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Browsing by Author "Asirdizer M."

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The Correlation between Skull Fractures and Intracranial Lesions Due to Traffic Accidents
(2003) Yavuz M.S.; Asirdizer M.; Cetin G.; Balci Y.G.; Altinkok M.
In this study, it was aimed to investigate the relationship between skull fractures and intracranial lesions following head injury. For this purpose, 500 cases, which were referred to the Third Committee of Council of Forensic Medicine in Istanbul due to traffic accidents by the courts of laws between 1998 and 2000, were examined retrospectively. They were categorized in 3 groups based on findings of their cranium x-rays and brain tomographies. 1- The cases who have fractures in skull bones with brain lesions 2- The cases who have fractures in skull bones with no brain lesions 3-The cases who have brain lesions with no skull fractures. They were examined in detail according to age, sex, localization of skull fractures and brain lesions, and if surgery was applied or not. Of the cases, 152 (30.4%) had only linear fractures, 69 (13.8%) had depressed fractures, 92 (18.4%) had linear fractures plus intracranial lesions, 49 (9.8%) had depressed fractures plus intracranial lesions and 138 (27.6%) had only intracranial lesions. The rate of intracranial lesion among the cases with the skull fracture was 38.9% (141/362), while the rate of skull fracture among the cases with the intracranial lesion was 50.3% (141/279) (P < 0.001). Male to female ratios were 2.4/1 for linear fractures, 5.2/1 for depressed fractures, and 3.5/1 for intracranial lesions. Linear fractures were more frequent among females whereas depressed fractures were often among males (χ2: 9.68, df: 4, p: 0.046). The mean age was 26.3. The rate of depressed fractures was higher the age groups of 0-30 years. (χ 2: 16.28, df: 4, p: 0.003). Depressed fractures in the regions of frontal and parietal and, linear fracture in the regions of temporal and occipital were found at higher rates (P < 0.001). In conclusion, we reviewed skull fractures and/or intracranial lesions due to traffic accidents, and found depressed fractures to be more common among males whereas linear fractures to be more common among females and young males. In the male, the skull architecture is thicker and stronger than females and young males. We can state that presence of skull fractures lowers the incidence of intracranial lesions by lowering the intracranial pressure.
Deaths due to terrorist bombings in Istanbul (Turkey)
(Churchill Livingstone, 2004) Yavuz M.S.; Asirdizer M.; Cetin G.; Yavuz M.F.; Cansunar F.N.; Kolusayin R.O.
Our study was based on a retrospective analysis of terrorist bombing related deaths in Istanbul (Turkey) between 1976 and 2000. A total of 45,714 autopsy case reports from the Morgue Department of Council of Forensic Medicine were reviewed for this study. There were 120 (0.26%) deaths due to terrorist bombing. Terrorist bombing related deaths were significantly higher during the years of increasing terrorism events in Turkey. Ninety-eight (81.7%) of cases were male and 22 (18.3%) of cases were female. The most frequent age groups of victims and terrorists was between 21 and 30 years of age (n = 60; 50% of the total cases). In 49 events only one death occurred. The highest mortality was 24 in a single event. In this study, we have renewed of characteristics traumatic lesion to ascertain the cause of deaths and other autopsy findings in victims and terrorists. We also emphasize that scene investigation and medico-legal autopsy are the most important procedures provide appropriate information about deaths due to terrorist bombings. © 2004 Elsevier Ltd and AFP. All rights reserved.
Medicolegal evaluation of vascular injuries of limbs in Turkey
(Churchill Livingstone, 2004) Asirdizer M.; Yavuz M.S.; Buken E.; Daglar S.; Uzun I.
