bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic Value of Subdivisions of Nighttime Blood Pressure Fall in Hypertensives Followed Up for 8.2 Years. Does Nondipping Classification Need to Be Redefined?
Authors: Bastos José Mesquita , Bertoquini Susana , Polónia Jorge 
Published: April 2010

J Clin Hypertens(Greenwich). 2010;12:508–515. © 2010 Wiley Periodicals, Inc.To evaluate the long‐term prognostic significance of different ranges of the percentage fall in nighttime blood pressure (BP) of the nondipping pattern, 1200 hypertensive patients (645 women, age 51±12 years) underwent ambulatory BP monitoring under stabilized therapy. The occurrence of cardiovascular (CV) events was followed for 9833 patient‐years and analyzed by the Cox hazard model. There were 152 CV fatal/nonfatal events (79 strokes, 51 coronary events, 22 others) during the 15.2 years of follow‐up. According to nighttime BP fall (%) the authors noted: <0% (reverse‐dippers [RD], n=83); 0%–4.9% (nondippers 1 [ND1], n=207); 5%–9.9% (nondippers 2 [ND2], n=311), 10%–19.9% (dippers [D], n=523); and ≥20% (extreme dippers [ED], n=76). After adjustment for confounding variables, hazard ratios (95% confidence interval) of CV event and stroke in RD vs D were 2.29 (1.31–3.99) and 2.46 (1.11–5.49); of ND1 vs D were 1.42 (1.12–1.79) and 1.62 (1.17–2.23); and of ND1 vs ND2 were 2.24 (1.33–3.75) and 2.30 (1.15–4.58). No differences were found in RD vs ND1 and ND2 vs D. Nondippers have a higher CV risk than dippers but only for a nighttime BP fall <5% suggesting that the limits for nondipping should be redefined for a stratification of CV risk.
The Association Between C‐Reactive Protein Levels and Insulin Therapy in Obese vs Nonobese Veterans With Type 2 Diabetes Mellitus
Authors: Khatana Sameed Ahmed M. , Taveira Tracey H. , Dooley Andrea G. , Wu Wen‐Chih 
Published: April 2010

J Clin Hypertens (Greenwich). 2010;12:462–468. ©2010 Wiley Periodicals, Inc.The authors studied the association between insulin use and C‐reactive protein (CRP) levels in obese (body mass index ≥30 kg/m2) and nonobese (body mass index <30 kg/m2) patients with type 2 diabetes at the Providence Veterans Affairs Medical Center. There were 64 nonobese participants (insulin use and average daily dose, 23.4% and 7.0±18.2 units at baseline and 27.1% and 9.3±21.0 units at follow‐up, respectively) and 106 obese participants (insulin use and daily dose, 39.6% and 28.2±47.3 units at baseline and 43.0% and 28.7±47.7 units at follow‐up, respectively). Both use and daily dose of insulin were modeled with CRP levels of participants upon discharge from an intensive cardiac risk management clinic and at a 1‐year follow‐up visit using a linear mixed effects model for repeated measures. There was a significant direct association between log CRP and both insulin use and daily dose for nonobese participants (β=0.3, P=.03 and β=0.01, P=.02, respectively) but not for obese participants (P=.8 and P=.5, respectively). Due to the association between insulin therapy and CRP in nonobese patients, these results may aid clinicians in deciding on the initiation of insulin therapy for nonobese diabetic patients when noninsulin alternatives are available.
Coenzyme Q10 prevents human lens epithelial cells from light‐induced apoptotic cell death by reducing oxidative stress and stabilizing BAX / Bcl‐2 ratio
Authors: Kernt Marcus , Hirneiss Christoph , Neubauer Aljoscha S. , Ulbig Michael W. , Kampik Anselm 
Published: April 2010

