13 results on '"Gerardo Corigliano"'
Search Results
2. CAPTURE: A cross-sectional study on the prevalence of cardiovascular disease in adults with type 2 diabetes in Italy
- Author
-
Giuseppina T. Russo, Gerardo Corigliano, Franco Arturi, Maria Gisella Cavallo, Cristiano Bette, and Edoardo Mannucci
- Subjects
Adult ,Nutrition and Dietetics ,Endocrinology, Diabetes and Metabolism ,Medicine (miscellaneous) ,Type 2 diabetes ,Middle Aged ,Cardiovascular disease ,Cross-sectional study ,Italy ,Prevalence ,Glucagon-Like Peptide-1 Receptor ,Cross-Sectional Studies ,Glucose ,Diabetes Mellitus, Type 2 ,Cardiovascular Diseases ,Glucagon-Like Peptide 1 ,Humans ,Hypoglycemic Agents ,Cardiology and Cardiovascular Medicine ,Sodium-Glucose Transporter 2 Inhibitors ,Aged - Abstract
The prevalence of type 2 diabetes (T2D) in Italy is increasing and cardiovascular disease (CVD) represents the leading cause of death in this population. CAPTURE was a multinational, multicentre, non-interventional, cross-sectional study assessing the prevalence of CVD, atherosclerotic CVD (AsCVD) and CVD subtypes among patients with T2D, across 13 countries. Here we report the results from Italy.Overall, 816 patients with T2D (median age, 69 years [interquartile range: 62-75]; median duration of diabetes, 11.2 years [interquartile range: 5.7-18.7]) were recruited during routine clinical visits at secondary care centres in Italy between December 2018-September 2019. The prevalence of CVD was estimated at 38.8%, largely accounted for by AsCVD (33.1%). The most prevalent CVD subtype was coronary heart disease (20.8%), followed by carotid artery disease (13.2%). Most patients (85.9%) were prescribed oral glucose-lowering agents (GLAs), particularly biguanide (76.7%). Insulin use was higher in patients with CVD (41.3%) than in patients without CVD (32.9%). Sodium-glucose co-transporter-2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) were prescribed to 20.2% vs 14.6%, and 14.5% vs 16.6% of patients with CVD compared to those without CVD, respectively.The results show that, in Italy, more than one in three patients with T2D attending secondary care centres have CVD, 85% of whom have AsCVD, yet only a minority are treated with SGLT2is and GLP-1 RAs, in discordance with the recommendations of current national and international guidelines.
- Published
- 2022
3. Comparison between Policaptil Gel Retard and Metformin by Testing of Temporal Changes in Patients with Metabolic Syndrome and Type 2 Diabetes
- Author
-
Giuseppina Guarino, Felice Strollo, Teresa Della-Corte, Ersilia Satta, Carmine Romano, Carmelo Alfarone, Gerardo Corigliano, Marco Corigliano, Giuseppe Cozzolino, Clementina Brancario, Carmine Martino, Domenica Oliva, Agostino Vecchiato, Clelia Lamberti, Luca Franco, and Sandro Gentile
- Subjects
Policaptil Gel Retard® ,metformin ,metabolic syndrome ,diabetes ,cardio-vascular risk score - Abstract
Introduction: Metabolic Syndrome (MS) is a pathologic condition characterized by Type 2 diabetes mellitus (T2DM), insulin resistance, abdominal obesity, hypertension, and hyperlipidemia. Until now, specific drugs such as metformin (MET) have been used to address its individual components; however, according to the recommendation of WHO, various plant extracts might be used as alternative medicines due to the side effects of pharmacologic agents. Policaptil Gel Retard® (PGR), a macromolecule complex based on polysaccharides which slows down the absorption rates of carbohydrates and fats, proved effective against glucose abnormalities. Our study aimed to verify the short-term efficacy and safety of PGR under real-life conditions. Methods: We evaluated both the 6-month changes in metabolic parameters in Italian patients with MS and T2DM, and the 10-year CV risk score (10-y-CV-RS) from the CUORE equation, competitively randomized to Policaptil Gel Retard (2172 mg before each main meal); Group A, n = 75, or Metformin (1500–2000 mg/day equally divided between the two main meals), and Group B, n = 75. Results: Fasting plasma glucose and HbA1c decreased significantly and similarly (p < 0.001) in the two groups. A significant decrease in BMI (−20% in the PGR group (p < 0.01), −14.3% in the MET group (p < 0.05)), % visceral fat, and UA levels was also apparent in both groups (p < 0.01). The opposite occurred for lipid profile, which improved significantly in the PGR group but remained unchanged in the MET group. Consequently, only the PGR group experienced a significant decrease in the 10-y-CV-RS (31.4 ± 8.0 vs. 19.7 ± 5.2, p < 0.0001), whereas this remained unchanged in the MET group (32.2 ± 3.3 vs. 30.5 ± 8.7; p n.s.). Conclusions: PGR could represent a suitable alternative to MET as a first-line treatment option, especially now that an ever-increasing number of people prefer natural products based on plant extracts. This is particularly pertinent given that, besides trying to avoid gastrointestinal side-effects as much as possible, patients might be sensitive to ecotoxicology-related problems involving plants and animals caused by the worldwide spread of environmental MET metabolites.