This study evaluated 372 cases of post-traumatic extremity vessel lesions, for which the Forensic Medicine Council, Istanbul, Turkey prepared medicolegal evaluation reports between 1998 and 2000. The study group (n = 372) comprised of 346 men (93.0%) and 26 women (6.9%), and their ages ranged between 6 and 73 years (30.18±6.13). There were 378 artery (74.5%), and 131 vein injuries (25.5%) out of a total of 509 limb vascular injuries. The most frequently injured arteries and veins were the femoral artery (n = 73), and the deep femoral vein (n = 41), respectively. The causes of injuries were as follows: cutting and stabbing complements, in 160 cases (43.0%); gunshots in 136 cases (36.6%); traffic accidents in 52 cases (14%); work accidents in 23 cases (6.2%); and blunt trauma in one case (0.3%). These injuries were accompanied by local nerve lesions (27.1%), local bone lesions (37.1%), and injuries to other organs (11.0%). The medicolegal assessments by the Forensic Medicine Council showed that there were risk of death in 371 cases. Additionally, there was 'organ dysfunction' in 37 (9.9%) and 'organ loss' in 53 (14.2%) cases. The results of this study suggested that the main causes of severe vascular injuries (i.e. those accompanied by bone and nerve lesions) had serious consequences such as amputation, permanent disorders or loss of function and were caused by gunshot and traffic accidents. © 2003 Elsevier Ltd and AFP. All rights reserved.
Unusual torture methods and mass murders applied by a terror organization
(2004) Asirdizer M.; Yavuz M.S.; Sari H.; Canturk G.; Yorulmaz C.
This study aims at describing autopsy findings of 19 victims killed by various torture methods applied by a terror organization after they had been kidnapped by this organization, as well as the unusual and unique binding style applied during these killings. The present study also aims at describing the unusual killing method of binding for literature and discussing international descriptions of torture.
Femoral and tibial fractures in a child with myelomeningocele
(2005) Asirdizer M.; Zeyfeoglu Y.
Femoral and tibial fractures can occur from accidents, child abuse or pathological causes. It is often very difficult to distinguish the cause among those cases. Radiological diagnosis may be needed for clinicians and medical examiners in order to assist determining the reason of fractures. In this report, we submit a case with femoral and tibial fractures associated with myelomeningocele. This patient was diagnosed as child abuse by clinicians. On review it was decided that her fractures were not because of non-accidental injury. The values of bone mineral density of the upper limb were low and illness caused her fractures. © 2004 Elsevier Ltd and AFP. All rights reserved.
The role of eustachian valve and patent foramen ovale in sudden death
(2006) Asirdizer M.; Tatlisumak E.
Sudden unexpected cardiac death is the leading cause of death in industrialized countries. Patent foramen ovale and eustachian valve are two of cardiac diseases and they may be associated with clinical disorders as embolism, stroke, plathypnea-orthodeoxia syndrome, carcinoid heart disease, atrial flutter and endocarditis. The literature for the roles of patent foramen ovale and eustachian valve in the causes of sudden deaths are reviewed. © 2005 Elsevier Ltd and AFP.
Identification of unknown bodies by using CT images of frontal sinus
(Elsevier Ireland Ltd, 2007) Tatlisumak E.; Yilmaz Ovali G.; Aslan A.; Asirdizer M.; Zeyfeoglu Y.; Tarhan S.
The aim of the study was to define a simple system for the identification of unknown bodies by using CT images of frontal sinus and to discuss whether it was worth to add measurements to the system or not. The system was including simple features as F (presence or absence of frontal sinus), S (intersinus and intrasinus septum) and S (scalloping), and named as FSS system. Measurements selected for the study were width, height, anteroposterior length, total width of two sinuses, the distance between the highest points of the two sinuses and the distance of each sinus to its maximum lateral limit. The study was conducted retrospectively on the paranasal CT scans of 100 cases (38 male and 62 female) who had no apparent sinonasal pathology. All the features and measurements were coded according to the system defined by the authors for each case and coded formulas were compared. At least 93% of the formulas could be eliminated for a case by using FSS system. The rate of success was increased to 98% by adding measurements. Contrary to objective criteria of FSS system, measurements were prone to bias. Therefore, in practice success rate would be expected to be lower than calculated. In the study population, instead of making 100 measurements, eliminating the most of the cases with FSS system and later discriminating the rest by pattern matching was seen logical. © 2006 Elsevier Ireland Ltd. All rights reserved.
CT study on morphometry of frontal sinus
(2008) Tatlisumak E.; Ovali G.Y.; Asirdizer M.; Aslan A.; Ozyurt B.; Bayindir P.; Tarhan S.
