{"title":"Fatal rupture of descending thoracic aortic aneurysm in a Nigerian patient","authors":"M. Ajani, O. Faniyi, A. Salami","doi":"10.4103/atp.atp_20_18","DOIUrl":"https://doi.org/10.4103/atp.atp_20_18","url":null,"abstract":"Aortic aneurysms are rare conditions in black patients and carry a high mortality if detected late. Unfortunately, the rarity of the condition makes detection a difficulty for many physicians as diagnosis in the early stages requires a high index of suspicion. The varied symptoms presented by the patient often mimic other less severe, but more common conditions and may cause a misdiagnosis. We report a 79-year-old male known hypertensive patient who presented a day before demise with a 4 h history of severe epigastric pain. He was managed for acute exacerbation of peptic ulcer disease to rule out pancreatitis. However, all investigations done were within normal limits. His clinical condition deteriorated, and he died 18 h after admission. An autopsy revealed massive left hemothorax and a tear in the descending aortic aneurysm. Microscopic examination confirmed complicated atherosclerosis in the descending thoracic aorta. The misdiagnosis, in this case, leads to wrong management with the patient receiving treatment for severe peptic ulcer. There is a need to consider this disease in patients who present with severe nonspecific abdominal symptoms.","PeriodicalId":307224,"journal":{"name":"Annals of Tropical Pathology","volume":"112 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126152257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prevalence of overweight and obesity among health-care workers in University of Benin Teaching Hospital, Benin City, Nigeria","authors":"T. Adaja, O. Idemudia","doi":"10.4103/atp.atp_30_18","DOIUrl":"https://doi.org/10.4103/atp.atp_30_18","url":null,"abstract":"Background: Overweight and obesity seem to be responsible for the occurrence of noncommunicable diseases among the health-care workers. This study was conducted among the health-care workers in the University of Benin Teaching Hospital (UBTH), Benin City, South-South Nigeria, to determine the prevalence of overweight and obesity and assess their lipid profile. Subjects and Methods: Three hundred and twenty-five hospital workers ranging from doctors, nurses, and other health-care workers were recruited for this study. Demographic and socioeconomic data were collected using a structured questionnaire. One hundred and sixty (49%) were male while 165 (51%) were female with average age of 40.9 ± 8.8 years and average body mass index (BMI) of 26.7 ± 5.9 kg/m2. BMI and blood pressure measurements were taken using standard techniques. BMI was classified using the National Institutes of Health criteria, 2000. Results: Based on BMI, the prevalence of overweight and generalized obesity among health-care workers in the UBTH, Benin City, were 31.7% and 25.5%, respectively. Overweight and obesity are more common among female health-care workers than their male counterparts. Using the waist circumference, approximately 60% of the health-care workers had central obesity, while 57.2% are either overweight or obese. More than half of the overweight and obese patients have elevated low-density lipoprotein-cholesterol. Conclusion: The high prevalence of overweight and obesity seen among health-care workers calls for the introduction of therapeutic lifestyle modification in this group of workers. Even though there was no significant difference in the lipid levels across the BMI categories, the means of total cholesterol were found to be elevated among health-care workers.","PeriodicalId":307224,"journal":{"name":"Annals of Tropical Pathology","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132202476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Abubakar, S. Shehu, Saad A Ahmed, A. Liman, Karo C Akpobi, A. Mohammed, U. Mohammed, S. Abdullahi, D. Suleiman, B. Kabir
