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Najafzadeh M, Mohammadian F, Mirabian S, Ganji Z, Akbari H, Rezaie M, Ranjbar E, Zare H, Nasseri S, Ferini‐Strambi L. Rapid eye movement sleep behavior disorder and its relation to Parkinson's disease: The potential of graph measures as brain biomarkers to identify the underlying physiopathology of the disorder. Brain Behav 2024; 14:e3460. [PMID: 38494747 PMCID: PMC10945078 DOI: 10.1002/brb3.3460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 02/09/2024] [Accepted: 02/13/2024] [Indexed: 03/19/2024] Open
Abstract
Rapid eye movement behavior disorder (RBD) is a parasomnia characterized by the loss of skeletal muscle atonia during the rapid eye movement (REM) sleep phase. On the other hand, idiopathic RDB (iRBD) is considered the prelude of the various α-synucleinopathies, including Parkinson's disease (PD), dementia with Lewy bodies and multiple system atrophy. Consequently, over 40% of patients eventually develop PD. Recent neuroimaging studies utilizing structural magnetic resonance imaging (s-MRI), diffusion-weighted imaging (DWI), and functional magnetic resonance imaging (fMRI) with graph theoretical analysis have demonstrated that patients with iRBD and Parkinson's disease have extensive brain abnormalities. Thus, it is crucial to identify new biomarkers that aid in determining the underlying physiopathology of iRBD group. This review was conducted systematically on the included full-text articles of s-MRI, DWI, and fMRI studies using graph theoretical analysis on patients with iRBD, per the procedures recommended by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The literature search was conducted through the PubMed and Google scholar databases concentrating on studies from September to January 2022. Based on the three perspectives of integration, segregation, and centrality, the reviewed articles demonstrated that iRBD is associated with segregation disorders in frontal and limbic brain regions. Moreover, this study highlighted the need for additional longitudinal and multicenter studies to better understand the potential of graph metrics as brain biomarkers for identifying the underlying physiopathology of iRBD group.
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Affiliation(s)
- Milad Najafzadeh
- Department of Medical Physics, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Fatemeh Mohammadian
- Department of Medical Physics, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Sara Mirabian
- Department of Medical Physics, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Zohre Ganji
- Department of Medical Physics, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Hossein Akbari
- Department of Medical Physics, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Masoud Rezaie
- Department of Medical Physics, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Esmaeil Ranjbar
- Department of Anatomy and Cell Biology, School of MedicineMashhad University of Medical SciencesMashhadIran
| | - Hoda Zare
- Department of Medical Physics, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
- Medical Physics Research CenterMashhad University of Medical SciencesMashhadIran
| | - Shahrokh Nasseri
- Department of Medical Physics, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
- Medical Physics Research CenterMashhad University of Medical SciencesMashhadIran
| | - Luigi Ferini‐Strambi
- Vita‐Salute San Raffaele UniversityMilanItaly
- Division of Neuroscience, Sleep Disorders CenterSan Raffaele Scientific InstituteMilanItaly
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Khoramian D, Haghparast M, Honardari A, Nouri E, Ranjbar E, Abedi-Friouzjah R, Zarifi S, Anam C, Najafzadeh M, Afkhami-Ardakni M. Estimation and comparison of the effective dose and lifetime attributable risk of thyroid cancer between males and females in routine head computed tomography scans: a multicentre study. J Med Radiat Sci 2024. [PMID: 38216155 DOI: 10.1002/jmrs.752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 12/23/2023] [Indexed: 01/14/2024] Open
Abstract
INTRODUCTION A significant number of head computed tomography (CT) scans are performed annually. However, due to the close proximity of the thyroid gland to the radiation field, this procedure can expose the gland to ionising radiation. Consequently, this study aimed to estimate organ dose, effective dose (ED) and lifetime attributable risk (LAR) of thyroid cancer from head CT scans in adults. METHODS Head CT scans of 74 patients (38 males and 36 females) were collected using three different CT scanners. Age, sex, and scanning parameters, including scan length, tube current-time product (mAs), pitch, CT dose index, and dose-length product (DLP) were collected. CT-Expo software was used to calculate thyroid dose and ED for each patient based on scan parameters. LARs were subsequently computed using the methodology presented in the Biologic Effects of Ionizing Radiation (BEIR) Phase VII report. RESULTS Although the mean thyroid organ dose (2.66 ± 1.03 mGy) and ED (1.6 ± 0.4 mSv) were slightly higher in females, these differences were not statistically significant compared to males (mean thyroid dose, 2.52 ± 1.31 mGy; mean ED, 1.5 ± 0.4 mSv). Conversely, there was a significant difference between the mean thyroid LAR of females (0.91 ± 1.35) and males (0.20136 ± 0.29) (P = 0.001). However, the influencing parameters were virtually identical for both groups. CONCLUSIONS The study's results indicate that females have a higher LAR than males, which can be attributed to higher radiation sensitivity of the thyroid in females. Thus, additional care in the choice of scan parameters and irradiated scan field for female patients is recommended.