The aim of this study was to determine the prevalence and morphological characteristics of the frontal sinus in an adult population. This study was conducted retrospectively on paranasal CT scans in the axial and coronal planes of 300 cases (123 male and 177 female). The mean age was 40.74 ± 13.34 (range 20-83). Measurements of the width, height and anteroposterior length for each sinus and total width were obtained from CT scans. Measurements were compared statistically with relation to side and sex. The cases were divided into subgroups according to age for each sex and each measurement parameter was also compared among the subgroups. All measurements tended to be larger on the left side and were significantly larger in males than females. There was a significant difference in the anteroposterior lengths of right and left sides in both males and females and height for males and width for females. In both sexes, the highest values of measurements were usually observed at the 31-40 age group and there was a tendency to decrease with aging. The larger diameters of the left frontal sinus imply that it may be more possibly violated during surgical interventions. Morphometric features differed significantly in the two sexes at different ages and comparison with previous studies presented great regional variability. The size of the frontal sinus was seen to be related to age and sex. The knowledge provided in the present study is useful for some surgical procedures and widens the anthropometric knowledge of humanity. © 2008 Wiley-Liss, Inc.
A battered child case with duodenal perforation
(2008) Yavuz M.S.; Buyukyavuz I.; Savas C.; Ozguner I.F.; Kupeli A.; Asirdizer M.
Battered child syndrome can refer to children exposed to harmful, non-accidental and preventable physical treatment by those are responsible for their care which prevents the child's physical, cognitive and spiritual development. A 28 months old boy was submitted to hospital due to abdominal blunt trauma. He had been firstly applied to Isparta Children Hospital by his parents with the complaint of fever. In the first examination, he was conscious, his general condition was poor there was respiratory acidosis, and neck stiffness was present. There were several fresh traumatic lesions on his face and left arm. His complaints were thought due to meningitis and antibiotics were started. He was transported to Suleyman Demirel University Hospital after a day because of vomiting, abdominal pain, tender, distended and silent abdomen, and air-fluid levels in direct abdominal X-rays. An old fracture of the right 9th rib was detected with chest X-ray in university hospital. Additionally, abdominal ultrasound scan showed distended bowel loops filled with fluid. Laparotomy revealed a complete rupture of the junction of the third and fourth parts of the duodenum and several hemorrhagic regions on bowel loops. The patient was discharged after 42 days. This case report described the case through both medical and legal processed in Turkey. © 2007 Elsevier Ltd and FFLM.
Criminal and legal responsibilities in Tourette's syndrome
(Mediafarm Group, 2009) Gullucayir S.; Asirdizer M.; Yavuz M.S.; Zeyfeoglu Y.; Ulucay T.
Tourettes Syndrome (TS) is a neuropsychological disorder characterized by the presence of multiple involuntary motor tics accompanied by one or more vocal tics. Articles about TS and criminal responsibility and the restriction of civil rights are limited. A person with TS was evaluated to consider his criminal responsibility after swearing at a referee during a football game. He was also evaluated as to whether or not he was capable of professionally driving a service bus. Additionally, medico-legal situations regarding military service, obtaining a shotgun license and marriages of patients with TS were considered.
Defining the macroscopic and microscopic findings of experimental focal brain ischemia in rats from a forensic scientist's point of view
(2009) Tatlisumak E.; Inan S.; Asirdizer M.; Apaydin N.; Hayretdag C.; Kose C.; Tekdemir I.
Approximately 10% of all deaths in the world occur as a result of stroke. Determination of the time schedule of the pathologic events in a stroke patient is invaluable for a forensic specialist. The aim of this study was to define the schedule of the macroscopic and microscopic changes that occurred in a rat model of permanent focal ischemia for providing useful clues for the evaluation of stroke patients. Male Wistar rats weighing 250 to 350 g were used in this study. Permanent focal brain ischemia was applied by the suture occlusion method. The animals were divided into 7 experimental groups (n ≤ 6) with time schedules including 1.5, 3, 6, 12, 24, 72 hours, and the sham. Brains were harvested at the end of the determined time schedule. Lesions in the frontoparietal cortex were evaluated macroscopically first and later hematoxylin eosin stained sections from the infarct core were investigated microscopically. Macroscopically, enlargement of the ipsilateral hemisphere was mild at 6 hour, apparent at 12 and 24 hours, and mild again at 72 hours. Microscopically, ischemic changes were apparent even at 1.5 hour. Red neurons and infiltration of the parenchyma with neutrophil leukocytes were observed at 12 hours. Pannecrosis and massive leukocyte infiltration were observed at 72 hours. Macroscopic and microscopic findings obtained from a rat model may provide clues for determination of the time-dependent changes due to brain ischemia in human subjects. Finally, the benefits of determination of time course of pathologic changes in the brain for forensic scientists were discussed. © 2009 by Lippincott Williams & Wilkins.