Abstract.Background:  Cataract is one of the most prevalent eye disease and a major cause for legal blindness in the world. Beside others, cumulative light‐exposure and apoptotic cell death are significantly associated with cataract development. In contrast, supplementation with antioxidants has been suggested to prevent premature cataractogenesis. This study investigates possible protective effects of Coenzyme Q10 (CoQ10) regarding light‐induced stress and apoptotic cell death in human lens epithelial cells (LEC).Methods:  Human LEC were either pre‐incubated with CoQ10 or not and then exposed to white light. After 10–40 min of irradiation viability, induction of intracellular reactive oxygen species (ROS), apoptosis and cell death was determined. Expression of apoptotic BAX and anti‐apoptotic Bcl‐2 protein and their mRNA were determined by RT‐PCR and Western blot analysis.Results:  Light exposure decreased LEC viability and Bcl‐2 expression and increased intracellular ROS, apoptotic cell death, and BAX expression in a time‐of‐irradiation‐dependent manner. Phototoxic cell death and apoptosis, as well as decrease of Bcl‐2 and increase in BAX expression was significantly reduced, when cells were pre‐incubated with CoQ10.Conclusions:  In this study, CoQ10 significantly reduced light‐induced LEC‐damage and attenuated phototoxic effects on BAX and Bcl‐2 expression. Therefore, CoQ10 supplementation might also be useful in preventing LEC death and consecutive cataract formation in vivo.
Assessment of the safety of Qin Kai Ling injection: a systematic review
Authors: Hao Yuan , Kong Xiangyu , Wu Taixiang 
Published: April 2010

Abstract Objective Qin Kai Ling (QKL) injection, which is based upon the traditional Chinese medicine formulation ‘An Gong Niu Huang Wan’, is widely used in treatment of many diseases. This review aims to assess the safety of QKL. Methods We searched Chinese databases CNKI and VIP for articles published between January 1987 and April 2009. Results A total of 1486 cases were included in this review. We were unable to determine the frequency of ADR/AE induced by QKL due to the lack of complete production and market information. We estimate, based on the limited data, that the risk of ADR/AE from QKL use should be low. We found some ADR/AE may have been induced by incorrect use of QKL, such as use in infants, or use with incompatible drugs, and some places may not suite for use of QKL, for example, four of seven patients died in private clinics or patient's home. We unable to distinguish whether incidents were ADRs or AEs because the poor reports. Conclusion Current evidence, while weak, indicates that QKL carries a low risk of ADR/AE, and some adverse events that do occur may be ascribed to improper use of the drug. Reporting of ADR/AEs needs to be greatly improved, and should follow the ‘Recommendations for reporting traditional Chinese medicine adverse drug reaction”.
Temporary storage of fresh frozen plasma above −30°C has no negative impact on the quality of clotting factors and inhibitors
Authors: MOOG RAINER , KNOP DIETMAR , WENZEL FOLKER 
Published: April 2010

SUMMARYFresh frozen plasma (FFP) should be stored at temperatures > −30°C according to national and international guidelines to maintain the stability of clotting factors and inhibitors. In the present report, FFP was accidentally stored at < −30°C due to icing of the freezer. To ensure the quality of the FFPs a battery of tests of clotting factors and inhibitors was performed. Our data demonstrate that temporary storage of FFP at temperature < −30°C does not negatively affect the quality of FFPs. The European requirement of 70% activity of factor VIII was met by all units.
Suction-Side Gill
Region Film Cooling: Effects of Hole Shape and Orientation on Adiabatic Effectiveness and Heat
Transfer Coefficient
Authors: Chappell Justin , Ligrani Phil , Sreekanth Sri , Lucas Terry 
Published: April 2010