- Published
- 2022
4. Lipohypertrophy in Elderly Insulin-Treated Patients With Type 2 Diabetes
- Author
-
Carmine Romano, Giuseppina Guarino, Domenica Oliva, Giampiero Marino, Teresa Della Corte, Maria Rosaria Improta, Marco Corigliano, Rosa Simonetti, Sandro Gentile, Sara Colarusso, Emilia Martedì, Alessandra Fusco, Marco Piscopo, Viviana Russo, Felice Strollo, Gerardo Corigliano, Sebastiano Vaia, and Ersilia Satta
- Subjects
medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,030209 endocrinology & metabolism ,Review ,Type 2 diabetes ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Diabetes mellitus ,Internal medicine ,Internal Medicine ,medicine ,Insulin ,Buttocks ,Skin ,Glycemic ,Diabetes Complication ,business.industry ,Diabetes ,Lipohypertrophy ,medicine.disease ,Ageing ,medicine.anatomical_structure ,business ,Subcutaneous tissue - Abstract
Background The number of older adults with insulin-treated diabetes mellitus (DM) is steadily increasing worldwide. Errors in the insulin injection technique can lead to skin lipohypertrophy (LH), which is the accumulation of fat cells and fibrin in the subcutaneous tissue. While lipohypertrophic lesions/nodules (LHs) due to incorrect insulin injection techniques are very common, they are often flat and hardly visible and thus require thorough deep palpation examination and ultrasonography (US) for detection. Detection is crucial because such lesions may eventually result in poor diabetes control due to their association with unpredictable insulin release patterns. Skin undergoes fundamental structural changes with aging, possibly increasing the risk for LH. We have therefore investigated the effect of age on the prevalence of LHs and on factors potentially associated with such lesions. Methods A total of 1227 insulin-treated outpatients with type 2 DM (T2DM) referred to our diabetes centers were consecutively enrolled in the study. These patients underwent a thorough clinical and US evaluation of the skin at injection sites, as previously described, with up to 95% concordance betweenthe clinical and US screening techniques. Of these 1227 patients, 718 (59%) had LH (LH+) and 509 (41%) were LH-free (LH−). These patients were then assigned to two age class groups (≤ 65 years and > 65 years), and several clinical features, diabetes complication rates, and injection habits were investigated. Results Comparison of the two age subgroups revealed that 396 (48%) and 322 (79%) patients in the younger and older groups, respectively, had LHs (p
- Published
- 2020
5. Insulin-Induced Skin Lipohypertrophy in Type 2 Diabetes: a Multicenter Regional Survey in Southern Italy
- Author
-
Giuseppina Guarino, Domenica Oliva, Sandro Gentile, Felice Strollo, Gerardo Corigliano, Carmine Martino, Clementina Brancario, Ersilia Satta, Agostino Vecchiato, Antonio Vetrano, Marco Corigliano, Emilia Martedì, Sara Colarusso, Carmine Romano, Giampiero Marino, Clelia Lamberti, Teresa Della Corte, Viviana Russo, Carmelo Alfarone, Giuseppe Cozzolino, Alessandra Fusco, Maria Rosaria Improta, Marco Piscopo, and Rosa Simonetti
- Subjects
Pediatrics ,medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,Concordance ,Diabetes ,Type 2 Diabetes Mellitus ,Lipohypertrophy ,Type 2 diabetes ,Hypoglycemia ,medicine.disease ,Education ,Quality of life ,Diabetes mellitus ,Internal Medicine ,Medicine ,Glycemic variability ,business ,Original Research ,Glycemic - Abstract
