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Frame-by-frame annotation of bounding boxes by clinical experts is often required to train fully supervised object detection models on medical video data. We propose a method for improving object detection in medical videos through weak supervision from video-level labels. More concretely, we aggregate individual detection predictions into video-level predictions and extend a teacher-student training strategy to provide additional supervision via a video-level loss. We also introduce improvements to the underlying teacher-student framework, including methods to improve the quality of pseudo-labels based on weak supervision and adaptive schemes to optimize knowledge transfer between the student and teacher networks. We apply this approach to the clinically important task of detecting lung consolidations (seen in respiratory infections such as COVID-19 pneumonia) in medical ultrasound videos. Experiments reveal that our framework improves detection accuracy and robustness compared to baseline semi-supervised models, and improves efficiency in data and annotation usage.
Subject(s)
COVID-19ABSTRACT
Background and objectives: Mucormycosis is a complication in post-coronavirus disease 2019 (COVID-19) patients in India. This study was done to evaluate the prognostic value of clinical, histopathologic findings, microbiological features, and biochemical parameters such as D-dimer, lactate dehydrogenase, and serum ferritin in post- COVID-19-patients with rhino-orbital mucormycosis. Methods: This retrospective observational study was carried out on biopsies taken from 50 post-COVID-19 patients suspected of mucormycosis. The biopsy specimens were processed and stained with hematoxylin and eosin, periodic acid– schiff, and Wright-Giemsa. In addition, 10–20% potassium hydroxide wet mount and culture on sabouraud dextrose agar were performed to detect Mucor. The biochemical parameters were measured using ARCHITECT ci8200 chemistry analyzer. Results: Overall, 30 cases (60%) were positive for fungal elements, and growth of Mucor spp. was found in 28 cases (56%). In histopathology, 70% of cases (n=35) showed broad, aseptate, ribbon-like hyphae with wide-angled branching diagnostic of mucormycosis. There seemed to be a site-wise overlap between the nasal/maxillary sinus and rhinoorbital/rhino-cerebral variety. There was no difference between the patients in terms of gender. The most common risk factor was diabetes mellitus (observed in 80% of cases). In patients with invasive mucormycosis, inflammatory biomarkers such as serum ferritin, serum lactate dehydrogenase, C-reactive protein, and Ddimer were greater than the normal range, whereas procalcitonin was within the reference range. Conclusion: It can be concluded that raised metabolic markers, direct 10% KOH examination and histological features including angioinvasion as well as rhino-orbital and cerebral extension might assist doctors in diagnosis, progression, and survival rate. [ FROM AUTHOR] Copyright of Medical Laboratory Journal is the property of Golestan University of Medical Sciences, Deputy of Research & Technology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
Everybody in the world including the health care sector has witnessed the devastating effects of COVID- 19 infection. It is an enigma to say whether COVID -19 has gone for good or not, but has definitely presented as a challenge in itself for dental professionals. Complications have escalated especially at the end of the 2nd wave, probably due to various immunosuppressant drugs that have been used for it's aggressive treatment. These cases highlights osteomyelitis of maxilla and surrounding structures in patients due raised levels of blood sugar and also due to steroidal therapy. Recent reports that have been published, show a rate of approximately 80.76% of such cases in maxilla, out of which 61.53% patients were found to be diabetic before diagnosis. These cases presents post COVID-19 osteomyelitis which is believed to be triggered by highly raised blood sugar levels in a patient who was not a known case of diabetes mellitus.
ABSTRACT
The SARS-CoV-2 virus is primarily transmitted through direct or indirect contact with the mucous membranes of the mouth and nostrils. The presence of SARS-CoV-2 in sputum with a high viral load suggested that maintaining good oral hygiene could be critical in limiting COVID-19 disease. Brushing the teeth frequently and regularly with widely available amphiphilic detergent, sodium lauryl sulfate (SLS)-based toothpastes could help in preventing the spread of SARS-CoV-2. We proposed a community survey-based methodology followed by an in vitro biochemical strategy to test the virucidal potentiality of SLS, an amphiphilic detergent found in these toothpastes. Through biomolecular structure and docking analysis using models of spike protein and SLS, we showed a possible molecular mechanism of action for SLS-enabled viral particle inactivation.