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Affiliation(s)
- Daryoush Khoramian
- The Advocate Centre for Clinical Research, Ayatollah Yasrebi Hospital, Kashan, Iran
| | - Mohammad Haghparast
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Faculty of Para-Medicine, Hormozgan University of Medical Sciences, Bandar-Abbas, Iran
| | - Adnan Honardari
- Department of Radiology, Faculty of Para-Medicine, Hormozgan University of Medical Sciences, Bandar-Abbas, Iran
| | - Ebrahim Nouri
- Department of Radiology, Faculty of Para-Medicine, Hormozgan University of Medical Sciences, Bandar-Abbas, Iran
| | - Esmail Ranjbar
- Department of Anatomy and Cell Biology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Razagh Abedi-Friouzjah
- Cellular and Molecular Research Centre, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Shiva Zarifi
- Radiation Oncology Department, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Choirul Anam
- Department of Physics, Faculty of Mathematics and Sciences, Diponegoro University, Semarang, Indonesia
| | - Milad Najafzadeh
- Department and Research Centre of Medical Physics, Mashhad University of Medical Science, Mashhad, Iran
| | - Mahdieh Afkhami-Ardakni
- Department of Radiology, Faculty of Para-Medicine, Hormozgan University of Medical Sciences, Bandar-Abbas, Iran
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Haghparast M, Afkhami Ardekani M, Navaser M, Refahi S, Najafzadeh M, Ghaffari H, Masoumbeigi M. Assessment of background radiation levels in the southeast of Iran. Med J Islam Repub Iran 2020. [DOI: 10.47176/mjiri.34.56] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Haghparast M, Afkhami Ardekani M, Navaser M, Refahi S, Najafzadeh M, Ghaffari H, Masoumbeigi M. Assessment of background radiation levels in the southeast of Iran. Med J Islam Repub Iran 2020; 34:56. [PMID: 32934945 PMCID: PMC7481852 DOI: 10.34171/mjiri.34.56] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Indexed: 12/03/2022] Open
Abstract
Background: Measuring background radiation (BR) is highly important from different perspectives, especially from that of human health. This study was conducted to measure BR in the southeast of Iran.
Methods: BR was measured in Hormozgan and Sistan-Bluchestan provinces using portable Environmental Radiation Meter Type 6- 80 detector. The average value was used to calculate the absorbed dose rate and indoor annual effective dose (AED) from BR. In addition, excess lifetime cancer risk (ELCR) was evaluated.
Results: The results showed that the maximum and minimum absorbed dose rates were 71.9 and 34.2 nGy.h-1 in Abomoosa and Minab in Hormozgan province and 90.0 and 47.8 nGy.h-1 in Zahedan and Chabahar in Sistan-Bluchestan province, respectively. Data indicated that these areas had a lower BR level compared with the worldwide level. The ELCR from indoor AED was larger compared with the worldwide average of 0.29 × 10-3.
Conclusion: This study provided a reference for designing and developing specific regional surveys associated with the measurement of natural BR in the southeast of Iran.
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Affiliation(s)
- Mohammad Haghparast
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Department of Radiology, Faculty of Paramedicine, Hormozgan University of Medical Sciences, Bandar-Abbas, Iran
| | - Mahdieh Afkhami Ardekani
- Department of Radiology, Faculty of Paramedicine, Hormozgan University of Medical Sciences, Bandar-Abbas, Iran
| | - Mahmoud Navaser
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Soheila Refahi
- Department of Medical Physics, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Milad Najafzadeh
- Department of Radiology, Faculty of Paramedicine, Hormozgan University of Medical Sciences, Bandar-Abbas, Iran
| | - Hamed Ghaffari
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mahboubeh Masoumbeigi
- Department of Medical Physics & Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Zarifi S, Ahangari HT, Jia SB, Tajik-Mansoury MA, Najafzadeh M. GATE MODELING OF LATERAL SCATTERING OF PROTON PENCIL BEAMS. Radiat Prot Dosimetry 2020; 189:76-88. [PMID: 32112096 DOI: 10.1093/rpd/ncaa015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 01/12/2020] [Accepted: 02/10/2020] [Indexed: 06/10/2023]
Abstract
To validate the GATE Monte Carlo simulation code and to investigate the lateral scattering of proton pencil beams in the major body tissue elements in the therapeutic energy range. In this study, GATE Monte Carlo simulation code was used to compute absorbed dose and fluence of protons in a water cubic phantom for the clinical energy range. To apply the suitable physics model for simulation, different physics lists were investigated. The present research also investigated the optimal value of the water ionization potential as a simulation parameter. Thereafter, the lateral beam profile of proton pencil beams were simulated at different energies and depths in body tissue elements. The range results obtained using the QGSP_BIC_EMY physics showed the best compatibility with the NIST database data. Moreover, it was found that the 76 eV is the optimal value for the water ionization potential. In the next step, it was shown that the beam halo can be described by adding a supplementary Gaussian function to the standard single-Gaussian model, which currently is used by treatment planning systems (TPS).
