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(PDF) International Symposium: Mechanism of Pancreatitis—Between Bedside and Laboratory | Williams john - Academia.edu
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The symposium attracted experts and clinicians from Japan, Asia, Europe, India, Australia, United States, and Canada. The symposium consisted of the following sessions: epidemiology of pancreatitis, molecular mechanisms of acute pancreatitis (AP), molecular mechanisms of pancreatic fibrosis, hereditary pancreatitis (HP), and treatment of pancreatitis.","publication_date":"2002,,","publication_name":"Pancreas","grobid_abstract_attachment_id":"90009051"},"document_type":"paper","pre_hit_view_count_baseline":null,"quality":"high","language":"en","title":"International Symposium: Mechanism of Pancreatitis—Between Bedside and Laboratory","broadcastable":false,"draft":null,"has_indexable_attachment":true,"indexable":true}}["work"]; window.loswp.workCoauthors = [149483619]; window.loswp.locale = "en"; window.loswp.countryCode = "SG"; window.loswp.cwvAbTestBucket = ""; window.loswp.designVariant = "ds_vanilla"; window.loswp.fullPageMobileSutdModalVariant = "full_page_mobile_sutd_modal"; window.loswp.useOptimizedScribd4genScript = false; window.loswp.appleClientId = 'edu.academia.applesignon';</script><script 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data-login_uri="https://www.academia.edu/registrations/google_one_tap" data-moment_callback="onGoogleOneTapEvent" id="g_id_onload"></div><div class="ds-top-related-works--grid-container"><div class="ds-related-content--container ds-top-related-works--container"><h2 class="ds-related-content--heading">Related papers</h2><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="0" data-entity-id="6083365" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/6083365/Hereditary_pancreatitis_a_model_for_inflammatory_diseases_of_the_pancreas">Hereditary pancreatitis: a model for inflammatory diseases of the pancreas</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="9166303" href="https://pitt.academia.edu/DavidWhitcomb">David Whitcomb</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Best Practice & Research in Clinical Gastroenterology, 2002</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Hereditary pancreatitis: a model for inflammatory diseases of the pancreas","attachmentId":49025930,"attachmentType":"pdf","work_url":"https://www.academia.edu/6083365/Hereditary_pancreatitis_a_model_for_inflammatory_diseases_of_the_pancreas","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/6083365/Hereditary_pancreatitis_a_model_for_inflammatory_diseases_of_the_pancreas"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="1" data-entity-id="57036897" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/57036897/Etiopathogenesis_of_Acute_Pancreatitis">Etiopathogenesis of Acute Pancreatitis</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="41663267" href="https://independent.academia.edu/FGorelick">F. Gorelick</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Surgical Clinics of North America, 1999</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Etiopathogenesis of Acute Pancreatitis","attachmentId":72128961,"attachmentType":"pdf","work_url":"https://www.academia.edu/57036897/Etiopathogenesis_of_Acute_Pancreatitis","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/57036897/Etiopathogenesis_of_Acute_Pancreatitis"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="2" data-entity-id="6083349" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/6083349/Chronic_Pancreatitis_Diagnosis_Classification_and_New_Genetic_Developments">Chronic Pancreatitis: Diagnosis, Classification, and New Genetic Developments</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="9166303" href="https://pitt.academia.edu/DavidWhitcomb">David Whitcomb</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Gastroenterology, 2001</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Chronic Pancreatitis: Diagnosis, Classification, and New Genetic Developments","attachmentId":49025978,"attachmentType":"pdf","work_url":"https://www.academia.edu/6083349/Chronic_Pancreatitis_Diagnosis_Classification_and_New_Genetic_Developments","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/6083349/Chronic_Pancreatitis_Diagnosis_Classification_and_New_Genetic_Developments"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="3" data-entity-id="102497254" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/102497254/Etiology_of_Pancreatitis_in_Patients_at_a_Tertiary_Care_Center">Etiology of Pancreatitis in Patients