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Interleukin-1β (IL-1β) is a key orchestrator in inflammatory and several immune responses. IL-1β exerts its effects through interleukin-1 receptor type I (IL-1RI) and interleukin-1 receptor accessory protein (IL-1RAcP), which together form a heterotrimeric signaling-competent complex. Canakinumab and gevokizumab are highly specific IL-1β monoclonal antibodies. Canakinumab is known to neutralize IL-1β by competing for binding to IL-1R and therefore blocking signaling by the antigen:antibody complex. Gevokizumab is claimed to be a regulatory therapeutic antibody that modulates IL-1β bioactivity by reducing the affinity for its IL-1RI:IL-1RAcP signaling complex. How IL-1β signaling is affected by both canakinumab and gevokizumab was not yet experimentally determined. We have analyzed the crystal structures of canakinumab and gevokizumab antibody binding fragment (Fab) as well as of their binary complexes with IL-1β. Furthermore, we characterized the epitopes on IL-1β employed by the antibodies by NMR epitope mapping studies. The direct comparison of NMR and X-ray data shows that the epitope defined by the crystal structure encompasses predominantly those residues whose NMR resonances are severely perturbed upon complex formation. The antigen:Fab co-structures confirm the previously identified key contact residues on IL-1β and provide insight into the mechanisms leading to their distinct modulation of IL-1β signaling. A significant steric overlap of the binding interfaces of IL-1R and canakinumab on IL-1β causes competitive inhibition of the association of IL-1β and its receptor. In contrast, gevokizumab occupies an allosteric site on IL-1β and complex formation results in a minor reduction of binding affinity to IL-1RI. This suggests two different mechanisms of IL-1β pathway attenuation.  相似文献   

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Ulrich Demmer 《Ethnos》2015,80(1):91-116
This paper explores an understanding of the person in terms of practical reason. Based on my fieldwork among the Jenu Kurumba and on ethnographic data on four other communities, I analyse how these five communities conceptualise the ethical person. To understand these concepts, I consult studies of an anthropology of ethics concerned with practical reason. Additionally I draw on Charles Taylor's concept of the ‘agent plus’ and Alasdair MacIntyre's notion of the ‘practical reasoner’. I argue that both Neo-Aristotelian notions are fundamentally important for understanding the concepts of the ethical person among the five cultural formations investigated in this paper.  相似文献   

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This paper is intended to be a critical appraisal of ethical investment with respect to animal experimentation. It is aimed at a wide readership, ranging from scientists in the field and laypersons interested in laboratory animal welfare, potential investors, to senior management in industries directly or indirectly involved in animal testing.  相似文献   

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Objective

To test the ‘Liverpool Osteoarthritis in Dogs’ (LOAD) questionnaire for construct and criterion validity, and to similarly test the Helsinki Chronic Pain Index (HCPI) and the Canine Brief Pain Inventory (CBPI).

Design

Prospective Study.

Animals

222 dogs with osteoarthritis.

Procedure

Osteoarthritis was diagnosed in a cohort of dogs on the basis of clinical history and orthopedic examination. Force-platform analysis was performed and a “symmetry index” for peak vertical force (PVF) was calculated. Owners completed LOAD, CBPI and HCPI instruments. As a test of construct validity, inter-instrument correlations were calculated. As a test of criterion validity, the correlations between instrument scores and PVF symmetry scores were calculated. Additionally, internal consistency of all instruments was calculated and compared to those previously reported. Factor analysis is reported for the first time for LOAD, and is compared to that previously reported for CBPI and HCPI.

Results

Significant moderate correlations were found between all instruments, implying construct validity for all instruments. Significant weak correlations were found between LOAD scores and PVF symmetry index, and between CBPI scores and PVF symmetry index.