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Affiliation(s)
- Shiva Zarifi
- Department of Medical Physics, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Hadi Taleshi Ahangari
- Department of Medical Physics, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | | | | | - Milad Najafzadeh
- Department of Radiology, Faculty of Para-Medicine, Hormozgan University of Medical Sciences, Bandare-Abbas, Iran
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Najafzadeh M, Shahzad F, Ghaderi N, Ansari K, Jacob B, Wright A. Urticaria (angioedema) and COVID-19 infection. J Eur Acad Dermatol Venereol 2020; 34:e568-e570. [PMID: 32525251 PMCID: PMC7307033 DOI: 10.1111/jdv.16721] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/15/2020] [Accepted: 05/20/2020] [Indexed: 11/30/2022]
Affiliation(s)
- M Najafzadeh
- School of Life Sciences, University of Bradford, Bradford, UK
| | - F Shahzad
- School of Life Sciences, University of Bradford, Bradford, UK
| | - N Ghaderi
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, UK
| | - K Ansari
- NIOC hospital Tehran, Tehran, Iran
| | - B Jacob
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, UK
| | - A Wright
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, UK
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Mahmoudi A, Geraily G, Hadisinia T, Shirazi A, Najafzadeh M. Beam penumbra reduction of Gamma Knife machine model 4C using Monte Carlo simulation. Comput Methods Programs Biomed 2020; 188:105261. [PMID: 31841789 DOI: 10.1016/j.cmpb.2019.105261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 11/30/2019] [Accepted: 12/04/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND OBJECTIVE In small radiation fields used in stereotactic radiosurgery penumbra is an important portion of the field size especially when critical organs at risk are located near the treatment sites. This study was aimed to reduce penumbra width (90%-50% isodose lines) of Gamma Knife (GK) machine by investigating of source to diaphragm distance (SDD) and designing compensating filter. METHODS Compensating filters at the end of the helmet collimators with the aim of reducing penumbra as well as reducing hot spots appeared near the edge of beam were modeled using Monte Carlo simulation code. Moreover, the SDD parameter was increased as one of the effective factors on penumbra width. RESULTS Results showed that single beam penumbra width using optimal design of filters was decreased by 59.49%, 42.50%, 39.02% and 34.44% with attenuation of 30.53%, 13.67%, 11.43% and 9.82% for 4, 8, 14 and 18 mm field sizes, respectively. CONCLUSIONS The designed filters lead to considerable reductions in single beams penumbra width as well as a noticeable reduction in maximum dose emerged near the beam edge due to the curved lateral surface of filters.
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Affiliation(s)
- Atefeh Mahmoudi
- Department of Medical Physics and Biomedical Engineering, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Ghazale Geraily
- Department of Medical Physics and Biomedical Engineering, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran.
| | - Tahereh Hadisinia
- Department of Medical Physics and Biomedical Engineering, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran.
| | - Alireza Shirazi
- Department of Medical Physics and Biomedical Engineering, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran.