{"title":"Adenocarcinoma of the prostate: Correlation between serum prostate-specific antigen and Gleason grade group","authors":"M. Abubakar, S. Shehu, Saad A Ahmed, A. Liman, Karo C Akpobi, A. Mohammed, U. Mohammed, S. Abdullahi, D. Suleiman, B. Kabir","doi":"10.4103/atp.atp_28_18","DOIUrl":"https://doi.org/10.4103/atp.atp_28_18","url":null,"abstract":"Introduction: Serum prostatic-specific antigen (PSA) concentration determination has established itself as the leading tool in screening for, as well as in estimating the prognosis of, adenocarcinoma of the prostate. This prognostication is usually done in conjunction with the Gleason score and other prognostic indices. The aim of this study was to determine the association between serum PSA concentration and the new (2016 modified) Gleason grade group of tumor among patients with adenocarcinoma of the prostate. Study Design: A retrospective, analytic study. Study Setting: Department of Pathology, Ahmadu Bello University Teaching Hospital, Zaria. Study Period: January 2006 to December 2013. Materials and Methods: A total of 211 patients with biopsy-based diagnosis of adenocarcinoma of the prostate were studied. Each of the cases was graded using the (2016 modified) Gleason grading system. Prebiopsy serum PSA concentration in each of the patients was retrieved from either the patient's case records in the Urology Unit of the hospital or from the values filled in by the requesting surgeon. Gleason grade groups of patients were correlated with serum PSA concentration. Results: Gleason grade group 1 was most common in our study with 68 (32.2%) of our patients falling within that category. The study revealed a statistically significant relationship between the serum PSA concentration and the Gleason grade group of cancer (P = 0.00). Conclusion: This study concluded that the serum PSA concentration has a statistically significant association with the Gleason grade group of the tumor in prostatic adenocarcinoma patients. Therefore, patients with high serum PSA concentrations are likely to have high tumor grade group.","PeriodicalId":307224,"journal":{"name":"Annals of Tropical Pathology","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126689164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Suleiman, J. Ejembi, F. Giwa, O. Jimoh, A. Suleiman, A. Olayinka
{"title":"Serotype distribution pattern of Streptococcus Pneumoniae isolates from invasive infections at a university teaching hospital in Northern Nigeria","authors":"M. Suleiman, J. Ejembi, F. Giwa, O. Jimoh, A. Suleiman, A. Olayinka","doi":"10.4103/atp.atp_33_18","DOIUrl":"https://doi.org/10.4103/atp.atp_33_18","url":null,"abstract":"Background: Infections with Streptococcus pneumoniae are endemic worldwide. It is a public health problem and responsible for 1.6 million of 8.8 million annual deaths of children under 5 years of age, with 50% occurring in sub-Saharan Africa. This descriptive study was done to determine the prevalent S. pneumoniae serotypes responsible for infections at Ahmadu Bello University Teaching Hospital, Shika-Zaria, Nigeria. Materials and Methods: Clinical specimens of blood, cerebrospinal fluid, and aspirates from abscess, ear swab, throat swab, pus and sputa were collected over a period of 18 months from 420 patients with pneumonia, meningitis, septicemia, and otitis media. Specimens were cultured on 5% defibrinated sheep blood agar and chocolate agar. Incubation was done aerobically in a CO2-enriched atmosphere at 37°C for 18–24 h. Isolates of S. pneumoniae were identified by standard biochemical techniques using Gram reaction, catalase test, Optochin disc, and bile solubility tests. Antimicrobial susceptibility was determined by the modified Kirby–Bauer disc diffusion method with Mueller–Hinton agar supplemented with 5% sheep blood. Serotyping was done using the slide agglutination method (Denka Seiken Co. Ltd., Japan). The serotype final results were recorded as matching, discordant, or nontypeable. Results: A total of 420 patients participated in this study, in which 227 were males (54%) and 193 were females (46%). Participants' ages ranged from 2 days to 85 years. S. pneumoniae isolates were mainly from blood 12 (52.2%) and sputum 6 (26.1%). Samples with most isolates were from the pediatric age group of 15 years (65.2%). The serotypes identified were 6, 19, and 20 which were all from blood, as none of the strains from sputum was typeable. Conclusion: The major S. pneumoniae serotypes found in this study were 6, 19, and 20.","PeriodicalId":307224,"journal":{"name":"Annals of Tropical Pathology","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131321446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Vhriterhire, J. Ngbea, T. Ugbem, A. Dauda, O. Jegede, D. Yakubu, A. Amos
