Publications by authors named "Şaban Oğuz Demirdöğen"

13 Publications

  • Page 1 of 1

Case Report: A Rare Case of Crimean-Congo Hemorrhagic Fever Associated with Epididymo-Orchitis.

Am J Trop Med Hyg 2021 Jan 4. Epub 2021 Jan 4.

Depertmant of Pulmonology, Ataturk University, Erzurum, Turkey.

Crimean-Congo hemorrhagic fever (CCHF) is an acute infectious disease that affects multiple organ systems and is characterized by extensive ecchymosis, internal hemorrhage, and hepatic dysfunction. The reported case fatality rate varies between 8% and 80%. It is frequently transmitted by ticks, which are endemic in the Northeast Anatolia region of Turkey in spring and summer. Our patient presented from an endemic area with fever, malaise, joint pain, and scrotal pain following a tick bite, and real-time PCR analysis of venous blood was positive for CCHF. Based on Doppler ultrasound performed because of the patient's scrotal pain, he was diagnosed as having epididymo-orchitis, which was considered secondary to CCHF after ruling out other etiologies and resolved with scrotal elevation and anti-inflammatory treatment. Being a very rare complication, this report aimed to document this case of CCHF-associated epididymo-orchitis in the literature.
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http://dx.doi.org/10.4269/ajtmh.20-1143DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7941844PMC
January 2021

Treatment management of COVID-19 positive patients with renal colic secondary to distal ureteral stone.

Int J Clin Pract 2020 Dec 28:e13976. Epub 2020 Dec 28.

Department Of Urology, Ataturk University Medical Faculty, Erzurum, Turkey.

Objective: In this study, we aimed to contribute to the literature by sharing and evaluating the clinical characteristics and our treatment and follow-up approaches in patients in the COVID-19 positive treatment process who had presented to our hospital's emergency department with a distal ureteral stone and to examine the effects of the pandemic and disease in this group of patients.

Method: The study included 14 patients infected with COVID-19 who had presented to the Erzurum City Hospital Emergency Department between August 2020 and December 2020 with the complaint of renal colic in which distal ureteral stones were detected in the tests. The demographic and clinical characteristics of patients, laboratory and radiological examinations, characteristics of ureteral stones, details of treatments applied to patients, treatment procedures of patients who had undergone surgical treatment, patient files, visit and operation notes and the patient discharge reports were retrospectively reviewed and evaluated.

Results: The study included 14 patients. The average age of the patients was 35.7 (±14.35). The average stone size was 6.2 (±1.8) mm. Analgesic treatment and MET for distal ureteral stones were begun in 11 (78.6%) of the patients. Pain control was achieved in nine patients (64.2%) with analgesic treatment and MET, and the stone was removed without invasive intervention. Surgical intervention was performed in a total of five patients (35.7%).

Conclusion: In most COVID-19 infected patients with renal colic and a distal ureteral stone, results can be obtained using MET. Patients with a distal ureteral stone and persistent renal colic can be safely and effectively treated by endoscopic ureteral stone treatment after taking necessary precautions. Prospective, randomised, and controlled studies are required on this subject.
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http://dx.doi.org/10.1111/ijcp.13976DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7883115PMC
December 2020

Vesicovaginal fistula repair experiences in a single center high volume of 33 years and necessity of cystostomy.

Turk J Urol 2021 Jan 20;47(1):66-72. Epub 2020 Aug 20.

Department of Urology, Atatürk University Faculty of Medicine, Erzurum, Turkey.

Objective: The aim of this study was to retrospectively examine the patients who underwent surgical treatment for vesicovaginal fistula (VVF) repair in our clinic, to evaluate our surgical preferences, success, and treatment results, to compare these with the literature, and firstly to reveal the necessity of cystostomy and its effect on treatment success.

Material And Methods: Between 1985 and 2018, a retrospective evaluation was performed on the records of 102 patients who underwent surgical treatment for VVF repair. All cases underwent a detailed physical examination and had their routine laboratory tests and imaging methods. In obese patients, a Foley catheter was moved into the bladder through the fistula tract, then inflated in order to push the vagina and bladder wall upwards. A transurethral catheter was used in all cases, and cystostomy was used in 58 (56.9%).