A case of shotgun injury which occurred while an unconventional home security alarm system was being checked
(Elsevier Ireland Ltd, 2009) Asirdizer M.; Yavuz M.S.
Installation of devices involving shotguns is rarely encountered in forensic medicine practice. In this case report, authors aimed to present an unusual and rare case of shotgun injury due to a home security alarm system and its legal assessment. An electrical technician was invited to a summer house to check a home security alarm system installed by another firm which he worked for previously. It was an unconventional home security alarm system attached to a shotgun. The technician was injured with 18 buckshot pellets (no: 4) while checking the system. The host was convicted of a possible intent to cause a life-threatening injury to the technician. We think that this verdict will set a precedent for similar cases. © 2009 Elsevier Ireland Ltd. All rights reserved.
Suicides in Turkey between 1996 and 2005: General perspective
(2010) Asirdizer M.; Yavuz M.S.; Demirag Aydin S.; Dizdar M.G.
Suicide is a significant problem in the world. Sharing the information about the national suicide rates in the international scientific area is an important issue for not only the solution of the problem, but also improving the efforts for decreasing the suicidal deaths. We aimed to add the statistical information about the rates, the risk factors, and the methods of suicides in Turkey to the literature. The suicide rates in Turkey increased in the period between 1996 and 2005 years; it was 3.8 per 100,000 populations in 2005. The average ratio of male to female was 1.58/1 between 1996 and 2005 years. The suicidal deaths increased above the age of 75, especially in male population. In females, the most dangerous period was 15 to 24 age group. The major risk factor for suicides was found to be illness (29.6%) for both genders and especially for above middle ages. Hanging was the most preferred method for both genders and for most of the age groups in Turkey. Suicides increased in the spring and summer. Copyright © 2010 by Lippincott Williams & Wilkins.
A comparative and comprehensive analysis of nonsexual assaults
(2011) Asirdizer M.; Yavuz M.S.
The aim of this study was to make a comparative and comprehensive analysis of nonsexual assaults in 488 medico-legal cases presented to Forensic Medicine Outpatient Clinic of Celal Bayar University Hospital (Manisa, Turkey), between 2005 and 2009. There were blunt force injuries (BFI) in 262 cases (53.7%), sharp force injuries (SFI) in 163 cases (33.4%), and firearm-related wounds (FRW) in 63 cases (12.9%). The results showed significant differences in the monthly distribution of assaults, localization of injuries, and severity of injuries depending on the types of assaults. Most of the injuries were localized to the face, head, and neck in BFI and SFI and to the lower limbs in FRW. The results of this study will help researchers to investigate characteristics of victims, offenders, and injuries and types of assaults because of nonsexual violence. © 2011 American Academy of Forensic Sciences.
Review of detection frequency and type of synthetic cannabinoids in herbal compounds analyzed by Istanbul Narcotic Department of the Council of Forensic Medicine, Turkey
(Churchill Livingstone, 2013) Gurdal F.; Asirdizer M.; Aker R.G.; Korkut S.; Gocer Y.; Kucukibrahimoglu E.E.; Ince C.H.
