Matching Items (10)
Filtering by
- All Subjects: Health Sciences
- Creators: Ainsworth, Barbara
- Creators: Sweazea, Karen
- Member of: Theses and Dissertations
- Member of: Barrett, The Honors College Thesis/Creative Project Collection
- Status: Published
Effect of a Wii Fit® intervention on balance, muscular fitness, and bone health in middle-aged women
Description
Sustaining a fall can be hazardous for those with low bone mass. Interventions exist to reduce fall-risk, but may not retain long-term interest. "Exergaming" has become popular in older adults as a therapy, but no research has been done on its preventative ability in non-clinical populations. The purpose was to determine the impact of 12-weeks of interactive play with the Wii Fit® on balance, muscular fitness, and bone health in peri- menopausal women. METHODS: 24 peri-menopausal-women were randomized into study groups. Balance was assessed using the Berg/FICSIT-4 and a force plate. Muscular strength was measured using the isokinetic dynamometer at 60°/180°/240°/sec and endurance was assessed using 50 repetitions at 240°/sec. Bone health was tracked using dual-energy x-ray absorptiometry (DXA) for the hip/lumbar spine and qualitative ultrasound (QUS) of the heel. Serum osteocalcin was assessed by enzyme immunoassay. Physical activity was quantified using the Women's Health Initiative Physical Activity Questionnaire and dietary patterns were measured using the Nurses' Health Food Frequency Questionnaire. All measures were repeated at weeks 6 and 12, except for the DXA, which was completed pre-post. RESULTS: There were no significant differences in diet and PA between groups. Wii Fit® training did not improve scores on the Berg/FICSIT-4, but improved center of pressure on the force plate for Tandem Step, Eyes Closed (p-values: 0.001-0.051). There were no significant improvements for muscular fitness at any of the angular velocities. DXA BMD of the left femoral neck improved in the intervention group (+1.15%) and decreased in the control (-1.13%), but no other sites had significant changes. Osteocalcin indicated no differences in bone turnover between groups at baseline, but the intervention group showed increased bone turnover between weeks 6 and 12. CONCLUSIONS: Findings indicate that WiiFit® training may improve balance by preserving center of pressure. QUS, DXA and osteocalcin data confirm that those in the intervention group were experiencing more bone turnover and bone formation than the control group. In summary, twelve weeks of strength /balance training with the Wii Fit® shows promise as a preventative intervention to reduce fall and fracture risk in non-clinical middle aged women who are at risk.
ContributorsWherry, Sarah Jo (Author) / Swan, Pamela D (Thesis advisor) / Adams, Marc (Committee member) / Der Ananian, Cheryl (Committee member) / Sweazea, Karen (Committee member) / Vaughan, Linda (Committee member) / Arizona State University (Publisher)
Created2014
Description
ABSTRACT The hormone leptin is an important regulator of body weight and energy balance, while nitric oxide (NO) produced in the blood vessels is beneficial for preventing disease-induced impaired vasodilation and hypertension. Elevations in the free radical superoxide can result in impaired vasodilation through scavenging of NO. Omega 3 is a polyunsaturated fatty acid that is beneficial at reducing body weight and in lowering many cardiovascular risk factors like atherosclerosis. The present study was designed to examine the change in plasma concentrations of leptin, nitric oxide, and the antioxidant superoxide dismutase in addition to examining the association between leptin and NO in healthy normal weight adult female subjects before and following omega 3 intakes. Participants were randomly assigned to either a fish oil group (600 mg per day) or a control group (1000 mg of coconut oil per day) for 8 weeks. Results showed no significant difference in the percent change of leptin over the 8 week supplementation period for either group (15.3±31.9 for fish oil group, 7.83±27 for control group; p=0.763). The percent change in NO was similarly not significantly altered in either group (-1.97±22 decline in fish oil group, 11.8±53.9 in control group; p=0.960). Likewise, the percent change in superoxide dismutase for each group was not significant following 8 weeks of supplementation (fish oil group: 11.94±20.94; control group: 11.8±53.9; p=0.362). The Pearson correlation co-efficient comparing the percent change of both leptin and NO was r2= -0.251 demonstrating a mildly negative, albeit insignificant, relationship between these factors. Together, these findings suggest that daily supplementation with 600 mg omega 3 in healthy females is not beneficial for improving these cardiovascular risk markers. Future studies in this area should include male subjects as well as overweight subjects with larger doses of fish oil that are equivalent to three or more servings per week. The importance of gender cannot be underestimated since estrogen has protective effects in the vasculature of females that may have masked any further protective effects of the fish oil. In addition, overweight individuals are often leptin-resistant and develop impaired vasodilation resulting from superoxide-mediated scavenging of nitric oxide. Therefore, the reported antioxidant and weight loss properties of omega 3 supplementation may greatly benefit overweight individuals.