Conclusion and Clinical Relevance

LOAD is an owner-completed clinical metrology instrument that can be recommended for the measurement of canine osteoarthritis. It is convenient to use, validated and, as demonstrated here for the first time, has a correlation with force-platform data.  相似文献   

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IntroductionTo understand if and which patients would be open-minded to Complementary and Alternative Medicine (CAM) use parallel to their oncological treatment. Moreover, we sought to determine which methods are most accepted and which are the primary motivators to use CAM.MethodsWe developed and anonymously conducted a questionnaire for patients in the oncology center (TU Munich). Questions focus on different CAM methods, previous experiences, and willingness to apply or use CAM when offered in a university-based setting.ResultsA total of 171 of 376 patients (37.4% women, 62.0% men, 0.6% unknown) participated. This corresponds to a return rate of 45%. Median age was 64 years (17–87 years). Of all participants, 15.2% used CAM during their oncological therapy; 32.7% have used it in the past. The majority (81.9%) was not using CAM during therapy; 55.5% have not used CAM in the past respectively. The analysis revealed a significant correlation between education and CAM use during therapy (r = 0.18; p = 0.02), and CAM use in the past (r = 0.17; p = 0.04). Of all patients using CAM during therapy, favored methods were food supplements (42.3%), vitamins/minerals (42.3%), massage (34.6%). Motivations are especially the reduction of side effect and stress, the positive effect of certain CAM-treatments on the immune system and tumor therapy. Results showed no difference between women and men. Most patients not having had any experience with CAM complain about the deficiency of information by their treating oncologist (31.4%) as well as missing treatment possibilities (54.3%).ConclusionSince many patients believe in study results demonstrating the efficacy of CAM, it stresses our task to develop innovative study protocols to investigate the outcomes of certain CAM on symptom reduction or other endpoints. Thus, prospective trials and innovative evidence-based treatment concepts to include CAM into high-end oncology is what patients demand and what a modern oncology center should offer.  相似文献   