at a Tertiary Care Center</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="75529299" href="https://independent.academia.edu/FahdHaider2">Fahd Haider</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Pakistan Armed Forces Medical Journal</p><p class="ds-related-work--abstract ds2-5-body-sm">Objective: To compare etiological frequencies in patients of acute pancreatitis presenting to our setup with international data. Study Design: Cross-sectional study Place and Duration of Study: Department of Gastroenterology, Pakistan Emirates Military Hospital & Combined Military Hospital, Rawalpindi Pakistan, from Aug 2020 to Jan 2022. Methodology: Patients over 12 years suffering from pancreatitis were recruited using a convenience sampling technique based upon predefined criteria for diagnosis of pancreatitis on a questionnaire. Relevant basic lab tests, including chemistries and imaging, including Ultrasound abdomen and CECT abdomen, were analyzed to establish aetiology. Data were continuously uploaded into an electronic data sheet. International Consensus Diagnostic Criteria (ICDC) algorithms were applied to diagnose autoimmune pancreatitis. Results: Out of 120 patients, 74(61.7%) were males, and 46(38.3%) were females. Biliary pancreatitis was the most common aetiology 50(41....</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Etiology of Pancreatitis in Patients at a Tertiary Care Center","attachmentId":102751327,"attachmentType":"pdf","work_url":"https://www.academia.edu/102497254/Etiology_of_Pancreatitis_in_Patients_at_a_Tertiary_Care_Center","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/102497254/Etiology_of_Pancreatitis_in_Patients_at_a_Tertiary_Care_Center"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="4" data-entity-id="28320282" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/28320282/New_advances_in_acute_pancreatitis">New advances in acute pancreatitis</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="52828501" href="https://independent.academia.edu/EugeneDimagno">Eugene Dimagno</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Current opinion in gastroenterology, 2007</p><p class="ds-related-work--abstract ds2-5-body-sm">We endeavor to review important new advances in acute pancreatitis made in the past year. 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Persistent organ failure and multiple organ dysfunction syndrome but not necessarily extent of necrosis were demonstrated to p...</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"New advances in acute pancreatitis","attachmentId":48650906,"attachmentType":"pdf","work_url":"https://www.academia.edu/28320282/New_advances_in_acute_pancreatitis","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/28320282/New_advances_in_acute_pancreatitis"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="5" data-entity-id="121429932" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/121429932/Prevalence_Overview_and_Treatment_Strategies_for_Pancreatitis">Prevalence, Overview, and Treatment Strategies for Pancreatitis</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="227103702" href="https://jagannathuniversity.academia.edu/Deepakgarg">Deepak Garg</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Journal of Pharma Insights and Research , 2024</p><p class="ds-related-work--abstract ds2-5-body-sm">Pancreatitis is an inflammatory condition of the pancreas, with acute pancreatitis being the most prevalent form. The primary etiologies are gallstones and excessive alcohol consumption, accounting for 70-80% of cases. While most acute pancreatitis cases are mild and self-limiting, approximately 20-30% progress to a severe form characterized by pancreatic necrosis and organ failure, leading to a high mortality rate of around 15%. Chronic pancreatitis is a progressive, debilitating condition resulting from repeated inflammatory episodes or other factors, causing irreversible pancreatic damage and impaired exocrine and endocrine function. Accurate diagnosis and timely intervention are crucial in pancreatitis management. Mild acute pancreatitis is typically managed with supportive care, including fluid resuscitation, pain control, and early enteral nutrition. Severe cases may require intensive care, antibiotic prophylaxis, and interventions for complications like infected necrosis. Chronic pancreatitis necessitates lifestyle modifications, pain management, enzyme supplementation, and potential endoscopic or surgical interventions for duct decompression or resection. This review aims to provide a comprehensive overview of pancreatitis, encompassing its epidemiology, etiology, classification systems, and evidence-based management strategies. Recent advances in diagnostic modalities, novel therapeutic approaches, and surgical techniques are discussed. Additionally, the review highlights the importance of a multidisciplinary approach and the need for tailored treatment plans based on individual patient factors and disease severity.