Scaramuzza, Andrea, Bonfanti, Riccardo, Buono, Pietro, Cardella, Francesca, Cauvin, Vittoria, Chiari, Giovanni, D'Annunzio, Giuseppe, Frongia, Anna Paola, Iafusco, Dario, Patera, Ippolita Patrizia, Toni, Sonia, Tumini, Stefano, Rabbone, Ivana, Lombardo, Fortunato, Carle, Flavia, Gesuita, Rosaria, Lera, Riccardo, De Luna, Livia, Gualtieri, Antonella, Zecchino, Clara, Piccinno, Elvira, Reinstadler, Petra, Prandi, Elena, Gallo, Francesco, Morganti, Gianfranco, Ripoli, Carlo, La Loggia, Alfonso, Scanu, Piera, Cardinale, Giuliana, Tomaselli, Letizia Grazia, Citriniti, Felice, Lazzaro, Nicola, De Donno, Valeria, Mainetti, Benedetta, Coccioli, Maria Susanna, Maccioni, Rosella, Marongiu, Ugo, Bruzzese, Mariella, Iannilli, Antonio, Pardi, Daniela, Confetto, Santino, Zanfardino, Angela, Iughetti, Lorenzo, Franzese, Adriana, Cadario, Francesco, Milia, Anna Franca, Piredda, Gavina, Soro, Miriam, Correddu, Antonella, Galderisi, Alfonso, De Berardinis, Fiorella, Federico, Giovanni, Zanette, Giorgio, Suprani, Tosca, Pedini, Annalisa, Bitti, Maria Luisa Manca, Delvecchio, Maurizio, Trada, Michela, Meloni, Gianfranco, Gaiero, Alberto, Bulciolu, Pasquale, Guerraggio, Lucia, Faleschini, Elena, Zanatta, Manuela, Salvatoni, Alessandro, Maffeis, Claudio, Arnaldi, Claudia, Cherubini, Valentino, Skrami, Edlira, Ferrito, Lucia, Zucchini, Stefano, Scaramuzza, Andrea, Bonfanti, Riccardo, Buono, Pietro, Cardella, Francesca, Cauvin, Vittoria, Chiari, Giovanni, D'Annunzio, Giuseppe, Frongia, Anna Paola, Iafusco, Dario, Patera, Ippolita Patrizia, Toni, Sonia, Tumini, Stefano, Rabbone, Ivana, Lombardo, Fortunato, Carle, Flavia, Gesuita, Rosaria, Lera, Riccardo, De Luna, Livia, Gualtieri, Antonella, Zecchino, Clara, Piccinno, Elvira, Reinstadler, Petra, Prandi, Elena, Gallo, Francesco, Morganti, Gianfranco, Ripoli, Carlo, La Loggia, Alfonso, Scanu, Piera, Cardinale, Giuliana, Tomaselli, Letizia Grazia, Citriniti, Felice, Lazzaro, Nicola, De Donno, Valeria, Mainetti, Benedetta, Coccioli, Maria Susanna, Maccioni, Rosella, Marongiu, Ugo, Bruzzese, Mariella, Iannilli, Antonio, Pardi, Daniela, Confetto, Santino, Zanfardino, Angela, Iughetti, Lorenzo, Franzese, Adriana, Cadario, Francesco, Milia, Anna Franca, Piredda, Gavina, Soro, Miriam, Correddu, Antonella, Galderisi, Alfonso, De Berardinis, Fiorella, Federico, Giovanni, Zanette, Giorgio, Suprani, Tosca, Pedini, Annalisa, Bitti, Maria Luisa Manca, Delvecchio, Maurizio, Trada, Michela, Meloni, Gianfranco, Gaiero, Alberto, Bulciolu, Pasquale, Guerraggio, Lucia, Faleschini, Elena, Zanatta, Manuela, Salvatoni, Alessandro, Maffeis, Claudio, Arnaldi, Claudia, Cherubini, V., Skrami, E., Ferrito, L., Zucchini, S., Scaramuzza, A., Bonfanti, R., Buono, P., Cardella, F., Cauvin, V., Chiari, G., D'Annunzio, G., Frongia, A. P., Iafusco, D., Patera, I. P., Toni, S., Tumini, S., Rabbone, I., Lombardo, F., Carle, F., Gesuita, R., Lera, R., De Luna, L., Gualtieri, A., Zecchino, C., Piccinno, E., Reinstadler, P., Prandi, E., Gallo, F., Morganti, G., Ripoli, C., La Loggia, A., Scanu, P., Cardinale, G., Tomaselli, L. G., Citriniti, F., Lazzaro, N., De Donno, V., Mainetti, B., Coccioli, M. S., Maccioni, R., Marongiu, U., Bruzzese, M., Iannilli, A., Pardi, D., Confetto, S., Zanfardino, A., Iughetti, L., Franzese, A., Cadario, F., Milia, A. F., Piredda, G., Soro, M., Correddu, A., Galderisi, A., De Berardinis, F., Federico, G., Zanette, G., Suprani, T., Pedini, A., Bitti, M. L. M., Delvecchio, M., Trada, M., Meloni, G., Gaiero, A., Bulciolu, P., Guerraggio, L., Faleschini, E., Zanatta, M., Salvatoni, A., Maffeis, C., and Arnaldi, C.