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While ride-hailing ridership declined in 2020 due to COVID-19 induced restrictions like stay-at-home orders, food/grocery delivery services became quasi-essential. This study investigates if and how public perceptions of gig work related to platform-based ride-hailing and food/grocery delivery services changed during the early stages of the pandemic. We collected a sample of 23,845 Twitter posts ('tweets') related to these platform-based services within two-week periods before and after the US COVID-19 emergency declaration. Sentiment analysis on tweets was conducted to investigate changes in public perception of gig work. Tweet content was analyzed by descriptively coding about 10% of the sample of tweets manually along ten different dimensions (e.g., personal experience, informative, and about driver);then we used thematic analysis to gain an understanding about the public's views towards gig work/workers. We tested supervised machine learning methods to explore their potential to classify the rest of the sample along the ten descriptive dimensions. The number of tweets increased by approximately 150% after the emergency declaration and became more positive in sentiment. Qualitative results indicate that tweets about negative personal experiences with drivers/companies decreased during COVID-19, while tweets exhibiting a sense of community (e.g., sharing information) and concern towards gig workers increased. Findings can inform policy and workforce changes regarding platform-based service companies. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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An increased pathogenic waste post-COVID-19 pandemic forced policymakers to treat biomedical waste (BMW) similar to municipal solid waste (MSW) to dispose into dumpsites and MSW landfills across the globe. The granular bentonite of geosynthetic clay liners (GCLs) does not completely seal the macro-voids upon saturation due to the loss of osmotic potential in the salt environment from the leachate. Such behavior of GCLs can lead to advection-dominant virus migration through the liner system. A knowledge of the fate and transport of coronavirus and other viral pathogens in compacted clays is essential for safe disposal of the viral pathogens in MSW landfills. Although the attenuation and transport parameters for coronavirus have been recently evaluated theoretically, experimental backup is currently lacking. The present work uses Newcastle disease virus (NDV) as a surrogate to coronavirus due to structural similarities for studying the fate and transport in the compacted natural clays. This study also implicitly addresses the waste management facilities for waste generated from NDV outbreaks through poultry litter and carcasses. The interaction of bentonite and kaolin clays with the NDV was studied by varying the virus concentration, interaction time, and clay dose using batch sorption tests. The studied clays showed excellent attenuation efficiency for the NDV. Design parameters, viz., the diffusion coefficient and retardation factor, were evaluated, affirming the suitability of these clays for exclusive pathogenic waste disposal protocols that are discussed in this article.
Subject(s)
COVID-19 , Refuse Disposal , Humans , Bentonite/chemistry , Clay , Pandemics , Refuse Disposal/methodsABSTRACT
HMG-CoA reductase inhibitors (statins), lipoprotein lipase activators (PPARα agonists) or fibrates are commonly used for controlling increased lipid levels in hyperlipidemia. Fenofibrate (FEN) belongs to the second generation prodrug fibric acid (isobutyric acid) derivative belonging to lipoprotein lipase activator class of drug. Results of clinical studies suggest that FEN can substantially reduce severe acute respiratory syndrome coronavirus 2. alpha and beta variant infection in human cell efficiently. This review article provides an in-depth examination of critical analytical methodologies used in the pharmaceutical analysis of FEN in pure forms, biological samples and pharmaceuticals. According to literature study reports several analytical techniques have been used for determination of FEN alone or in the combined dosage forms. Based on the literature, it was determined that high-performance liquid chromatography and UV/vis-spectrophotometry are the most widely used methods for FEN analysis. Sahoo et al. have developed the best HPLC method in bulk and pharmaceutical dosage form with the retention time of 19.268 min using phosphate buffer (pH 3.0): acetonitrile in the ratio of 30:70 (% v/v) as mobile phase. The information presented here may provide a solid foundation for future research on FEN in the field of drug analysis.
