Database : MEDLINE
Search on : Chorioamnionitis [Words]
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[PMID]: 29409815
[Au] Autor:Vander Haar EL; So J; Gyamfi-Bannerman C; Han YW
[Ad] Address:Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY, USA.
[Ti] Title:Fusobacterium nucleatum and adverse pregnancy outcomes: Epidemiological and mechanistic evidence.
[So] Source:Anaerobe;50:55-59, 2018 Feb 02.
[Is] ISSN:1095-8274
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Fusobacterium nucleatum is a Gram-negative anaerobic oral commensal associated with periodontal disease. F.nucleatum has been implicated in a wide spectrum of systemic diseases, including oral, gastro-intestinal, rheumatologic, and vascular pathologies. As pregnancy risk has been linked to periodontal disease, there has also been significant research into the effects of periodontal disease on adverse pregnancy outcomes. This article reviews the epidemiological and mechanistic evidence of the role of F.nucleatum in adverse pregnancy outcomes.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1802
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher

  2 / 4379 MEDLINE  
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[PMID]: 29268623
[Au] Autor:Wallace B; Peisl A; Seedorf G; Nowlin T; Kim C; Bosco J; Kenniston J; Keefe D; Abman SH
[Ad] Address:University of Colorado at Denver - Anschutz Medical Campus, 129263, Surgery and Pediatric Heart Lung Center, Aurora, Colorado, United States.
[Ti] Title:Anti-sFlt-1 Therapy Preserves Lung Alveolar and Vascular Growth in Antenatal Models of BPD.
[So] Source:Am J Respir Crit Care Med;, 2017 Dec 21.
[Is] ISSN:1535-4970
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Rationale/Objectives: Pregnancies complicated by antenatal stress, including preeclampsia (PE) and chorioamnionitis (CA), increase the risk for bronchopulmonary dysplasia (BPD) in preterm infants but biologic mechanisms linking prenatal factors with BPD are uncertain. Levels of soluble fms-like tyrosine kinase 1 (sFlt-1), an endogenous antagonist to vascular endothelial growth factor (VEGF), are increased in amniotic fluid and maternal blood in PE and associated with CA. Since impaired VEGF signaling has been implicated in the pathogenesis of BPD, we hypothesized that fetal exposure to sFlt-1 decreases lung growth and causes abnormal lung structure and pulmonary hypertension during infancy. METHODS: To test this hypothesis, we studied the effects of anti-sFlt-1 monoclonal antibody (Mab) treatment on lung growth in 2 established antenatal models of BPD that mimic PE and CA induced by intra-amniotic (IA) injections of sFlt-1 or endotoxin (ETX), respectively. In experimental PE, Mab was administered by 3 different approaches, including antenatal treatment by either IA instillation or maternal uterine artery infusion, or by postnatal intra-peritoneal injections. RESULTS: With each strategy, Mab therapy improved infant lung structure as assessed by radial alveolar count, vessel density, right ventricular hypertrophy and lung function. As found in the PE model, the adverse lung effects of IA ETX were also reduced by antenatal or postnatal Mab therapy. CONCLUSIONS: We conclude that treatment with anti-sFlt-1 Mab preserves lung structure and function and prevents RVH in 2 rat models of BPD of antenatal stress and speculate that early Mab therapy may provide a novel strategy for the prevention of BPD.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1164/rccm.201707-1371OC

  3 / 4379 MEDLINE  
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[PMID]: 29363450
[Au] Autor:Porter MC; Pennell CE; Woods P; Dyer J; Merritt AJ; Currie BJ
[Ad] Address:Microbiology Department, PathWest Laboratories, Perth, Australia.
[Ti] Title:Case Report: Chorioamnionitis and Premature Delivery due to Infection in Pregnancy.
[So] Source:Am J Trop Med Hyg;98(3):797-799, 2018 Mar.
[Is] ISSN:1476-1645
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:We report a case of placental infection leading to preterm delivery in a mother diagnosed with septicemia and pneumonia due to in pregnancy. Placental infection occurred despite prolonged ceftazidime therapy.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Data-Review
[do] DOI:10.4269/ajtmh.17-0789