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Prevalence, Overview, and Treatment Strategies for Pancreatitis","attachmentId":116307124,"attachmentType":"pdf","work_url":"https://www.academia.edu/121429932/Prevalence_Overview_and_Treatment_Strategies_for_Pancreatitis","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/121429932/Prevalence_Overview_and_Treatment_Strategies_for_Pancreatitis"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="6" data-entity-id="27139370" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/27139370/Fibrosis_Reduces_Severity_of_Acute_on_Chronic_Pancreatitis_in_Humans">Fibrosis Reduces Severity of Acute-on-Chronic Pancreatitis in Humans</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="51199406" href="https://mitpune.academia.edu/DhirajYadav">Dhiraj Yadav</a><span>, </span><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="51215836" href="https://independent.academia.edu/JennyKarlsson10">Jenny Karlsson</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Gastroenterology, 2013</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Fibrosis Reduces Severity of Acute-on-Chronic Pancreatitis in Humans","attachmentId":47388516,"attachmentType":"pdf","work_url":"https://www.academia.edu/27139370/Fibrosis_Reduces_Severity_of_Acute_on_Chronic_Pancreatitis_in_Humans","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/27139370/Fibrosis_Reduces_Severity_of_Acute_on_Chronic_Pancreatitis_in_Humans"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="7" data-entity-id="56974429" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/56974429/Evidence_for_diagnosis_of_early_chronic_pancreatitis_after_three_episodes_of_acute_pancreatitis_a_cross_sectional_multicentre_international_study_with_experimental_animal_model">Evidence for diagnosis of early chronic pancreatitis after three episodes of acute pancreatitis: a cross-sectional multicentre international study with experimental animal model</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="34715018" href="https://u-szeged.academia.edu/ZsoltDubravcsik">Zsolt Dubravcsik</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Scientific Reports</p><p class="ds-related-work--abstract ds2-5-body-sm">Chronic pancreatitis (CP) is an end-stage disease with no specific therapy; therefore, an early diagnosis is of crucial importance. In this study, data from 1315 and 318 patients were analysed from acute pancreatitis (AP) and CP registries, respectively. The population from the AP registry was divided into AP (n = 983), recurrent AP (RAP, n = 270) and CP (n = 62) groups. The prevalence of CP in combination with AP, RAP2, RAP3, RAP4 and RAP5 + was 0%, 1%, 16%, 50% and 47%, respectively, suggesting that three or more episodes of AP is a strong risk factor for CP. Laboratory, imaging and clinical biomarkers highlighted that patients with RAP3 + do not show a significant difference between RAPs and CP. Data from CP registries showed 98% of patients had at least one AP and the average number of episodes was four. We mimicked the human RAPs in a mouse model and found that three or more episodes of AP cause early chronic-like morphological changes in the pancreas. We concluded that three o...</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Evidence for diagnosis of early chronic pancreatitis after three episodes of acute pancreatitis: a cross-sectional multicentre international study with experimental animal model","attachmentId":72098115,"attachmentType":"pdf","work_url":"https://www.academia.edu/56974429/Evidence_for_diagnosis_of_early_chronic_pancreatitis_after_three_episodes_of_acute_pancreatitis_a_cross_sectional_multicentre_international_study_with_experimental_animal_model","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/56974429/Evidence_for_diagnosis_of_early_chronic_pancreatitis_after_three_episodes_of_acute_pancreatitis_a_cross_sectional_multicentre_international_study_with_experimental_animal_model"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="8" data-entity-id="88192716" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/88192716/International_Consensus_Guidelines_for_Risk_Factors_in_Chronic_Pancreatitis_Recommendations_from_the_working_group_for_the_international_consensus_guidelines_for_chronic_pancreatitis_in_collaboration_with_the_International_Association_of_Pancreatology_the_American_Pancreatic_Association_the_Ja_">International Consensus Guidelines for Risk Factors in Chronic Pancreatitis. Recommendations from the working group for the international consensus guidelines for chronic pancreatitis in collaboration with the International Association of Pancreatology, the American Pancreatic Association, the Ja...