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The hippocampus has unique access to neuronal activity across all of the neocortex. Yet an unanswered question is how the transfer of information between these structures is gated. One hypothesis involves temporal-locking of activity in the neocortex with that in the hippocampus. New data from the Matthew E. Diamond laboratory shows that the rhythmic neuronal activity that accompanies vibrissa-based sensation, in rats, transiently locks to ongoing hippocampal θ-rhythmic activity during the sensory-gathering epoch of a discrimination task. This result complements past studies on the locking of sniffing and the θ-rhythm as well as the relation of sniffing and whisking. An overarching possibility is that the preBötzinger inspiration oscillator, which paces whisking, can selectively lock with the θ-rhythm to traffic sensorimotor information between the rat’s neocortex and hippocampus.The hippocampus lies along the margins of the cortical mantle and has unique access to neuronal activity across all of the neocortex. From a functional perspective, the hippocampus forms the apex of neuronal processing in mammals and is a key element in the short-term working memory, where neuronal signals persist for tens of seconds, that is independent of the frontal cortex (reviewed in [1,2]). Sensory information from multiple modalities is highly transformed as it passes from primary and higher-order sensory areas to the hippocampus. Several anatomically defined regions that lie within the temporal lobe take part in this transformation, all of which involve circuits with extensive recurrent feedback connections (reviewed in [3]) (Fig 1). This circuit motif is reminiscent of the pattern of connectivity within models of associative neuronal networks, whose dynamics lead to the clustering of neuronal inputs to form a reduced set of abstract representations [4] (reviewed in [5]). The first way station in the temporal lobe contains the postrhinal and perirhinal cortices, followed by the medial and lateral entorhinal cortices. Of note, olfactory input—which, unlike other senses, has no spatial component to its representation—has direct input to the lateral entorhinal cortex [6]. The third structure is the hippocampus, which contains multiple substructures (Fig 1).Open in a separate windowFig 1Schematic view of the circuitry of the temporal lobe and its connections to other brain areas of relevance.Figure abstracted from published results [715]. Composite illustration by Julia Kuhl.The specific nature of signal transformation and neuronal computations within the hippocampus is largely an open issue that defines the agenda of a great many laboratories. Equally vexing is the nature of signal transformation as the output leaves the hippocampus and propagates back to regions in the neocortex (Fig 1)—including the medial prefrontal cortex, a site of sensory integration and decision-making—in order to influence perception and motor action. The current experimental data suggest that only some signals within the sensory stream propagate into and out of the hippocampus. What regulates communication with the hippocampus or, more generally, with structures within the temporal lobe? The results from studies in rats and mice suggest that the most parsimonious hypothesis, at least for rodents, involves the rhythmic nature of neuronal activity at the so-called θ-rhythm [16], a 5–10 Hz oscillation (reviewed in [17]). The origin of the rhythm is not readily localized to a single locus [10], but certainly involves input from the medial septum [17] (a member of the forebrain cholinergic system) as well as from the supramammillary nucleus [10,18] (a member of the hypothalamus). The medial septum projects broadly to targets in the hippocampus and entorhinal cortex (Fig 1) [10]. Many motor actions, such as the orofacial actions of sniffing, whisking, and licking, occur within the frequency range of the θ-rhythm [19,20]. Thus, sensory input that is modulated by rhythmic self-motion can, in principle, phase-lock with hippocampal activity at the θ-rhythm to ensure the coherent trafficking of information between the relevant neocortical regions and temporal lobe structures [2123].We now shift to the nature of orofacial sensory inputs, specifically whisking and sniffing, which are believed to dominate the world view of rodents [19]. Recent work identified a premotor nucleus in the ventral medulla, named the vibrissa region of the intermediate reticular zone, whose oscillatory output is necessary and sufficient to drive rhythmic whisking [24]. While whisking can occur independently of breathing, sniffing and whisking are synchronized in the curious and aroused animal [24,25], as the preBötzinger complex in the medulla [26]—the oscillator for inspiration—paces whisking at nominally 5–10 Hz through collateral projections [27]. Thus, for the purposes of reviewing evidence for the locking of orofacial sensory inputs to the hippocampal θ-rhythm, we confine our analysis to aroused animals that function with effectively a single sniff/whisk oscillator [28].What is the evidence for the locking of somatosensory signaling by the vibrissae to the hippocampal θ-rhythm? The first suggestion of phase locking between whisking and the θ-rhythm was based on a small sample size [29,30], which allowed for the possibility of spurious correlations. Phase locking was subsequently reexamined, using a relatively large dataset of 2 s whisking epochs, across many animals, as animals whisked in air [31]. The authors concluded that while whisking and the θ-rhythm share the same spectral band, their phases drift incoherently. Yet the possibility remained that phase locking could occur during special intervals, such as when a rat learns to discriminate an object with its vibrissae or when it performs a memory-based task. This set the stage for a further reexamination of this issue across different epochs in a rewarded task. Work from Diamond''s laboratory that is published in the current issue of PLOS Biology addresses just this point in a well-crafted experiment that involves rats trained to perform a discrimination task.Grion, Akrami, Zuo, Stella, and Diamond [32] trained rats to discriminate between two different textures with their vibrissae. The animals were rewarded if they turned to a water port on the side that was paired with a particular texture. Concurrent with this task, the investigators also recorded the local field potential in the hippocampus (from which they extracted the θ-rhythm), the position of the vibrissae (from which they extracted the evolution of phase in the whisk cycle), and the spiking of units in the vibrissa primary sensory cortex. Their first new finding is a substantial increase in the amplitude of the hippocampal field potential at the θ-rhythm frequency—approximately 10 Hz for the data of Fig 2A—during the two, approximately 0.5 s epochs when the animal approaches the textures and whisks against it. There is significant phase locking between whisking and the hippocampal θ-rhythm during both of these epochs (Fig 2B), as compared to a null hypothesis of whisking while the animal whisked in air outside the discrimination zone. Unfortunately, the coherence between whisking and the hippocampal θ-rhythm could not be ascertained during the decision, i.e., turn and reward epochs. Nonetheless, these data show that the coherence between whisking and the hippocampal θ-rhythm is closely aligned to epochs of active information gathering.Open in a separate windowFig 2Summary of findings on the θ-rhythm in a rat during a texture discrimination task, derived from reference [32]. (A) Spectrogram showing the change in spectral power of the local field potential in the hippocampal area CA1 before, during, and after a whisking-based discrimination task. (B) Summary index of the increase in coherence between the band-limited hippocampal θ-rhythm and whisking signals during approach of the rat to the stimulus and subsequent touch. The index reports sin(ϕHϕW)2+cos(ϕHϕW)2, where ɸH and ɸW are the instantaneous phase of the hippocampal and whisking signals, respectively, and averaging is over all trials and animals. (C) Summary indices of the increase in coherence between the band-limited hippocampal θ-rhythm and the spiking signal in the vibrissa primary sensory cortex (“barrel cortex”). The magnitude of the index for each neuron is plotted