  4 / 4379 MEDLINE  
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[PMID]: 28454703
[Au] Autor:Starikov RS; Inman K; Has P; Iqbal SN; Coviello E; He M
[Ad] Address:Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Women & Infants Hospital of Rhode Island, Providence, RI, USA; Phoenix Perinatal Associates, Phoenix, AZ, USA; Warren Alpert Medical School of Brown University, Providence, RI, USA.
[Ti] Title:Correlation of placental pathology and perinatal outcomes with Hemoglobin A1c in early pregnancy in gravidas with pregestational diabetes mellitus.
[So] Source:Placenta;52:94-99, 2017 Apr.
[Is] ISSN:1532-3102
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Data on the correlation among Hemoglobin A1c (HbA1c), placental pathology, and perinatal outcome in the pregestational diabetic population is severely lacking. We believe that this knowledge will enhance the management of pregnancies complicated by pregestational diabetes. We hypothesize that placental pathology correlates with glycemic control at an early gestational age. METHODS: This is a retrospective cohort study conducted from 2003 to 2011at a large tertiary care center. Women included had a singleton gestation, preexisting diabetes mellitus, and information about delivery and placental pathology available for review. Placental pathology and perinatal outcomes were compared across three groups of patients with differing HbA1c levels (<6.5%, 6.5-8.4%, and ≥8.5%). RESULTS: 293 placentas were examined. HbA1c was measured at a mean of 9.5week gestation. Median HbA1c was 7.5%, interquartile range 6.5%-8.9%. 23% of the cohort had HbA1c <6.5%, 41.9% between 6.5% and 8.4%, and 34.8%>8.5%. BMI varied significantly by group (35.4 vs. 34.4 vs. 32.0 respectively, P=0.04). Individual placental lesions did not vary with HbA1c levels. The incidence of acute chorioamnionitis differed significantly in the type 1 population and "distal villous hypoplasia" varied in the type 2 population. DISCUSSION: The results show that HbA1c values in early pregnancy are poor predictors of future placental pathologies. As a result, HbA1c values obtained during early gestation (which reflect the level of glycemic control over an extended period of time) do not correlate with any particular placental pathology, despite reflecting the potential for placental insults secondary to pre-gestational diabetes.
[Mh] MeSH terms primary: Blood Glucose
Diabetes Mellitus, Type 1/pathology
Diabetes Mellitus, Type 2/pathology
Glycated Hemoglobin A/analysis
Placenta/pathology
Pregnancy in Diabetics/pathology
[Mh] MeSH terms secundary: Adult
Diabetes Mellitus, Type 1/blood
Diabetes Mellitus, Type 2/blood
Female
Humans
Pregnancy
Pregnancy Outcome
Pregnancy in Diabetics/blood
Retrospective Studies
Young Adult
[Pt] Publication type:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Name of substance:0 (Blood Glucose); 0 (Glycated Hemoglobin A); 0 (hemoglobin A1c protein, human)
[Em] Entry month:1803
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[Js] Journal subset:IM
[Da] Date of entry for processing:170430
[St] Status:MEDLINE

  5 / 4379 MEDLINE  
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[PMID]: 29501938
[Au] Autor:Stafford IA; Rodrigue E; Berra A; Adams W; Heard AJ; Hagan JL; Stafford SJ
[Ad] Address:Louisiana State University Health Sciences Center, School of Medicine, New Orleans, LA, United States. Electronic address: Irene.stafford@bcm.edu.
[Ti] Title:The strong correlation between neonatal early-onset Group B Streptococcal disease and necrotizing enterocolitis.
[So] Source:Eur J Obstet Gynecol Reprod Biol;223:93-97, 2018 Feb 24.
[Is] ISSN:1872-7654
[Cp] Country of publication:Ireland
[La] Language:eng
[Ab] Abstract:BACKGROUND: Necrotizing enterocolitis (NEC) is a leading cause of newborn gastrointestinal emergencies, affecting 1-3 per 1000 live births. Although NEC has been linked to a microbial etiology, associations with maternal intrapartum and resultant newborn early-onset invasive Group B streptococcus (EO-GBS) have been weakly defined. OBJECTIVE: The study aim was to determine the relationship between EO-GBS and NEC. STUDY DESIGN: Data from 2008 to 2015 were collected from pediatric records with ICD diagnosis codes consistent with all stages of NEC, with the exception of neonatal EO-GBS data (only available 2011-2015). RESULTS: For the 131 newborns meeting inclusion criteria, the mean gestational age (GA) and birthweight at delivery was 30.2 weeks and 1449 g. Maternal comorbidities were not associated with a more advanced stage of NEC, however male gender (OR 3.2, p < .001), lower mean 1 (OR = 0.89, p = .045) and 5 min Apgar scores (OR = 0.84, p = .009) were significantly associated with higher NEC stage, after controlling for GA. Infectious morbidities including chorioamnionitis (OR = 1.5, p = .553) and intrapartum antibiotic administration (OR = 1.3, p = .524) were not significantly associated with higher NEC stage. Neither neonatal sepsis workup (OR = 0.27, p = .060) nor positive blood culture (OR = 0.97, p = .942) prior to NEC diagnosis were statistically significant. Type of feed prior to diagnosis (p = .530) was not significantly associated with NEC stage, however, expressed breast milk tended to be protective against higher stage of NEC (OR = 0.49, p = .055). Type of feed included total parenteral nutrition, mother's or donor expressed breast milk, trophic, full and high calorie feeds. Of the 579 newborns admitted from 2011 to 2015, 13 (2%) were diagnosed with EO-GBS and 64 met diagnostic criteria for NEC. GBS positive newborns had significantly higher odds of NEC (OR = 5.37, p = .009). NEC stage was not significantly different for patients with GBS positive vs. GBS negative mothers (p = .732), nor was there a significant difference in GA (p = .161). CONCLUSION: Our study is the first to describe a strong correlation between neonatal EO- GBS disease and NEC, with more than a five-fold increase in the odds of developing NEC in newborns of GBS positive mothers. PURPOSE: To investigate a possible relationship between EO-GBS disease and the neonatal diagnosis of NEC. Secondary analysis will determine if maternal antepartum and intrapartum factors along with neonatal variables contribute to a more advanced stage of NEC by retrospective chart review of patient data collected at Children's Hospital: New Orleans.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180304
[Lr] Last revision date:180304
[St] Status:Publisher