ContributorsAlanbagy, Samer (Author) / Sweazea, Karen (Thesis advisor) / Johnston, Carol (Committee member) / Shepard, Christina (Committee member) / Lespron, Christy (Committee member) / Arizona State University (Publisher)
Created2014
Description
The common cold is a significant cause of morbidity world-wide, with human rhinovirus infections accounting for a majority colds suffered each year. While the symptoms of the common cold are generally mild and self-limiting, vulnerable populations such as individuals with asthma can experience severe secondary complications including acute asthma exacerbation which can result in severe morbidity. Most human rhinovirus types utilize Intercellular Adhesion Molecule-1 (ICAM-1) as a receptor to enter cells and initiate infection. Expression of this cell-surface protein is elevated in the respiratory tract of asthma patients. The theoretical basis for this research is the observation that plasma measures of the soluble form of Intercellular Adhesion Molecule-1 (sICAM-1) decrease in response to vitamin C supplementation. As rhinovirus infection occurs in the upper respiratory tract, the primary aim of this study was to evaluate change in sICAM-1 concentration in nasal lavage of asthmatic individuals in response to vitamin C supplementation. Otherwise healthy asthmatic adults between the ages of 18-65 years who were not currently using steroidal nasal sprays, smoking, or actively training for competitive sports were recruited from a university community and surrounding area to participate in an 18-day double-blind randomized placebo-controlled supplement study with a parallel arm design. 13 subjects were stratified based on age, gender, BMI and baseline plasma vitamin C level to receive either 500 mg vitamin C twice daily (VTC, n=7) or placebo (PLC, n=6). Biochemical measures included nasal lavage sICAM-1, plasma sICAM-1, plasma histamine, and plasma vitamin C. Survey measures included Wisconsin Upper Respiratory Symptom Survey-21 to assess colds, Daytime Symptom Diary Scale to assess asthma symptoms, and measures of diet quality including a vitamin C food frequency questionnaire and Rapid Eating Assessment for Participants. No between group comparison of means reached significance (Mann-Whitney U test, p>0.05). Nasal lavage sICAM-1 levels were decreased in VTC group by 37% at study day 4, although this finding did not reach significance. Findings in this study can be used to develop future investigations into the response of nasal lavage sICAM-1 to vitamin C supplementation.
ContributorsGnant, Lindsay (Author) / Johnston, Carol (Thesis advisor) / Sweazea, Karen (Committee member) / Chang, Yung (Committee member) / Arizona State University (Publisher)
Created2014
Description
Introduction: Several faith-based or faith-placed programs have focused on the physical dimension of wellness in efforts to improve health by increasing physical activity and improving diet behaviors. However, these programs were not designed to intervene on the mental dimension of wellness which is critical for stress reduction and health behavior change. Purpose: To evaluate the feasibility of a spirituality-based stress reduction and health behavior change intervention using the Spiritual Framework of Coping (SFC) model. Methods: This study was a quasi-experimental one group pretest posttest design. The study was a total of eight weeks conducted at a non-denominational Christian church. Participants were recruited from the church through announcements and flyers. The Optimal Health program met once a week for 1.5 hours with weekly phone calls during an additional four week follow-up period. Feasibility was assessed by the acceptability, demand, implementation, practicality, integration, and limited efficacy of the program. Analysis: Frequencies for demographics were assessed. Statistical analyses of feasibility objectives were assessed by frequencies and distribution of responses to feasibility evaluations. Limited efficacy of pretest and posttest measures were conducted using paired t-test (p <.05). Results: The Optimal Health Program was positively accepted by participants. The demand for the program was shown with average attendance of 78.7%. The program was successfully implemented as shown by meeting session objectives and 88% homework completion. The program was both practical for the intended participants and was successfully integrated within the existing environment. Limited efficacy changes within the program were mostly non-significant. Conclusion: This study tested the feasibility of implementing the Optimal Health program that specifically targeted the structural components of the Spiritual Framework of Coping Model identified to create meaning making and enhance well-being. This program may ultimately be used to help individuals improve and balance the spiritual, mental, and physical dimensions of wellness. However, length of study and limited efficacy measures will need to be reevaluated for program success.
