Anicteric hepatoxicity: a potential health risk of occupational exposures in Nigerian petroleum oil refining and distribution industry
Literature abounds linking one's job to certain unpalatable health outcomes. Since exposures to hazardous conditions in industrial environments often results in sundry health effects among workers, we embarked on this study to investigate the hepatic health effects of occupational activities in...
Gespeichert in:
Veröffentlicht in: | Journal of occupational medicine and toxicology (London, England) England), 2014-01, Vol.9 (1), p.3-3 |
---|---|
Hauptverfasser: | , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 3 |
---|---|
container_issue | 1 |
container_start_page | 3 |
container_title | Journal of occupational medicine and toxicology (London, England) |
container_volume | 9 |
creator | Ezejiofor, Tobias I Ndubuisi Ezejiofor, Anthonet N Orisakwe, Orish E Nwigwe, Hariet C Osuala, Ferdinand Ou Iwuala, Moses Oe |
description | Literature abounds linking one's job to certain unpalatable health outcomes. Since exposures to hazardous conditions in industrial environments often results in sundry health effects among workers, we embarked on this study to investigate the hepatic health effects of occupational activities in the petroleum refining and distribution industry.
Biochemical markers of liver functions were assayed in plasma, using Reflotron dry chemistry spectrophotometric system. The study was conducted on randomly selected workers of Port Harcourt Refining Company (PHRC) and Pipelines and Petroleum Product Marketing Company (PPMC) both in Alesa-Eleme near Port Harcourt, Nigeria, as well as non-oil work civil servants serving as control subjects.
Results showed that, bilirubin ranged 0.3-1.6 mg/dl with a mean of 0.66±0.20mg/dl among the oil workers as against 0.5-1.00mg/dl with a mean of 0.58±0.13mg/dl in non-oil workers, Alkaline phosphatase ranged 50.00-296.00u/l (mean: 126.21±39.49u/l) in oil workers as against 40.20-111u/l (mean: 66.83±18.54u/l) for non-oil workers, Aspartic transaminases (AST) ranged 5.80-140.20u/l (mean: 21.81±11.49u/l) in oil workers against 18.00-44.00u/l (mean: 26.89±6.99u/l) for non-oil workers, while Alanine transaminases (ALT) ranged 4.90-86.00u/l (mean: 22.14±11.28u/l) in oil workers as against 10.00-86.60u/l (mean: 22.30±10.22u/l) for the non-oil workers. A close study of the results revealed that although the mean values for all the studied parameters were still within the parametric reference ranges, however, relative to the referents, there were significant increases (P0.05), whereas data for age and exposure period classifications revealed that irrespective of the age of the worker, the effects are likely to start after the first five years, manifesting fully after the first decade of occupational exposures. Thus, an update of industrial/occupational health measures is necessary for a safer and healthier work environment. |
doi_str_mv | 10.1186/1745-6673-9-3 |
format | Article |
fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3901343</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A540640665</galeid><sourcerecordid>A540640665</sourcerecordid><originalsourceid>FETCH-LOGICAL-b572t-166d31ef7173840955d28f191f8668192d0d060f5c88ffddef31d8c48e11702a3</originalsourceid><addsrcrecordid>eNp1UsuOFCEUrRiNM44u3RoSN25qhKKAKhdmOhNfyUQ3uiY0j-47VkEJlJn-Ab9bKj220z4CCVzuuQcO51bVU4LPCen4SyJaVnMuaN3X9F51eojv39mfVI9Susa4ZQzTh9VJ07ZM4IaeVj9WHnS2ETTa2knlcAMa8u4VUmgK2foMaigZNeQtipC-ouBQ0HouUAi-5OzNFNIcbULg0UfYFCrl0WRzDIOdRxRgQNE68OA3SHmDDKQcYT0v9aXGzCXcPa4eODUk--R2Pau-vH3z-fJ9ffXp3YfL1VW9ZqLJNeHcUGKdIIJ2Le4ZM03nSE9cx3lH-sZggzl2THedc8ZYR4npdNtZQopeRc-q13veaV6P1ugiMKpBThFGFXcyKJDHGQ9buQnfJe0xoS0tBBd7gjWE_xAcZ3QY5eKDXHyQvVwoXty-IYZvs01ZjpC0HQblbZiTJAxjITjHC_T5H9DrMMfy7QXV9oQRIfrmN2qjBivBu1Bu1gupXLEW8zI5K6jzf6DKMHYEHXzxqJwfFdT7Ah1DSsXDg0qC5dJ7f-l6dvdvD-hfzUZ_AhDk1qI</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1491517792</pqid></control><display><type>article</type><title>Anicteric