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To compare the efficacy of the sublabial and modified Denker's procedure in clearance of fungal disease from the anterior wall of maxilla and the pre-maxillary area i.e. the difficult areas of maxillary sinus. A prospective observational study was conducted over a period of 2 months (April 21-June 21) in the ENT department of Sawai Man Singh hospital, Jaipur. All the patients with clinical involvement of the premaxilla or the cheek abutting the anterior wall of maxilla were included in the study population. Cases matched in both groups were subjected to debridement either by the sublabial or the modified denker's approach. Outcomes were measured by assessing the daily CRP values, post-operative DNE every 3 days after pack removal, and imaging at the end of 1 month. Repeat biopsies were performed in patients that still had persistent symptoms after getting operated on. 16 of the 60 patients (26.6%) operated on by the endoscopic approach showed evidence of residual disease on follow-up whereas only 5 patients (9.6%) in the other category had a similar outcome. Most of the recidivism was seen in the anterior maxilla. Lower rates of complications were found following debridement by the sublabial approach. Since the sublabial approach is the most direct approach for the key areas of fungal involvement of maxillary sinus, it is recommended over the modified Denker's procedure for disease clearance from pre maxilla and the anterior wall of maxillary sinus. This view is also supported by the lower rates of complications encountered following the former.
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Invasive fungal rhinosinusitis was seen to rise to epidemic levels after the 2nd wave of ongoing Covid pandemic, especially in tropical countries, maximally in India. A similar trend is being observed for cases who have recently recovered from dengue virus infection. Post dengue invasive fungal infection is a new presentation and any associations between it and Covid pandemic need to be studied in detail to help prepare for any complications. 3 patients presented to the out-patient department of E.N.T at a tertiary level teaching hospital in East India with complains similar to rhinosinusitis. These patients were then evaluated and diagnosed to be infected from Mucormycosis and Aspergillosis fungal sinusitis after which they were managed with surgical debridement and systemic antifungal therapy. All had a recent history of recovery from Dengue virus infection and a possible association could be suspected. 3 patients presented with complains of pain over upper jaw with orbital swelling and loss of vision developing over a period of 24 days. Two of them had ulceration of hard palate. They were then subjected to Contrast MRI along with CT scan of the Paranasal sinuses which depicted pansinus involvement with intracranial extension in two patients. These were then planned for diagnostic nasal endoscopies along with biopsies which turned out to be Invasive fungal sinusitis in the form of Aspergillosis and Mucormycosis. All the 3 patients had recent history of recovery from Dengue virus infection and did not have any other co-morbidities. Covid Associated Mucormycosis (CAM) is a well-known entity now but no reports of Dengue associated Invasive fungal sinusitis are yet reported. Whether this new phenomenon has anything to do with the interactions between dengue virus and coronavirus is not known at present and needs to be studied in detail so appropriate management protocols can be formulated.
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This research study investigates the efficiency of different information retrieval (IR) systems in accessing relevant information from the scientific literature during the COVID-19 pandemic. The study applies the TREC framework to the COVID-19 Open Research Dataset (CORD-19) and evaluates BM25, Contriever, and Bag of Embeddings IR frameworks. The objective is to build a test collection for search engines that tackle the complex information landscape during a pandemic. The study uses the CORD-19 dataset to train and evaluate the IR models and compares the results to those manually labeled in the TREC-COVID IR Challenge. The results indicate that advanced IR models like BERT and Contriever better retrieve relevant information during a pandemic. However, the study also highlights the challenges in processing large datasets and the need for strategies to focus on abstracts or summaries. Overall, the research highlights the importance of effectively tailored IR systems in dealing with information overload during crises like COVID-19 and can guide future research and development in this field.
Subject(s)
COVID-19ABSTRACT
BACKGROUND AND AIM: Physicians need to be aware of the difficulties that SARS-CoV-2 infection brings to other regions of the body, such as the kidneys, even though the key emphasis is on pulmonary characteristics. The most frequent kidney complication among COVID-19 hospitalized patients is considered acute kidney injury (AKI). This study aimed to describe overall different aspects of acute kidney injury (AKI) in COVID-19 patients admitted to JLNMCH during the COVID-19 pandemic and to determine the prevalence of AKI among COVID-19 hospitalized patients. METHODS AND MATERIALS: All adult patients (over the age of 18 years) who screened positive for COVID-19 in a swab specimen from areas of nasopharyngeal by reverse transcriptase polymerase chain reaction and then hospitalized were included in the study. Information was gathered on the patient's demographics, general medical history, and drugs prescribed. From past medical information, associated comorbidities and home pharmaceuticals were identified. We gathered hospitalization information, such as duration of stay in ICU, details about the application of mechanical ventilation, information regarding extracorporeal membrane aeration, details of the use of vasopressor administration, and baseline results of laboratory test along with baseline clinical information during 48 hours of hospitalization. RESULTS: The percentage of patients with no history of AKI requiring traumatic mechanical ventilation was 79.4%, while the percentage of patients with no history of AKI not requiring traumatic mechanical ventilation was 11.5%. The difference was relevant statistically (p<0.001). The percentage of patients with AKI of any stage requiring traumatic mechanical ventilation was 22.8%, while the percentage of patients with no history of AKI not requiring traumatic mechanical ventilation was 76.8%. The difference was relevant statistically (p<0.022). CONCLUSION: We discovered that AKI was a rather typical finding among hospitalized COVID-19 patients. Patients hospitalized for COVID-19 had a poor prognosis if they developed AKI.
