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Özdemir İ, Etyemez S, Barker PB. High-field downfield MR spectroscopic imaging in the human brain. Magn Reson Med 2024; 92:890-899. [PMID: 38469953 PMCID: PMC11209804 DOI: 10.1002/mrm.30075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 02/07/2024] [Accepted: 02/19/2024] [Indexed: 03/13/2024]
Abstract
PURPOSE To investigate the feasibility of downfield MR spectroscopic imaging (DF-MRSI) in the human brain at 7T. METHODS A 7T DF-MRSI pulse sequence was implemented based on the previously described methodology at 3T, with 3D phase-encoding,1 3 ‾ 3 1 ‾ $$ 1\overline{3}3\overline{1} $$ spectral-spatial excitation, and frequency selective refocusing. Data were pre-processed followed by analysis using the "LCModel" software package, and metabolite maps created from the LCModel results. Total scan time, including brain MRI and a water-reference MRSI, was 24 min. The sequence was tested in 10 normal volunteers. Estimated metabolite levels and uncertainty values (Cramer Rao lower bounds, CRLBs) for nine downfield peaks were compared between seven different brain regions, anterior cingulate cortex (ACC), centrum semiovale (CSO), corpus callosum (CC), cerebellar vermis (CV), dorsolateral prefrontal cortex (DLPFC), posterior cingulate cortex (PCC), and thalamus (Thal). RESULTS DF peaks were relatively uniformly distributed throughout the brain, with only a small number of peaks showing any significant regional variations. Most DF peaks had average CRLB<25% in most brain regions. Average SNR values were higher for the brain regions ACC and DLPFC (˜7 ± 0.95, mean ± SD) while in a range of 3.4-6.0 for other brain regions. Average linewidth (FWHM) values were greater than 35 Hz in the ACC, CV, and Thal, and 22 Hz in CC, CSO, DLPFC, and PCC. CONCLUSION High-field DF-MRSI is able to spatially map exchangeable protons in the human brain at high resolution and with near whole-brain coverage in acceptable scan times, and in the future may be used to study metabolism of brain tumors or other neuropathological disorders.
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Affiliation(s)
- İpek Özdemir
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Semra Etyemez
- Department of Obstetrics & Gynecology, Weill Cornell Medicine, New York, NY
- Department of Psychiatry, Weill Cornell Medicine, New York, NY
| | - Peter B. Barker
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
- F.M. Kennedy Krieger Institute, Baltimore, MD, United States
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Swago S, Elliott MA, Nanga RPR, Wilson NE, Cember A, Reddy R, Witschey WR. Quantification of cross-relaxation in downfield 1 H MRS at 7 T in human calf muscle. Magn Reson Med 2023; 90:11-20. [PMID: 36807934 PMCID: PMC10149600 DOI: 10.1002/mrm.29615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 12/30/2022] [Accepted: 01/23/2023] [Indexed: 02/20/2023]
Abstract
PURPOSE The purpose of this study was to characterize the 1 H downfield MR spectrum from 8.0 to 10.0 ppm of human skeletal muscle at 7 T and determine the T1 and cross-relaxation rates of observed resonances. METHODS We performed downfield MRS in the calf muscle of 7 healthy volunteers. Single-voxel downfield MRS was collected using alternately selective or broadband inversion-recovery sequences and spectrally selective 90° E-BURP RF pulse excitation centered at 9.0 ppm with bandwidth = 600 Hz (2.0 ppm). MRS was collected using TIs of 50-2500 ms. We modeled recovery of the longitudinal magnetization of three observable resonances using two models: (1) a three-parameter model accounting for the apparent T1 recovery and (2) a Solomon model explicitly including cross-relaxation