</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="33452819" href="https://independent.academia.edu/XMolero">Xavier Molero</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Pancreatology, 2020</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"International Consensus Guidelines for Risk Factors in Chronic Pancreatitis. Recommendations from the working group for the international consensus guidelines for chronic pancreatitis in collaboration with the International Association of Pancreatology, the American Pancreatic Association, the Ja...","attachmentId":92212931,"attachmentType":"pdf","work_url":"https://www.academia.edu/88192716/International_Consensus_Guidelines_for_Risk_Factors_in_Chronic_Pancreatitis_Recommendations_from_the_working_group_for_the_international_consensus_guidelines_for_chronic_pancreatitis_in_collaboration_with_the_International_Association_of_Pancreatology_the_American_Pancreatic_Association_the_Ja_","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/88192716/International_Consensus_Guidelines_for_Risk_Factors_in_Chronic_Pancreatitis_Recommendations_from_the_working_group_for_the_international_consensus_guidelines_for_chronic_pancreatitis_in_collaboration_with_the_International_Association_of_Pancreatology_the_American_Pancreatic_Association_the_Ja_"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="9" data-entity-id="79205992" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/79205992/Chronic_Pancreatitis_Current_Status_and_Challenges_for_Prevention_and_Treatment">Chronic Pancreatitis: Current Status and Challenges for Prevention and Treatment</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="166176219" href="https://independent.academia.edu/GrazielaRibeiroBaena">Graziela Ribeiro Baena</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Digestive diseases and sciences, 2017</p><p class="ds-related-work--abstract ds2-5-body-sm">This paper reviews the current status of our understanding of the epidemiology, diagnosis, and management of the continuum of pancreatic diseases from acute and recurrent acute pancreatitis to chronic pancreatitis and the diseases that are often linked with pancreatitis including diabetes mellitus and pancreatic cancer. In addition to reviewing the current state of the field, we identify gaps in knowledge that are necessary to address to improve patient outcomes in these conditions.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Chronic Pancreatitis: Current Status and Challenges for Prevention and Treatment","attachmentId":85999209,"attachmentType":"pdf","work_url":"https://www.academia.edu/79205992/Chronic_Pancreatitis_Current_Status_and_Challenges_for_Prevention_and_Treatment","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/79205992/Chronic_Pancreatitis_Current_Status_and_Challenges_for_Prevention_and_Treatment"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div></div></div><div class="ds-sticky-ctas--wrapper js-loswp-sticky-ctas hidden"><div class="ds-sticky-ctas--grid-container"><div class="ds-sticky-ctas--container"><button class="ds2-5-button js-swp-download-button" data-signup-modal="{"location":"continue-reading-button--sticky-ctas","attachmentId":90009051,"attachmentType":"pdf","workUrl":null}">See full PDF</button><button class="ds2-5-button ds2-5-button--secondary js-swp-download-button" data-signup-modal="{"location":"download-pdf-button--sticky-ctas","attachmentId":90009051,"attachmentType":"pdf","workUrl":null}"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span>Download PDF</button></div></div></div><div class="ds-below-fold--grid-container"><div class="ds-work--container js-loswp-embedded-document"><div class="attachment_preview" data-attachment="Attachment_90009051" style="display: none"><div class="js-scribd-document-container"><div class="scribd--document-loading js-scribd-document-loader" style="display: block;"><img alt="Loading..." src="//a.academia-assets.com/images/loaders/paper-load.gif" /><p>Loading Preview</p></div></div><div style="text-align: center;"><div class="scribd--no-preview-alert js-preview-unavailable"><p>Sorry, preview is currently unavailable. 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