Subjects
Male, Longitudinal study, Pediatrics, medicine.medical_specialty, endocrine system diseases, Diabetic ketoacidosis, Adolescent, Population, 030209 endocrinology & metabolism, Longitudinal Studie, Logistic regression, Article, Diabetic Ketoacidosis, Diabetic Ketoacidosi, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Diabetes mellitus, Humans, Medicine, Age Factor, Longitudinal Studies, Family history, education, Diabetes, Ketoacidosis, Type 1 diabetes, education.field_of_study, Multidisciplinary, business.industry, Age Factors, nutritional and metabolic diseases, medicine.disease, Ketoacidosis, Diabetes Mellitus, Type 1, Italy, Female, business, Human
Abstract

This longitudinal population-based study analyses the frequency of diabetic ketoacidosis (DKA) at type 1 diabetes diagnosis in Italian children under 15 years of age, during 2004–2013. DKA was defined as absent (pH ≥ 7.30), mild/moderate (7.1 ≤ pH

Published
2016

2. The Silent Epidemic of Diabetic Ketoacidosis at Diagnosis of Type 1 Diabetes in Children and Adolescents in Italy During the COVID-19 Pandemic in 2020

Author

Valentino Cherubini, Monica Marino, Andrea E. Scaramuzza, Valentina Tiberi, Adriana Bobbio, Maurizio Delvecchio, Elvira Piccinno, Federica Ortolani, Stefania Innaurato, Barbara Felappi, Francesco Gallo, Carlo Ripoli, Maria Rossella Ricciardi, Filomena Pascarella, Filomena A. Stamati, Felice Citriniti, Claudia Arnaldi, Sara Monti, Vanna Graziani, Fiorella De Berardinis, Cosimo Giannini, Francesco Chiarelli, Maria Zampolli, Rosaria De Marco, Giulia Patrizia Bracciolini, Caterina Grosso, Valeria De Donno, Barbara Piccini, Sonia Toni, Susanna Coccioli, Giuliana Cardinale, Marta Bassi, Nicola Minuto, Giuseppe D’Annunzio, Claudio Maffeis, Marco Marigliano, Angela Zanfardino, Dario Iafusco, Assunta S. Rollato, Alessia Piscopo, Stefano Curto, Fortunato Lombardo, Bruno Bombaci, Silvia Sordelli, Chiara Mameli, Maddalena Macedoni, Andrea Rigamonti, Riccardo Bonfanti, Giulio Frontino, Barbara Predieri, Patrizia Bruzzi, Enza Mozzillo, Francesco Rosanio, Adriana Franzese, Gavina Piredda, Francesca Cardella, Brunella Iovane, Valeria Calcaterra, Maria Giulia Berioli, Anna Lasagni, Valentina Pampanini, Patrizia Ippolita Patera, Riccardo Schiaffini, Irene Rutigliano, Gianfranco Meloni, Luisa De Sanctis, Davide Tinti, Michela Trada, Lucia Paola Guerraggio, Roberto Franceschi, Vittoria Cauvin, Gianluca Tornese, Francesca Franco, Gianluca Musolino, Giulio Maltoni, Valentina Talarico, Antonio Iannilli, Lorenzo Lenzi, Maria Cristina Matteoli, Erica Pozzi, Carlo Moretti, Stefano Zucchini, Ivana Rabbone, Rosaria Gesuita, Cherubini, Valentino, Marino, Monica, Scaramuzza, Andrea E, Tiberi, Valentina, Bobbio, Adriana, Delvecchio, Maurizio, Piccinno, Elvira, Ortolani, Federica, Innaurato, Stefania, Felappi, Barbara, Gallo, Francesco, Ripoli, Carlo, Ricciardi, Maria Rossella, Pascarella, Filomena, Stamati, Filomena A, Citriniti, Felice, Arnaldi, Claudia, Monti, Sara, Graziani, Vanna, De