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In this paper, a mathematical model for assessing the impact of COVID-19 on tuberculosis disease is proposed and analysed. There are pieces of evidence that patients with Tuberculosis (TB) have more chances of developing the SARS-CoV-2 infection. The mathematical model is qualitatively and quantitatively analysed by using the theory of stability analysis. The dynamic system shows endemic equilibrium point which is stable when R 0 < 1 and unstable when R 0 > 1 . The global stability of the endemic point is analysed by constructing the Lyapunov function. The dynamic stability also exhibits bifurcation behaviour. The optimal control theory is used to find an optimal solution to the problem in the mathematical model. The sensitivity analysis is performed to clarify the effective parameters which affect the reproduction number the most. Numerical simulation is carried out to assess the effect of various biological parameters in the dynamic of both tuberculosis and COVID-19 classes. Our simulation results show that the COVID-19 and TB infections can be mitigated by controlling the transmission rate γ .
ABSTRACT
SARS-CoV-2 is a novel coronavirus that causes a potentially fatal respiratory disease known as coronavirus disease (COVID-19) and is responsible for the ongoing pandemic with increasing mortality. Understanding the host-virus interaction involved in SARS-CoV-2 pathophysiology will enhance our understanding of the mechanistic basis of COVID-19 infection. The characterization of post-transcriptional gene regulatory networks, particularly pre-mRNA splicing, and the identification and characterization of host proteins interacting with the 5' and 3'UTRs of SARS-CoV-2 will improve our understanding of post-transcriptional gene regulation during SARS-CoV-2 pathogenesis. Here, we demonstrate that either SARS-CoV-2 infection or exogenous overexpression of the 5' and 3'UTRs of the viral genomic RNAs, results in reduced mRNA levels possibly due to modulation of host cell pre-mRNA splicing. Further, we have investigated the potential RNA-binding proteins interacting with the 5' and 3'UTRs, using in-silico approaches. Our results suggest that 5' and 3'UTRs indeed interact with many RNA-binding proteins. Our results provide a primer for further investigations into the UTR-mediated regulation of splicing and related molecular mechanisms in host cells.
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BACKGROUND AND AIMS: A massive surge in coronavirus disease 2019 (COVID-19) cases and deaths occurred in India during March-April 2021, and this was considered as second wave of the pandemic in the country. This study was conducted to find out the perceptions about second wave of the COVID-19 pandemic among Indian adults. METHODS: An online-survey-based cross-sectional study was conducted over 3 weeks from April 21, 2021 to May 11, 2021. Information regarding sociodemographic profile, perceptions about COVID-19 during second wave, perceptions and practices related to COVID-19 vaccination, COVID-19 appropriate behavior, and government's response to the pandemic was collected. Descriptive analysis was performed. RESULTS: A total of 408 study participants were included. Mean age of the study participants was 29.2 ± 10.4 years. Around 92.6 percent (378) of respondents agreed that COVID-19 in 2021 is different from 2020. Perceived reasons for increased severity and cases were change in virus characteristics; social, religious, and political gatherings; and complacent behavior by people. Three-fourth (311, 76.2 percent) of the study participants agreed that vaccines have a positive role against COVID-19. Majority of the study participants (329, 80.6 percent) concurred that lockdown restrictions help in control of the pandemic. About 60.3 percent (246) of respondents had less trust on government post this pandemic compared to pre-COVID-19 times. CONCLUSION: The public perception about reasons for second wave in India acknowledges both human and virus factors and highlights the importance of shared responsibility between citizens and government for controlling the pandemic.
