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Epilepsy and Etiopathogenesis in Dogs and Cats

Yıl 2021, Cilt: 6 Sayı: 3, 229 - 238, 31.12.2021

Nurdan Arıburnu Arda Selin Tunç

https://doi.org/10.51754/cusbed.871042

Öz

Epilepsy, which is frequently encountered in animals recently, is defined as a neurological disorder that causes seizures or unusual behavior, sensations, and loss of awareness. Epilepsy affects the well-being of patients in both human and veterinary medicine throughout their lives. Today, it is still not possible to explain exactly why epilepsy is formed. In this review given about the information on the etiopathogenesis of epilepsy, it will contribute to the development of its pathogenesis, and the full understanding of the pathogenesis of epilepsy will play a major role in the development of effective treatment and antiepileptic drugs.

Anahtar Kelimeler

Central nervous system epilepsy etiology neurology pathogenesis

Kaynakça

  • Akman O (2004) Geçirilmiş febril konvulsiyonların generalize tonik-klonik ve absans epilepsiler üzerine etkisi. Bilim Uzmanlığı Tezi, Kocaeli.
  • Aroniadou-Anderjaska V, Fristch B, Qashu F, Braga MF (2008) Pathology and pathophysiology of the amygdala in epileptogenesis and epilepsy. Epilepsy Res. 78:102-116.
  • Baka RD, Polizopoulou ZS (2019) Feline Epilepsy: An update. J Hellenic Vet Med Soc. 70(4): 1749-1756.
  • Banks WA, Erickson MA (2010) The blood-brain barrier and immune function and dysfunction. Neurobiol Dis. 37:26-32.
  • Bastar J, Spampanato JG, Kadam SD, Zayachkivsky A, J Ekstrand, Staley KJ, Dudek FE (2017) Perinatal Hypoxic-Ischemic Encephalopathy: A Model of Stroke-Induced Pediatric Epilepsy. Pitkänen A, Buckmaster PS, Galanopoulou AS, Moshé SL(eds) Models of Seizures and Epilepsy. Academic Press, p.713-725.
  • Berendt M, Farquhar RG, Mandigers PJJ, Pakozdy A, Bhatti SFM, Risio LD, Fischer A, Long S, Matıasek K, Muñana K, Patterson EE, Penderis J, Platt S, Podell M, Potschka H, Pumarola MB, Rusbridge C, Stein VM, Tipold A, Volk HA (2015) International veterinary epilepsy task force concensus report on epilepsy definition, classification and terminology in companion animals. BMC Vet Res. 11: 182.
  • Biel M, Kramer M, Forterre F, Jurina K, Lautersack O, Failing K, Schmidt MJ (2013) Outcome of ventriculoperitoneal shunt implantation for treatment of congenital internal hydrocephalus in dogs and cats: 36 cases (2001-2009). J Am Vet Med Assoc. 242(7): 948-958.
  • Chesler M, Kaila K (1992) Modulation of pH by neuronal activity. Trends Neurosci. 15:396-402.
  • Dichter MA, Ayala GF (1987) Cellular mechanisms of epilepsy:a status report. Science. 237:157-164.
  • Erlen A, Potschka H, Volk HA, Sauter-Louis C, O'neill DG (2018) Seizure occurance in dogs under primary veterinary care in the UK:prevalence and risk factors. J Vet Intern Med. 32(5): 1665-1676.
  • Ekenstedt KJ, Patterson EE, Mickelson JR (2012) Canine epilepsy genetics. Mamm Genome. 23: 28-39.
  • Farrell JS, Wolff MD, Teskey GC (2017) Neurodegeneration and Pathology in Epilepsy: Clinical and Basic Perspectives. Beart P, Robinson M, Rattray M, Maragakis N (eds) Neurodegenerative Diseases. Advances in Neurobiolog. vol 15. Springer, Cham.
  • Fisher RS (1989) Animal models of the epilepsies. Brain Res Rev. 14:245-278.
  • Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross JH, Elger CE, Engel J Jr, Forsgren L, French JA, Glynn M, Hesdorffer DC, Lee BI, Mathern GW, Moshé SL, Perucca E, Scheffer IE, Tomson T, Watanabe M, Wiebe S (2014) ILAE Official Report: A practical clinical definition of epilepsy. Epilepsia. 55:475-482.
  • Foster ES, Carillo JM, Patnaik AK (1988) Clinical signs of tumors affecting the rostral cerebrum in 43 dogs. J Vet Intern Med. 2(2):71-74.
  • Friedenberg SG, Butler AL, Wei L, Moore SA, Cooper ES (2012) Seizures following head trauma in dogs: 259 cases (1999-2009). J Am Vet Med Assoc. 241(11): 1479-1483.
  • Galan A, Gamıto A, Carletti BE, Guisado A, De Las Mulas JM, Pérez J, Martin EM (2014) Uncommon acute neurologic presentation of canine distemper in 4 adult dogs. Can Vet J. 55(4): 373-378.
  • Ghormley TM, Feldman DG, Cook JR (2015) Epilepy in dogs five years of age and older: 99 cases (2006-2011). J Am Vet Med Assoc. 246(4): 447-450.
  • Gilbert SE, Cardy TJ, Bertram S, Taylor-Brown F (2020) Diagnostic utility of cerebrospinal fluid analysis in dogs with suspected idiopathic epilepsy. Aust Vet J.
  • Goutal CM, Brugmann BL, Ryan KA (2012) Insulinoma in dogs:a review. J Am Anim Hosp Assoc. 48(3):151-163.
  • Gunn-Moore D, Reed N (2011) CNS disease in the cat. Current knowledge of infectious causes. J Feline Med Surg. 13:824-836.
  • Gupta RC (2007) Veterinary Toxicology, 1st Edition, USA, Elsevier.
  • Heske L, Nødtvedt A, Jäderlund KH, Berendt M, Egenvall A (2014) A cohort study of epilepsy among 665,000 insured dogs: Incidence, mortality and survival after diagnosis. Vet J. 202:471-476.
  • Hess RS (2010) Insulin-secreting islet cell neoplasia. Disorders of the Parothyd glands. In: Ettınger SJ and Feldman EC (eds) Textbook of Veterinary Internal Medicine, 7th Edition, Saunders Elsevier, p.1779-1782.
  • Hooser SB, Khan S (2018) Common toxicologic issues in small animals: an update. An Issue of Veterinary Clinics of North America: Small Animal Practice, Volume 48-6, 1st Edition, USA, Elsevier.
  • Kearsley-Fleet L, O'Neill DG, Volk HA, Church DB, Brodbelt DC (2013) Prevalence and risk factors for canine epilepsy of unknown origin in the UK. Vet Rec. 172:338.
  • Laidlaw J, Richens A, Chadwick D (1993) A Textbook of Epileps. Churchil-Livingstone, USA.
  • Lorenz MD, Coates JR, Kent M (2011) Handbook of Veterinary Neurology, 5th Edition, USA, Elsevier.
  • Markovich JE, Freeman LM, Heinze CR (2014) Analysis of thiamine concentrations in commercial canned foods formulated for cats. J Am Vet Med Assoc. 244: 175-179.
  • Meldrum BS, Akbar MT, Chapman AG (1999) Glutamate receptors and transporters in genetic and acquired models of epilepsy. Epilepsy Res. 36:189–204.
  • Nemes A, Najm IM, Gale JT, Ying Z, Johnson M, Gonzalez-Martinez J (2016) Underlying cortical dysplasia as risk factor for traumatic epilepsy: an animal study. J Neurotrauma. 33(20): 1883-1891.
  • O’Brien D (1998) Toxic and metabolic causes of seizures. Clin Tech Small Anim Pract. 13(3): 159-66.
  • Podell M (2008) Novel Approaches to Feline Epilepsy. ACVIM.
  • Ransohoff RM, Kivisakk P, Kidd G (2003) Three or more routes for leukocyte migration into the central nervous system. Nat Rev Immunol. 3:569-581.