In recent years, synthetic cannabinoids have been frequently observed in seized materials all over the world. This new generation of designer drugs, mixed with herbal substances, is also known as "Herbal Highs" or "Legal Highs". There are many articles about the history, type and pharmaco-chemical properties of synthetic cannabinoids in the literature; however the number of articles about the frequency of their detection is limited. In this study, we evaluated the type and detection frequency of synthetic cannabinoids in Istanbul and its surrounding area. The reports of the Council of Forensic Medicine-Istanbul Narcotic Department were retrospectively reviewed for the presence of synthetic cannabinoids in herbal compounds sent by the judicial authorities between August 01, 2010 and March 31, 2012. Among 1200 herbal compounds, 1179 of them (98.3%) contained synthetic cannabinoids. Twenty-one samples (1.7%) had other psychoactive substances. The analysis of 1179 samples showed that JWH-018 was present in 1172 (99.4%) of the samples. JWH-081 was found in 777 samples (65.9%) together with JWH-018. Samples had different package names. "Bonzai Aromatic Potpourri" (n = 755; 64.0%) and "Bonzai Plant Growth Regulator" (n = 316; 26.8%) were the most common product names amongst the herbal products in this study. It is clear from the present study and previous studies that brand name of synthetic cannabinoids that dominate the market exhibit regional differences as to the type and detection frequency of synthetic cannabinoids and the content of herbal highs packages. The number and diversity of synthetic cannabinoid compounds have increased dramatically in the drug market in recent years. New, different, potent derivatives appear on the market almost every day and this presents important problems that need to be solved by scientists and judicial authorities working to prevent their harm. These problems include the limited knowledge about their frequency, the lack of analytical data and reference standards for analysis of these new derivates, the lack of information on their toxic effects, and information about the metabolism and metabolites for toxicological analysis in human subjects. © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
A review of suspected cases of driving under the influence of drugs (DUID) involved in traffic accidents in Istanbul (Turkey)
(Churchill Livingstone, 2013) Acar F.; Asirdizer M.; Aker R.G.; Kucukibrahimoglu E.E.; Ates I.; Erol Y.; Sahin A.
Nowadays traffic accidents, which have high mortality and morbidity, are an important public health problem. The association between the use of alcohol and/or drugs by drivers and the increased risk of traffic accidents with a high risk of death and injury has been well described in the literature. This study aimed to review the incidence of cases of driving under the influence of drugs (DUID) among all cases of driving under the influence (DUI) of alcohol and/or other drugs involved in traffic accidents and to evaluate the type of the psychoactive drugs (with or without alcohol) detected in blood samples in Istanbul and its surrounding area. This study is the first investigation on the subject of DUID cases in Turkey. The reports of the Istanbul Toxicology Department of the Council of Forensic Medicine (Turkey) on suspected DUID cases involved in traffic accidents between 1 July 2010 and 30 June 2011 were retrospectively reviewed for alcohol and/or drug use. Alcohol analysis was requested in 4274 suspected DUI cases, whereas drug along with alcohol analysis was requested in only 91. The rate of suspected DUID cases (n = 91) among the suspected DUI cases (n = 4274) was only 2.1% and in this study, we evaluated only the DUID cases in detail. Alcohol was present in 44% of suspected DUID cases. Psychoactive drugs were present in 15.4% of cases. The incidence among 46 confirmed DUID cases was found to be 17.4% for cannabis, 8.7% for benzodiazepines, 4.3% for barbiturates, 4.3% for antidepressants, 2.2% for cocaine and 2.2% for amphetamines. Although there is a zero-tolerance approach for DUID in the Turkish regulations, it is not well recognised and not inspected by police and legal authorities who are responsible for taking measures in traffic accidents and for routine traffic controls in Turkey. It is concluded that psychoactive drugs should be checked as well as alcohol in all traffic accident cases and roadside controls. © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
The postman always rings twice: Two cases of shotgun deaths associated with an unconventional home security alarm system
(Lippincott Williams and Wilkins, 2014) Asirdizer M.; Turkmen N.; Akan O.; Yavuz M.S.
Injury and death cases caused by booby traps are not common in forensic medicine practice. Besides, installation of booby traps including firearms is generally for suicidal and rarely for homicidal purposes. Although few patents were described about home security alarm system that were created by firearms in the United States, 1 sample of injury with a similar unconventional mechanism of home safety system was reported by Asirdizer and Yavuz in 2009. In the published case report, the story of an electrical technician who was invited to a summer house by the homeowner to check the home security alarm system was reported. In the so-called report, he was stated to be injured by the shotgun attached to the unconventional home security alarm system while checking the system. As a result, the homeowner was convicted of a possible intent to cause a life-threatening injury to the technician.The so-called homeowner and his wife died by the same shotgun attached to the same unconventional home security alarm system 4 years on from the first event. In the present case report, we have aimed to present the findings of the crime scene and the autopsies of these unusual 2 deaths and to discuss individual and legal factors in paving the way for the deaths of 2 people. © 2014 by Lippincott Williams & Wilkins.