| | - Milad Najafzadeh
- Department of Radiology, Faculty of Para-Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Islamic Republic of Iran
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Abedi-Firouzjah R, Vafapour H, Banaei A, Ebrahimnejad Gorji K, Najafzadeh M, Ataei G, Momeni F. Data on the cancer risk and mortalities induced by annual background radiations at various ages in Kohgiluyeh and Boyer-Ahmad province, Iran. Data Brief 2020; 30:105487. [PMID: 32346562 PMCID: PMC7178478 DOI: 10.1016/j.dib.2020.105487] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/15/2020] [Accepted: 03/18/2020] [Indexed: 11/29/2022] Open
Abstract
Measurement of background radiations (BRs) as the sources of cancer risk, is important. The aim of this study was to measure the BR, as well as its cancer risk and mortalities in Kohgiluyeh and Boyer-Ahmad province (KBAp). Indoors and outdoors BRs were measured in eight cities utilizing a Geiger-Muller detector. Five main locations (north, east, west, south, and center) were chosen for measuring outdoor and indoor BRs in each city of KBAp. The BEIR VII-Phase 2 model was used to calculate the BRs induced cancer risks and mortalities of various cancer types at different ages. The average dose rates of outdoor and indoor were 136.9 ± 12.5 and 149.3 ± 19.8 nSv.h−1, respectively. The average annual effective doses (AEDs) for adults, children, and infants were 0.17, 0.19, and 0.22 mSv.y−1 due to the outdoor, and 0.73, 0.84, and 0.94 mSv.y−1 resulting from the indoor exposure, respectively. The average lifetime risk for one year BRs induced cancers was 164.8 ± 15.7 and 307.1 ± 32.3 (in 100,000 people) for new-borns male and female, in that order. This risk decreased with age and reached 11.2 ± 1.6 and 13.8 ± 1.6 (in 100,000 people) for men and women at the age of 80, respectively. The average lifetime risk of mortality due to cancers induced by annual BRs was 70.7 ± 8.3 and 113.8 ± 10.6 (incidence probability in 100,000 people) for new-borns male and female respectively. This risk decreased with age and reached 9.8 ± 1.3 and 12.2 ± 1.3 (in 100,000 people) for men and women at the age of 80 years, respectively.
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Affiliation(s)
| | - Hassan Vafapour
- Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Amin Banaei
- Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
- Department of Radiology, Faculty of Paramedical Sciences, AJA University of Medical Sciences, Tehran, Iran
| | - Kourosh Ebrahimnejad Gorji
- Department of Medical Physics Radiobiology and Radiation Protection, Babol University of Medical Sciences, Babol, Iran
| | - Milad Najafzadeh
- Department of Radiology, Faculty of Para-Medicine, Hormozgan University of Medical Sciences, Bandare- Abbas, Iran
| | - Gholamreza Ataei
- Department of Radiology Technology, Faculty of Paramedical Sciences, Babol University of Medical Science, Babol, Iran
| | - Farideh Momeni
- Medical Physics and Medical Engineering Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Corresponding author.
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D’Andrea E, Ahnen DJ, Sussman DA, Najafzadeh M. Quantifying the impact of adherence to screening on colorectal cancer incidence and mortality. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Current recommendations of The US Preventive Services Task Force (USPSTF) on colorectal cancer (CRC) screening strategies are based on models that assume 100% adherence to screening. Since adherence can largely affect the outcomes of a screening modality, we aimed to assess the comparative effectiveness of CRC screening strategies under published rates of actual adherence.
Methods
We developed an individual-level simulation model and validated it against landmark trials and USPSTF models. Then we assessed the effectiveness of colonoscopy (COL), flexible sigmoidoscopy (FS), high-sensitivity guaiac fecal occult blood test (HS-gFOBT), fecal immunochemical test (FIT), multitarget stool DNA test (FIT-DNA), computed tomography colonography (CTC), and methylated SEPT9 DNA test (SEPT9) in reducing CRC incidence and mortality. For each strategy, we also estimated the incremental life-years gained, number of colonoscopies, and adverse events.
Results
Assuming 100% adherence, FIT-DNA, FIT, HS-gFOBT, and SEPT9 averted 58 to 59 CRC cases and 28 CRC deaths; COL and CTC strategies 56 cases and 27 deaths, while FS averted 39 cases and 19 deaths per 1,000 individuals. Life-years gained were similar across FIT-DNA, FIT, HS-gFOBT, SEPT9, CTC, and COL strategies. The total number of colonoscopies was highest with COL (3,567), followed by SEPT9 (3,231), HS-gFOBT (2,584), FIT-DNA (2,079), FIT (2,067), CTC (1,691) and FS (1,538) strategies. Assuming actual adherence, SEPT9 averted 54 CRC cases and 26 CRC deaths, followed by COL with 49 cases and 24 deaths, and FIT-DNA, FIT, CTC and HS-gFOBT with approximately 36 to 41 cases and 18 to 21 deaths averted per 1000 individuals screened. Life-years gained reflected the effectiveness of each strategy in reducing CRC cases and deaths.
