Gubler DJ, 1998. Dengue and dengue hemorrhagic fever. Clin Microbiol Rev 11 :480–496.
World Health Organization, 1997. Dengue Haemorrhagic Fever: Diagnosis, Treatment, Prevention and Control. Second edition. Geneva: World Health Organization.
Gubler DJ, 2002. Epidemic dengue/dengue hemorrhagic fever as a public health, social and economic problem in the 21st century. Trends Microbiol 10 :100–103.
World Health Organization. Impact of Dengue. Available at: http://www.who.int/csr/disease/dengue/impact/en/index.html. Accessed November 30, 2008.
Neff JM, Morris L, Gonzalez-Alcover R, Coleman PH, Lyss SB, Negron H, 1967. Dengue fever in a Puerto Rican community. Am J Epidemiol 86 :162–184.
Russell PK, Buescher EL, McCown JM, Ordonez J, 1966. Recovery of dengue viruses from patients during epidemics in Puerto Rico and East Pakistan. Am J Trop Med Hyg 15 :573–579.
King WW, 1917. The epidemic of dengue in Puerto Rico: 1915. New Orleans Med Surg 69 :564–571.
Likosky WH, Calisher CH, Michelson AL, Correa-Coronas R, Henderson BE, Feldman RA, 1973. An epidermiologic study of dengue type 2 in Puerto Rico, 1969. Am J Epidemiol 97 :264–275.
Morens DM, Rigau-Perez JG, Lopez-Correa RH, Moore CG, Ruiz-Tiben EE, Sather GE, Chiriboga J, Eliason DA, Casta-Velez A, Woodall JP, 1986. Dengue in Puerto Rico, 1977: public health response to characterize and control an epidemic of multiple serotypes. Am J Trop Med Hyg 35 :197–211.
Gubler DJ, 1993. Dengue and dengue hemorrhagic in the Americas. Thongcharoen P, ed. Dengue Hemorrhagic Fever. Thongcharoen P, ed. New Delhi, India and Geneva: World Health Organization, 9–22.
Gubler DJ, Kuno G, Sather GE, Velez M, Oliver A, 1984. Mosquito cell cultures and specific monoclonal antibodies in surveillance for dengue viruses. Am J Trop Med Hyg 33 :158–165.
Waterman SH, Novak RJ, Sather GE, Bailey RE, Rios I, Gubler DJ, 1985. Dengue transmission in two Puerto Rican communities in 1982. Am J Trop Med Hyg 34 :625–632.
Dietz V, Gubler DJ, Ortiz S, Kuno G, Casta-Velez A, Sather GE, 1996. The 1986 dengue and dengue hemorrhagic fever epidemic in Puerto Rico: epidemiologic and clinical observations. P R Health Sci J 15 :201–210.
Rigau-Perez JG, Vorndam AV, Clark GG, 2001. The dengue and dengue hemorrhagic fever epidemic in Puerto Rico, 1994–1995. Am J Trop Med Hyg 64 :67–74.
Rigau-Perez JG, Ayala-Lopez A, Garcia-Rivera EJ, Hudson SM, Vorndam V, Reiter P, Cano MP, Clark GG, 2002. The reappearance of dengue-3 and a subsequent dengue-4 and dengue-1 epidemic in Puerto Rico in 1998. Am J Trop Med Hyg 67 :355–362.
U.S.Census Bureau. American Fact Finder. Available at: http://factfinder.census.gov/servlet/DatasetMainPageServlet. Accessed November 30, 2008.
Rigau-Perez JG, 1999. Surveillance for an emerging disease: dengue hemorrhagic fever in Puerto Rico, 1988–1997. Puerto Rico Association of Epidemiologists. P R Health Sci J 18 :337–345.
Chien LJ, Liao TL, Shu PY, Huang JH, Gubler DJ, Chang GJ, 2006. Development of real-time reverse transcriptase PCR assays to detect and serotype dengue viruses. J Clin Microbiol 44 :1295–1304.
Lanciotti RS, 2003. Molecular amplification assays for the detection of flaviviruses. Adv Virus Res 61 :67–99.
Rosen L, Gubler D, 1974. The use of mosquitoes to detect and propagate dengue viruses. Am J Trop Med Hyg 23 :1153–1160.