  6 / 4379 MEDLINE  
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[PMID]: 29274832
[Au] Autor:Visconti K; Senthamaraikannan P; Kemp MW; Saito M; Kramer BW; Newnham JP; Jobe AH; Kallapur SG
[Ad] Address:Divisions of Neonatology and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Ohio, and the School of Women's and Infants' Health, The University of Western Australia, Perth, Australia.
[Ti] Title:Extremely preterm fetal sheep lung responses to antenatal steroids and inflammation.
[So] Source:Am J Obstet Gynecol;218(3):349.e1-349.e10, 2018 Mar.
[Is] ISSN:1097-6868
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: The efficacy of antenatal steroids for fetal lung maturation in the periviable period is not fully understood. OBJECTIVE: We sought to determine the lung maturational effects of antenatal steroids and inflammation in early gestation sheep fetuses, similar to the periviable period in human beings. STUDY DESIGN: Date-mated ewes with singleton fetuses were randomly assigned to 1 of 4 treatment groups (n= 8/group): (1) maternal intramuscular injection of betamethasone; (2) intraamniotic lipopolysaccharide; (3) betamethasone+ lipopolysaccharide; and (4) intraamniotic+ intramuscular saline (controls). Fetuses were delivered surgically 48 hours later at 94 days' gestation (63% term gestation) for comprehensive evaluations of lung maturation, and lung and systemic inflammation. RESULTS: Relative to controls, first, betamethasone increased the fetal lung air space to mesenchymal area ratio by 47% but did not increase the messenger RNAs for the surfactant proteins-B and -C that are important for surfactant function or increase the expression of pro-surfactant protein-C in the alveolar type II cells. Second, betamethasone increased expression of 1 of the 4 genes in surfactant lipid synthetic pathways. Third, betamethasone increased genes involved in epithelium sodium channel transport, but not sodium-potassium adenosine triphosphatase or Aquaporin 5. Fourth, lipopolysaccharide increased proinflammatory genes in the lung but did not effectively recruit activated inflammatory cells. Last, betamethasone incompletely suppressed lipopolysaccharide-induced lung inflammation. In the liver, betamethasone when given alone increased the expression of serum amyloid A3 and C-reactive protein messenger RNAs. CONCLUSION: Compared the more mature 125-day gestation sheep, antenatal steroids do not induce pulmonary surfactants during the periviable period, indicating a different response.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180302
[Lr] Last revision date:180302
[St] Status:In-Data-Review