{"title":"Histopathology quality assurance: A general survey of physicians' satisfaction in Nigeria","authors":"R. Vhriterhire, J. Ngbea, T. Ugbem, A. Dauda, O. Jegede, D. Yakubu, A. Amos","doi":"10.4103/atp.atp_11_18","DOIUrl":"https://doi.org/10.4103/atp.atp_11_18","url":null,"abstract":"Background: The monitoring of clients' satisfaction is paramount to the success of a quality assurance scheme in a histopathology laboratory, from the accessioning of specimens to the delivery of the reports to physicians. This study was designed to determine the levels of physician satisfaction with certain aspects of pathologists' report including accuracy, content, and turnaround time (TAT) in Nigeria. Materials and Methods: Self-administered questionnaires were given to physicians from six hospitals with on-site pathology laboratories. The respondents were required to grade their responses as very satisfied, satisfied, undecided, dissatisfied, and very dissatisfied, on the report accuracy, report completeness, report timeliness, and ease of access to a pathologist, on a Likert-like scale. Results: There were 251 respondents consisting of 197 males, 50 females, and 4 who declined to disclose their gender. The respondents gave a total of 1198 responses. These included very satisfied (54, 4.5%), satisfied (580, 48.4%), undecided (290, 24.2%), dissatisfied (236, 19.7%), and very dissatisfied (38, 3.2%). Physicians from surgery specialty were the mostly contented with histopathology services (19.2 satisfaction rate, n = 1155), followed by responses from obstetrics and gynecology (15.2) and pediatrics (7.3). The specialty of the physician has no statistical influence on levels of satisfaction. Physicians were most satisfied with the diagnostic accuracy of reports (26.7%, n = 634) and least satisfied with report timeliness (12.8%, n = 634). Conclusion: This cross-sectional survey of levels of physician's satisfaction with histopathology service in different hospitals in Nigeria suggests that even though most express satisfaction with the accuracy of reports, there remains low satisfaction with TAT.","PeriodicalId":307224,"journal":{"name":"Annals of Tropical Pathology","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123096124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Leveraging social media for pathology education: Patterns and perceptions among undergraduates","authors":"I. Osaigbovo","doi":"10.4103/atp.atp_34_18","DOIUrl":"https://doi.org/10.4103/atp.atp_34_18","url":null,"abstract":"Background: The use of social media in medical education is an emerging field of study in the developed world, but there is little evidence of scholarly inquiry into this field in Nigeria. Acceptability among learners is a crucial factor to consider when adopting technology in education. The aim of this study was to assess how undergraduates use social media and their perceptions about its use in pathology education. Materials and Methods: A paper-based questionnaire was administered to 169 4th year medical and dental students in the University of Benin. Data were analyzed using descriptive and simple inferential statistics. Results: All respondents were aware of social media and most had devices with which they could access the internet; 80.5% used mobile phones. Facebook (95.3%), Instagram (56.8%), and Twitter (44.4%) were the most common social media platforms used by students. Social media is used for educational purposes by 82.8% of students and 68.6% indicated that they would like their pathology educators to teach using social media. Distraction from noneducational feeds was the major aversion to the use of social media in pathology education (66%). Conclusion: Most undergraduate pathology students actively use social media for varied purposes including education. Many find the idea of educators engaging with them through social media acceptable. Opportunities abound for pathology educators to leverage this veritable educational tool.","PeriodicalId":307224,"journal":{"name":"Annals of Tropical Pathology","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128395221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prevalence and distribution of high risk human papillomavirus subtypes in invasive cervical cancer in South-West Nigeria","authors":"N. Orah, A. Banjo","doi":"10.4103/atp.atp_42_18","DOIUrl":"https://doi.org/10.4103/atp.atp_42_18","url":null,"abstract":"Context: Despite the high incidence of cervical cancer in Nigeria, there are only a few large scale population