hepatoxicity: a potential health risk of occupational exposures in Nigerian petroleum oil refining and distribution industry</title><source>DOAJ Directory of Open Access Journals</source><source>SpringerNature Journals</source><source>PubMed Central Open Access</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Springer Nature OA/Free Journals</source><creator>Ezejiofor, Tobias I Ndubuisi ; Ezejiofor, Anthonet N ; Orisakwe, Orish E ; Nwigwe, Hariet C ; Osuala, Ferdinand Ou ; Iwuala, Moses Oe</creator><creatorcontrib>Ezejiofor, Tobias I Ndubuisi ; Ezejiofor, Anthonet N ; Orisakwe, Orish E ; Nwigwe, Hariet C ; Osuala, Ferdinand Ou ; Iwuala, Moses Oe</creatorcontrib><description>Literature abounds linking one's job to certain unpalatable health outcomes. Since exposures to hazardous conditions in industrial environments often results in sundry health effects among workers, we embarked on this study to investigate the hepatic health effects of occupational activities in the petroleum refining and distribution industry.
Biochemical markers of liver functions were assayed in plasma, using Reflotron dry chemistry spectrophotometric system. The study was conducted on randomly selected workers of Port Harcourt Refining Company (PHRC) and Pipelines and Petroleum Product Marketing Company (PPMC) both in Alesa-Eleme near Port Harcourt, Nigeria, as well as non-oil work civil servants serving as control subjects.
Results showed that, bilirubin ranged 0.3-1.6 mg/dl with a mean of 0.66±0.20mg/dl among the oil workers as against 0.5-1.00mg/dl with a mean of 0.58±0.13mg/dl in non-oil workers, Alkaline phosphatase ranged 50.00-296.00u/l (mean: 126.21±39.49u/l) in oil workers as against 40.20-111u/l (mean: 66.83±18.54u/l) for non-oil workers, Aspartic transaminases (AST) ranged 5.80-140.20u/l (mean: 21.81±11.49u/l) in oil workers against 18.00-44.00u/l (mean: 26.89±6.99u/l) for non-oil workers, while Alanine transaminases (ALT) ranged 4.90-86.00u/l (mean: 22.14±11.28u/l) in oil workers as against 10.00-86.60u/l (mean: 22.30±10.22u/l) for the non-oil workers. A close study of the results revealed that although the mean values for all the studied parameters were still within the parametric reference ranges, however, relative to the referents, there were significant increases (P<0.05) in plasma bilirubin (though anicteric) and alkaline phosphatase that was not matched with a corresponding increase in the plasma transaminases, suggesting a possibility that toxic anicteric hepatoxicity is part of the potential health effects of sundry exposures in the Nigeria petroleum oil refining and distribution industry. Gender differentiation data showed that though the mean values for the parameters were higher in males than females, the increases were not significant in most cases (P>0.05), whereas data for age and exposure period classifications revealed that irrespective of the age of the worker, the effects are likely to start after the first five years, manifesting fully after the first decade of occupational exposures. Thus, an update of industrial/occupational health measures is necessary for a safer and healthier work environment.</description><identifier>ISSN: 1745-6673</identifier><identifier>EISSN: 1745-6673</identifier><identifier>DOI: 10.1186/1745-6673-9-3</identifier><identifier>PMID: 24457023</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Bilirubin ; Health aspects ; Liver diseases ; Occupational hazards ; Petroleum industry ; Petroleum refineries ; Phosphatases ; Toxicity</subject><ispartof>Journal of occupational medicine and toxicology (London, England), 2014-01, Vol.9 (1), p.3-3</ispartof><rights>COPYRIGHT 2014 BioMed Central Ltd.