Burke DS, Nisalak A, Ussery MA, 1982. Antibody capture immunoassay detection of Japanese encephalitis virus immunoglobulin M and G antibodies in cerebrospinal fluid. J Clin Microbiol 16 :1034–1042.
Miagostovich MP, Nogueira RM, dos Santos FB, Schatzmayr HG, Araujo ES, Vorndam V, 1999. Evaluation of an IgG enzyme-linked immunosorbent assay for dengue diagnosis. J Clin Virol 14 :183–189.
Johnson AJ, Martin DA, Karabatsos N, Roehrig JT, 2000. Detection of anti-arboviral immunoglobulin G by using a monoclonal antibody-based capture enzyme-linked immunosorbent assay. J Clin Microbiol 38 :1827–1831.
Nelson Textbook of Pediatrics, 2000. 16th edition. St Louis: W.B. Saunders, St. Louis.
The Harriet Lane Handbook, A Manual for Pediatric House Officers, 2002. 16th edition. Philadelphia: Mosby Inc.
Hollowell JG, van Assendelft OW, Gunter EW, Lewis BG, Najjar M, Pfeiffer C, 2005. Hematological and iron-related analytes: reference data for persons aged 1 year and over: United States, 1988–94. Vital Health Stat 11 1–156.
Pediatric Reference Ranges, 1999. Fourth edition. Washington, DC: AACC Press.
Tietz Textbook of Clinical Chemistry, 1999. Second edition. St. Louis: W.B. Saunders.
Lockitch G, Halstead AC, Quigley G, MacCallum C, 1988. Age- and sex-specific pediatric reference intervals: study design and methods illustrated by measurement of serum proteins with the Behring LN Nephelometer. Clin Chem 34 :1618–1621.
Messer WB, Gubler DJ, Harris E, Sivananthan K, de Silva AM, 2003. Emergence and global spread of a dengue serotype 3, subtype III virus. Emerg Infect Dis 9 :800–809.
Diaz Aquino JD, Tang WF, Ishii R, Ono T, Eshita Y, Aono H, Makino Y, 2008. Molecular epidemiology of dengue serotypes 2 and 3 in Paraguay during 2001–2006: the association of viral clade introductions with shifting serotype dominance. Virus Res 137 :266–270.
Bennett SN, Holmes EC, Chirivella M, Rodriguez DM, Beltran M, Vorndam V, Gubler D, McMillan WO, 2003. Selection-driven evolution of emergent dengue virus. Mol Biol Evol 20 :1650–1658.
Hammond SN, Balmaseda A, Perez L, Tellez Y, Saborio SI, Mercado JC, Videa E, Rodriguez Y, Perez MA, Cuadra R, Solano S, Rocha J, Idiaquez W, Gonzalez A, Harris E, 2005. Differences in dengue severity in infants, children, and adults in a 3-year hospital-based study in Nicaragua. Am J Trop Med Hyg 73 :1063–1070.
Espinoza-Gomez F, Diaz-Duenas P, Torres-Lepe C, Cedillo-Nakay RA, Newton-Sanchez OA, 2005. Clinical pattern of hospitalized patients during a dengue epidemic in Colima, Mexico. Dengue Bull 29 :8–17.
Ooi EE, Hart TJ, Tan HC, Chan SH, 2001. Dengue seroepidemiology in Singapore. Lancet 357 :685–686.
Ooi EE, Goh KT, Gubler DJ, 2006. Dengue prevention and 35 years of vector control in Singapore. Emerg Infect Dis 12 :887–893.
Ministry of Health, Singapore, 2006. Dengue surveillance in Singapore, 2005. Epidemiol News Bull 32 :9–14.
Guha-Sapir D, Schimmer B, 2005. Dengue fever: new paradigms for a changing epidemiology. Emerg Themes Epidemiol 2 :1.
Nimmannitya S, 1987. Dengue haemorrhagic fever in Thailand. Southeast Asian J Trop Med Public Health 18 :291–294.
Nisalak A, Endy TP, Nimmannitya S, Kalayanarooj S, Thisayakorn U, Scott RM, Burk DS, Hoke CH, Innis BL, Vaughn DW, 2003. Serotype-specific dengue virus circulation and dengue disease in Bangkok, Thailand from 1973 to 1999. Am J Trop Med Hyg 68 :191–202.