Results: The most common cause was prior hysterectomy for benign diseases in 35 (34.31%) cases. Among a total of 102 cases with for VVF, 95 (93.1%) were primary, 5 (4.9%) secondary, and 2 (1.9%) tertiary. The transvesical and O'Connor approaches (transabdominal) were performed in 61 (59.8%) and 41 (40.2%) cases, respectively. Transvaginal approach was not used in any of the cases. Cystostomy was applied in 58 (56.9%) of cases and not applied in 44 (43.1%).

Conclusion: Complete excision of the fistula tract and sealing of the layers separately using the water-tight technique are extremely crucial factors to increase the success rate of VVF repair. In cases where good transurethral drainage is ensured, cystostomy is unnecessary and may increase the risk of infection.
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http://dx.doi.org/10.5152/tud.2020.20080DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7815243PMC
January 2021

Questionnaire-guided evaluation of the effectiveness of long-term intravesical 0.2% chondroitin sulfate therapy in interstitial cystitis.

Int Urogynecol J 2020 Feb 11. Epub 2020 Feb 11.

Department of Public Health, Atatürk University Faculty of Medicine, Erzurum, Turkey.

Introduction And Hypothesis: To investigate the long-term feasibility, safety and effectiveness of intravesical chondroitin sulfate therapy in patients with one or more forms of chronic cystitis.

Methods: The study included 62 female patients with interstitial cystitis/painful bladder syndrome (IC/PBS) who received intravesical chondroitin sulfate (40 ml/80 mg) therapy between 2014 and 2018. A total of 15 doses of intravesical treatment were applied, once weekly in the first month and once monthly from the second month onward. A 3-day voiding diary, a visual analog scale (VAS), the O'Leary Sant Indexes (ICSI/ICPI), the Pelvic Pain and Urgency/Frequency Symptom (PPUFS) Scale and PPUF Bother scores were recorded and evaluated through prospective comparison before treatment and at the first month and first year. Patients were also assessed using the Global Response Assessment (GRA) at the end of the first month and first year to assess the effectiveness of responses to treatment.

Results: In the first month of treatment, 0.2% chondroitin sulfate was ineffective in 22.5% of patients, with mild improvement observed in 40.0% and moderate-good improvement in 37.0%. Evaluation at the end of the first year revealed mild improvement in 21.0% of patients and moderate-good improvement in 79.0%. Statistically significant improvements were observed in all scoring systems at 1 and 12 months compared with pre-treatment values (p < 0.001).

Conclusion: Long-term intravesical chondroitin sulfate therapy is a safe and highly successful therapeutic modality that produces significant improvement in patients' quality of life and symptoms in the treatment of IC/PBS.
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http://dx.doi.org/10.1007/s00192-020-04245-0DOI Listing
February 2020

Analgesic efficacy of ultrasound-guided quadratus lumborum block during extracorporeal shock wave lithotripsy.

Agri 2020 Jan;32(1):44-47

Department of Urology, Ataturk University Faculty of Medicine, Erzurum, Turkey.

Extracorporeal shockwave lithotripsy (ESWL) is widely used for the treatment of urinary tract calculi; however, the vast majority of the patients does not tolerate the procedure without analgesia and sedation. Pain control in ESWL has been crucial for process success and patient comfort. Systemic drugs, such as non-steroid anti-inflammatory drugs, opioids, alfa-2 agonist and various local and regional anesthesia methods (transversus abdominis plane block, paravertebral block, infiltration) have been applied to control ESWL pain. Quadratus lumborum block (QLB) is performed as one of the regional anesthetic techniques for abdominal surgery. This block provides anesthesia and analgesia on the anterior and lateral wall of the abdomen. In this report, we presented the analgesic efficacy of QLB in 15 patients, which included nine renal and six ureter stones for ESWL. The mean of the VAS scores ranged from 0.20±0.41 to 2.73±1.22, and mean fentanyl consumption was 15.00±15.08 mcg during the procedure. No opioid-related side effects were observed in any of the patients. Full fragmentation was obtained in nine of the 15 patients, and partial fragmentation was obtained in five patients.
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http://dx.doi.org/10.5505/agri.2017.54036DOI Listing
January 2020

Less painful ESWL with ultrasound-guided quadratus lumborum block: a prospective randomized controlled study.