ContributorsWalker, Jenelle R (Author) / Swan, Pamela (Thesis advisor) / Ainsworth, Barbara (Committee member) / Chisum, Jack (Committee member) / Fleury, Julie (Committee member) / Hooker, Steven (Committee member) / Arizona State University (Publisher)
Created2012
Description
Birds have unusually high plasma glucose concentrations compared to mammals of similar size despite their high metabolic rate. While birds use lipids as their main source of energy, it is still unclear how and why they maintain high plasma glucose concentrations. To investigate a potential underlying mechanism, this study looks at the role of lipolysis in glucose homeostasis. The purpose of this study is to examine the effects of decreased glycerol availability (through inhibition of lipolysis) on plasma glucose concentrations in mourning doves. The hypothesis is that decreased availability of glycerol will result in decreased production of glucose through gluconeogenesis leading to reduced plasma glucose concentrations. In the morning of each experiment, mourning doves were collected at the Arizona State University Tempe campus, and randomized into either a control group (0.9% saline) or experimental group (acipimox, 50mg/kg BM). Blood samples were collected prior to treatment, and at 1, 2, and 3 hours post-treatment. At 3 hours, doves were euthanized, and tissue samples were collected for analysis. Acipimox treatment resulted in significant increases in blood glucose concentrations at 1 and 2 hours post- treatment as well as renal triglyceride concentrations at 3 hours post-treatment. Change in plasma free glycerol between 0h and 3h followed an increasing trend for the acipimox treated animals, and a decreasing trend in the saline treated animals. These results do not support the hypothesis that inhibition of lipolysis should decrease blood glycerol and blood glucose levels. Rather, the effects of acipimox in glucose homeostasis appear to differ significantly between birds and mammals suggesting differing mechanisms for glucose homeostasis.
ContributorsKouteib, Soukaina (Author) / Sweazea, Karen (Thesis director) / Deviche, Pierre (Committee member) / Chandler, Douglas (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor)
Created2015-05
Description
Background and purpose: Regular physical activity (PA) provides benefits for cognitive health and helps to improve or maintain quality of life among older adults. Objective PA measures have been increasingly used to overcome limitations of self-report measures. The purpose of this study was to investigate the association of objectively measured PA and sedentary time with cognitive function among older adults.
Methods: Participants were recruited from the parent REasons for Geographic and Racial Differences in Stroke (REGARDS) Study. ActicalTM accelerometers provided estimates of PA variables, including moderate-to-vigorous PA (MVPA), high light PA (HLPA), low light PA (LLPA) and sedentary time, for 4-7 consecutive days. Prevalence and incidence of cognitive impairment were defined by the Six-Item Screener. Letter fluency, animal fluency, word list learning and Montreal Cognitive Assessment (orientation and recall) were conducted to assess executive function and memory.
Results: Of the 7,339 participants who provided accelerometer wear data > 4 days (70.1 ± 8.6 yr, 54.2% women, 31.7% African American), 320 participants exhibited impaired cognition. In cross-sectional analysis, participants in the highest MVPA% quartile had 39% lower odds of cognitive impairment than those in the lowest quartile (OR: 0.61, 95% C.I.: 0.39-0.95) after full adjustment. Further analysis shows most quartiles of MVPA% and HLPA% were significantly associated with executive function and memory (P<0.01). During 2.7 ± 0.5 years of follow-up, 3,385 participants were included in the longitudinal analysis, with 157 incident cases of cognitive impairment. After adjustments, participants in the highest MVPA% quartile had 51% lower hazards of cognitive impairment (HR: 0.49, 95% C.I.: 0.28-0.86). Additionally, MVPA% was inversely associated with change in memory z-scores (P<0.01), while the highest quartile of HLPA% was inversely associated with change in executive function and memory z-scores (P<0.01).