versus phase in the θ-rhythm. The arrows show the concentration of units around the mean phase—black arrows for the vector average across only neurons with significant phase locking (solid circles) and gray arrows for the vector average across all neurons (open and closed circles). The concurrent positions of the vibrissae are indicated. The vector average is statistically significant only for the approach (p < 0.0001) and touch (p = 0.04) epochs.The second finding by Grion, Akrami, Zuo, Stella, and Diamond [32] addresses the relationship between spiking activity in the vibrissa primary sensory cortex and the hippocampal θ-rhythm. The authors find that spiking is essentially independent of the θ-rhythm outside of the task (foraging in Fig 2C), similar to the result for whisking and the θ-rhythm (Fig 2B). They observe strong coherence between spiking and the θ-rhythm during the 0.5 s epoch when the animal approaches the textures (approach in Fig 2C), yet reduced (but still significant) coherence during the touch epoch (touch in Fig 2C). The latter result is somewhat surprising, given past work from a number of laboratories that observe spiking in the primary sensory cortex and whisking to be weakly yet significantly phase-locked during exploratory whisking [3337]. Perhaps overtraining leads to only a modest need for the transfer of sensory information to the hippocampus. Nonetheless, these data establish that phase locking of hippocampal and sensory cortical activity is essentially confined to the epoch of sensory gathering.Given the recent finding of a one-to-one locking of whisking and sniffing [24], we expect to find direct evidence for the phase locking of sniffing and the θ-rhythm. Early work indeed reported such phase locking [38] but, as in the case of whisking [29], this may have been a consequence of too small a sample and, thus, inadequate statistical power. However, Macrides, Eichenbaum, and Forbes [39] reexamined the relationship between sniffing and the hippocampal θ-rhythm before, during, and after animals sampled an odorant in a forced-choice task. They found evidence that the two rhythms phase-lock within approximately one second of the sampling epoch. We interpret this locking to be similar to that seen in the study by Diamond and colleagues (Fig 2B) [32]. All told, the combined data for sniffing and whisking by the aroused rodent, as accumulated across multiple laboratories, suggest that two oscillatory circuits—the supramammillary nucleus and medial septum complex that drives the hippocampal θ-rhythm and the preBötzinger complex that drives inspiration and paces the whisking oscillator during sniffing (Fig 1)—can phase-lock during epochs of gathering sensory information and likely sustain working memory.What anatomical pathway can lead to phase locking of these two oscillators? The electrophysiological study of Tsanov, Chah, Reilly, and O’Mara [9] supports a pathway from the medial septum, which is driven by the supramammillary nucleus, to dorsal pontine nuclei in the brainstem. The pontine nucleus projects to respiratory nuclei and, ultimately, the preBötzinger oscillator (Fig 1). This unidirectional pathway can, in principle, entrain breathing and whisking. Phase locking is not expected to occur during periods of basal breathing, when the breathing rate and θ-rhythm occur at highly incommensurate frequencies. However, it remains unclear why phase locking occurs only during a selected epoch of a discrimination task, whereas breathing and the θ-rhythm occupy the same frequency band during the epochs of approach, as well as touch-based target selection (Fig 2A). While a reafferent pathway provides the rat with information on self-motion of the vibrissae (Fig 1), it is currently unknown whether that information provides feedback for phase locking.A seeming requirement for effective communication between neocortical and hippocampal processing is that phase locking must be achieved at all possible phases of the θ-rhythm. Can multiple phase differences between sensory signals and the hippocampal θ-rhythm be accommodated? Two studies report that the θ-rhythm undergoes a systematic phase-shift along the dorsal–ventral axis of the hippocampus [40,41], although the full extent of this shift is only π radians [41]. In addition, past work shows that vibrissa input during whisking is represented among all phases of the sniff/whisk cycle, at levels from primary sensory neurons [42,43] through thalamus [44,45] and neocortex [3337], with a bias toward retraction from the protracted position. A similar spread in phase occurs for olfactory input, as observed at the levels of the olfactory bulb [46] and cortex [47]. Thus, in principle, the hippocampus can receive, transform, and output sensory signals that arise over all possible phases in the sniff/whisk cycle. In this regard, two signals that are exactly out-of-phase by π radians can phase-lock as readily as signals that are in-phase.What are the constraints for phase locking to occur within the observed texture identification epochs? For a linear system, the time to lock between an external input and hippocampal theta depends on the observed spread in the spectrum of the θ-rhythm. This is estimated as Δf ~3 Hz (half-width at half-maximum amplitude), implying a locking time on the order of 1/Δf ~0.3 s. This is consistent with the approximate one second of enhanced θ-rhythm activity observed in the study by Diamond and colleagues (Fig 2A) [32] and in prior work [39,48] during a forced-choice task with rodents.Does the θ-rhythm also play a role in the gating of output from the hippocampus to areas of the neocortex? Siapas, Lubenov, and Wilson [48] provided evidence that hippocampal θ-rhythm phase-locks to electrical activity in the medial prefrontal cortex, a site of sensory integration as well as decision-making. Subsequent work [4951] showed that the hippocampus drives the prefrontal cortex, consistent with the known unidirectional connectivity between Cornu Ammonis area 1 (CA1) of the hippocampus and the prefrontal cortex [11] (Fig 1). Further, phase locking of hippocampal and prefrontal cortical activity is largely confined to the epoch of decision-making, as opposed to the epoch of sensory gathering. Thus, over the course of approximately one second, sensory information flows into and then out of the hippocampus, gated by phase coherence between rhythmic neocortical and hippocampal neuronal activity.It is of interest that the medial prefrontal cortex receives input signals from sensory areas in the neocortex [52] as well as a transformed version of these input signals via the hippocampus (Fig 1). Yet it remains to be determined if this constitutes a viable hub for the comparison of the original and transformed signals. In particular, projections to the medial prefrontal cortex arise from the ventral hippocampus [2], while studies on the phase locking of hippocampal θ-rhythm to prefrontal neocortical activity were conducted in dorsal hippocampus, where the strength of the θ-rhythm is strong compared to the ventral end [53]. Therefore, similar recordings need to be performed in the ventral hippocampus. An intriguing possibility is that the continuous phase-shift of the θ-rhythm along the dorsal to the ventral axis of the hippocampus [40,41] provides a means to encode the arrival of novel inputs from multiple sensory modalities relative to a common clock.A final issue concerns the locking between sensory signals and hippocampal neuronal activity in species that do not exhibit a continuous θ-rhythm, with particular reference to bats [5456] and primates [5760]. One possibility is that only the up and down swings of neuronal activity about a mean are important, as opposed to the rhythm per se. In fact, for animals in which orofacial input plays a relatively minor role compared to rodents, such a scheme of clocked yet arrhythmic input may be a necessity. In this case, the window of processing is set by a stochastic interval between transitions, as opposed to the periodicity of the θ-rhythm. This may imply that up/down swings of neuronal activity may drive hippocampal–neocortical communications in all species, with communication mediated via phase-locked oscillators in rodents and via synchronous fluctuations in bats and primates. The validity of this scheme and its potential consequence on neuronal computation remains an open issue and a focus of ongoing research.  相似文献   