Scand J Urol 2019 Dec 9;53(6):411-416. Epub 2019 Sep 9.

Department of Urology, Ataturk University School of Medicine, Erzurum, Turkey.

Extracorporeal shock wave lithotripsy (ESWL) has been widely used for the treatment of urinary tract stones and is usually administered as an outpatient procedure, although the vast majority of patients do not tolerate it without sedoanalgesia. The quadratus lumborum block (QLB) is a newly-defined technique for abdominal surgery. The aim of this study was to evaluate the analgesic efficacy of ultrasound-guided QLB in ESWL. Forty patients, aged 18-65, with ASA physical status I-II and scheduled for ESWL were randomly assigned to Group C (control group) and Group QLB (treatment group). Group QLB received single-shot USG-guided transmuscular QLB with 10 ml of 0.5% bupivacaine and 10 ml of 2% lidocaine before a 20-min ESWL procedure. No intervention was performed on Group C. Visual analogue scale (VAS) scores, opioid consumption, patient satisfaction, ESWL and stone details were recorded. VAS scores were significantly lower in Group QLB at all time intervals ( 0.05). Fentanyl consumption during ESWL was significantly lower in Group QLB than in Group C ( 0.001). The fragmentation success rate was significantly higher in Group QLB than in Group C (19/20 vs 14/20, respectively,  0.046). Patient satisfaction was also higher in Group QLB ( 0.011). This study shows that QLB provided adequate analgesia for ESWL and that it reduced extra opioid consumption significantly compared to the control group.
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http://dx.doi.org/10.1080/21681805.2019.1658636DOI Listing
December 2019

A comparison between the efficacy and safety of microscopic inguinal and subinguinal varicocelectomy.

Turk J Urol 2019 07 1;45(4):254-260. Epub 2019 Jul 1.

Department of Urology, Atatürk University School of Medicine, Erzurum, Turkey.

Objective: To compare microscopic inguinal (MIV) and subinguinal varicocelectomy (MSV) surgeries with respect to efficacy and safety.

Material And Methods: Patients who underwent varicocelectomy between January 2002 and January 2018 were evaluated retrospectively and prospectively. The patients who underwent varicocelectomy until December 2015 were analyzed retrospectively and the cases after January 2016 were analyzed prospectively. In our study, the married infertile male cases were compared on the basis of operation duration, number of ligated veins, number of preserved veins, postoperative pain score (visual analogue scale: VAS), patient satisfaction, surgeon satisfaction, changes in sperm parameters, testicular consistency, pregnancy rates, and complications, such as hydrocele, testicular atrophy, and recurrence of varicocele. Surgical success rates were compared by semen analysis between unmarried infertile male cases because pregnancy rates cannot be tested. The patients were recalled for control examinations every 3 months for 1 year and tested the above-mentioned parameters. Statistical Package for the Social Sciences Version 20 Windows Software was used for data analysis and comparison between the two groups.

Results: The study included a total of 136 adult patients. Mean age of the patients was 28.14 (20-41) years. MSV and MIV were performed in 62 (45.6%) and 74 (54.4%) patients, respectively. No statistically significant difference was detected between the two groups in terms of admission duration, semen parameters within the 1-year follow-up process, hormonal changes, and complication rates. Operation duration was significantly longer in the MSV group. It was determined that a fewer number of veins were ligated, and a fewer number of veins needed to be ligated in the MIV group. The analysis of all the patients revealed that pain scores at 4 and 24 hours postoperatively were significantly statistically lower in the MSV group.