Conclusion: Higher levels of objectively measured MVPA% were independently associated with lower prevalence and incidence of cognitive impairment, and better memory and executive function in older adults. Higher levels of HLPA% were also independently associated with better memory and executive function. The amount of MVPA associated with lower risk of cognitive impairment (259 min/week) is >70% higher than the minimal amount of MVPA recommended by PA guidelines.
Methods: Participants were recruited from the parent REasons for Geographic and Racial Differences in Stroke (REGARDS) Study. ActicalTM accelerometers provided estimates of PA variables, including moderate-to-vigorous PA (MVPA), high light PA (HLPA), low light PA (LLPA) and sedentary time, for 4-7 consecutive days. Prevalence and incidence of cognitive impairment were defined by the Six-Item Screener. Letter fluency, animal fluency, word list learning and Montreal Cognitive Assessment (orientation and recall) were conducted to assess executive function and memory.
Results: Of the 7,339 participants who provided accelerometer wear data > 4 days (70.1 ± 8.6 yr, 54.2% women, 31.7% African American), 320 participants exhibited impaired cognition. In cross-sectional analysis, participants in the highest MVPA% quartile had 39% lower odds of cognitive impairment than those in the lowest quartile (OR: 0.61, 95% C.I.: 0.39-0.95) after full adjustment. Further analysis shows most quartiles of MVPA% and HLPA% were significantly associated with executive function and memory (P<0.01). During 2.7 ± 0.5 years of follow-up, 3,385 participants were included in the longitudinal analysis, with 157 incident cases of cognitive impairment. After adjustments, participants in the highest MVPA% quartile had 51% lower hazards of cognitive impairment (HR: 0.49, 95% C.I.: 0.28-0.86). Additionally, MVPA% was inversely associated with change in memory z-scores (P<0.01), while the highest quartile of HLPA% was inversely associated with change in executive function and memory z-scores (P<0.01).
Conclusion: Higher levels of objectively measured MVPA% were independently associated with lower prevalence and incidence of cognitive impairment, and better memory and executive function in older adults. Higher levels of HLPA% were also independently associated with better memory and executive function. The amount of MVPA associated with lower risk of cognitive impairment (259 min/week) is >70% higher than the minimal amount of MVPA recommended by PA guidelines.
ContributorsZhu, Wenfei (Author) / Hooker, Steven P (Thesis advisor) / Wadley, Virginia (Committee member) / Ainsworth, Barbara (Committee member) / Der Ananian, Cheryl (Committee member) / Buman, Matthew (Committee member) / Arizona State University (Publisher)
Created2015
Description
Physical activity, sedentary behaviors, and sleep are often associated with cardiometabolic biomarkers commonly found in metabolic syndrome. These relationships are well studied, and yet there are still questions on how each activity may affect cardiometabolic biomarkers. The objective of this study was to examine data from the BeWell24 studies to evaluate the relationship between objectively measured physical activity and sedentary behaviors and cardiometabolic biomarkers in middle age adults, while also determining if sleep quality and duration mediates this relationship. A group of inactive participants (N = 29, age = 52.1 ± 8.1 years, 38% female) with increased risk for cardiometabolic disease were recruited to participate in BeWell24, a trial testing the impact of a lifestyle-based, multicomponent smartphone application targeting sleep, sedentary, and more active behaviors. During baseline, interim (4 weeks), and posttest visits (8 weeks), biomarker measurements were collected for weight (kg), waist circumference (cm), glucose (mg/dl), insulin (uU/ml), lipids (mg/dl), diastolic and systolic blood pressures (mm Hg), and C reactive protein (mg/L). Participants wore validated wrist and thigh sensors for one week intervals at each time point to measure sedentary behavior, physical activity, and sleep outcomes. Long bouts of sitting time (>30 min) significantly affected triglycerides (beta = .15 (±.07), p<.03); however, no significant mediation effects for sleep quality or duration were present. No other direct effects were observed between physical activity measurements and cardiometabolic biomarkers. The findings of this study suggest that reductions in long bouts of sitting time may support reductions in triglycerides, yet these effects were not mediated by sleep-related improvements.