effects. RESULTS Three resonances were observed in human calf muscle at 7 T at 8.0, 8.2, and 8.5 ppm. We found broadband (broad) and selective (sel) inversion recovery T1 = mean ± SD (ms): T1-broad,8.0ppm = 2108.2 ± 664.5, T1-sel,8.0ppm = 753.6 ± 141.0 (p = 0.003); T1-broad,8.2ppm = 2033.5 ± 338.4, T1-sel,8.2ppm = 135.3 ± 35.3 (p < 0.0001); and T1-broad,8.5ppm = 1395.4 ± 75.4, T1-sel,8.5ppm = 107.1 ± 40.0 (p < 0.0001). Using the Solomon model, we found T1 = mean ± SD (ms): T1-8.0ppm = 1595.6 ± 491.1, T1-8.2ppm = 1737.2 ± 963.7, and T1-8.5ppm = 849.8 ± 282.0 (p = 0.04). Post hoc tests corrected for multiple comparisons showed no significant difference in T1 between peaks. The cross-relaxation rate σAB = mean ± SD (Hz) of each peak was σAB,8.0ppm = 0.76 ± 0.20, σAB,8.2ppm = 5.31 ± 2.27, and σAB,8.5ppm = 7.90 ± 2.74 (p < 0.0001); post hoc t-tests revealed the cross-relaxation rate of the 8.0 ppm peak was significantly slower than the peaks at 8.2 ppm (p = 0.0018) and 8.5 ppm (p = 0.0005). CONCLUSION We found significant differences in effective T1 and cross-relaxation rates of 1 H resonances between 8.0 and 8.5 ppm in the healthy human calf muscle at 7 T.
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Affiliation(s)
- Sophia Swago
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA
| | - Mark A. Elliott
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Ravi Prakash Reddy Nanga
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Neil E. Wilson
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Abigail Cember
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Ravinder Reddy
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Walter R. Witschey
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Gonçalves SI, Simões RV, Shemesh N. Short TE downfield magnetic resonance spectroscopy in a mouse model of brain glioma. Magn Reson Med 2022; 88:524-536. [PMID: 35315536 DOI: 10.1002/mrm.29243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 11/11/2022]
Abstract
PURPOSE Enhanced cell proliferation in tumors can be associated with altered metabolic profiles and dramatic microenvironmental changes. Downfield magnetic resonance spectroscopy (MRS) has received increasing attention due to its ability to report on labile resonances of molecules not easily detected in upfield 1 H MRS. Image-selected-in-vivo-spectroscopy-relaxation enhanced MRS (iRE-MRS) was recently introduced for acquiring short echo-time (TE) spectra. Here, iRE-MRS was used to investigate in-vivo downfield spectra in glioma-bearing mice. METHODS Experiments were performed in vivo in an immunocompetent glioma mouse model at 9.4 T using a cryogenic coil. iRE-MRS spectra were acquired in N = 6 glioma-bearing mice (voxel size = 2.23 mm3 ) and N = 6 control mice. Spectra were modeled by a sum of Lorentzian peaks simulating known downfield resonances, and differences between controls and tumors were quantified using relative peak areas. RESULTS Short TE tumor spectra exhibited large qualitative differences compared to control spectra. Most peaks appeared modulated, with strong attenuation of NAA (∼7.82, 7.86 ppm) and changes in relative peak areas between 6.75 and 8.49 ppm. Peak areas tended to be smaller for DF6.83 , DF7.60 , DF8.18 and NAA; and larger for DF7.95 and DF8.24 . Differences were also detected in signals resonating above 8.5 ppm, assumed to arise from NAD+. CONCLUSIONS In-vivo downfield 1 H iRE-MRS of mouse glioma revealed differences between controls and tumor bearing mice, including in metabolites which are not easily detectable in the more commonly investigated upfield spectrum. These findings motivate future downfield MRS investigations exploring pH and exchange contributions to these differences.