Introduction Lipohypertrophies (LHs) due to incorrect insulin injection techniques have been described in the literature for decades. Their rate averages 38%, but this is still controversial because of the vast range reported by different publications, most of which fail to describe the selected detection protocol and therefore are not entirely reliable. We still need to identify the real LH rate, and only consistently using a standardized method in a large cohort of insulin-treated (IT) patients make this possible. Methods Our group performed thorough clinical skin examinations on patients suffering from type 2 diabetes mellitus (T2DM): 1247 IT T2DM outpatients were examined according to a standardized protocol, previously published elsewhere, as well as an ultrasound scan of the same skin areas to assess the degree of concordance between the two methods and to evaluate the demographic, clinical, and behavioral risk factors (RF) as well as metabolic consequences of identified LHs. Results The concordance between the two methods was 99%. Identified risk factors for LHs were needle reuse, failure to rotate injection sites, and ice-cold insulin injections. High HbA1c values, wide glycemic variability, and longstanding proneness to hypoglycemia with a high rate of ongoing hypoglycemic events proved to be significantly associated with LHs, too; the same applied to cardiovascular and renal complications as well as to living alone and being retired. Conclusions Based on a strict well-structured methodology, our data confirmed what has already been reported in the literature on factors leading to, or associated with, LHs and, for the first time in adults, indicated cryotrauma from ice-cold insulin injections and specific social conditions as factors facilitating LH occurrence. HCPs should therefore plan a yearly clinical examination of all injection sites to improve patient quality of life through better glucose control and a reduced rate of hypoglycemic events. Trial Registration Trial registration no. 127-11.01.2019, approved by the Scientific and Ethics Committee of Campania University “Luigi Vanvitelli,” Naples, Italy.
- Published
- 2020
6. LA PERSONA CON DIABETE TIPO 1 E LE IMMERSIONI SUBACQUEE
- Author
-
Andrea Fazi, Elena Gamarra, Umberto Valentini, Pasquale Longobardi, Gerardo Corigliano, Elena Cimino, Matteo Andrea Bonomo, Giovanni Careddu, and Paolo Di Bartolo
- Subjects
03 medical and health sciences ,0302 clinical medicine ,business.industry ,Medicine ,030209 endocrinology & metabolism ,030212 general & internal medicine ,business - Abstract
7, 8, 9 7; 8; 9
- Published
- 2019
7. A randomized, open-label, comparative, crossover trial on preference, efficacy, and safety profiles of lispro insulin u-100 versus concentrated lispro insulin u-200 in patients with type 2 diabetes mellitus: a possible contribution to greater treatment adherence
- Author
-
Caterina Colella, Domenica Oliva, Luigia Miretto, Gerardo Corigliano, Giuseppina Guarino, Alessandra Fusco, Viviana Russo, Marco Piscopo, Felice Strollo, Maria Rosaria Improta, Giampiero Marino, Antonietta Santorelli, Sandro Gentile, Alessandra D’Alessandro, Marco Corigliano, Sara Colarusso, Armando Giammarco, Rosa Simonetti, Emilia Martedì, Gentile, S., Fusco, A., Colarusso, S., Piscopo, M., Improta, M. R., Corigliano, M., Martedi, E., Oliva, D., Santorelli, A., Simonetti, R., Giammarco, A., Colella, C., Miretto, L., D'Alessandro, A., Russo, V., Guarino, G., Marino, G., Corigliano, G., and Strollo, F.