  • Risio De L, Platt S Canine and Feline Epilepsy: Diagnosis and Management. UK:CPI Group.
  • Rossmeisl JH JR, Jones JC, Zimmerman KL, Robertson JL (2013) Survival time following hospital discharge in dogs with palliatively treated primary brain tumors.J Am Vet Med Assoc. 242(2): 193-8.
  • Schoeman T, Williams J, Van Wilpe E (2002) Polyglucosan storage disease in a dog resembling Lafora’s disease. J Vet Intern Med. 16: 201-207.
  • Schwartz M (2011) Canine intracranial neoplasia: clinical risk factors for development of epileptic seizures. J Small Anim Pract. 52(12): 632-637.
  • Sewell AC, Haskins ME, Giger U (2006) Inherited metabolic disease in companion animals:searching for nature’s mistakes. Vet J. 174(2):252-259.
  • Sloviter RS, Bumanglag AV (2012) Defining “epileptogenesis” and identifying “antiepileptogenic targets” in animal models of acquired temporal lobe epilepsy is not as simple as it might seem. Neuropharmacology. 69:3-15.
  • Smith MO, Turrel JM, Bailey CS, Cain GR (1989) Neurologic abnormalities as the predominant signs of neoplasia of the nasal cavity in dogs and cats: seven cases (1973-1986). J Am Vet Med Assoc. 195(2): 242-245.
  • Snyder JM, Shofer FS, Van Winkle TJ, Massicotte C (2006) Canine intracranial primary neoplasia: 173 cases (1986-2003). J Vet Intern Med. 20(3): 669-675.
  • Sonat F (2009) Hayvanlarda Epilepsi. Uludag Univ Vet Fak Derg. 1: 47-52.
  • Steinmetz S, Tipold A, Loscher W (2013) Epilepsy after head injury in dogs:a natural model of posttraumatic epilepsy. Epilepsia. 54(4): 580-588.
  • Troxel MT, Vite CH, Van Winkle TJ, Newton AL, Tiches D, Dayrell-Hart B, Kapatkin AS, Shofer FS, Steinberg SA (2003) Feline intracranial neoplasia:retrospective review of 160 cases (1985-2001). J Vet Intern Med. 17(6): 850-859.
  • Wahle AM, Bruhschwein A, Matiasek K, Putschbach K, Wagner E, Mueller RS, Fischer A (2014) Clinical characterization of epilepsy of unknown cause in cats. J Vet Intern Med. 28(1): 182-188.
  • Wang R. Zeng GQ, Tong RZ, Zhou D, Hong Z (2016) Serum matrix metalloproteinase-2: A potential biomarker for diagnosis of epilepsy. Epilepsy Res. 122: 114-119.
  • Van Meervenne SAE, Volk HA, Van Ham LML (2014) Association between Estrus and Onset of Seizures in Dogs with Idiopathic Epilepsy. J Vet Intern Med. 29: 251-253.
  • Veena PS, Mehta HK, Chaurasia Rahul CR (2020) Studies on the incidence and haematobiochemical changes in canine epilepsy J Entomol Zool Stud. 8(2): 985-987.
  • Vezzani A, French J, Bartfai T, Baram TZ (2011) The role of inflammation in epilepsy. Nat Rev Neurol. 7:31-40.
  • Vezzani A, Balosso S, Ravizza T (2019) Neuroinflammatory pathways as treatment targets and biomarkers in epilepsy. Nat Rev Neurol. 15(8): 459-472.
  • Young KL, Villar D, Carson TL, Ierman PM, Moore RA, Bottoff MR. (2003) Tremorgenic mycotoxin intoxication with penitrem A and roquefortine in two dogs. J Am Vet Med Assoc. 222(1): 52-53, 35.
  • Yin YH, Ahmad N, Makmor-Bakry M (2013) Pathogenesis of Epilepsy: Challenges in Animal Models. Iran J Basic Med Sci. 16: 1119-1132.
  • Xiong ZQ, Qian W, Suzuki K, Mcnamaraj O (2003) Formation of complement membrane attack complex in mammalian cerebral cortex evokes seizures and neurodegeneration. J Neurosci. 23:955-960.