Wichmann O, Hongsiriwon S, Bowonwatanuwong C, Chotivanich K, Sukthana Y, Pukrittayakamee S, 2004. Risk factors and clinical features associated with severe dengue infection in adults and children during the 2001 epidemic in Chonburi, Thailand. Trop Med Int Health 9 :1022–1029.
Thomas SJ, Strickman D, Vaughn DW, 2003. Dengue epidemiology: virus epidemiology, ecology, and emergence. Adv Virus Res 61 :235–289.
Klein SL, 2000. The effects of hormones on sex differences in infection: from genes to behavior. Neurosci Biobehav Rev 24 :627–638.
Bouman A, Heineman MJ, Faas MM, 2005. Sex hormones and the immune response in humans. Hum Reprod Update 11 :411–423.
Angele MK, Frantz MC, Chaudry IH, 2006. Gender and sex hormones influence the response to trauma and sepsis: potential therapeutic approaches. Clinics 61 :479–488.
Fish EN, 2008. The X-files in immunity: sex-based differences predispose immune responses. Nat Rev Immunol 8 :737–744.
Lambert KC, Curran EM, Judy BM, Lubahn DB, Estes DM, 2004. Estrogen receptor-alpha deficiency promotes increased TNF-alpha secretion and bacterial killing by murine macrophages in response to microbial stimuli in vitro. J Leukoc Biol 75 :1166–1172.
Lambert KC, Curran EM, Judy BM, Milligan GN, Lubahn DB, Estes DM, 2005. Estrogen receptor alpha (ER alpha) deficiency in macrophages results in increased stimulation of CD4+ T cells while 17beta-estradiol acts through ER alpha to increase IL-4 and GATA-3 expression in CD4+ T cells independent of antigen presentation. J Immunol 175 :5716–5723.
Lang TJ, 2004. Estrogen as an immunomodulator. Clin Immunol 113 :224–230.
Marriott I, Huet-Hudson YM, 2006. Sexual dimorphism in innate immune responses to infectious organisms. Immunol Res 34 :177–192.
Schroder J, Kahlke V, Staubach KH, Zabel P, Stuber F, 1998. Gender differences in human sepsis. Arch Surg 133 :1200–1205.
Dong T, Moran E, Vinh CN, Simmons C, Luhn K, Peng Y, Wills B, Phuong Dung N, Thi Thu Thao L, Hien TT, McMichael A, Farrar J, Roeland-Jones S, 2007. High pro-inflammatory cytokine secretion and loss of high avidity cross-reactive cytotoxic T-cells during the course of secondary dengue virus infection. PLoS One 2 :e1192.
Lei HY, Yeh TM, Liu HS, Lin YS, Chen SH, Liu CC, 2001. Immunopathogenesis of dengue virus infection. J Biomed Sci 8 :377–388.
Halstead SB, 1970. Observations related to pathogensis of dengue hemorrhagic fever. VI. Hypotheses and discussion. Yale J Biol Med 42 :350–362.
Dechant EJ, Rigau-Perez JG, 1999. Hospitalizations for suspected dengue in Puerto Rico, 1991–1995: estimation by capture–recapture methods. The Puerto Rico Association of Epidemiologists. Am J Trop Med Hyg 61 :574–578.
Meltzer MI, Rigau-Perez JG, Clark GG, Reiter P, Gubler DJ, 1998. Using disability-adjusted life years to assess the economic impact of dengue in Puerto Rico: 1984–1994. Am J Trop Med Hyg 59 :265–271.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 5007 | 4902 | 1002 |
Full Text Views | 326 | 17 | 4 |
PDF Downloads | 111 | 12 | 3 |
Dengue is a mosquito-borne viral disease that affects 40% of the world’s population. Nearly four million U.S. citizens live in dengue-endemic areas; the most affected population resides in Puerto Rico. Data from a dengue surveillance system were used to describe all suspected cases reported in Puerto Rico in 2007. Rates of infection per 10,000 residents were calculated by age, sex, and residence. Rates and clinical outcomes were compared with those from outbreaks in 1994–1995 and 1998. In 2007, 10,508 suspected cases were reported; 52.5% persons were hospitalized, 31.8% reported hemorrhage, 2.2% had dengue hemorrhage fever, and 44 died. A total of 3,293 (33.0%) of processed specimens were laboratory positive for dengue virus (DENV); DENV-3 (1,342, 61.7%) and DENV-2 (677, 31.1%) were detected most often. The overall incidence of laboratory-positive dengue was 8.6 infections per 10,000 population. Rates were highest among persons 10–14 years of age (19.0), followed by persons 15–19 years of age (17.9) and infants (10.9). Higher rates of hospitalization and hemorrhage were reported in 2007 than in 1994–1995 or 1998. United States citizens residing in Puerto Rico are at risk of acquiring dengue. Data suggest that the severity is worsening, and persons 10–19 years of age and infants continue to be most affected.