Asymmetry, handedness and auricle morphometry; [Asimetría, lateralidad y morfometría de la oreja]
(Universidad de la Frontera, 2015) Tatlisumak E.; Yavuz M.S.; Kutlu N.; Asirdizer M.; Yoleri L.; Aslan A.
The aims of this study were to determine various morphometric measurements of auricle, to investigate asymmetry and its relation with handedness in both sexes. Main morphometric measurements of both auricles and hand preferences were determined on 200 male and 200 female healthy university students. All measurements of the auricles were larger in males than the corresponding ones in females and all the differences except earlobe widths were statistically significant. All measurements of left and right auricles were statistically significantly different in both sexes except earlobe length in males, and distance from the highest point of the auricle to the bottom of the intertragic notch and earlobe length in females. Auricle length and distance from the highest point of the auricle to the bottom of the intertragic notch had higher values at the left side and all other measurements were larger at the right side. There was no significant difference between the measurements of the corresponding auricles of the righthanded and lefthanded subjects. All measurements were larger at the right side except auricle length and distance from the highest point of the auricle to the bottom of the intertragic notch in righthanded and lefthanded subjects and all differences except earlobe length were significantly different in righthanded subjects as in the total population but in lefthanded subjects the difference of the auricle width was not significant, either. There was an apparent asymmetry of right and left auricles of normal people in the current study which should be taken in to consideration in plastic surgeries of the external ear, designing the ear devices and forensic applications of earprints. © 2015, Universidad de la Frontera. All rights reserved.
The effects of gender and age on forensic personal identification from frontal sinus in a Turkish population
(Saudi Arabian Armed Forces Hospital, 2017) Tatlisumak E.; Asirdizer M.; Bora A.; Hekimoglu Y.; Etli Y.; Gumus O.; Keskin S.
Objectives: To define the dimensions of the frontal sinus in groups standardized for age and gender and to discuss the reasons and the effects of the variations. Methods: Frontal sinus measurements were obtained from paranasal CT scans of 180 males and 180 females in the Radiology Department of Dursun Odabas Medical Center of Yuzuncu Yil University, Van, which is located in Eastern Turkey, between February and March 2016. The width and height of sinuses were measured on a coronal plane, and the anteroposterior length was measured on an axial plane. Volumes were calculated using the Hospital Information Management Systems and Image Archiving and Management System program. The Statistical Package of the Social Science version 13 was used for statistical analyses. Results: We determined differences in the frontal sinus measurements of different age groups in a Turkish adult population. Frontal sinus dimensions were usually higher in females and lower in males after 40-49 years of age than their younger counterparts, but the measurements were lower in females and higher in males in 70≤ years of age group than 60-69 years of age. Left frontal sinus was dominant in young age groups but right frontal sinus was dominant in groups 40-49 years of age or older. Conclusion: We observed crossing of the measurements between the different age groups, which we could not find clear explanations. The results of such studies may affect forensic identification from frontal sinus measurements. © 2017, Saudi Arabian Armed Forces Hospital. All rights reserved.
The possible effects of altitude and climate on the development of the frontal sinus in adults; [Los Posibles Efectos de la Altitud y el Clima sobre el Desarrollo del Seno Frontal en Adultos]
(Universidad de la Frontera, 2017) Asirdizer M.; Tatlisumak E.; Bora A.; Tarhan S.; Ovali G.Y.; Hekimoglu Y.; Kartal E.; Keskin S.
Climatic and altitude features of living region may affect human body. Many changes in several tissues and organs and several health problems due to climatic and altitude effects were defined in the literature. However, there were limited number of studies which evaluated correlation between development of frontal sinus and climatic/altitude effect. In this study, widths, heights, AP lengths and volumes of frontal sinus were compared by Paranasal CT scans in populations living in Van which has colder climate and higher altitude and Manisa which has milder climate and lower altitude. It was found that widths, antero-posterior lengths and volumes of frontal sinus were higher in populations living in colder climate and higher altitude according to populations living in milder climate and lower altitude. Heights of frontal sinuses were on the contrary of this. These results were found appropriate to increasing of cephalic index in cold climate according to Allen’s Rule. We suggest that larger population study should be made with peoples having the same or similar race and genetic structure in different climate and altitude regions and the proportional comparison of frontal sinus measurements with cephalic index should be considered in future studies. © 2017, Universidad de la Frontera. All rights reserved.

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