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Affiliation(s)
| | - Rui V Simões
- Champalimaud Research, Champalimaud Foundation, Lisbon, Portugal
| | - Noam Shemesh
- Champalimaud Research, Champalimaud Foundation, Lisbon, Portugal
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Považan M, Schär M, Gillen J, Barker PB. Magnetic resonance spectroscopic imaging of downfield proton resonances in the human brain at 3 T. Magn Reson Med 2021; 87:1661-1672. [PMID: 34971460 DOI: 10.1002/mrm.29142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE To develop an MRSI technique capable of mapping downfield proton resonances in the human brain. METHODS A spectral-spatial excitation and frequency-selective refocusing scheme, in combination with 2D phase encoding, was developed for mapping of downfield resonances without any perturbation of the water magnetization. An alternative scheme using spectral-spatial refocusing was also investigated for simultaneous detection of both downfield and upfield resonances. The method was tested in 5 healthy human volunteers. RESULTS Downfield metabolite maps with a nominal spatial resolution of 1.5 cm3 were recorded at 3 T in a scan time of 12 minutes. Cramer-Rao lower bounds for nine different downfield peaks were 20% or less over a single supraventricular slice. Downfield spectral profiles were similar to those in the literature recorded previously using single-voxel localization methods. The same approach was also used for upfield MRSI, and simultaneous upfield and downfield acquisitions. CONCLUSION The developed MRSI pulse sequence was shown to be an efficient way of rapidly mapping downfield resonances in the human brain at 3 T, maximizing sensitivity through the relaxation enhancement effect. Because the MRSI approach is efficient in terms of data collection and can be readily implemented at short TE, somewhat higher spatial resolution can be achieved than has been reported in previous single-voxel downfield MRS studies. With this approach, nine downfield resonances could be mapped in a single slice for the first time using MRSI at 3 T.
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Affiliation(s)
- Michal Považan
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michael Schär
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Joseph Gillen
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Peter B Barker
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
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Dziadosz M, Bogner W, Kreis R. Non-water-excitation MR spectroscopy techniques to explore exchanging protons in human brain at 3 T. Magn Reson Med 2020; 84:2352-2363. [PMID: 32602971 DOI: 10.1002/mrm.28322] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 04/23/2020] [Accepted: 04/23/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE To develop localization sequences for in vivo MR spectroscopy (MRS) on clinical scanners of 3 T to record spectra that are not influenced by magnetization transfer from water. METHODS Image-selected in vivo spectroscopy (ISIS) localization and chemical-shift-selective excitation (termed I-CSE) was combined in two ways: first, full ISIS localization plus a frequency-selective spin-echo and second, two-dimensional (2D) ISIS plus a frequency-selective excitation and slice-selective refocusing. The techniques were evaluated at 3 T in phantoms and human subjects in comparison to standard techniques with water presaturation or metabolite-cycling. ISIS included gradient-modulated offset-independent adiabatic (GOIA)-type adiabatic inversion pulses; echo times were 8-10 ms. RESULTS The novel 2D and 3D I-CSE methods yield upfield spectra that are comparable to those from standard MRS, except for shorter echo times and a limited frequency range. On the downfield/high-frequency side, they yield much more signal for exchangeable protons when compared to MRS with water presaturation or metabolite-cycling and longer echo times. CONCLUSION Novel non-water-excitation MRS sequences offer substantial benefits for the detection of metabolite signals that are otherwise suppressed by saturation transfer from water. Avoiding water saturation and using very short echo times allows direct observation of faster exchanging moieties than was previously possible at 3 T and additionally makes the methods less susceptible to fast T2 relaxation.