</rights><rights>2014 Ezejiofor et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</rights><rights>Copyright © 2014 Ezejiofor et al.; licensee BioMed Central Ltd. 2014 Ezejiofor et al.; licensee BioMed Central Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b572t-166d31ef7173840955d28f191f8668192d0d060f5c88ffddef31d8c48e11702a3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3901343/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3901343/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,27929,27930,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24457023$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ezejiofor, Tobias I Ndubuisi</creatorcontrib><creatorcontrib>Ezejiofor, Anthonet N</creatorcontrib><creatorcontrib>Orisakwe, Orish E</creatorcontrib><creatorcontrib>Nwigwe, Hariet C</creatorcontrib><creatorcontrib>Osuala, Ferdinand Ou</creatorcontrib><creatorcontrib>Iwuala, Moses Oe</creatorcontrib><title>Anicteric hepatoxicity: a potential health risk of occupational exposures in Nigerian petroleum oil refining and distribution industry</title><title>Journal of occupational medicine and toxicology (London, England)</title><addtitle>J Occup Med Toxicol</addtitle><description>Literature abounds linking one's job to certain unpalatable health outcomes. Since exposures to hazardous conditions in industrial environments often results in sundry health effects among workers, we embarked on this study to investigate the hepatic health effects of occupational activities in the petroleum refining and distribution industry.
Biochemical markers of liver functions were assayed in plasma, using Reflotron dry chemistry spectrophotometric system. The study was conducted on randomly selected workers of Port Harcourt Refining Company (PHRC) and Pipelines and Petroleum Product Marketing Company (PPMC) both in Alesa-Eleme near Port Harcourt, Nigeria, as well as non-oil work civil servants serving as control subjects.
Results showed that, bilirubin ranged 0.3-1.6 mg/dl with a mean of 0.66±0.20mg/dl among the oil workers as against 0.5-1.00mg/dl with a mean of 0.58±0.13mg/dl in non-oil workers, Alkaline phosphatase ranged 50.00-296.00u/l (mean: 126.21±39.49u/l) in oil workers as against 40.20-111u/l (mean: 66.83±18.54u/l) for non-oil workers, Aspartic transaminases (AST) ranged 5.80-140.20u/l (mean: 21.81±11.49u/l) in oil workers against 18.00-44.00u/l (mean: 26.89±6.99u/l) for non-oil workers, while Alanine transaminases (ALT) ranged 4.90-86.00u/l (mean: 22.14±11.28u/l) in oil workers as against 10.00-86.60u/l (mean: 22.30±10.22u/l) for the non-oil workers. A close study of the results revealed that although the mean values for all the studied parameters were still within the parametric reference ranges, however, relative to the referents, there were significant increases (P<0.05) in plasma bilirubin (though anicteric) and alkaline phosphatase that was not matched with a corresponding increase in the plasma transaminases, suggesting a possibility that toxic anicteric hepatoxicity is part of the potential health effects of sundry exposures in the Nigeria petroleum oil refining and distribution industry. Gender differentiation data showed that though the mean values for the parameters were higher in males than females, the increases were not significant in most cases (P>0.05), whereas data for age and exposure period classifications revealed that irrespective of the age of the worker, the effects are likely to start after the first five years, manifesting fully after the first decade of occupational exposures. Thus, an update of industrial/occupational health measures is necessary for a safer and healthier work environment.