Köpeklerde ve Kedilerde Epilepsi ve Etiyopatogenezisi

Yıl 2021, Cilt: 6 Sayı: 3, 229 - 238, 31.12.2021

Nurdan Arıburnu Arda Selin Tunç

https://doi.org/10.51754/cusbed.871042

Öz

Hayvanlarda son zamanlarda sıkça karşılaşılan epilepsi, nöbetlere veya olağandışı davranış, duyumlara ve farkındalık kaybına neden olan nörolojik bir bozukluk olarak tanımlanmaktadır. Epilepsi hem beşerî hekimlikte hem de veteriner hekimlikte hastaların hayatları boyunca refahlarını olumsuz etkilemektedir. Günümüzde halen epilepsinin neden şekillendiği tam olarak açıklanamamaktadır. Bu derlemede paylaşılan epilepsinin etiyopatogenezine ilişkin bilgiler, hastalığın patogenezinin geliştirilmesine ve tam olarak anlaşılmasına katkıda bulunacak ve böylece etkili tedavi metotlarının geliştirilmesinde ve antiepileptik ilaçlar üzerindeki çalışmaların yoğunlaşmasında büyük rol oynayacaktır.

Anahtar Kelimeler

Epilepsi etiyoloji merkezi sinir sistemi nöroloji patogenezis

Kaynakça

  • Akman O (2004) Geçirilmiş febril konvulsiyonların generalize tonik-klonik ve absans epilepsiler üzerine etkisi. Bilim Uzmanlığı Tezi, Kocaeli.
  • Aroniadou-Anderjaska V, Fristch B, Qashu F, Braga MF (2008) Pathology and pathophysiology of the amygdala in epileptogenesis and epilepsy. Epilepsy Res. 78:102-116.
  • Baka RD, Polizopoulou ZS (2019) Feline Epilepsy: An update. J Hellenic Vet Med Soc. 70(4): 1749-1756.
  • Banks WA, Erickson MA (2010) The blood-brain barrier and immune function and dysfunction. Neurobiol Dis. 37:26-32.
  • Bastar J, Spampanato JG, Kadam SD, Zayachkivsky A, J Ekstrand, Staley KJ, Dudek FE (2017) Perinatal Hypoxic-Ischemic Encephalopathy: A Model of Stroke-Induced Pediatric Epilepsy. Pitkänen A, Buckmaster PS, Galanopoulou AS, Moshé SL(eds) Models of Seizures and Epilepsy. Academic Press, p.713-725.
  • Berendt M, Farquhar RG, Mandigers PJJ, Pakozdy A, Bhatti SFM, Risio LD, Fischer A, Long S, Matıasek K, Muñana K, Patterson EE, Penderis J, Platt S, Podell M, Potschka H, Pumarola MB, Rusbridge C, Stein VM, Tipold A, Volk HA (2015) International veterinary epilepsy task force concensus report on epilepsy definition, classification and terminology in companion animals. BMC Vet Res. 11: 182.
  • Biel M, Kramer M, Forterre F, Jurina K, Lautersack O, Failing K, Schmidt MJ (2013) Outcome of ventriculoperitoneal shunt implantation for treatment of congenital internal hydrocephalus in dogs and cats: 36 cases (2001-2009). J Am Vet Med Assoc. 242(7): 948-958.
  • Chesler M, Kaila K (1992) Modulation of pH by neuronal activity. Trends Neurosci. 15:396-402.
  • Dichter MA, Ayala GF (1987) Cellular mechanisms of epilepsy:a status report. Science. 237:157-164.
  • Erlen A, Potschka H, Volk HA, Sauter-Louis C, O'neill DG (2018) Seizure occurance in dogs under primary veterinary care in the UK:prevalence and risk factors. J Vet Intern Med. 32(5): 1665-1676.
  • Ekenstedt KJ, Patterson EE, Mickelson JR (2012) Canine epilepsy genetics. Mamm Genome. 23: 28-39.
  • Farrell JS, Wolff MD, Teskey GC (2017) Neurodegeneration and Pathology in Epilepsy: Clinical and Basic Perspectives. Beart P, Robinson M, Rattray M, Maragakis N (eds) Neurodegenerative Diseases. Advances in Neurobiolog. vol 15. Springer, Cham.
  • Fisher RS (1989) Animal models of the epilepsies. Brain Res Rev. 14:245-278.
  • Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross JH, Elger CE, Engel J Jr, Forsgren L, French JA, Glynn M, Hesdorffer DC, Lee BI, Mathern GW, Moshé SL, Perucca E, Scheffer IE, Tomson T, Watanabe M, Wiebe S (2014) ILAE Official Report: A practical clinical definition of epilepsy. Epilepsia. 55:475-482.
  • Foster ES, Carillo JM, Patnaik AK (1988) Clinical signs of tumors affecting the rostral cerebrum in 43 dogs. J Vet Intern Med. 2(2):71-74.
  • Friedenberg SG, Butler AL, Wei L, Moore SA, Cooper ES (2012) Seizures following head trauma in dogs: 259 cases (1999-2009). J Am Vet Med Assoc. 241(11): 1479-1483.
  • Galan A, Gamıto A, Carletti BE, Guisado A, De Las Mulas JM, Pérez J, Martin EM (2014) Uncommon acute neurologic presentation of canine distemper in 4 adult dogs. Can Vet J. 55(4): 373-378.
  • Ghormley TM, Feldman DG, Cook JR (2015) Epilepy in dogs five years of age and older: 99 cases (2006-2011). J Am Vet Med Assoc. 246(4): 447-450.
  • Gilbert SE, Cardy TJ, Bertram S, Taylor-Brown F (2020) Diagnostic utility of cerebrospinal fluid analysis in dogs with suspected idiopathic epilepsy. Aust Vet J.
  • Goutal CM, Brugmann BL, Ryan KA (2012) Insulinoma in dogs:a review. J Am Anim Hosp Assoc. 48(3):151-163.
  • Gunn-Moore D, Reed N (2011) CNS disease in the cat. Current knowledge of infectious causes. J Feline Med Surg. 13:824-836.
  • Gupta RC (2007) Veterinary Toxicology, 1st Edition, USA, Elsevier.
  • Heske L, Nødtvedt A, Jäderlund KH, Berendt M, Egenvall A (2014) A cohort study of epilepsy among 665,000 insured dogs: Incidence, mortality and survival after diagnosis. Vet J. 202:471-476.
  • Hess RS (2010) Insulin-secreting islet cell neoplasia. Disorders of the Parothyd glands. In: Ettınger SJ and Feldman EC (eds) Textbook of Veterinary Internal Medicine, 7th Edition, Saunders Elsevier, p.1779-1782.
  • Hooser SB, Khan S (2018) Common toxicologic issues in small animals: an update. An Issue of Veterinary Clinics of North America: Small Animal Practice, Volume 48-6, 1st Edition, USA, Elsevier.
  • Kearsley-Fleet L, O'Neill DG, Volk HA, Church DB, Brodbelt DC (2013) Prevalence and risk factors for canine epilepsy of unknown origin in the UK. Vet Rec. 172:338.
  • Laidlaw J, Richens A, Chadwick D (1993) A Textbook of Epileps. Churchil-Livingstone, USA.
  • Lorenz MD, Coates JR, Kent M (2011) Handbook of Veterinary Neurology, 5th Edition, USA, Elsevier.
  • Markovich JE, Freeman LM, Heinze CR (2014) Analysis of thiamine concentrations in commercial canned foods formulated for cats. J Am Vet Med Assoc. 244: 175-179.
  • Meldrum BS, Akbar MT, Chapman AG (1999) Glutamate receptors and transporters in genetic and acquired models of epilepsy. Epilepsy Res. 36:189–204.
  • Nemes A, Najm IM, Gale JT, Ying Z, Johnson M, Gonzalez-Martinez J (2016) Underlying cortical dysplasia as risk factor for traumatic epilepsy: an animal study. J Neurotrauma. 33(20): 1883-1891.
  • O’Brien D (1998) Toxic and metabolic causes of seizures. Clin Tech Small Anim Pract. 13(3): 159-66.
  • Podell M (2008) Novel Approaches to Feline Epilepsy. ACVIM.
  • Ransohoff RM, Kivisakk P, Kidd G (2003) Three or more routes for leukocyte migration into the central nervous system. Nat Rev Immunol. 3:569-581.
  • Risio De L, Platt S Canine and Feline Epilepsy: Diagnosis and Management. UK:CPI Group.
  • Rossmeisl JH JR, Jones JC, Zimmerman KL, Robertson JL (2013) Survival time following hospital discharge in dogs with palliatively treated primary brain tumors.J Am Vet Med Assoc. 242(2): 193-8.
  • Schoeman T, Williams J, Van Wilpe E (2002) Polyglucosan storage disease in a dog resembling Lafora’s disease. J Vet Intern Med. 16: 201-207.