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Affiliation(s)
- Martyna Dziadosz
- Departments of Radiology and Biomedical Research, University of Bern, Bern, Switzerland.,Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Wolfgang Bogner
- High-field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Vienna, Austria
| | - Roland Kreis
- Departments of Radiology and Biomedical Research, University of Bern, Bern, Switzerland
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Lin L, Považan M, Berrington A, Chen Z, Barker PB. Water removal in MR spectroscopic imaging with L2 regularization. Magn Reson Med 2019; 82:1278-1287. [PMID: 31148254 DOI: 10.1002/mrm.27824] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 04/03/2019] [Accepted: 05/01/2019] [Indexed: 12/31/2022]
Abstract
PURPOSE An L2-regularization based postprocessing method is proposed and tested for removal of residual or unsuppressed water signals in proton MR spectroscopic imaging (MRSI) data recorded from the human brain at 3T. METHODS Water signals are removed by implementation of the L2 regularization using a synthesized water-basis matrix that is orthogonal to metabolite signals of interest in the spectral dimension. Simulated spectra with variable water amplitude and in vivo brain MRSI datasets were used to demonstrate the proposed method. Results were compared with two commonly-used postprocessing methods for removing water signals. RESULTS The L2 method yielded metabolite signals that were close to true values for the simulated spectra. Residual/unsuppressed water signals in human brain short- and long-echo time MRSI datasets were efficiently removed by the proposed method allowing good quality metabolite maps to be reconstructed with minimized contamination from water signals. Significant differences of the creatine signal were observed between brain long-echo time MRSI without and with water saturation, attributable to the previously described magnetization transfer effect. CONCLUSIONS With usage of a synthesized water matrix generated based on reasonable prior knowledge about water and metabolite resonances, the L2 method is shown to be an effective way to remove water signals from MRSI of the human brain.
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Affiliation(s)
- Liangjie Lin
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of Electronic Science, Xiamen University, Xiamen, China
| | - Michal Považan
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Adam Berrington
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Zhong Chen
- Department of Electronic Science, Xiamen University, Xiamen, China
| | - Peter B Barker
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland
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Gonçalves SI, Ligneul C, Shemesh N. Short echo time relaxation‐enhanced MR spectroscopy reveals broad downfield resonances. Magn Reson Med 2019; 82:1266-1277. [DOI: 10.1002/mrm.27806] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 03/28/2019] [Accepted: 04/17/2019] [Indexed: 12/31/2022]
Affiliation(s)
- Sónia I. Gonçalves
- Champalimaud Research Champalimaud Centre for the Unknown Lisbon Portugal
| | - Clémence Ligneul
- Champalimaud Research Champalimaud Centre for the Unknown Lisbon Portugal
| | - Noam Shemesh
- Champalimaud Research Champalimaud Centre for the Unknown Lisbon Portugal
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Giapitzakis I, Shao T, Avdievich N, Mekle R, Kreis R, Henning A. Metabolite‐cycled STEAM and semi‐LASER localization for MR spectroscopy of the human brain at 9.4T. Magn Reson Med 2017; 79:1841-1850. [DOI: 10.1002/mrm.26873] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 07/25/2017] [Accepted: 07/25/2017] [Indexed: 12/24/2022]
Affiliation(s)
- Ioannis‐Angelos Giapitzakis
- High‐Field Magnetic Resonance, Max Planck Institute for Biological CyberneticsTübingen Germany
- IMPRS for Cognitive & Systems NeuroscienceTübingen Germany
| | - Tingting Shao
- High‐Field Magnetic Resonance, Max Planck Institute for Biological CyberneticsTübingen Germany
| | - Nikolai Avdievich
- High‐Field Magnetic Resonance, Max Planck Institute for Biological CyberneticsTübingen Germany
| | - Ralf Mekle
- Center for Stroke Research Berlin (CSB), Charité Universitätsmedizin BerlinBerlin Germany
| | - Roland Kreis
- Departments of Radiology and Clinical ResearchUniversity BernBern Switzerland
| | - Anke Henning
- High‐Field Magnetic Resonance, Max Planck Institute for Biological CyberneticsTübingen Germany
- Institute of PhysicsUniversity of GreifswaldGreifswald Germany
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MacMillan EL, Bolliger CS, Boesch C, Kreis R. Influence of muscle fiber orientation on water and metabolite relaxation times, magnetization transfer, and visibility in human skeletal muscle. Magn Reson Med 2015; 75:1764-70. [PMID: 25982125 DOI: 10.1002/mrm.25778] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 04/09/2015] [Accepted: 04/27/2015] [Indexed: 11/07/2022]
Abstract
PURPOSE To gain a deeper understanding of the influence of skeletal muscle fiber orientation on metabolite visibility, magnetization transfer from water, and water proton relaxation rates in (1)H MR spectra. METHODS Non-water-suppressed MR spectroscopy was performed in tibialis anterior muscle (TA) of 10 healthy adults, with the TA oriented either parallel or at the magic angle to the 3T field. Spectra were acquired with metabolite-cycled PRESS, and water inversion from 50 to 2510 ms before excitation. Water proton T2 relaxation was sampled with STEAM with echo times from 12 to 272 ms. RESULTS Apparent concentrations of total creatine (tCr), taurine, and trimethylammonium compounds were reduced by 29% to 67% when TA was parallel to B0. Both tCr peak areas were strongly correlated to the methylene peak splitting. Magnetization transfer rates from water to tCr CH3 were not significantly different between orientations. Water T1s were similar between orientations, but T2s were statistically significantly shorter by 1 ms in the parallel orientation (P = 0.002). CONCLUSION Muscle metabolite visibilities in MR spectroscopy and water T2 times depend substantially on muscle fiber orientation relative to B0 . In contrast, magnetization transfer rates appear to depend on muscle composition, rather than fiber orientation.