Conclusion: MIV and MSV are distinct, efficient, and safe surgical techniques with specific advantages and disadvantages. Their efficacy and safety rates are similar.
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http://dx.doi.org/10.5152/tud.2019.72547DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6619852PMC
July 2019

Diagnosis and Conservative Management of Ureteral Orifice Injury During Robotic Prostatectomy for a Large Prostate with a Prominent Median Lobe.

J Endourol Case Rep 2019 30;5(2):39-41. Epub 2019 May 30.

Department of Urology, Koc University, School of Medicine, Istanbul, Turkey.

Robot-assisted laparoscopic radical prostatectomy (RALRP) is now considered the standard treatment for localized prostate cancer. However, challenges may arise when dealing with large prostates with a prominent median lobe because the ureteral orifices may not always be visible during dissection and maybe injured in the process. We describe our experience on the diagnosis and conservative management of ureteral orifice injury in this situation. A Gleason score 3 + 3 prostatic adenocarcinoma was detected during 12-quadrant prostate biopsy performed after measurement of a serum prostate specific antigen value of 8.1 ng/mL in a 65-year-old man presenting with lower urinary tract symptoms. The left ureter orifice was observed to have been injured by scissors at dissection of the neck of the bladder and enlarged median lobe at RALRP. An online video call was made to more experienced robotic surgeons for advice. Diagnosis and management of the ureteral injury are presented. Ureteral orifice injury during an RALRP may be managed conservatively with intraoperative ureteral stenting without the need for reimplantation nor conversion to open surgical techniques. Online video call with experienced robotic surgeons is helpful in the decision process.
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http://dx.doi.org/10.1089/cren.2018.0109DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6555169PMC
May 2019

Robotic radical prostatectomy in 93 cases: Outcomes of the first ERUS robotic urology curriculum trained surgeon in Turkey.

Turk J Urol 2019 05 4;45(3):183-188. Epub 2019 Feb 4.

Clinic of Urology, Ankara Atatürk Training and Research Hospital, Ankara, Turkey.

Objective: This study presents the surgical, oncological, and functional outcomes of the first 93 robotic radical prostatectomy (RARP) procedures performed in Erzurum, Turkey. These procedures were performed by a single surgeon who had completed the European Association of Urology Robotic Urology Section (ERUS) RARP curriculum in an ERUS-certified training center in Ankara.

Material And Methods: The study present the results of 93 RARP procedures performed by a single surgeon. The surgeon performing the operations completed an ERUS training program structured for RARP by two robotic surgeons holding ERUS training certificates in an ERUS-approved academic robotic surgery training center in Ankara. The RARP cases performed by the surgeon after completion of the training between April 2016 and August 2018 were retrospectively evaluated.

Results: The mean patient age was 63.62±7.04 years, and the mean preoperative serum prostate-specific antigen level was 8.34±4.96 ng/mL. Preoperatively, 82 and 4 patients had prostate biopsy Gleason scores of 3+3 and 4+3, respectively. Bilateral neurovascular bundle (NVB) sparing, unilateral NVB-sparing, and non-NVB-sparing surgery were performed in 21, 13, and 59 cases, respectively. The mean prostate weight was 85.34±47.57 g. Posterior rhabdosphincter reconstruction was performed in 60 (64.5%) cases. Mean console time, intraoperative blood loss, duration of hospital stay, and urethral catheter removal time were 170.49±36.50 min, 100.70±34.08 cc, 6.84±2.28 days, and 7.40±3.11 days, respectively. During the perioperative period (0-30 days), five minor (prolonged drain output, n=3; rectocele, n=1; gout arthritis, n=1) and six major (inguinal hernia, n=1; incisional hernia, n=2; anastomotic urinary leakage, n=2; myocardial infarction, n=1) complications were identified. No complication was detected during postoperative days 31-90. Postoperative pathological stages included pT2a, pT2b, and pT2c disease in 77 (82.8%), 9 (9.7%), and 7 (7.5%) patients, respectively. The positive surgical margin (SM) rate was 10.7% (n=10), including patients with pT2a (n=6) and pT2c (n=2) diseases. Eleven (11.8%) patients underwent pelvic lymph node (LN) dissection. The mean LN yield was 16.45±4.29. The mean length of follow-up was 11.17±8.01 months. Biochemical recurrence was observed in two patients, one of whom received maximal androgen blockage (MAB), and the other one received pelvic radiotherapy+MAB. All the patients with at least one-year follow-up (n=48, 51.6%) were fully continent (0 pads/day). Of the 40 (43%) patients with no preoperative erectile dysfunction (ED) and with at least three-month follow-up, 18 (45%) had no ED, with or without any additional medication including phosphodiesterase-5 (PDE5) inhibitors.