Conclusions
Adherence is a key factor in determining the effectiveness of CRC screening and strategies with higher expected adherence rates have the potential to reduce cancer incidence and mortality.
Key messages
Adherence has a substantial impact on screening outcomes, such as cancer incidence and mortality, and may influence selection of optimal screening strategies. Strategies with higher expected adherence rates can lead to clinically meaningful benefits compared to strategies that may have better one-time sensitivity and/or specificity.
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Affiliation(s)
- E D’Andrea
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, USA
| | - D J Ahnen
- School of Medicine and Gastroenterology of the Rockies, University of Colorado, Denver, USA
| | - D A Sussman
- Division of Gastroenterology, Department of Medicine, University of Miami Miller School of Medicine, Miami, USA
| | - M Najafzadeh
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, USA
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Najafzadeh M, Hoseini-Ghafarokhi M, Bolagh RSM, Haghparast M, Zarifi S, Nickfarjam A, Farhood B, Chow JCL. Benchmarking of Monte Carlo model of Siemens Oncor® linear accelerator for 18MV photon beam: Determination of initial electron beam parameters. J Xray Sci Technol 2019; 27:1047-1070. [PMID: 31498147 DOI: 10.3233/xst-190568] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE This study aims to benchmark a Monte Carlo (MC) model of the 18 MV photon beam produced by the Siemens Oncor® linac using the BEAMnrc and DOSXYZnrc codes. METHODS By matching the percentage depth doses and beam profiles calculated by MC simulations with measurements, the initial electron beam parameters including electron energy, full width at half maximum (spatial FWHM), and mean angular spread were derived for the 10×10 cm2 and 20×20 cm2 field sizes. The MC model of the 18 MV photon beam was then validated against the measurements for different field sizes (5×5, 30×30 and 40×40 cm2) by gamma index analysis. RESULTS The optimum values for electron energy, spatial FWHM and mean angular spread were 14.2 MeV, 0.08 cm and 0.8 degree, respectively. The MC simulations yielded the comparable measurement results of these optimum parameters. The gamma passing rates (with acceptance criteria of 1% /1 mm) for percentage depth doses were found to be 100% for all field sizes. For cross-line profiles, the gamma passing rates were 100%, 97%, 95%, 96% and 95% for 5×5, 10×10, 20×20, 30×30 and 40×40 cm2 field sizes, respectively. CONCLUSIONS By validation of the MC model of Siemens Oncor® linac using various field sizes, it was found that both dose profiles of small and large field sizes were very sensitive to the changes in spatial FWHM and mean angular spread of the primary electron beam from the bending magnet. Hence, it is recommended that both small and large field sizes of the 18 MV photon beams should be considered in the Monte Carlo linac modeling.
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Affiliation(s)
- Milad Najafzadeh
- Department of Radiology, Faculty of Para-Medicine, Hormozgan University of Medical Sciences, Bandare-Abbas, Iran
| | - Mojtaba Hoseini-Ghafarokhi
- Department of Radiology and Nuclear Medicine, School of Para Medical Science, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Mohammad Haghparast
- Department of Radiology, Faculty of Para-Medicine, Hormozgan University of Medical Sciences, Bandare-Abbas, Iran
| | - Shiva Zarifi
- Department of Medical Physics, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Abolfazl Nickfarjam
- Department of Medical Physics, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Bagher Farhood
- Department of Medical Physics and Radiology, Faculty of Paramedical Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - James C L Chow
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
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Najafzadeh M, Nickfarjam A, Jabbari K, Markel D, Chow JCL, Takabi FS. Dosimetric verification of lung phantom calculated by collapsed cone convolution: A Monte Carlo and experimental evaluation. J Xray Sci Technol 2019; 27:161-175. [PMID: 30614811 DOI: 10.3233/xst-180425] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To evaluate the dose calculation accuracy in the Prowess Panther treatment planning system (TPS) using the collapsed cone convolution (CCC) algorithm. METHODS The BEAMnrc Monte Carlo (MC) package was used to predict the dose distribution of photon beams produced by the Oncor® linear accelerator (linac). The MC model of an 18 MV photon beam was verified by measurement using a p-type diode dosimeter. Percent depth dose (PDD) and dose profiles were used for comparison based on three field sizes: 5×5, 10×10, and 20×20cm2. The accuracy of the CCC dosimetry was also evaluated using a plan composed of a simple parallel-opposed field (11×16cm2) in a lung phantom comprised of four tissue simulating media namely, lung, soft tissue, bone and spinal cord. The CCC dose calculation accuracy was evaluated by MC simulation and measurements according to the dose difference and 3D gamma analysis. Gamma analysis was carried out through comparison of the Monte Carlo simulation and the TPS calculated dose. RESULTS Compared to the dosimetric results measured by the Farmer chamber, the CCC algorithm underestimated dose in the planning target volume (PTV), right lung and lung-tissue interface regions by about -0.11%, -1.6 %, and -2.9%, respectively. Moreover, the CCC algorithm underestimated the dose at the PTV, right lung and lung-tissue interface regions in the order of -0.34%, -0.4% and -3.5%, respectively, when compared to the MC simulation. Gamma analysis results showed that the passing rates within the PTV and heterogeneous region were above 59% and 76%. For the right lung and spinal cord, the passing rates were above 80% for all gamma criteria. CONCLUSIONS This study demonstrates that the CCC algorithm has potential to calculate dose with sufficient accuracy for 3D conformal radiotherapy within the thorax where a significant amount of tissue heterogeneity exists.