  7 / 4379 MEDLINE  
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[PMID]: 29426264
[Au] Autor:Mousavi AS; Hashemi N; Kashanian M; Sheikhansari N; Bordbar A; Parashi S
[Ad] Address:a Department of Obstetrics & Gynecology , Iran University of Medical Sciences, Hazrate Rasoole Akram Teaching Hospital , Tehran , Iran.
[Ti] Title:Comparison between maternal and neonatal outcome of PPROM in the cases of amniotic fluid index (AFI) of more and less than 5 cm.
[So] Source:J Obstet Gynaecol;:1-5, 2018 Feb 09.
[Is] ISSN:1364-6893
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:The study was performed on pregnant women with a gestational age of 26-32 weeks of pregnancy, who had been admitted to the hospital with a confirmed diagnosis of premature rupture of membranes. In all eligible women, ultrasounds were performed for the evaluation of amniotic fluid index. Then, the women were divided into two groups according to amniotic fluid index of ≥5 cm and <5 cm. These women were followed and monitored up to delivery. The women of the two groups did not have significant difference between them according to age, gestational age at the time of ruptured membrane, body mass index, gravidity, parity, gestational age at delivery and route of delivery. Maternal morbidities including chorioamnionitis, placental abruption, uterine atony after delivery and retention of placenta did not show significant difference between the two groups. There was no significant difference between the two groups' amniotic fluid index <5 cm and amniotic fluid index ≥5 cm, regarding neonatal morbidities, except for neonatal sepsis and neonatal death, which were higher in the amniotic fluid index <5 cm group [7(14.6%) versus 1(2.3%), p = .039, RR = 7.7 (95%CI 0.04-0.06) and 11(30.9%) versus 2(4.7%), p = .013, RR = 6.095 (95%CI = 1.26-29.31)]. In the subgroups of two categories of gestational ages of 26 -29 and 30 -34 , neonatal morbidities were higher in the amniotic fluid index <5 cm group. The results suggest that amniotic fluid index <5 cm should be considered as a warning sign for predicting poor prognosis of pregnancy complicated by preterm premature rupture of membranes. Impact statement What is already known on this subject? In a retrospective study in 1993, the relationship between oligohydramnios (which was defined as the largest single packet of fluid less than 2 2 cm) at the time of hospital admission, and the outcome of mother, foetus and neonates in a gestational age of less than 35 weeks of pregnancy was evaluated. In the oligohydramnios group, chorioamnionitis and funistis were more common. Also, the mean gestational age at the time of delivery and neonatal weight was less than that of the normal amniotic fluid group. According to these results, it was concluded that a low amniotic fluid volume in the women with preterm premature rupture of membranes (PPROM) can be considered as a prognostic factor in the cases of conservative management of PPROM. In contrast, the other study, which was performed on a larger sample size (290 patients), could not show more cases of amnionitis in the cases of amniotic fluid index (AFI) of less than 5 cm; however, the latency period was shorter in comparison with AFI of more than 5 cm. What do the results of this study add? Chorioamnionitis, placental abruption and uterine atony after delivery, retention of placenta and route of delivery did not show a significant difference between the two groups. Respiratory distress syndrome (RDS), need of surfactant and intubation, intra ventricular haemorrhage (IVH) and duration of neonatal intensive care unit (NICU) admission did not show a significant difference between the two groups; however, the rate of neonatal sepsis and neonatal death were higher in the AFI <5 cm group. What are the implications of these findings for clinical practice and/or further research? The results suggest that AFI <5 cm should be considered as a warning sign for predicting poor prognosis of pregnancy complicated by PPROM.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[St] Status:Publisher
[do] DOI:10.1080/01443615.2017.1394280

  8 / 4379 MEDLINE  
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[PMID]: 29483569
[Au] Autor:Hooven TA; Randis TM; Polin RA
[Ad] Address:Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
[Ti] Title:What's the harm? Risks and benefits of evolving rule-out sepsis practices.
[So] Source:J Perinatol;, 2018 Feb 26.
[Is] ISSN:1476-5543
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Asymptomatic term and late-preterm newborns with risk factors for early onset sepsis commonly undergo laboratory evaluation and receive empiric antibiotic therapy. Some have challenged the rationale for current "rule-out sepsis" practices, arguing that they lead to unnecessary overtreatment and healthcare costs. A series of recent clinical studies has explored scheduled serial observations as an alternative to laboratory testing and empiric antibiotics for asymptomatic newborns with historical risk factors for sepsis. These studies have shared the conclusion that serial observation is safe and cost-effective for well-appearing term and late-preterm babies, but they are also somewhat speculative because culture-proven early onset sepsis is an extremely low prevalence diagnosis. Here, we review the evolving consensus of optimal rule-out sepsis practices. We examine chorioamnionitis as an example of a problematic risk factor that has contributed to the controversy surrounding this topic. We also discuss how introduction of online sepsis risk calculators has allowed more precise delineation of a patient's chances of developing culture-proven infection. Finally, we analyze existing data from published studies to estimate the number needed to harm (NNH) when an observation-based strategy is used instead of a risk-based approach. We conclude that, if harm is defined as death or serious sepsis complications such as hemodynamic instability or neurologic injury, the NNH is 1610, compared to an NNH of 7 and 2.9 for IV infiltrates and delayed breastfeeding, respectively-two common and potentially consequential complications of NICU admission for a rule-out sepsis. We believe that the differential between risk of serious harm from observing a well-appearing term or late-preterm newborn with risk factors for sepsis and the risk of less significant but common NICU complications argues in favor of the ongoing trend toward less aggressive management of newborns with sepsis risks.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1802
[Cu] Class update date: 180227
[Lr] Last revision date:180227
[St] Status:Publisher
[do] DOI:10.1038/s41372-018-0081-3