Conclusion: RARP is a safe minimally invasive procedure with acceptable morbidity, excellent operative, pathological and oncological outcomes, and satisfactory functional results. The ERUS RARP curriculum provides effective and sufficient training.
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http://dx.doi.org/10.5152/tud.2019.24444DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469731PMC
May 2019

An Evaluation of Response to Therapy in Patients Undergoing Radiotherapy or Surgery in the Treatment of Prostate Cancer.

Medeni Med J 2019 27;34(3):263-270. Epub 2019 Sep 27.

Erzurum Regional Training and Research Hospital, Departments of Urology, Erzurum, Turkey.

Objective: This study compared biochemical recurrence (BR), biochemical recurrence-free survival (BRFS) and overall survival (OS) rates and therapeutic methods in patients undergoing definitive radiotherapy (RT) or radical prostatectomy (RP) because of diagnosis of prostate cancer.

Method: Files of 128 patients undergoing RP (n=82) or RT (n=46), who did not receive salvage therapy, and with serum PSA levels monitored three-monthly for at least two years were examined retrospectively. Patients were assigned into low, intermediate and high risk groups based on D'Amico risk classifications. RP was performed in the surgical arm and in the RT arm 70-74 Gy RT were applied using 3D conformal RT technique.

Results: BR was not detected among low risk group patients over 10-year follow-up. No difference was determined between the treatment arms in BR in the intermediate risk patients, while the RT arm was statistically significantly better among the high risk patients (p=0.04). OS rates in the low, intermediate, and high risk groups were 97.1%, 93.8%, and 92.3%, respectively, in the RP, and 81.8%, 92.9%, and 90.5%, respectively, in RT (p>0.05) group. BRFS rates in the intermediate and high risk groups were 92.3%, vs 95.2% in RP, and 79.6%, vs 81.6% in RT (p>0.05).

Conclusion: There was no significant difference between BRFS and OS rates in the two arms of prostate cancer treatment, although RT was better in the high risk group patients in terms of BR. Longer-term studies involving high-dose RT techniques applied with maximum protection of normal tissue and supporting the effectiveness of RT are needed.
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http://dx.doi.org/10.5222/MMJ.2019.28159DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7433734PMC
September 2019

Ultrasound-guided low thoracic paravertebral block versus peritubal infiltration for percutaneous nephrolithotomy: a prospective randomized study.

Urolithiasis 2020 Jun 18;48(3):235-244. Epub 2018 Dec 18.

Department of Anesthesiology and Reanimation, Ataturk University School of Medicine, Erzurum, Turkey.