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Affiliation(s)
- Milad Najafzadeh
- Department of Medical Physics, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Radiology, Faculty of Para-Medicine, Hormozgan University of Medical Sciences, Bandare-Abbas, Iran
| | - Abolfzal Nickfarjam
- Department of Medical Physics, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Radiotherapy Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Keyvan Jabbari
- Department of Medical Physics, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Daniel Markel
- Department of Radiation Oncology, University of Toronto and Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - James C L Chow
- Department of Radiation Oncology, University of Toronto and Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Fatemeh Shirani Takabi
- Department of Medical Physics, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Al Ayoub Y, Gopalan RC, Najafzadeh M, Mohammad MA, Anderson D, Paradkar A, Assi KH. Development and evaluation of nanoemulsion and microsuspension formulations of curcuminoids for lung delivery with a novel approach to understanding the aerosol performance of nanoparticles. Int J Pharm 2018; 557:254-263. [PMID: 30597263 DOI: 10.1016/j.ijpharm.2018.12.042] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 12/08/2018] [Accepted: 12/12/2018] [Indexed: 01/23/2023]
Abstract
Extensive research has demonstrated the potential effectiveness of curcumin against various diseases, including asthma and cancers. However, few studies have used liquid-based vehicles in the preparation of curcumin formulations. Therefore, the current study proposed the use of nanoemulsion and microsuspension formulations to prepare nebulised curcuminoid for lung delivery. Furthermore, this work expressed a new approach to understanding the aerosol performance of nanoparticles compared to microsuspension formulations. The genotoxicity of the formulations was also assessed. Curcuminoid nanoemulsion formulations were prepared in three concentrations (100, 250 and 500 µg/ml) using limonene and oleic acid as oil phases, while microsuspension solutions were prepared by suspending curcuminoid particles in isotonic solution (saline solution) of 0.02% Tween 80. The average fine particle fraction (FPF) and mass median aerodynamic diameter (MMAD) of the nebulised microsuspension formulations ranged from 26% and 7.1 µm to 40% and 5.7 µm, for 1000 µg/ml and 100 µg/ml respectively. In a comparison of the low and high drug concentrations of the nebulised nanoemulsion, the average FPF and MMAD of the nebulised nanoemulsion formulations prepared with limonene oil ranged from 50% and 4.6 µm to 45% and 5.6 µm, respectively; whereas the FPF and MMAD of the nebulised nanoemulsion prepared with oleic acid oil ranged from 46% and 4.9 µm to 44% and 5.6 µm, respectively. The aerosol performance of the microsuspension formulations were concentration dependent, while the nanoemulsion formulations did not appear to be dependent on the curcuminoids concentration. The performance and genotoxicity results of the formulations suggest the suitability of these preparations for further inhalation studies in animals.
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Affiliation(s)
- Yuosef Al Ayoub
- School of Pharmacy and Medical Sciences, University of Bradford, Bradford BD7 1DP, UK
| | - R C Gopalan
- School of Pharmacy and Medical Sciences, University of Bradford, Bradford BD7 1DP, UK
| | - M Najafzadeh
- School of Chemistry and Biosciences, University of Bradford, Bradford BD7 1DP, UK
| | - M A Mohammad
- School of Pharmacy and Medical Sciences, University of Bradford, Bradford BD7 1DP, UK
| | - D Anderson
- School of Chemistry and Biosciences, University of Bradford, Bradford BD7 1DP, UK
| | - A Paradkar
- School of Pharmacy and Medical Sciences, University of Bradford, Bradford BD7 1DP, UK
| | - K H Assi
- School of Pharmacy and Medical Sciences, University of Bradford, Bradford BD7 1DP, UK.