- Subjects
Blood Glucose ,Male ,insulin ,Injection ,medicine.medical_specialty ,Glycated Hemoglobin A ,Treatment adherence ,medicine.medical_treatment ,030209 endocrinology & metabolism ,macromolecular substances ,030204 cardiovascular system & hematology ,Injections ,Medication Adherence ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,Internal medicine ,Diabetes mellitus ,medicine ,Surveys and Questionnaire ,Humans ,Hypoglycemic Agents ,Insulin lispro ,Lispro U-200 ,Pharmacology (medical) ,In patient ,adherence ,device ,Aged ,Glycated Hemoglobin ,Cross-Over Studies ,Insulin Lispro ,Hypoglycemic Agent ,business.industry ,Insulin ,Type 2 Diabetes Mellitus ,Patient Preference ,General Medicine ,Cross-Over Studie ,Middle Aged ,medicine.disease ,Crossover study ,Preference ,Diabetes Mellitus, Type 2 ,diabete ,Female ,business ,Human ,medicine.drug - Abstract
Background: Several outstanding pharmacological advances making innovative drugs sophisticateddevices available during the last few years. Nevertheless too many patients still disappointingly fail to meetthe metabolic targets suggested by current guidelines. Incorrect insulin administration techniques may greatly affect metabolic control in T2DM people. The aim of our study was to compare glycemic control associated with a concentrated insulin analog preparation (U-200 lispro) in people with T2DM to the one observed with standard U-100 lispro. The secondary endpoint of our study was patients’ preference and performance ratings of U-200 lispro. Methods: 126 patients with T2DM were enrolled. They were also assessed for limited joint mobility syndrome (LJMS),defined as limitation in at least two anatomical areas of the dominant upper extremity. After a 4-weekstructured insulin injection education period. Half of them were randomized to U-100 lispro, half to U-200 and after 12weeks they were switched to the other preparation for 12weeks. At the end a questionnaire was also administered to investigate patient preference. Results: No significant variation in fasting blood glucose, HbA1c, severe or mild hypoglycemic rate and daily fast-acting insulin analog dose was observed with U-100 lispro while U-200 lispro treatment was associated with a significant improvement of all the above mentioned parameters and with around 20% decrease in insulin requirement. Moreover patients’ answers to the questionnaire pointed out a higher preference for U-200 lispro for continuing treatment due to fewer difficulties completing injection. Discussion: The explanation of better metabolic results with the U-200 device might be the lower inner piston inertia and volume and shorter duration of a complete injection. Conclusions: Checking for LJIMS before insulin prescription could be adopted as a standard practiceaimed at choosing the most suitable device for patient's specific characteristics and abilities. The use of U-200 lispro might improve treatment adherence and metabolic control. This would also result intocost reduction by saving about half the amount of pens per year and of time spent to both fill prescriptionand dump the pharmacy.
- Published
- 2018
8. Exercise related care pathways for people with diabetes: Literature review and expert consensus
- Author
-
Cristina De Fazio, Roberta Assaloni, Gerardo Corigliano, Sandro Gentile, and Felice Strollo
- Subjects
medicine.medical_specialty ,Consensus ,business.industry ,Endocrinology, Diabetes and Metabolism ,MEDLINE ,Expert consensus ,General Medicine ,Diabetes mellitus therapy ,medicine.disease ,Exercise Therapy ,Diabetes mellitus ,Internal Medicine ,medicine ,Critical Pathways ,Diabetes Mellitus ,Humans ,Intensive care medicine ,business ,Expert Testimony - Published
- 2019
9. Unexplained Hypoglycaemia and Large Glycaemic Variability: Skin Lipohypertrophy as a Predictive Sign
- Author
-
G. Guarino, Emilia Martedì, Antonio Ceriello, Stefano de Riu, Gennaro Clemente, F. Strollo, Sandro Gentile, Gerardo Corigliano, Vincenzo Armentano, and Iole Gaeta