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The capacity to induce crassulacean acid metabolism developmentally (constitutive CAM) and to up-regulate CAM expression in response to drought stress (facultative CAM) was studied in whole shoots of seven species by measuring net CO(2) gas exchange for up to 120 day-night cycles during early growth. In Clusia rosea, CAM was largely induced developmentally. Well-watered seedlings began their life cycle as C(3) plants and developed net dark CO(2) fixation indicative of CAM after the initiation of the fourth leaf pair following the cotyledons. Thereafter, CAM activity increased progressively and drought stress led to only small additional, reversible increases in dark CO(2) fixation. In contrast, CAM expression was overwhelmingly under environmental control in seedlings and mature plants of Clusia pratensis. C(3)-type CO(2) exchange was maintained under well-watered conditions, but upon drought stress, CO(2) exchange shifted, in a fully reversible manner, to a CAM-type pattern. Clusia minor showed CO(2) exchange reponses intermediate to those of C. rosea and C. pratensis. Clusia cretosa operated in the C(3) mode at all times. Notably, reversible stress-induced increases of dark CO(2) fixation were also observed during the developmental progression to pronounced CAM in young Kalancho? daigremontiana and Kalancho? pinnata, two species considered constitutive CAM species. Drought-induced up-regulation of CAM was even detected in young cladodes of a cactus, Opuntia ficus-indica, an archetypal constitutive CAM species. Evidently, the defining characteristics of constitutive and facultative CAM are shared, to variable degrees, by all CAM species.  相似文献   