based studies on HPV prevalence and genotype distribution. Aims: This study was carried out to determine the prevalence and distribution of human papillomavirus (HPV) types in invasive cervical cancer (ICC) in Nigeria. Settings and Design: Cross sectional period prevalence study. Methods and Material: Paraffin embedded tissue blocks of two hundred and thirty five archival cervical cancers diagnosed in three participating laboratories from South West Nigeria were analyzed for the presence of HPV DNA. Statistical Analysis: Data analysis was performed with the Statistical Package STATA 10. Results: Of the one hundred and eighty seven samples that were considered appropriate for HPV detection after histological evaluation 160 (85.6%) were positive for HPV DNA. The five most common types identified as single types among HPV positive cases were HPV16 (46.9%), HPV18 (19.4%), HPV45 (11.9%), HPV35 (5.0%), and HPV31 (3.1%). Others were HPV33, 39, 51, 52, 56, 58, 59, 66, and 68. HPV16 and 18 in single/multiple infections accounted for 69.4% of the samples. Multiple infections were detected in 4.4%. All the adenosquamous and neuroendocrine carcinomas tested positive for HPV, while 86.1% and 66.7% of the squamous cell and the adenocarcinomas were positive, respectively. Conclusion: These results are in consonance with reports from all other parts of the world that HPV16 and 18 accounts for almost 70% of cervical cancers, supporting data that effective vaccination against these two types will reduce the cervical burden in South West Nigeria.","PeriodicalId":307224,"journal":{"name":"Annals of Tropical Pathology","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114557740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pattern of patients presentation with metastatic breast cancer for palliative external beam radiotherapy in the University College Hospital Ibadan","authors":"H. Ibrahim, A. Umar","doi":"10.4103/atp.atp_36_18","DOIUrl":"https://doi.org/10.4103/atp.atp_36_18","url":null,"abstract":"Background: Breast cancer is the most common cancer among Nigerian women. In Nigeria and indeed Africa as a continent, majority of patients present to the hospital with advanced diseases. This event is a major source of morbidity and mortality in our poor-resource setting and can significantly decrease patient's quality of life. Materials and Methods: Patient's case notes with advanced breast cancers referred for palliative radiotherapy were retrieved from the departmental archives. Patient's biodata was extracted, which included age, sex, and year of referral. Other information extracted includes histology types diagnosed at primary sites, presenting symptoms, type of imaging modality used for confirmation of metastasis, and sites of metastasis. Data collected were analyzed using SPSS version 20. Results: A total of 584 patients with advanced breast cancers were seen during the study period (January 2005 to December 2009), representing an annual referral rate of about 84 patients/year from various centers across the country. Four hundred and twenty-one patients were eligible for the study. The mean age of patients was 45.9 years with only two male patients. Bone was the most common site of metastasis (66.7%) followed by lungs (17.1%). Pain due to bone metastasis accounted for 62.7% of presenting symptoms, followed by dyspnea and cough from lung metastasis (17.1%), multiple symptoms (7.4%), and symptoms associated with brain metastasis (6.2%). Conventional X-ray remained the dominant imaging modality for the confirmation of metastasis in both bones and lungs which accounted for 69.8% of used imaging modalities. Conclusion: Breast cancer metastasis to the bone and lungs remain the major source of morbidity and mortality, with majority of patients presenting with pain and dyspnea. Conventional X-rays remain the common imaging modality for confirmation of metastases in our environment despite advanced imaging techniques (positron emission tomography (PET)–computed tomography and 18F-fluoro-2-deoxyglucose-PET) used for the similar purpose in other parts of the world.","PeriodicalId":307224,"journal":{"name":"Annals of Tropical Pathology","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115144956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. B. Achusi, S. Raphael, A. Awolola, F. Abdulkareem, A. A. Banjo, S. Ojo