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D'Andrea E, Raby B, Weinhouse GL, Choudhry NK, Najafzadeh M. Time to rethink the diagnosis of lung cancer? A cost-effectiveness analysis on a new genomic device. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- E D'Andrea
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - B Raby
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - GL Weinhouse
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - NK Choudhry
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - M Najafzadeh
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
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Asadi A, Razavi-Ratki SK, Jabbari K, Najafzadeh M, Nickfarjam A. Monte Carlo evaluation of the potential benefits of flattening filter free beams from the Oncor® clinical linear accelerator. J Xray Sci Technol 2018; 26:281-302. [PMID: 29562568 DOI: 10.3233/xst-17315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To evaluate the potential privileges of flattening filter-free (FFF) photon beams from Oncor® linac for 6 MV and 18 MV energies. METHODS A Monte Carlo (MC) model of Oncor® linac was built using BEAMnrc MCCode and verified by the measured data using 6 MV and 18 MV energies. A comprehensive set of data was also characterized for MC model of Oncor® machine running with and without flattening filter (FF) for 6 MV and 18 MV beams in six field sizes. The investigated characteristics included mean energy, energy spectrum, photon spatial fluence, superficial dose, percent depth dose (PDD), dose output, and out-of-field dose with two indexes of lateral dose profile and isodose curve at three depths. RESULTS Using FFF enhanced the energy uniformity 3.4±0.11% (6 MV) and 2.05±0.09% (18 MV) times and improved dose output by factor of 2.91 (6 MV) and 4.2 (18 MV) on the central axis, respectively. Using FFF also reduced the PDD dependencies by 9.1% (6 MV) and 5.57% (18 MV). In addition, using FFF had a lower out-of-field dose due to the reduced head scatter and softer spectra. CONCLUSIONS The findings in this study suggested that using FFF, Oncor® machine could achieve better treatment results with lower dose toxicity and a shorter beam-on time.
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Affiliation(s)
- Amin Asadi
- Medical Physics Department, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seid Kazem Razavi-Ratki
- Radiotherapy Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Radiology Department, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Keyvan Jabbari
- Medical Physics Department, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Milad Najafzadeh
- Medical Physics Department, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Abolfazl Nickfarjam
- Medical Physics Department, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Radiotherapy Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Mamiya H, Tahara R, Tolaney S, Choudhry N, Najafzadeh M. Cost-effectiveness of palbociclib in hormone receptor-positive advanced breast cancer. Ann Oncol 2017; 28:1825-1831. [DOI: 10.1093/annonc/mdx201] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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Gagne J, Tsacogianis T, Wirta S, Rogers J, Calado F, Chang C, Turner S, Schlienger R, Balas B, Abdurrob A, Najafzadeh M, Wang S. P1467Characteristics of early sacubitril/valsartan users in US electronic health record data. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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17
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Najafzadeh M, Kim SC, Patterson C, Schneeweiss S, Katz JN, Brick GW, Ready JE, Polinski JM, Patorno E. Patients' perception about risks and benefits of antithrombotic treatment for the prevention of venous thromboembolism (VTE) after orthopedic surgery: a qualitative study. BMC Musculoskelet Disord 2015; 16:319. [PMID: 26503220 PMCID: PMC4624375 DOI: 10.1186/s12891-015-0777-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 10/15/2015] [Indexed: 11/24/2022] Open
Abstract
Background The 9th edition of the American College of Chest Physicians’ Antithrombotic Therapy and Prevention of Thrombosis guidelines emphasize the importance of considering the risk–benefit ratio of “patient-important” outcomes. However, little is known about patients’ perception and understanding regarding the different outcomes of antithrombotic treatment after orthopedic surgery, and the factors that influence their decision to use these treatments. Using a series of semi-structured interviews, we explored patients’ understanding and perception concerning the benefits and risks of antithrombotic treatment for the prevention of venous thromboembolism (VTE) after joint replacement surgery. Methods A series of semi-structured interviews were conducted with patients who had undergone knee or hip replacement surgery at a tertiary care hospital (Brigham and Women’s Hospital, Boston, MA) in 2014. Discussions were recorded and transcribed. Two investigators independently coded and analyzed the data to identify important themes and concepts using the constant comparative method. Results Of 64 patients who were invited, 12 patients (19 %) completed the interviews. The majority of patients (92 %) were aware of the benefits of antithrombotic therapy for reducing the risk of blood clots, while less than half of them had a clear understanding of deep vein thrombosis and pulmonary embolism. While all patients were aware of risk of minor bleeding, only 6 patients (50 %) considered the risk of major bleeding as a possible side effect of antithrombotic treatment. Overall, patients perceived bleeding as a less important outcome than a thrombotic event. The lack of awareness about the risk of major bleeding, the assumption that a short-term exposure would not meaningfully affect bleeding risk, and the assumption that bleeding is a controllable event influenced their perception. Most patients (83 %) stated that their decision to use antithrombotic medications was mainly based on the trust in their physician’s expertise. Conclusions Patients perceived thrombotic events as more important outcomes than bleeding events. Patients’ understanding of thrombotic and bleeding events varies and may play a key role in their preferences. The majority of patients stated that trust in their physician’s expertise had a large influence on their decision to use antithrombotic medications.