Berardinis, Fiorella, Giannini, Cosimo, Chiarelli, Francesco, Zampolli, Maria, De Marco, Rosaria, Bracciolini, Giulia Patrizia, Grosso, Caterina, De Donno, Valeria, Piccini, Barbara, Toni, Sonia, Coccioli, Susanna, Cardinale, Giuliana, Bassi, Marta, Minuto, Nicola, D'Annunzio, Giuseppe, Maffeis, Claudio, Marigliano, Marco, Zanfardino, Angela, Iafusco, Dario, Rollato, Assunta S, Piscopo, Alessia, Curto, Stefano, Lombardo, Fortunato, Bombaci, Bruno, Sordelli, Silvia, Mameli, Chiara, Macedoni, Maddalena, Rigamonti, Andrea, Bonfanti, Riccardo, Frontino, Giulio, Predieri, Barbara, Bruzzi, Patrizia, Mozzillo, Enza, Rosanio, Francesco, Franzese, Adriana, Piredda, Gavina, Cardella, Francesca, Iovane, Brunella, Calcaterra, Valeria, Berioli, Maria Giulia, Lasagni, Anna, Pampanini, Valentina, Patera, Patrizia Ippolita, Schiaffini, Riccardo, Rutigliano, Irene, Meloni, Gianfranco, De Sanctis, Luisa, Tinti, Davide, Trada, Michela, Guerraggio, Lucia Paola, Franceschi, Roberto, Cauvin, Vittoria, Tornese, Gianluca, Franco, Francesca, Musolino, Gianluca, Maltoni, Giulio, Talarico, Valentina, Iannilli, Antonio, Lenzi, Lorenzo, Matteoli, Maria Cristina, Pozzi, Erica, Moretti, Carlo, Zucchini, Stefano, Rabbone, Ivana, and Gesuita, Rosaria

Subjects
COVID - 19, Adolescent, type 1 diabetes, Endocrinology, Diabetes and Metabolism, Longitudinal Studie, Diabetic Ketoacidosis, socioeconomic status, DKA, Diabetes Mellitus, Humans, Longitudinal Studies, Child, Pandemics, Settore MED/38 - Pediatria Generale e Specialistica, Pandemic, type 1 diabete, Incidence, COVID-19, diabetes onset, Communicable Disease Control, Italy, Diabetes Mellitus, Type 1, socioeconomic statu, Human, Type 1
Abstract

Aim/HypothesisTo compare the frequency of diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes in Italy during the COVID-19 pandemic in 2020 with the frequency of DKA during 2017-2019.MethodsForty-seven pediatric diabetes centers caring for >90% of young people with diabetes in Italy recruited 4,237 newly diagnosed children with type 1 diabetes between 2017 and 2020 in a longitudinal study. Four subperiods in 2020 were defined based on government-imposed containment measures for COVID-19, and the frequencies of DKA and severe DKA compared with the same periods in 2017-2019.ResultsOverall, the frequency of DKA increased from 35.7% (95%CI, 33.5-36.9) in 2017-2019 to 39.6% (95%CI, 36.7-42.4) in 2020 (p=0.008), while the frequency of severe DKA increased from 10.4% in 2017-2019 (95%CI, 9.4-11.5) to 14.2% in 2020 (95%CI, 12.3-16.4, pConclusions/InterpretationThere was an increase in the frequency of DKA and severe DKA in children newly diagnosed with type 1 diabetes during the COVID-19 pandemic in 2020, with no apparent association with the severity of COVID-19 infection severity or containment measures. There has been a silent outbreak of DKA in children during the pandemic, and preventive action is required to prevent this phenomenon in the event of further generalized lockdowns or future outbreaks.