{"title":"Pattern of diseases in human immunodeficiency virus/AIDS patients in Lagos University Teaching Hospital: A 1-year prospective autopsy study","authors":"I. B. Achusi, S. Raphael, A. Awolola, F. Abdulkareem, A. A. Banjo, S. Ojo","doi":"10.4103/atp.atp_19_18","DOIUrl":"https://doi.org/10.4103/atp.atp_19_18","url":null,"abstract":"Background and Objective: Nigeria has the second largest number of individuals living with human immunodeficiency virus/AIDS (HIV/AIDS) in the world after South Africa and contributes about 9% of the global HIV burden. It has also been estimated that there are 336,379 annual new HIV infections and about 192,000 of these individuals die of HIV/AIDS annually in Nigeria. Yet, there is a paucity of autopsy data among HIV/AIDS deaths in Nigeria. The objective of this study was to describe autopsy findings in HIV/AIDS cases in Lagos University Teaching Hospital (LUTH), a tertiary health center in Southwest Nigeria, which has one of the highest autopsy rates in the country. Materials and Methods: This 1-year prospective descriptive study included all HIV-1- and HIV-2-positive cases referred for autopsy examination at the Anatomic and Molecular Pathology Department of LUTH, Lagos, Nigeria. The study population included HIV-positive cases of all ages and sex. Results: Seven hundred and fifty-four autopsies were performed over the study period giving an autopsy rate of 33.1%. Forty-four patients (21 males and 23 females) were found to be HIV positive representing a prevalence of 5.8%. Of these, 23 (53.3%) cases were diagnosed antemortem, while 21 (47.7%) were diagnosed in the autopsy room. The patients' age ranged from 6 h to 69 years with a median age of 34 years. Infections were seen in 27 (61.4%) cases, out of which 13 (48.1%) were AIDS defining infections: 8 (18.2%) of them had tuberculosis, 2 (4.5%) cases of nontuberculous bacterial pneumonia, 1 (2.3%) case each of cryptococcosis, Pneumocystis jiroveci pneumonia, and progressive multifocal leukoencephalopathy (2.3%). Two (4.5%) patients had neoplasms (one case each of non-Hodgkin lymphoma and pleomorphic sarcoma). Miscellaneous causes of death included hypertensive heart disease, perforated strangulated right inguinal hernia, perforated ileoileal intussusceptions, and penetrating perineal injury. Conclusion: This study showed a demographic pattern of HIV infection comparable with previous national surveillance data, but a higher HIV seroprevalence than the most recent national surveillance data. Opportunistic infections were the most common cause of mortality in HIV infection and about half of HIV infected persons presented to the autopsy room undiagnosed.","PeriodicalId":307224,"journal":{"name":"Annals of Tropical Pathology","volume":"80 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133612240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Jimoh, J. Ejembi, S. Aliyu, Muhammed S. Abubakar, M. Ibrahim, A. Olayinka
{"title":"Postburns sepsis caused by multidrug-resistant Acinetobacter baumannii","authors":"O. Jimoh, J. Ejembi, S. Aliyu, Muhammed S. Abubakar, M. Ibrahim, A. Olayinka","doi":"10.4103/atp.atp_18_18","DOIUrl":"https://doi.org/10.4103/atp.atp_18_18","url":null,"abstract":"Healthcare-associated infections are among the major complications of modern medical treatment due to the increasing age and complexity of patients, increasing usage of invasive devices, and often inappropriate use of antimicrobial therapy. Acinetobacter species is associated with healthcare-associated infections due to its ability to survive for long periods of time on surfaces and its capacity to develop drug resistance. Multidrug-resistant (MDR) Acinetobacter is a challenge to manage clinically and is associated with mortality rates as high as 35%. We present a 25-year-old home maker with burns wound sepsis due to multidrug-resistant Acinetobacter baumannii which was successively managed with combination of drug regimen and institution of proper infection prevention control practices. We recommend minimization of invasive device in high dependency unit, scaling up of infection control practices, and further research into the efficacy of combination of ciprofloxacin, rifampicin, and amikacin in the treatment of MDR A. baumannii burns wound sepsis.","PeriodicalId":307224,"journal":{"name":"Annals of Tropical Pathology","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131826245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}