Gubler DJ, 1998. Dengue and dengue hemorrhagic fever. Clin Microbiol Rev 11 :480–496.
World Health Organization, 1997. Dengue Haemorrhagic Fever: Diagnosis, Treatment, Prevention and Control. Second edition. Geneva: World Health Organization.
Gubler DJ, 2002. Epidemic dengue/dengue hemorrhagic fever as a public health, social and economic problem in the 21st century. Trends Microbiol 10 :100–103.
World Health Organization. Impact of Dengue. Available at: http://www.who.int/csr/disease/dengue/impact/en/index.html. Accessed November 30, 2008.
Neff JM, Morris L, Gonzalez-Alcover R, Coleman PH, Lyss SB, Negron H, 1967. Dengue fever in a Puerto Rican community. Am J Epidemiol 86 :162–184.
Russell PK, Buescher EL, McCown JM, Ordonez J, 1966. Recovery of dengue viruses from patients during epidemics in Puerto Rico and East Pakistan. Am J Trop Med Hyg 15 :573–579.
King WW, 1917. The epidemic of dengue in Puerto Rico: 1915. New Orleans Med Surg 69 :564–571.
Likosky WH, Calisher CH, Michelson AL, Correa-Coronas R, Henderson BE, Feldman RA, 1973. An epidermiologic study of dengue type 2 in Puerto Rico, 1969. Am J Epidemiol 97 :264–275.
Morens DM, Rigau-Perez JG, Lopez-Correa RH, Moore CG, Ruiz-Tiben EE, Sather GE, Chiriboga J, Eliason DA, Casta-Velez A, Woodall JP, 1986. Dengue in Puerto Rico, 1977: public health response to characterize and control an epidemic of multiple serotypes. Am J Trop Med Hyg 35 :197–211.
Gubler DJ, 1993. Dengue and dengue hemorrhagic in the Americas. Thongcharoen P, ed. Dengue Hemorrhagic Fever. Thongcharoen P, ed. New Delhi, India and Geneva: World Health Organization, 9–22.
Gubler DJ, Kuno G, Sather GE, Velez M, Oliver A, 1984. Mosquito cell cultures and specific monoclonal antibodies in surveillance for dengue viruses. Am J Trop Med Hyg 33 :158–165.
Waterman SH, Novak RJ, Sather GE, Bailey RE, Rios I, Gubler DJ, 1985. Dengue transmission in two Puerto Rican communities in 1982. Am J Trop Med Hyg 34 :625–632.
Dietz V, Gubler DJ, Ortiz S, Kuno G, Casta-Velez A, Sather GE, 1996. The 1986 dengue and dengue hemorrhagic fever epidemic in Puerto Rico: epidemiologic and clinical observations. P R Health Sci J 15 :201–210.
Rigau-Perez JG, Vorndam AV, Clark GG, 2001. The dengue and dengue hemorrhagic fever epidemic in Puerto Rico, 1994–1995. Am J Trop Med Hyg 64 :67–74.
Rigau-Perez JG, Ayala-Lopez A, Garcia-Rivera EJ, Hudson SM, Vorndam V, Reiter P, Cano MP, Clark GG, 2002. The reappearance of dengue-3 and a subsequent dengue-4 and dengue-1 epidemic in Puerto Rico in 1998. Am J Trop Med Hyg 67 :355–362.
U.S.Census Bureau. American Fact Finder. Available at: http://factfinder.census.gov/servlet/DatasetMainPageServlet. Accessed November 30, 2008.
Rigau-Perez JG, 1999. Surveillance for an emerging disease: dengue hemorrhagic fever in Puerto Rico, 1988–1997. Puerto Rico Association of Epidemiologists. P R Health Sci J 18 :337–345.