Published
2022

3. Albuminuric and non-albuminuric reduced eGFR phenotypes in youth with type 1 diabetes: Factors associated with cardiometabolic risk

Author

Maurizio Delvecchio, C. Ripoli, Claudia Piona, Alberto Casertano, Roberto Franceschi, Riccardo Schiaffini, Maria R Ricciardi, Valentino Tiberi, Elvira Piccinno, T. Suprani, Giulio Maltoni, Enza Mozzillo, Procolo Di Bonito, Angela Zanfardino, Dario Iafusco, Gianluca Tornese, Silvia Savastio, C. Arnaldi, Valentino Cherubini, Francesco Maria Rosanio, Brunella Iovane, Claudio Maffeis, Adriana Franzese, Di Bonito, P., Mozzillo, E., Rosanio, F. M., Maltoni, G., Piona, C. A., Franceschi, R., Ripoli, C., Ricciardi, M. R., Tornese, G., Arnaldi, C., Iovane, B., Iafusco, D., Zanfardino, A., Suprani, T., Savastio, S., Cherubini, V., Tiberi, V., Piccinno, E., Schiaffini, R., Delvecchio, M., Casertano, A., Maffeis, C., Franzese, A., Di Bonito, Procolo, Mozzillo, Enza, Rosanio, Francesco Maria, Maltoni, Giulio, Piona, Claudia Anita, Franceschi, Roberto, Ripoli, Carlo, Ricciardi, Maria Rossella, Tornese, Gianluca, Arnaldi, Claudia, Iovane, Brunella, Iafusco, Dario, Zanfardino, Angela, Suprani, Tosca, Savastio, Silvia, Cherubini, Valentino, Tiberi, Valentina, Piccinno, Elvira, Schiaffini, Riccardo, Delvecchio, Maurizio, Casertano, Alberto, Maffeis, Claudio, and Franzese, Adriana

Subjects
Male, Endocrinology, Diabetes and Metabolism, Medicine (miscellaneous), White, Diabetic nephropathy, 030204 cardiovascular system & hematology, Kidney, Gastroenterology, chemistry.chemical_compound, 0302 clinical medicine, cardiovascular disease, Retrospective Studie, Prevalence, eGFR, Medicine, Age Factor, Diabetic Nephropathies, Child, Children, Nutrition and Dietetics, cardiometabolic risk factor, type 1 diabete, Age Factors, Cardiovascular disease, Phenotype, Type 1 diabetes, Italy, Child, Preschool, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, Human, Glomerular Filtration Rate, Type 1, medicine.medical_specialty, microalbuminuria, Type 1 diabete, Adolescent, Renal function, 030209 endocrinology & metabolism, Risk Assessment, White People, Autoimmune thyroiditis, 03 medical and health sciences, children, Internal medicine, Diabetes Mellitus, Humans, Albuminuria, Diabetic kidney disease, diabetic nephropathy, diabetic kidney disease, cardiometabolic risk factors, type 1 diabetes, Retrospective Studies, Cross-Sectional Studie, Creatinine, Cardiometabolic risk factor, business.industry, Thyroiditis, Autoimmune, Biomarker, medicine.disease, Cardiometabolic risk factors, Cross-Sectional Studies, Diabetes Mellitus, Type 1, chemistry, Diabetic Nephropathie, Uric acid, Microalbuminuria, business, Biomarkers
Abstract