Subject(s)
COVID-19 , Adult , Humans , Adolescent , Young Adult , COVID-19/epidemiology , Pandemics , Cross-Sectional Studies , COVID-19 Vaccines , Communicable Disease ControlABSTRACT
COVID-19 has been a global pandemic. Flattening the curve requires intensive testing, and the world has been facing a shortage of testing equipment and medical personnel with expertise. There is a need to automate and aid the detection process. Several diagnostic tools are currently being used for COVID-19, including X-Rays and CT-scans. This study focuses on detecting COVID-19 from X-Rays. We pursue two types of problems: binary classification (COVID-19 and No COVID-19) and multi-class classification (COVID-19, No COVID-19 and Pneumonia). We examine and evaluate several classic models, namely VGG19, ResNet50, MobileNetV2, InceptionV3, Xception, DenseNet121, and specialized models such as DarkCOVIDNet and COVID-Net and prove that ResNet50 models perform best. We also propose a simple modification to the ResNet50 model, which gives a binary classification accuracy of 99.20% and a multi-class classification accuracy of 86.13%, hence cementing the ResNet50's abilities for COVID-19 detection and ability to differentiate pneumonia and COVID-19. The proposed model's explanations were interpreted via LIME which provides contours, and Grad-CAM, which provides heat-maps over the area(s) of interest of the classifier, i.e., COVID-19 concentrated regions in the lungs, and realize that LIME explains the results better. These explanations support our model's ability to generalize. The proposed model is intended to be deployed for free use.
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Tumor Necrosis Factor alpha (TNF-α) is a pleiotropic pro-inflammatory cytokine that is crucial in controlling the signaling pathways within the immune cells. Recent studies reported that higher expression levels of TNF-α are associated with the progression of several diseases, including cancers, cytokine release syndrome in COVID-19, and autoimmune disorders. Thus, it is the need of the hour to develop immunotherapies or subunit vaccines to manage TNF-α progression in various disease conditions. In the pilot study, we proposed a host-specific in-silico tool for predicting, designing, and scanning TNF-α inducing epitopes. The prediction models were trained and validated on the experimentally validated TNF-α inducing/non-inducing epitopes from human and mouse hosts. Firstly, we developed alignment-free (machine learning based models using composition-based features of peptides) methods for predicting TNF-α inducing peptides and achieved maximum AUROC of 0.79 and 0.74 for human and mouse hosts, respectively. Secondly, an alignment-based (using BLAST) method has been used for predicting TNF-α inducing epitopes. Finally, a hybrid method (combination of alignment-free and alignment-based method) has been developed for predicting epitopes. Hybrid approach achieved maximum AUROC of 0.83 and 0.77 on an independent dataset for human and mouse hosts, respectively. We have also identified potential TNF-α inducing peptides in different proteins of HIV-1, HIV-2, SARS-CoV-2, and human insulin. The best models developed in this study has been incorporated in the webserver TNFepitope (https://webs.iiitd.edu.in/raghava/tnfepitope/), standalone package and GitLab (https://gitlab.com/raghavalab/tnfepitope).