  9 / 4379 MEDLINE  
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[PMID]: 29480140
[Au] Autor:Yum SK; Kim MS; Kwun Y; Moon CJ; Youn YA; Sung IK
[Ad] Address:The Catholic University of Korea.
[Ti] Title:EXPRESS: Impact of histologic chorioamnionitis on pulmonary hypertension and respiratory outcomes in preterm infants.
[So] Source:Pulm Circ;:2045894018760166, 2018 Jan 01.
[Is] ISSN:2045-8932
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180226
[Lr] Last revision date:180226
[St] Status:Publisher
[do] DOI:10.1177/2045894018760166

  10 / 4379 MEDLINE  
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[PMID]: 29478370
[Au] Autor:Lannon SMR; Adams Waldorf KM; Fiedler T; Kapur RP; Agnew K; Rajagopal L; Gravett MG; Fredricks DN
[Ad] Address:a Department of Obstetrics & Gynecology , University of Washington , Seattle , Washington , USA.
[Ti] Title:Parallel detection of lactobacillus and bacterial vaginosis-associated bacterial DNA in the chorioamnion and vagina of pregnant women at term.
[So] Source:J Matern Fetal Neonatal Med;:1-201, 2018 Feb 25.
[Is] ISSN:1476-4954
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: The majority of early preterm births are associated with intrauterine infections, which are thought to occur when microbes traffic into the uterus from the lower genital tract and seed the placenta. Bacterial vaginosis (BV) is associated with heterogeneous bacterial communities in the vagina and is linked to preterm birth. The extent to which trafficking into the uterus of normal and BV-associated vaginal bacteria occurs is unknown. The study objective was to characterize in parallel the distribution and quantities of bacteria in the vagina, uterus, and placental compartments. METHODS: Pregnant women at term (≥ 37weeks) presenting for delivery were recruited prospectively. Swabs were collected in parallel from the vagina, chorioamnion. Choriodecidual swabs were collected if a cesarean section was performed. Samples were analyzed by culture, broad-range 16S rRNA gene PCR, and bacterial species-specific quantitative PCR (qPCR) for DNA from Lactobacillus and a panel of BV-associated bacteria. Results were correlated with placental histopathology. RESULTS: Of the 23 women enrolled, 15 were delivered by cesarean section (N = 10 without labor; N = 5 in labor) and eight were delivered vaginally. BV was diagnosed in two women not in labor. Placental histopathology identified chorioamnionitis or funisitis in six cases [1/10 (10%) not in labor; 5/13 (38%) in labor]. Among nonlaboring women, broad-range 16S qPCR detected bacteria in the chorioamnion and the choriodecidua (4/10; 40%). Among laboring women, Lactobacillus species were frequently detected in the chorioamnion by qPCR (4/13; 31%). In one case, mild chorioamnionitis was associated with qPCR detection of similar microbes in the chorioamnion and vagina (eg Leptotrichia / Sneathia , Megasphaera ), along a quantitative gradient. CONCLUSIONS: Microbial trafficking of lactobacilli and fastidious bacteria into the chorioamniotic membranes and choriodecidua occurs at term in normal pregnancies. In one case, we demonstrated a quantitative gradient between multiple bacterial species in the lower genital tract and placenta. Not all bacterial colonization is associated with placental inflammation and clinical sequelae. Further studies of the role of placental colonization with Lactobacillus in normal pregnancy and fastidious bacteria in chorioamnionitis may improve prevention and treatment approaches for preterm labor.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180226
[Lr] Last revision date:180226
[St] Status:Publisher
[do] DOI:10.1080/14767058.2018.1446208


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