Background and aim: Albuminuria and reduced eGFR are hallmarks of Diabetic Kidney Disease in adults. Our aim was to analyze factors associated with albuminuric and non-albuminuric mildly reduced eGFR phenotypes in youths with type 1 diabetes. Methods and results: This multicenter cross-sectional study included 1549 youths (age 5–17 years) with type 1 diabetes enrolled at 14 Italian Pediatric Diabetes Centers. Albuminuria, creatinine, glycosylated hemoglobin (HbA1c), lipids, blood pressure (BP), neutrophils (N) and lymphocytes (L) count were analyzed. Uric acid (UA) was available in 848 individuals. Estimated GFR (eGFR) was calculated using bedside Schwartz's equation. The sample was divided in three phenotypes: 1) normoalbuminuria and eGFR ≥90 mL/min/1.73 m2 (reference category, n = 1204), 2) albuminuric and normal GFR phenotype (n = 106), 3) non-albuminuric mildly reduced GFR (MRGFR) phenotype (eGFR 60–89 mL/min/1.73 m2, n = 239). Albuminuric and non-albuminuric reduced eGFR phenotypes were significantly associated with autoimmune thyroiditis (P =0.028 and P=0.044, respectively). Albuminuric phenotype showed high risk of high HbA1c (P=0.029), high BP (P < 0.001), and low HDL-C (P =0.045) vs reference category. Non-albuminuric MRGFR phenotype showed high risk of high BP (P < 0.0001), low HDL-C (P =0.042), high Triglycerides/HDL-C ratio (P =0.019), and high UA (P < 0.0001) vs reference category. Conclusion: Non albuminuric MRGFR phenotype is more prevalent than albuminuric phenotype and shows a worst cardiometabolic risk (CMR) profile). Both phenotypes are associated with autoimmune thyroiditis. Our data suggest to evaluate both albuminuria and eGFR earlier in type 1 diabetes to timely identify young people with altered CMR profile.

Published
2021

4. Diabetic ketoacidosis at the onset of disease during a national awareness campaign: A 2-year observational study in children aged 0-18 years

Author

Rabbone I., Maltoni G., Tinti D., Zucchini S., Cherubini V., Bonfanti R., Scaramuzza A., Lera R., Bobbio A., Piccinno E., Reinstadler P., Felappi B., Prandi E., Gallo F., Frongia AP., Ripoli C., Lo Presti D., Tomaselli L., Cardinale G., Stamati FA., Citriniti F., Suprani T., Graziani V., De Berardinis F., Zampolli M., De Marco R., Cavalli C., Lazzaro N., De Donno V., Toni S., Piccini B., Lenzi L., Mainetti B., Coccioli MS., d'Annunzio G., Minuto N., Aloe S., Lucchesi D., Cirillo S., Sordelli M., Del Vecchio F., Salzano LG., Meschi F., Iughetti L., Predieri B., Franzese A., Mozzillo Enza., Iafusco D., Cadario F., Savastio S., Piredda G., Cardella F., Iovane B., Calcaterra V., Berioli MG., Biagioni M., Randazzo E., Patera I., Schiaffini R., Rutigliano I., Lasagni A., Innaurato S., Gaiero A., Fichera G., Trada M., Guerraggio L., Cauvin V., Franceschi R., Tornese G., Salvatoni A., Marigliano M., Sabbion A., Maffeis C., Arnaldi C., Rabbone, I., Maltoni, G., Tinti, D., Zucchini, S., Cherubini, V., Bonfanti, R., Scaramuzza, A., Lera, R., Bobbio, A., Piccinno, E., Reinstadler, P., Felappi, B., Prandi, E., Gallo, F., Frongia, Ap., Ripoli, C., Lo Presti, D., Tomaselli, L., Cardinale, G., Stamati, Fa., Citriniti, F., Suprani, T., Graziani, V., De Berardinis, F., Zampolli, M., De Marco, R., Cavalli, C., Lazzaro, N., De Donno, V., Toni, S., Piccini, B., Lenzi, L., Mainetti, B., Coccioli, Ms., D'Annunzio, G., Minuto, N., Aloe, S., Lucchesi, D., Cirillo, S., Sordelli, M., Del Vecchio, F., Salzano, Lg., Meschi, F., Iughetti, L., Predieri, B., Franzese, A., Mozzillo, Enza., Iafusco, D., Cadario, F., Savastio, S., Piredda, G., Cardella, F., Iovane, B., Calcaterra, V., Berioli, Mg., Biagioni, M., Randazzo, E., Patera, I., Schiaffini, R., Rutigliano, I., Lasagni, A., Innaurato, S., Gaiero, A., Fichera, G., Trada, M., Guerraggio, L., Cauvin, V., Franceschi, R., Tornese, G., Salvatoni, A., Marigliano, M., Sabbion, A., Maffeis, C., Arnaldi, C., Rabbone, Ivana, Maltoni, Giulio, Tinti, Davide, Zucchini, Stefano, Cherubini, Valentino, Bonfanti, Riccardo, Scaramuzza, Andrea, Lera, Riccardo, Bobbio, Adriana, Piccinno, Elvira, Reinstadler, Petra, Felappi, Barbara, Prandi, Elena, Gallo, Francesco, Frongia, Anna Paola, Ripoli, Carlo, Lo Presti, Donatella, Tomaselli, Letizia, Cardinale, Giuliana, Stamati, Filomena Andreina, Citriniti, Felice, Suprani, Tosca, Graziani, Vanna, De Berardinis, Fiorella, Zampolli, Maria, De Marco, Rosaria, Cavalli, Claudio, Lazzaro, Nicola, De Donno, Valeria, Toni, Sonia, Piccini, Barbara, Lenzi, Lorenzo, Mainetti, Benedetta, Coccioli, Maria Susanna, D’Annunzio, Giuseppe, Minuto, Nicola, Aloe, Monica, Lucchesi, Sonia, Cirillo, Dante, Sordelli, Silvia, Delvecchio, Maurizio, Lombardo, Fortunato, Salzano, Giusy, Meschi, Franco, Iughetti, Lorenzo, Predieri, Barbara, Franzese, Adriana, Mozzillo, Enza, Iafusco, Dario, Cadario, Francesco, Savastio, Silvia, Cardella, Francesca, Iovane, Brunella, Calcaterra, Valeria, Berioli, Maria Giulia, Biagioni, Martina, Randazzo, Emioli, Patera, Ippolita Patrizia, Schiaffini, Riccardo, Rutigliano, Irene, Lasagni, Anna, Innaurato, Silvia, Gaiero, Alberto, Fichera, Grazziella, Trada, Michela, Guerraggio, Lucia, Cauvin, Vittoria, Franceschi, Roberto, Tornese, Gianluca, Salvatoni, Alessandro, Marigliano, Marco, Sabbion, Alberto, Maffeis, Claudio, and Arnaldi, Claudia