The aim of this study was to investigate the efficacy of peritubular infiltration and ultrasound-guided low thoracal paravertebral block in patients undergoing percutaneous nephrolithotomy (PCNL). Sixty patients, American Society of Anesthesiologists I-II, between the ages of 18 and 65 years undergoing PCNL were randomized into three groups. Group peritubal infiltration (Pi, n = 20) received infiltration along the nephrostomy tube 20 ml 0.25% bupivacaine, in 6 and 12 o'clock position. Group paravertebral block (Pv, n = 20) received single-shot paravertebral block with 20 ml 0.25% bupivacaine at the level of T8-T9. Group control (C, n = 20): no intervention is performed. Postoperative opioid consumption and pain scores, opioid-related side effects, and additional analgesic requirement were recorded. The fentanyl consumption in Group Pv was significantly lower in comparison to Group C in all time intervals (p < 0.05). In the comparison of Group Pv and Group Pi, fentanyl consumptions in the postoperative 0-4th hours (100.00 ± 50.65 and 145.00 ± 61.55, respectively), 4-8th hours (50.00 ± 64.88 and 121.25 ± 56.93 respectively), and in the total of 24 h (197.50 ± 133.74 and 368.75 ± 116.66 respectively) were significantly lower in Group Pv (p < 0.05). The dynamic VAS scores analyzed at the 1st and 2nd hours were significantly lower in Group Pv than Group Pi (p < 0.05). Eight patients in Group C, two patients in Group Pi and 1 patient in Group Pv required additional analgesics and the difference was significant (p < 0.05). Paravertebral block achieved more effective analgesia by reducing postoperative opioid consumption and VAS scores comparison to the control and peritubal infiltration groups in patients undergoing percutaneous nephrolithotomy.
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http://dx.doi.org/10.1007/s00240-018-01106-wDOI Listing
June 2020

Ultrasound-guided versus conventional injection for caudal block in children: A prospective randomized clinical study.

J Clin Anesth 2018 02 21;44:91-96. Epub 2017 Nov 21.

Department of Urology, Ataturk University School of Medicine, Erzurum, Turkey.

Study Objective: The aim of this study was to compare the efficacies of ultrasound guided sacral hiatus injection and conventional sacral canal injection performed for caudal block in children.

Design: Randomized controlled clinical trial.

Setting: Operating rooms of university hospital of Erzurum, Turkey.

Patients: One hundred-thirty four children, American Society of Anesthesiologists I-II, between the ages of 5 and 12, scheduled for elective phimosis and circumcision surgery.

Interventions: Patients assigned to two groups for ultrasound guided caudal block (Group U, n=68) or conventional caudal block (Group C, n=66). Caudal solution was prepared as 0.125% levobupivacaine plus 10mcg/kg morphine (total volume: 0.5ml/kg), and was administered to both groups.

Measurements: The block performing time, the block success rate, the number of needle puncture, the success at first puncture and the complications were recorded.

Main Results: The block performing time and the success rate of block were similar between Group U and Group C (109.96±49.73s vs 103.17±45.12s, and 97% vs 93%, respectively p>0.05). The first puncture success rate was higher in Group U than in Group C (80% vs 63%, respectively p=0.026). No significant difference was observed between the groups with regard to the number of needle punctures (p=0.060). The rates of vascular puncture and subcutaneus bulging were higher in Group C than in Group U (8/66 vs 1/68, and 8/66 vs 0/68, respectively p<0.05).

Conclusions: Despite the limitations in central neuroaxial anesthesia we recommend the use of ultrasound since it reduces the complications and increases the success rate of first puncture in pediatric caudal injection.
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http://dx.doi.org/10.1016/j.jclinane.2017.11.011DOI Listing
February 2018

Acute urinary retention after venlafaxine use.

Arch Ital Urol Androl 2017 Jun 30;89(2):160-161. Epub 2017 Jun 30.

Urology Department Atatürk University.

We describe a case of lower urinary system symptoms (LUSSs) and acute urinary retention that developed after treatment with a low dose of venlafaxine. A 48-year-old male patient was admitted to our clinic because of difficulty urinating, an intermittent stream, and trickling at the end of urination, together with urinary retention that had started about 45 days ago. The patient had been taking venlafaxine for the previous 6 months. The drug had been prescribed by the psychiatry department for a diagnosis of major depression, and the dose had been increased from 75 mg/day to 150 mg/day 1.5 months earlier. The patients' symptoms were thought to be related to venlafaxine, and the symptoms disappeared completely after venlafaxine was replaced with agomelatine. We concluded that the LUSSs and urinary retention were due to the venlafaxine treatment.
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http://dx.doi.org/10.4081/aiua.2017.2.160DOI Listing
June 2017