ContributorsLanich, Boyd (Author) / Buman, Matthew (Thesis advisor) / Ainsworth, Barbara (Committee member) / Huberty, Jennifer (Committee member) / Arizona State University (Publisher)
Created2017
Description
The transition to college has been identified as a vulnerable period for weight gain and the onset of obesity. Research has shown that the gut microbiota is different in obese compared to lean individuals, but a period of weight gain has never been studied in free-living individuals. The objective of this longitudinal, observational study was to assess the association between changes in the intestinal microbiota and weight-related outcomes in healthy college students living in on-campus dormitories at Arizona State University (n=39). Anthropometric measures and fecal samples were collected at the beginning and end of the school year, and microbial relative abundance for A. muciniphila, F. prausnitzii, R. gnavus, and L. acidophilus was measured through qPCR analyses. In this population, body mass index (BMI) and waist circumference (WC) increased by 0.97 ± 1.28 kg/m2 and 2.64 ± 4.90 cm, respectively. Wilcoxon-Rank tests revealed that R. gnavus fold change was significantly different between groups of weight loss/maintenance and weight gain ≥ 5% body weight (0.14 [-0.21, 0.64], n=24 vs. -0.14 [-0.92, 0.05], n=15, respectively; p=0.028). Correlation analyses suggested a significant negative association between A. muciniphila fold change and both % WC change and % BMI change (r= -0.66; p<0.01 and r= -0.33; p=0.04, respectively). However, multivariate regression analysis controlling for sex and race/ethnicity showed a significant association between A. muciniphila and % WC change, but not % BMI change (R2= 0.53; p<0.01 and R2= 0.24; p=0.15). F. prausnitzii was not associated with weight-related outcomes in this sample. L. acidophilus was excluded from study analyses after subsequent qPCR trials revealed no amplification in participant samples. Overall, this was the first study to show a relationship between A. muciniphila fold change and weight-related outcomes over a period of weight gain. Specifically, A. muciniphila was strongly negatively associated with WC in this sample. Further research is needed to more accurately describe these associations and potential mechanisms associated with the shift in gut microbiota observed with weight gain. Findings from future research may be used to develop interventions for college students aiming to shift the gut microbiota to prevent weight gain.
ContributorsJourney, Elizabeth (Author) / Whisner, Corrie M (Thesis advisor) / Bruening, Meredith (Committee member) / Sweazea, Karen (Committee member) / Arizona State University (Publisher)
Created2017
Description
It is broadly accepted that physical activity provides substantial health benefits. Despite strong evidence, approximately 60% to 95% of US adults are insufficiently active to obtain these health benefits. This dissertation explored five projects that examined the measurement properties and methodology for a variety of physical activity assessment methods. Project one identified validity evidence for the new MyWellness Key accelerometer in sixteen adults. The MyWellness Key demonstrated acceptable validity evidence when compared to a criterion accelerometer during graded treadmill walking and in free-living settings. This supports the use of the MyWellness Key accelerometer to measure physical activity. Project two evaluated validity (study 1) and test-retest reliability evidence (study 2) of the Global Physical Activity Questionnaire (GPAQ) in a two part study. The GPAQ was compared to direct and indirect criterion measures including object and subjective physical activity instruments. These data provided preliminary validity and reliability evidence for the GPAQ that support its use to assess physical activity. Project three investigated the optimal h.d-1 of accelerometer wear time needed to assess daily physical activity. Using a semi-simulation approach, data from 124 participants were used to compare 10-13 h.d-1 to the criterion 14 h.d-1. This study suggested that a minimum accelerometer wear time of 13 h.d-1 is needed to provide a valid measure of daily physical activity. Project four evaluated validity and reliability evidence of a novel method (Movement and Activity in Physical Space [MAPS] score) that combines accelerometer and GPS data to assess person-environment interactions. Seventy-five healthy adults wore an accelerometer and GPS receiver for three days to provide MAPS scores. This study provided evidence for use of a MAPS score for future research and clinical use. Project five used accelerometer data from 1,000 participants from the 2005-2006 National Health and Nutrition Examination Study. A semi-simulation approach was used to assess the effect of accelerometer wear time (10-14 h.d-1) on physical activity data. These data showed wearing for 12 h.d-1 or less may underestimate time spent in various intensities of physical activity.