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Affiliation(s)
- Erin Leigh MacMillan
- Department of Clinical Research and Institute of Diagnostic, Interventional and Pediatric Radiology, University of Bern, Bern, Switzerland.,Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Christine Sandra Bolliger
- Department of Clinical Research and Institute of Diagnostic, Interventional and Pediatric Radiology, University of Bern, Bern, Switzerland
| | - Chris Boesch
- Department of Clinical Research and Institute of Diagnostic, Interventional and Pediatric Radiology, University of Bern, Bern, Switzerland
| | - Roland Kreis
- Department of Clinical Research and Institute of Diagnostic, Interventional and Pediatric Radiology, University of Bern, Bern, Switzerland
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Takashima H, Shishido H, Imamura R, Akatsuka Y, Taniguchi K, Nakanishi M, Suzuki J, Nagahama H, Sakurai Y, Sakata M. Effect of ankle flexion on the quantification of MRS for intramyocellular lipids of the tibialis anterior and the medial gastrocnemius. Radiol Phys Technol 2015; 8:209-14. [PMID: 25676697 DOI: 10.1007/s12194-015-0309-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 01/31/2015] [Accepted: 02/02/2015] [Indexed: 12/27/2022]
Abstract
Muscle proton magnetic resonance spectroscopy (MRS) has been developed for non-invasive measurement of intramyocellular lipid (IMCL) levels. The majority of previous studies measuring IMCL with MRS have been performed on the calf muscle. The appearance of muscle MRS is influenced by bulk magnetic susceptibility and residual dipolar couplings, which depend on the angle between the muscle fibers and the main magnetic field. Our objective in this study was to evaluate the effect of ankle flexion and of the pennation angle on IMCL quantification in the calf muscle using proton MRS. The subjects comprised ten healthy male volunteers. In proton MRS, the ankle flexion angle was changed, and the pennation angle was measured from the tibialis anterior (TA) and the medial gastrocnemius (MG), respectively. We considered the relationship between the quantification of IMCL with (1)H MRS and the pennation angle by ankle flexion angle. The pennation angle of the TA and MG changed with the ankle flexion angle. The IMCL on the TA decreased significantly with plantar flexion (p < 0.05). However, the IMCL on the MG demonstrated no significant difference. The MR spectrum and IMCL quantitation changed with the pennation angle. Therefore, when spectra of individual subjects in longitudinal studies or between subjects are compared in cross-sectional studies, the foot position or calf muscle orientation must be considered.
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Affiliation(s)
- Hiroyuki Takashima
- Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital, South-1, West-16, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan,
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Shemesh N, Rosenberg JT, Dumez JN, Muniz JA, Grant SC, Frydman L. Metabolic properties in stroked rats revealed by relaxation-enhanced magnetic resonance spectroscopy at ultrahigh fields. Nat Commun 2014; 5:4958. [DOI: 10.1038/ncomms5958] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 08/11/2014] [Indexed: 01/24/2023] Open
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