</description><subject>Bilirubin</subject><subject>Health aspects</subject><subject>Liver diseases</subject><subject>Occupational hazards</subject><subject>Petroleum industry</subject><subject>Petroleum refineries</subject><subject>Phosphatases</subject><subject>Toxicity</subject><issn>1745-6673</issn><issn>1745-6673</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNp1UsuOFCEUrRiNM44u3RoSN25qhKKAKhdmOhNfyUQ3uiY0j-47VkEJlJn-Ab9bKj220z4CCVzuuQcO51bVU4LPCen4SyJaVnMuaN3X9F51eojv39mfVI9Susa4ZQzTh9VJ07ZM4IaeVj9WHnS2ETTa2knlcAMa8u4VUmgK2foMaigZNeQtipC-ouBQ0HouUAi-5OzNFNIcbULg0UfYFCrl0WRzDIOdRxRgQNE68OA3SHmDDKQcYT0v9aXGzCXcPa4eODUk--R2Pau-vH3z-fJ9ffXp3YfL1VW9ZqLJNeHcUGKdIIJ2Le4ZM03nSE9cx3lH-sZggzl2THedc8ZYR4npdNtZQopeRc-q13veaV6P1ugiMKpBThFGFXcyKJDHGQ9buQnfJe0xoS0tBBd7gjWE_xAcZ3QY5eKDXHyQvVwoXty-IYZvs01ZjpC0HQblbZiTJAxjITjHC_T5H9DrMMfy7QXV9oQRIfrmN2qjBivBu1Bu1gupXLEW8zI5K6jzf6DKMHYEHXzxqJwfFdT7Ah1DSsXDg0qC5dJ7f-l6dvdvD-hfzUZ_AhDk1qI</recordid><startdate>20140122</startdate><enddate>20140122</enddate><creator>Ezejiofor, Tobias I Ndubuisi</creator><creator>Ezejiofor, Anthonet N</creator><creator>Orisakwe, Orish E</creator><creator>Nwigwe, Hariet C</creator><creator>Osuala, Ferdinand Ou</creator><creator>Iwuala, Moses Oe</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T2</scope><scope>7U7</scope><scope>7X7</scope><scope>7XB</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7U1</scope><scope>7U2</scope><scope>5PM</scope></search><sort><creationdate>20140122</creationdate><title>Anicteric hepatoxicity: a potential health risk of occupational exposures in Nigerian petroleum oil refining and distribution industry</title><author>Ezejiofor, Tobias I Ndubuisi ; Ezejiofor, Anthonet N ; Orisakwe, Orish E ; Nwigwe, Hariet C ; Osuala, Ferdinand Ou ; Iwuala, Moses Oe</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b572t-166d31ef7173840955d28f191f8668192d0d060f5c88ffddef31d8c48e11702a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Bilirubin</topic><topic>Health aspects</topic><topic>Liver diseases</topic><topic>Occupational hazards</topic><topic>Petroleum industry</topic><topic>Petroleum refineries</topic><topic>Phosphatases</topic><topic>Toxicity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ezejiofor, Tobias I Ndubuisi</creatorcontrib><creatorcontrib>Ezejiofor, Anthonet N</creatorcontrib><creatorcontrib>Orisakwe, Orish E</creatorcontrib><creatorcontrib>Nwigwe, Hariet C</creatorcontrib><creatorcontrib>Osuala, Ferdinand Ou</creatorcontrib><creatorcontrib>Iwuala, Moses Oe</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Toxicology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of occupational medicine and toxicology (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ezejiofor, Tobias I Ndubuisi</au><au>Ezejiofor, Anthonet N</au><au>Orisakwe, Orish E</au><au>Nwigwe, Hariet C</au><au>Osuala, Ferdinand Ou</au><au>Iwuala, Moses Oe</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Anicteric hepatoxicity: a potential health risk of occupational exposures in Nigerian petroleum oil refining and distribution industry</atitle><jtitle>Journal of occupational medicine and toxicology (London, England)</jtitle><addtitle>J Occup Med Toxicol</addtitle><date>2014-01-22</date><risdate>2014</risdate><volume>9</volume><issue>1</issue><spage>3</spage><epage>3</epage><pages>3-3</pages><issn>1745-6673</issn><eissn>1745-6673</eissn><abstract>Literature abounds linking one's job to certain unpalatable health outcomes. Since exposures to hazardous conditions in industrial environments often results in sundry health effects among workers, we embarked on this study to investigate the hepatic health effects of occupational activities in the petroleum refining and distribution industry.