  • Schwartz M (2011) Canine intracranial neoplasia: clinical risk factors for development of epileptic seizures. J Small Anim Pract. 52(12): 632-637.
  • Sewell AC, Haskins ME, Giger U (2006) Inherited metabolic disease in companion animals:searching for nature’s mistakes. Vet J. 174(2):252-259.
  • Sloviter RS, Bumanglag AV (2012) Defining “epileptogenesis” and identifying “antiepileptogenic targets” in animal models of acquired temporal lobe epilepsy is not as simple as it might seem. Neuropharmacology. 69:3-15.
  • Smith MO, Turrel JM, Bailey CS, Cain GR (1989) Neurologic abnormalities as the predominant signs of neoplasia of the nasal cavity in dogs and cats: seven cases (1973-1986). J Am Vet Med Assoc. 195(2): 242-245.
  • Snyder JM, Shofer FS, Van Winkle TJ, Massicotte C (2006) Canine intracranial primary neoplasia: 173 cases (1986-2003). J Vet Intern Med. 20(3): 669-675.
  • Sonat F (2009) Hayvanlarda Epilepsi. Uludag Univ Vet Fak Derg. 1: 47-52.
  • Steinmetz S, Tipold A, Loscher W (2013) Epilepsy after head injury in dogs:a natural model of posttraumatic epilepsy. Epilepsia. 54(4): 580-588.
  • Troxel MT, Vite CH, Van Winkle TJ, Newton AL, Tiches D, Dayrell-Hart B, Kapatkin AS, Shofer FS, Steinberg SA (2003) Feline intracranial neoplasia:retrospective review of 160 cases (1985-2001). J Vet Intern Med. 17(6): 850-859.
  • Wahle AM, Bruhschwein A, Matiasek K, Putschbach K, Wagner E, Mueller RS, Fischer A (2014) Clinical characterization of epilepsy of unknown cause in cats. J Vet Intern Med. 28(1): 182-188.
  • Wang R. Zeng GQ, Tong RZ, Zhou D, Hong Z (2016) Serum matrix metalloproteinase-2: A potential biomarker for diagnosis of epilepsy. Epilepsy Res. 122: 114-119.
  • Van Meervenne SAE, Volk HA, Van Ham LML (2014) Association between Estrus and Onset of Seizures in Dogs with Idiopathic Epilepsy. J Vet Intern Med. 29: 251-253.
  • Veena PS, Mehta HK, Chaurasia Rahul CR (2020) Studies on the incidence and haematobiochemical changes in canine epilepsy J Entomol Zool Stud. 8(2): 985-987.
  • Vezzani A, French J, Bartfai T, Baram TZ (2011) The role of inflammation in epilepsy. Nat Rev Neurol. 7:31-40.
  • Vezzani A, Balosso S, Ravizza T (2019) Neuroinflammatory pathways as treatment targets and biomarkers in epilepsy. Nat Rev Neurol. 15(8): 459-472.
  • Young KL, Villar D, Carson TL, Ierman PM, Moore RA, Bottoff MR. (2003) Tremorgenic mycotoxin intoxication with penitrem A and roquefortine in two dogs. J Am Vet Med Assoc. 222(1): 52-53, 35.
  • Yin YH, Ahmad N, Makmor-Bakry M (2013) Pathogenesis of Epilepsy: Challenges in Animal Models. Iran J Basic Med Sci. 16: 1119-1132.
  • Xiong ZQ, Qian W, Suzuki K, Mcnamaraj O (2003) Formation of complement membrane attack complex in mammalian cerebral cortex evokes seizures and neurodegeneration. J Neurosci. 23:955-960.
Toplam 54 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Veteriner Cerrahi
Bölüm Derleme
Yazarlar

Nurdan Arıburnu 0000-0002-6136-3687

Arda Selin Tunç 0000-0002-4813-7626

Erken Görünüm Tarihi 24 Aralık 2021
Yayımlanma Tarihi 31 Aralık 2021
Yayımlandığı Sayı Yıl 2021Cilt: 6 Sayı: 3

Kaynak Göster

APA Arıburnu, N., & Tunç, A. S. (2021). Köpeklerde ve Kedilerde Epilepsi ve Etiyopatogenezisi. Cumhuriyet Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 6(3), 229-238. https://doi.org/10.51754/cusbed.871042
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