ContributorsHerrmann, Stephen (Author) / Ainsworth, Barbara (Thesis advisor) / Gaesser, Glenn (Committee member) / Der Ananian, Cheryl (Committee member) / Kang, Minsoo (Committee member) / Vega-Lopez, Sonia (Committee member) / Arizona State University (Publisher)
Created2011
Description
Most studies that explored the health benefits of interrupting sitting time focused on using different modalities (i.e., comparing walking vs standing breaks)33,36,59. However, experimental studies that directly compare patterns of interrupting sitting time through standing only are needed to advance the field. This study aimed to (i) determine if there is a difference in glucose response between continuous sitting (CS) and two intermittent standing regimes (high frequency, low duration breaks (HFLD) and low frequency, high duration breaks (LFHD)) and (ii) to determine if there is a difference in glucose response between the two strategies (HFLD vs. LFHD).
Ten sedentary employees (mean±SD age 46.8±10.6 years; 70% female) with impaired fasting glucose (mean glucose= 109.0±9.8 mg/dL) participated. Eligible participants were invited to three 7.5 hour laboratory visits where they were randomized to perform each study conditions: (i) CS, (ii) HFLD and (iii) LFHD. Standardized meals (breakfast and lunch) were given with each meal providing 33% of the participant’s total daily caloric needs following a typical American diet (50-60% carbohydrates, 25-30% fat, and 10-20% protein). Participants wore an activPAL device to measure compliance with the sit-stand condition and a continuous glucose monitor to measure post-prandial glucose response. Post-prandial mean glucose, incremental area under the curve and mean amplitude glycemic excursion between conditions were evaluated using linear mixed models.
Participants demonstrated high compliance with the study condition. The results indicated that the mean glucose of the HFLD condition were significantly lower (p< .01) than the CS condition with mean difference of -7.70 (-11.98, -3.42) mg/dL·3.5h and -5.76 (-9.50, -2.03) mg/dL·7h for lunch and total time, respectively. Furthermore, the mean post-prandial glucose during lunch and total time were significantly lower in the HFLD condition compared to the LFHD condition with mean difference of -9.94 (-14.13, -5.74) mg/dL·3.5h and -6.23 (-9.93, -2.52) mg/dL·7h, respectively. No differences were found between the CS and LFHD conditions.
This study provides evidence favoring the use of frequent interruptions in sitting time to improve glycemic control of prediabetic individuals. In contrast, less frequent, although longer bouts of standing resulted in similar post-prandial glucose profile to that of the continuous sitting condition despite total standing time being equal to the LFHD condition.
Ten sedentary employees (mean±SD age 46.8±10.6 years; 70% female) with impaired fasting glucose (mean glucose= 109.0±9.8 mg/dL) participated. Eligible participants were invited to three 7.5 hour laboratory visits where they were randomized to perform each study conditions: (i) CS, (ii) HFLD and (iii) LFHD. Standardized meals (breakfast and lunch) were given with each meal providing 33% of the participant’s total daily caloric needs following a typical American diet (50-60% carbohydrates, 25-30% fat, and 10-20% protein). Participants wore an activPAL device to measure compliance with the sit-stand condition and a continuous glucose monitor to measure post-prandial glucose response. Post-prandial mean glucose, incremental area under the curve and mean amplitude glycemic excursion between conditions were evaluated using linear mixed models.
Participants demonstrated high compliance with the study condition. The results indicated that the mean glucose of the HFLD condition were significantly lower (p< .01) than the CS condition with mean difference of -7.70 (-11.98, -3.42) mg/dL·3.5h and -5.76 (-9.50, -2.03) mg/dL·7h for lunch and total time, respectively. Furthermore, the mean post-prandial glucose during lunch and total time were significantly lower in the HFLD condition compared to the LFHD condition with mean difference of -9.94 (-14.13, -5.74) mg/dL·3.5h and -6.23 (-9.93, -2.52) mg/dL·7h, respectively. No differences were found between the CS and LFHD conditions.
This study provides evidence favoring the use of frequent interruptions in sitting time to improve glycemic control of prediabetic individuals. In contrast, less frequent, although longer bouts of standing resulted in similar post-prandial glucose profile to that of the continuous sitting condition despite total standing time being equal to the LFHD condition.
ContributorsToledo, Meynard John Lapore (Author) / Buman, Matthew P (Thesis advisor) / Ainsworth, Barbara (Committee member) / Gaesser, Glenn (Committee member) / Hooker, Steven (Committee member) / Pereira, Mark (Committee member) / Arizona State University (Publisher)
Created2019