Biochemical markers of liver functions were assayed in plasma, using Reflotron dry chemistry spectrophotometric system. The study was conducted on randomly selected workers of Port Harcourt Refining Company (PHRC) and Pipelines and Petroleum Product Marketing Company (PPMC) both in Alesa-Eleme near Port Harcourt, Nigeria, as well as non-oil work civil servants serving as control subjects.
Results showed that, bilirubin ranged 0.3-1.6 mg/dl with a mean of 0.66±0.20mg/dl among the oil workers as against 0.5-1.00mg/dl with a mean of 0.58±0.13mg/dl in non-oil workers, Alkaline phosphatase ranged 50.00-296.00u/l (mean: 126.21±39.49u/l) in oil workers as against 40.20-111u/l (mean: 66.83±18.54u/l) for non-oil workers, Aspartic transaminases (AST) ranged 5.80-140.20u/l (mean: 21.81±11.49u/l) in oil workers against 18.00-44.00u/l (mean: 26.89±6.99u/l) for non-oil workers, while Alanine transaminases (ALT) ranged 4.90-86.00u/l (mean: 22.14±11.28u/l) in oil workers as against 10.00-86.60u/l (mean: 22.30±10.22u/l) for the non-oil workers. A close study of the results revealed that although the mean values for all the studied parameters were still within the parametric reference ranges, however, relative to the referents, there were significant increases (P<0.05) in plasma bilirubin (though anicteric) and alkaline phosphatase that was not matched with a corresponding increase in the plasma transaminases, suggesting a possibility that toxic anicteric hepatoxicity is part of the potential health effects of sundry exposures in the Nigeria petroleum oil refining and distribution industry. Gender differentiation data showed that though the mean values for the parameters were higher in males than females, the increases were not significant in most cases (P>0.05), whereas data for age and exposure period classifications revealed that irrespective of the age of the worker, the effects are likely to start after the first five years, manifesting fully after the first decade of occupational exposures. Thus, an update of industrial/occupational health measures is necessary for a safer and healthier work environment.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>24457023</pmid><doi>10.1186/1745-6673-9-3</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1745-6673 |
ispartof | Journal of occupational medicine and toxicology (London, England), 2014-01, Vol.9 (1), p.3-3 |
issn | 1745-6673 1745-6673 |
language | eng |
recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3901343 |
source | DOAJ Directory of Open Access Journals; SpringerNature Journals; PubMed Central Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Springer Nature OA/Free Journals |
subjects | Bilirubin Health aspects Liver diseases Occupational hazards Petroleum industry Petroleum refineries Phosphatases Toxicity |
title | Anicteric hepatoxicity: a potential health risk of occupational exposures in Nigerian petroleum oil refining and distribution industry |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-14T13%3A45%3A18IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Anicteric%20hepatoxicity:%20a%20potential%20health%20risk%20of%20occupational%20exposures%20in%20Nigerian%20petroleum%20oil%20refining%20and%20distribution%20industry&rft.jtitle=Journal%20of%20occupational%20medicine%20and%20toxicology%20(London,%20England)&rft.au=Ezejiofor,%20Tobias%20I%20Ndubuisi&rft.date=2014-01-22&rft.volume=9&rft.issue=1&rft.spage=3&rft.epage=3&rft.pages=3-3&rft.issn=1745-6673&rft.eissn=1745-6673&rft_id=info:doi/10.1186/1745-6673-9-3&rft_dat=%3Cgale_pubme%3EA540640665%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1491517792&rft_id=info:pmid/24457023&rft_galeid=A540640665&rfr_iscdi=true |