Subject(s)
COVID-19 , Tumor Necrosis Factor-alpha , Humans , Animals , Mice , Epitopes , Pilot Projects , SARS-CoV-2 , PeptidesABSTRACT
Background: The COVID-19 pandemic along with its treatment has brought myriad potential complications including the heightened risk of secondary fungal infections like mucormycosis. Mucormycosis is a rare angioinvasive fungal infection that has traditionally been highly fatal despite surgical intervention and antifungal medications. Aim: To re-evaluate the risk factors, epidemiology, and possible COVID-19-associated conditions on a larger sample size than the existing data. Methodology: We studied the possible risk factors, clinical presentations, treatment, and outcome of 203 patients with mucormycosis in a single-center retrospective-prospective observational study for three months at a tertiary care hospital after obtaining due permission from the institutional ethics committee. Results: The mean age of patients was 52 ± 11.5 years, and 92.61% had a history of COVID-19 infection. Around 86.7% of patients were suffering from diabetes mellitus with 50% being already known cases whereas the other 50% developed post-COVID-19 infection;65.02% of patients were administered corticosteroids during their COVID-19 treatment. About 51.72% of patients required hospital admission and among them, 16.25% of patients required ICU support. The mean oxygen saturation (SpO2) levels on admission were 84.61 ± 12.96%, and 38.92% of patients required mechanical respiratory support. The mean duration between COVID-19 infection and the onset of mucormycosis was 18.80 ± 16.61 days. The most common clinical presentations were facial pain and swelling (26.6%) and ophthalmic symptoms including eye swelling, pain, and ptosis (25.12%). Antifungal treatment was given to all the patients and 89.36% of the patients underwent surgical debridement of fungal mass. At the end of three months, 60.59% of the 188 patients survived with improvement, 13.30% had no improvement and/or deterioration of health, and 18.72% succumbed to mucormycosis. Intracranial involvement and leukocytosis were positively associated with mortality whereas surgical intervention was significant for positive outcomes at the end of three months in patients with mucormycosis (p<0.05). Conclusion: The sudden rise of mucormycosis during the second wave of COVID-19 can be attributed to uncontrolled blood sugar levels along with high corticosteroid usage as well as various nosocomial factors during the COVID-19 treatment. Early and aggressive treatment with surgical intervention and antifungal drugs can improve disease outcomes.
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Background: COVID-19 is an infectious disease caused by novel coronavirus (SARS CoV-2). The mode of spread of the infection is through droplets and also through direct contact of contaminated surfaces. Measures such as social distancing and use of protective equipment are required to prevent the spread of infection. This study was designed to assess the awareness about COVID-19 among physiotherapists, during the two phases of lockdown. Materials and Methods: An online survey was conducted in two phases among 110 physiotherapists to assess their awareness and knowledge about the disease. The first phase of the study was done during the first COVID-19 wave in India between 25th and 30th of March 2020, and the second phase was conducted between 7th and 12th of May 2021 when the second wave of COVID-19 in India was at its peak. Results: It is essential for physiotherapists to understand COVID-19 as a disease and to know its mode of spread in order to take necessary precautions and measures within their working environment to prevent the spread of the disease. With the first phase of the study, we identified a need for educational and awareness programs in therapists and need of guidelines in order to implement effective and safe strategies in dealing with the patients during this pandemic. The second phase identified that better understanding existed in physiotherapists about the disease, with precautions taken at their workplace to prevent the spread of COVID-19. Conclusion: A better knowledge about COVID-19 was reflected among physiotherapists at the second lockdown phase than during the first lockdown.
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In this paper, a mathematical model for assessing the impact of COVID-19 on tuberculosis disease is proposed and analysed. There are pieces of evidence that patients with Tuberculosis (TB) have more chances of developing the SARS-CoV-2 infection. The mathematical model is qualitatively and quantitatively analysed by using the theory of stability analysis. The dynamic system shows endemic equilibrium point which is stable when
ABSTRACT
Modern manufacturing enterprises must be agile to cope with sudden demand changes arising from increased global competition, geopolitical factors, and unforeseen circumstances such as the Covid-19 pandemic. Small- and Medium-Sized Enterprises (SMEs) in the manufacturing sector lack agility due to lower penetration of Information Technology (IT) and Operational Technology (OT), the inability to employ highly skilled human capital, and the absence of a formal innovation ecosystem for new products or solutions. In recent years, Cloud-based Design and Manufacturing (CBDM) has emerged as an enabler for product realization by integrating various service-based models. However, the existing framework does not thoroughly support the innovation ecosystem from concept to product realization by formally addressing economic challenges and human skillset requirements. The present work considers the augmentation of the Design-as-a-Service (DaaS) model into the existing CBDM framework for enabling systematic product innovations. The DaaS model proposes to connect skilled human resources with enterprises interested in transforming an idea into a product or solution through the CBDM framework. The model presents an approach for integrating human resources with various CBDM elements and end-users through a service-based model. The challenges associated with successfully implementing the proposed model are also discussed. It is established that the DaaS has the potential for rapid and economical product discovery and can be readily accessible to SMEs or independent individuals. [ FROM AUTHOR] Copyright of Journal of Mechanical Design is the property of American Society of Mechanical Engineers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)