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Affiliation(s)
- M Najafzadeh
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - S C Kim
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. .,Division of Rheumatology, Immunology and Allergy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
| | - C Patterson
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - S Schneeweiss
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - J N Katz
- Division of Rheumatology, Immunology and Allergy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, USA. .,Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
| | - G W Brick
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
| | - J E Ready
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
| | - J M Polinski
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - E Patorno
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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Najafzadeh M, Gagne JJ, Choudhry NK, Polinski JM, Avorn J, Schneeweiss SS. Patients' Preferences in Anticoagulant Therapy: Discrete Choice Experiment. Circ Cardiovasc Qual Outcomes 2014; 7:912-9. [DOI: 10.1161/circoutcomes.114.001013] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Najafzadeh M, Marra CA, Sadatsafavi M, Aaron SD, Sullivan SD, Vandemheen KL, Jones PW, Fitzgerald JM. Cost effectiveness of therapy with combinations of long acting bronchodilators and inhaled steroids for treatment of COPD. Thorax 2008; 63:962-7. [DOI: 10.1136/thx.2007.089557] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Najafzadeh M, Sadatsafavi M, Marra CA. Interpretation of results of the cost-effectiveness analysis reported by Pellissier et al. on October 2007. Vaccine 2008; 26:5244; author reply 5245. [PMID: 18619510 DOI: 10.1016/j.vaccine.2008.06.063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2008] [Indexed: 10/21/2022]
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Marra CA, Marion SA, Guh DP, Najafzadeh M, Wolfe F, Esdaile JM, Clarke AE, Gignac MA, Anis AH. Not all “quality-adjusted life years” are equal. J Clin Epidemiol 2007; 60:616-24. [PMID: 17493521 DOI: 10.1016/j.jclinepi.2006.09.006] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2005] [Revised: 09/11/2006] [Accepted: 09/16/2006] [Indexed: 10/23/2022]
Abstract
BACKGROUND There is evidence that utility elicitation methods used in the calculation of quality-adjusted life years (QALYs) yield different results. It is not clear how these differences impact economic evaluations. METHODS Using a mathematical model incorporating data on efficacy, costs, and utility values, we simulated the experiences of 100,000 hypothetical rheumatoid arthritis patients over 10 years (50,000 exposed to infliximab plus methotrexate [MTX] and 50,000 exposed to MTX alone). QALYs, were derived from the Health Utilities Index 2 and 3 (HUI2 and HUI3), the Short Form 6-D (SF-6D), and the Euroqol 5-D (EQ-5D). Incremental cost-utility ratios were determined using each instrument to calculate QALYs and the results were compared using cost-effectiveness acceptability curves. RESULTS Using the different utility measurement methods, the mean difference in QALYs between the infliximab plus MTX and MTX groups ranged from a high of 1.95 QALYs (95% CI=1.93-1.97) using the HUI3 to 0.89 QALYs (95% CI=0.88-0.91) using the SF-6D. Adopting the commonly cited value of society's willingness to pay for a QALY of $50,000, 91% of the simulations favored the cost utility of infliximab plus MTX when using the HUI3 to calculate QALYs. However, when using the EQ-5D, HUI2, or the SF-6D utility values to calculate QALYS, the proportion of simulations that favored the cost utility of infliximab were 63%, 45%, and 12%, respectively. CONCLUSION Depending on the method for determining utility values used in the calculation of QALYs, very different incremental cost-utility ratios are generated.
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Affiliation(s)
- C A Marra
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
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Sadatsafavi M, Najafzadeh M. Cost-optimisation of screening for latent tuberculosis in close contacts. Eur Respir J 2006; 28:1285; author reply 1285-6. [PMID: 17138688 DOI: 10.1183/09031936.00094906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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