Subjects
Blood Glucose, Male, medicine.medical_specialty, Pediatrics, endocrine system diseases, Diabetic ketoacidosis, Adolescent, 030209 endocrinology & metabolism, Disease, 03 medical and health sciences, 0302 clinical medicine, diabetic ketoacidosis, Patient Education as Topic, Diabetes mellitus, Epidemiology, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, Child, Type 1 diabetes, diabetes, business.industry, Incidence (epidemiology), Incidence, epidemiology, Infant, Newborn, diabetic ketoacidosi, nutritional and metabolic diseases, Infant, medicine.disease, Diabetes Mellitus, Type 1, Italy, diabete, Child, Preschool, Pediatrics, Perinatology and Child Health, Observational study, Female, business, Prevention campaign
Abstract

ObjectiveAfter a previous survey on the incidence of diabetic ketoacidosis (DKA) at onset of type 1 diabetes in children in 2013–2014 in Italy, we aimed to verify a possible decline in the incidence of DKA at onset during a national prevention campaign.DesignProspective observational study.SettingMulticentre study throughout Italy.InterventionNational awareness campaign started in November 2015 and held until December 2017.PatientsDuring 2016 and 2017 we collected data on all patients aged 0–18 years with new-onset diabetes.Main outcome measuresDKA (pH ResultsRecords (n=2361) of children with newly diagnosed type 1 diabetes were collected from 58 out of 68 (85.3%) centres of the original survey participants and 100% of the previously surveyed tertiary centres. Overall, DKA was observed in 1124 patients, with an increased rate when compared with the previous survey (47.6% vs 38.5%, p=0.002), and severe DKA in 15.3%. In children below 6 years, DKA was observed in 323 out of 617 (52.5%) and severe DKA in 16.7%; in this age group, occurrence of DKA reduced by 21.3% (p=0.009). DKA treatment according to the ISPED guidelines was adopted in 95% of the centres, with a 27% improvement (p=0.025).ConclusionsDuring a 2-year awareness campaign, DKA at onset of diabetes in children and adolescents 0–18 years is still common and increased when compared with the 2013–2014 survey.

Published
2020

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