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One hundred years ago in 1915 ‘Die Entstehung der Kontinente und Ozeane’ by Alfred Wegener was published, destined to become one of the most controversial geological opus in the first half of the twentieth century. Wegener is the first to combine the most diverse geological (sensu lato) evidences in a single great synthesis. Nonetheless, apart from few upholders, the initial reaction to the drift hypothesis was fierce opposition, and the strongest criticism came from geophysics, the same discipline that, paradoxically, starting from the 1950s led to the Plate Tectonics revolution and, ultimately, to a complete re-evaluation of Wegener’s hypothesis. In the present paper we discuss the initial reaction of Italian scientists to the original continental drift theory, with particular focus on the period between the two world wars. Italian geologists like Fossa-Mancini and Gortani were almost favourable to the new theory, while authors such as Vardabasso and Sacco were neutral or even hostile to the new hypothesis, so iconoclastic for the widely accepted fixist vision of the time. In any case, all these scientists agreed that the new theory had great potential for reopening an enthusiastic debate on issues that were given as established paradigms – the genuine way for progress in science.  相似文献   

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The nineteenth century theologian, author and poet Charles Kingsley was a notable populariser of Darwinian evolution. He championed Darwin’s cause and that of honesty in science for more than a decade from 1859 to 1871. Kingsley’s interpretation of evolution shaped his theology, his politics and his views on race. The relationship between men and apes set the context for Kingsley’s consideration of these issues. Having defended Darwin for a decade in 1871 Kingsley was dismayed to read Darwin’s account of the evolution of morals in Descent of Man. He subsequently distanced himself from Darwin’s conclusions even though he remained an ardent evolutionist until his death in 1875.  相似文献   

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There are several organizations in the US with responsibilities for regulatory oversight of the planned introduction of recombinant DNA organisms into the environment. Equally, there are many kinds of projects which require assessment. The policies, recommendations and rulings of the various authorities have been integrated into a ‘Coordinated Framework’ which defines the operation of flexible case-by-case risk assessment. Additions to and revision of the guidelines are being made, a process which will continue in the light of new experience.  相似文献   

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Homopolar doublets with twofold rotational symmetry were generated in Paramecium tetraurelia and in P. undecaurelia by electrofusion or by arrested conjugation. These doublets underwent a complex cortical reorganization over time, which led to their reversion to singlets. This reorganization involved a reduction in number of ciliary rows, a progressive inactivation and loss of one oral meridian, and a reduction and eventual disappearance of one cortical surface (semicell) situated between the two oral meridians. The intermediate steps of this reorganization included some processes that resemble those previously described in regulating doublets of other ciliates, and others that are peculiar to members of the "P. aurelia" species-group and some of its close relatives. The former included a disappearance of one cortical landmark (a contractile vacuole meridian) and transient appearance of another (a third cytoproct) within the narrower semicell. The latter included a reorganization of the paratene zone and the associated invariant (non-duplicating) region to occupy the entire narrower semicell and a redistribution of zones of most active basal-body proliferation within the opposite, wider semicell. The final steps of reorganization involved anterior displacement, invagination, and resorption of one of the two oral apparatuses and eventual disappearance of the associated oral meridian. An oral meridian deprived of its oral apparatus, either by spontaneous resorption or microsurgical removal, could persist for some time in "incomplete doublets" before regulating to the singlet condition. The phylogenetically widespread events encountered in the regulation of doublets to singlets suggest that Paramecium shares some of the global regulatory properties that are likely to be ancestral in ciliates. The more specific events are probably associated with the complex cytoskeletal architecture of this organism and with the frequent occurrence of autogamy that was described in the preceding study (Prajer et al. 1999).  相似文献   

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Abstract

Drawing on interviews with 150 randomly sampled African Americans, we analyse how members of a stigmatized group understand their experience of stigmatization and assess appropriate responses when asked about the best approach to deal with stigmatization and about responses to specific incidents. Combining in-depth interviews with a systematic coding of the data, we make original contributions to the previous literature by identifying the relative salience of modalities and tools for responding. We also examine closely through qualitative data the two most salient modalities of response, ‘confronting’ and ‘deflating’ conflict, the most salient tools, teaching out-group members about African Americans, and ‘the management of the self’, a rationale for deflating conflict that is largely overlooked in previous studies. We find that ‘confronting’ is the more popular modality for responding to stigmatization among African Americans.  相似文献   

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