- Subjects
Pediatrics ,medicine.medical_specialty ,business.industry ,medicine ,Lipohypertrophy ,business ,medicine.disease ,Sign (mathematics) - Published
- 2016
10. Corrigendum to 'Exercise related care pathways for people with diabetes: Literature review and expert consensus' [Diabetes, Metab Syndr: Clin Res Rev 13 (4) (2019) 2755–2762]
- Author
-
Cristina De Fazio, Sandro Gentile, Felice Strollo, Roberta Assaloni, and Gerardo Corigliano
- Subjects
medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,Diabetes mellitus ,Internal Medicine ,medicine ,MEDLINE ,Expert consensus ,General Medicine ,Intensive care medicine ,medicine.disease ,business - Published
- 2019
11. Short-term Cardio-Vascular Risk Score Changes in Type 2 Diabetic Patients on Empaglifozin: A Real-Life Clinical Experience
- Author
-
Alessandra D’Alessandro, Armando Giammarco, Caterina Colella, Sandro Gentile, Alessandra Fusco, Viviana Russo, F. Strollo, Maria Rosaria Improta, Emilia Martedì, Antonietta Santorelli, Giampiero Marino, Marco Corigliano, Rosa Simonetti, G. Guarino, Sara Colarusso, Marco Piscopo, Domenica Oliva, Luigia Miretto, Gerardo Corigliano, Fusco, Alessandra, Colarusso, Sara, Piscopo, Marco, Improta, Maria Rosaria, Corigliano, Marco, Martedi, Emilia, Oliva, Domenica, Santorelli, Antonietta, Simonetti, Rosa, Giammarco, Armando, Colella, Caterina, Miretto, Luigia, D’Alessandro, Alessandra, Russo, Viviana, Guarino, Giuseppina, Marino, Giampiero, Corigliano, Gerardo, Strollo, Felice, and Gentile, Sandro
- Subjects
medicine.medical_specialty ,business.industry ,Internal medicine ,medicine ,Cardiology ,Vascular risk ,business ,Term (time) - Published
- 2017
12. The DAWN Youth WebTalk Study: methods, findings, and implications
- Author
-
Peyrot M, The DAWN Youth Survey Study Group: Henk-Jan Aanstoot, Barbara Anderson, Thomas Danne, Larry Deeb, Alexandra Greene Francine Kaufman, Karin Lange, Anja Østergren Nielsen, Mark Peyrot, Karin Rosenfeld, Luıs Eduardo Calliari, Fernanda Isposito, Fani Eta KornMalerbi, Vanessa Vivancos Pirolo, Katarina Braune, Richard Schlomann, Ralph Ziegler, Hansruedi Stahel, Massimo Massi Benedetti, Antonio Cabras, Marco Cappa, Franco Cerutti, Alessandro Cicognani, Valerio Cherubini, Francesco Chiarelli, Giuseppe Chiumello, Massimo Cipolli, Roberto Cocci, Gerardo Corigliano, Maria Iole Colombini, Simone Donadello, Simona Frontoni, Rosangela Ghidelli, Dario Iafusco, Niels Birkebæk, Ib Borly, Pernille Christoffersen, Thomas Hertel, JenniferWikre Jørgensen, Lene Juel Kristensen, Birthe Olsen, Lene Rasmussen, Kathrine Rayce, Mikael Tastum, A K Jhingan, Sanjay Kalra, Deepak Dalal, Archana Juneja, Santosh Singh, Sreejith Kumar, Yasuko Uchigata, Shin Amemiya, Shigeo Aono, Naoki Fukushima, Yutaka Igarashi, Rieko Maeda, Masato Matsushima, Masae Minami, Keiko Nakamura, Taisuke Okada, Eisuke Takazakura, Akira Takeda, Masato Takii, Tatsuhiko Urakami, M, Peyrot, DAWN Youth Survey Study Group: Henk-Jan Aanstoot, The, Anderson, Barbara, Danne, Thoma, Deeb, Larry, Greene Francine Kaufman, Alexandra, Lange, Karin, Østergren Nielsen, Anja, Peyrot, Mark, Rosenfeld, Karin, Eduardo Calliari, Luı, Isposito, Fernanda, Eta KornMalerbi, Fani, Vivancos Pirolo, Vanessa, Braune, Katarina, Schlomann, Richard, Ziegler, Ralph, Stahel, Hansruedi, Massi Benedetti, Massimo, Cabras, Antonio, Cappa, Marco, Cerutti, Franco, Cicognani, Alessandro, Cherubini, Valerio, Chiarelli, Francesco, Chiumello, Giuseppe, Cipolli, Massimo, Cocci, Roberto, Corigliano, Gerardo, Iole Colombini, Maria, Donadello, Simone, Frontoni, Simona, Ghidelli, Rosangela, Iafusco, Dario, Birkebæk, Niel, Borly, Ib, Christoffersen, Pernille, Hertel, Thoma, Jørgensen, Jenniferwikre, Juel Kristensen, Lene, Olsen, Birthe, Rasmussen, Lene, Rayce, Kathrine, Tastum, Mikael, K Jhingan, A, Kalra, Sanjay, Dalal, Deepak, Juneja, Archana, Singh, Santosh, Kumar, Sreejith, Uchigata, Yasuko, Amemiya, Shin, Aono, Shigeo, Fukushima, Naoki, Igarashi, Yutaka, Maeda, Rieko, Matsushima, Masato, Minami, Masae, Nakamura, Keiko, Okada, Taisuke, Takazakura, Eisuke, Takeda, Akira, Takii, Masato, and Urakami, Tatsuhiko