Chien LJ, Liao TL, Shu PY, Huang JH, Gubler DJ, Chang GJ, 2006. Development of real-time reverse transcriptase PCR assays to detect and serotype dengue viruses. J Clin Microbiol 44 :1295–1304.
Lanciotti RS, 2003. Molecular amplification assays for the detection of flaviviruses. Adv Virus Res 61 :67–99.
Rosen L, Gubler D, 1974. The use of mosquitoes to detect and propagate dengue viruses. Am J Trop Med Hyg 23 :1153–1160.
Burke DS, Nisalak A, Ussery MA, 1982. Antibody capture immunoassay detection of Japanese encephalitis virus immunoglobulin M and G antibodies in cerebrospinal fluid. J Clin Microbiol 16 :1034–1042.
Miagostovich MP, Nogueira RM, dos Santos FB, Schatzmayr HG, Araujo ES, Vorndam V, 1999. Evaluation of an IgG enzyme-linked immunosorbent assay for dengue diagnosis. J Clin Virol 14 :183–189.
Johnson AJ, Martin DA, Karabatsos N, Roehrig JT, 2000. Detection of anti-arboviral immunoglobulin G by using a monoclonal antibody-based capture enzyme-linked immunosorbent assay. J Clin Microbiol 38 :1827–1831.
Nelson Textbook of Pediatrics, 2000. 16th edition. St Louis: W.B. Saunders, St. Louis.
The Harriet Lane Handbook, A Manual for Pediatric House Officers, 2002. 16th edition. Philadelphia: Mosby Inc.
Hollowell JG, van Assendelft OW, Gunter EW, Lewis BG, Najjar M, Pfeiffer C, 2005. Hematological and iron-related analytes: reference data for persons aged 1 year and over: United States, 1988–94. Vital Health Stat 11 1–156.
Pediatric Reference Ranges, 1999. Fourth edition. Washington, DC: AACC Press.
Tietz Textbook of Clinical Chemistry, 1999. Second edition. St. Louis: W.B. Saunders.
Lockitch G, Halstead AC, Quigley G, MacCallum C, 1988. Age- and sex-specific pediatric reference intervals: study design and methods illustrated by measurement of serum proteins with the Behring LN Nephelometer. Clin Chem 34 :1618–1621.
Messer WB, Gubler DJ, Harris E, Sivananthan K, de Silva AM, 2003. Emergence and global spread of a dengue serotype 3, subtype III virus. Emerg Infect Dis 9 :800–809.
Diaz Aquino JD, Tang WF, Ishii R, Ono T, Eshita Y, Aono H, Makino Y, 2008. Molecular epidemiology of dengue serotypes 2 and 3 in Paraguay during 2001–2006: the association of viral clade introductions with shifting serotype dominance. Virus Res 137 :266–270.
Bennett SN, Holmes EC, Chirivella M, Rodriguez DM, Beltran M, Vorndam V, Gubler D, McMillan WO, 2003. Selection-driven evolution of emergent dengue virus. Mol Biol Evol 20 :1650–1658.
Hammond SN, Balmaseda A, Perez L, Tellez Y, Saborio SI, Mercado JC, Videa E, Rodriguez Y, Perez MA, Cuadra R, Solano S, Rocha J, Idiaquez W, Gonzalez A, Harris E, 2005. Differences in dengue severity in infants, children, and adults in a 3-year hospital-based study in Nicaragua. Am J Trop Med Hyg 73 :1063–1070.
Espinoza-Gomez F, Diaz-Duenas P, Torres-Lepe C, Cedillo-Nakay RA, Newton-Sanchez OA, 2005. Clinical pattern of hospitalized patients during a dengue epidemic in Colima, Mexico. Dengue Bull 29 :8–17.
Ooi EE, Hart TJ, Tan HC, Chan SH, 2001. Dengue seroepidemiology in Singapore. Lancet 357 :685–686.
Ooi EE, Goh KT, Gubler DJ, 2006. Dengue prevention and 35 years of vector control in Singapore. Emerg Infect Dis 12 :887–893.
Ministry of Health, Singapore, 2006. Dengue surveillance in Singapore, 2005. Epidemiol News Bull 32 :9–14.
Guha-Sapir D, Schimmer B, 2005. Dengue fever: new paradigms for a changing epidemiology. Emerg Themes Epidemiol 2 :1.
Nimmannitya S, 1987. Dengue haemorrhagic fever in Thailand. Southeast Asian J Trop Med Public Health 18 :291–294.
Nisalak A, Endy TP, Nimmannitya S, Kalayanarooj S, Thisayakorn U, Scott RM, Burk DS, Hoke CH, Innis BL, Vaughn DW, 2003. Serotype-specific dengue virus circulation and dengue disease in Bangkok, Thailand from 1973 to 1999. Am J Trop Med Hyg 68 :191–202.
Wichmann O, Hongsiriwon S, Bowonwatanuwong C, Chotivanich K, Sukthana Y, Pukrittayakamee S, 2004. Risk factors and clinical features associated with severe dengue infection in adults and children during the 2001 epidemic in Chonburi, Thailand. Trop Med Int Health 9 :1022–1029.
Thomas SJ, Strickman D, Vaughn DW, 2003. Dengue epidemiology: virus epidemiology, ecology, and emergence. Adv Virus Res 61 :235–289.
Klein SL, 2000. The effects of hormones on sex differences in infection: from genes to behavior. Neurosci Biobehav Rev 24 :627–638.
Bouman A, Heineman MJ, Faas MM, 2005. Sex hormones and the immune response in humans. Hum Reprod Update 11 :411–423.
Angele MK, Frantz MC, Chaudry IH, 2006. Gender and sex hormones influence the response to trauma and sepsis: potential therapeutic approaches. Clinics 61 :479–488.
Fish EN, 2008. The X-files in immunity: sex-based differences predispose immune responses. Nat Rev Immunol 8 :737–744.
Lambert KC, Curran EM, Judy BM, Lubahn DB, Estes DM, 2004. Estrogen receptor-alpha deficiency promotes increased TNF-alpha secretion and bacterial killing by murine macrophages in response to microbial stimuli in vitro. J Leukoc Biol 75 :1166–1172.
Lambert KC, Curran EM, Judy BM, Milligan GN, Lubahn DB, Estes DM, 2005. Estrogen receptor alpha (ER alpha) deficiency in macrophages results in increased stimulation of CD4+ T cells while 17beta-estradiol acts through ER alpha to increase IL-4 and GATA-3 expression in CD4+ T cells independent of antigen presentation. J Immunol 175 :5716–5723.
Lang TJ, 2004. Estrogen as an immunomodulator. Clin Immunol 113 :224–230.
Marriott I, Huet-Hudson YM, 2006. Sexual dimorphism in innate immune responses to infectious organisms. Immunol Res 34 :177–192.
Schroder J, Kahlke V, Staubach KH, Zabel P, Stuber F, 1998. Gender differences in human sepsis. Arch Surg 133 :1200–1205.
Dong T, Moran E, Vinh CN, Simmons C, Luhn K, Peng Y, Wills B, Phuong Dung N, Thi Thu Thao L, Hien TT, McMichael A, Farrar J, Roeland-Jones S, 2007. High pro-inflammatory cytokine secretion and loss of high avidity cross-reactive cytotoxic T-cells during the course of secondary dengue virus infection. PLoS One 2 :e1192.
Lei HY, Yeh TM, Liu HS, Lin YS, Chen SH, Liu CC, 2001. Immunopathogenesis of dengue virus infection. J Biomed Sci 8 :377–388.
Halstead SB, 1970. Observations related to pathogensis of dengue hemorrhagic fever. VI. Hypotheses and discussion. Yale J Biol Med 42 :350–362.
Dechant EJ, Rigau-Perez JG, 1999. Hospitalizations for suspected dengue in Puerto Rico, 1991–1995: estimation by capture–recapture methods. The Puerto Rico Association of Epidemiologists. Am J Trop Med Hyg 61 :574–578.
Meltzer MI, Rigau-Perez JG, Clark GG, Reiter P, Gubler DJ, 1998. Using disability-adjusted life years to assess the economic impact of dengue in Puerto Rico: 1984–1994. Am J Trop Med Hyg 59 :265–271.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 5007 | 4902 | 1002 |
Full Text Views | 326 | 17 | 4 |
PDF Downloads | 111 | 12 | 3 |