- Subjects
School ,Blood Glucose ,Parents ,medicine.medical_specialty ,Adolescent ,Health Personnel ,International Cooperation ,Endocrinology, Diabetes and Metabolism ,Settore MED/13 - Endocrinologia ,Young Adult ,Study methods ,Adaptation, Psychological ,Diabetes Mellitus ,Internal Medicine ,Humans ,Medicine ,Family ,Child ,Psychiatry ,Patient Care Team ,Internet ,Organizations ,Medical education ,Schools ,business.industry ,Blood Glucose Self-Monitoring ,Infant, Newborn ,Infant ,Social Support ,Diabetes Mellitu ,Health Survey ,Health Surveys ,Parent ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Quality of Life ,business ,Organization ,Human - Abstract
It has long been understood that psychosocial issues are important to an understanding of diabetes among young people. The diagnosis and management of diabetes places a substantial burden on youths and their families. This burden may disrupt normal developmental processes, and can have a major impact on psychosocial adjustment and successful disease management. The multinational DAWN Study was a pioneering effort to identify psychosocial barriers to optimal health and quality of life of people with diabetes and new ways to overcome those barriers. The DAWN Study interviewed more than 5000 adults with diabetes and almost 4000 diabetes care professionals, but did not include children and young people with diabetes, their families, or their care providers because it was recognized that diabetes in young people presents different psychosocial issues and challenges than diabetes in adults, and that a separate study would be required to identify opportunities to improve outcomes among young people with diabetes and their families. This realization gave rise to theDAWNYouth WebTalk Study. The objectives of this study were to: • gain understanding of the challenges and issues facing young people with diabetes and those with responsibility for supporting them; • identify new avenues for improving the psychosocial management of diabetes among young people; • stimulate new efforts to improve care for young people with diabetes and their families. This paper presents an initial overview of the methods and findings of theDAWNYouthWebTalk Study and discusses some of the implications of those findings.
- Published
- 2009
13. Blood glucose changes in diabetic children and adolescents engaged in most common sports activities
- Author
-
Gerardo, Corigliano, Nicolangelo, Iazzetta, Marco, Corigliano, and Felice, Strollo
- Subjects
Blood Glucose ,Male ,Adolescent ,Adaptation, Physiological ,Combined Modality Therapy ,Dietary Fats ,Aerobiosis ,Hypoglycemia ,Exercise Therapy ,Eating ,Diabetes Mellitus, Type 1 ,Hyperglycemia ,Dietary Carbohydrates ,Humans ,Female ,Dietary Proteins ,Child ,Energy Metabolism ,Oxidation-Reduction ,Sports - Abstract
Circulating insulin levels decrease and substrate glycogenolysis-mediated conversion into glucose increases just a few minutes after normal subjects start exercising, but during sustained physical activity muscles massively utilize blood glucose, thus causing glycogenolysis to increase further until the end of the session. After that, in order to get liver and muscle glycogen stores up to pre-exercise levels again, blood glucose is mostly utilized, thus causing late-onset hypoglycaemia in the absence of any extra carbohydrate supply and rebound hyperglycaemia after a while. This and other patho-physiological mechanisms are dealt with in the present paper, and practical hints are provided to the clinician to cope with children-specific adaptation phenomena to exercise in t1DM.
- Published
- 2006
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.