Abstract
The performance of suction-side gill region film cooling is investigated using the University of Utah transonic wind tunnel and a simulated turbine vane in a two-dimensional cascade. The effects of film cooling hole orientation, shape, and number of rows, and their resulting effects on thermal film cooling characteristics, are considered for four different hole configurations: round axial (RA), shaped axial (SA), round radial (RR), and round compound (RC). The mainstream Reynolds number based on axial chord is 500,000, the exit Mach number is 0.35, and the tests are conducted using the first row of holes only, second row of holes only, or both rows of holes at blowing ratios of 0.6 and 1.2. Carbon dioxide is used as the injectant to achieve density ratios of 1.73 to 1.92 similar to values present in operating gas turbine engines. A mesh grid is used to give a magnitude of longitudinal turbulence intensity of 5.7% at the inlet of the test section. Results show that the best overall protection over the widest range of blowing ratios and streamwise locations is provided by either the RC holes or the RR holes. This result is particularly significant because the RR hole arrangement, which has lower manufacturing costs compared with the RC and SA arrangements, produces better or equivalent levels of performance in terms of magnitudes of adiabatic film cooling effectiveness and heat transfer coefficient. Such improved performance (relative to RA and SA holes) is most likely a result of compound angles, which increases lateral spreading. As such, the present results indicate that compound angles appear to be more effective than hole shaping in improving thermal protection relative to that given by RA holes.
Eigenstructure of First-Order Velocity-Stress Equations for Waves in Elastic Solids of Trigonal 32 Symmetry
Authors: Yang Lixiang , Chen Yung-Yu , Yu S.-T. John 
Published: April 2010

AbstractThis paper reports the eigenstructure of a set of first-order hyperbolic partial differential equations for modeling waves in solids with a trigonal 32 symmetry. The governing equations include the equation of motion and partial differentiation of the elastic constitutive relation with respect to time. The result is a set of nine, first-order, fully coupled, hyperbolic partial differential equations with velocity and stress components as the unknowns. Shown in the vector form, the model equations have three 9×9 coefficient matrices. The wave physics are fully described by the eigenvalues and eigenvectors of these matrices; i.e., the nontrivial eigenvalues are the wave speeds, and a part of the corresponding left eigenvectors represents wave polarization. For a wave moving in a certain direction, three wave speeds can be identified by calculating the eigenvalues of the coefficient matrix in a rotated coordinate system. In this process, without using the plane-wave solution, we recover the Christoffel matrix and thus validate the formulation. To demonstrate this approach, two- and three-dimensional slowness profiles of quartz are calculated. Wave polarization vectors for wave propagation in several compression directions as well as noncompression directions are discussed.
SU‐DD‐A1‐06: RapidArc Patient Specific Quality Assurance: Comparison with DMLC IMRT
Authors: Popple R , Brezovich I , Duan J , Shen S , Wu X 
Published: April 2010

Purpose: To compare RapidArc (Varian Medical Systems) intensity modulated arc therapy and dynamic multileaf collimated IMRT (DMLC) delivery accuracy using patient specific quality assurance measurements. Method and Materials: We selected 6 cases (head and neck, para‐aortic lymph nodes, and 4 prostates) that were treated using both DMLC and RapidArc. The DMLC and RapidArc plans were equivalent with respect to target and critical structure dosimetry. Absolute dose measurements were made with an ionization chamber in a custom acrylic phantom, which was positioned such that the chamber was located in a high‐dose, low‐gradient region of the dose distribution. Film was used to obtain the dose distribution in a coronal plane at the level of the ionization chamber. A 2D ionization chamber array (Matrixx, IBA Dosimetry) was used to obtain a second measurement in the same coronal plane. The gamma index was calculated for both the film and 2D array measurements using the criteria of 3%/3mm. Results: The mean difference between the ionization chamber measurements and the calculations was 1.0% for both RapidArc and DMLC. The ranges were 0.6% to 1.6% and 0.0% to 2.3%, respectively. The mean fraction of pixels with gamma > 1 for the film was 4.3% (range 0.8% to 6.9%) for RapidArc and 10.4% (range 5.4% to 17.3%) for DMLC. For the 2D array the mean fraction of pixels with gamma > 1 was 0.5% (range 0.0% to 1.1%) for RapidArc and 1.6% (range 0.5% to 4.1%) for DMLC. Conclusion: The results demonstrate that RapidArc delivery is at least as accurate as that for DMLC. The mean fraction of pixels with gamma >1 and the range of fractions for both film and the 2D chamber array suggests that RapidArc may be modestly more accurate than DMLC.Conflict of Interest: Research sponsored by Varian Medical Systems.
SU‐DD‐A3‐06: Fully Automated Internal Marker Tracking Algorithm for Cine EPID Images
Authors: Park S , Ionascu D , Hacker F , Mamon H , Berbeco R 
Published: April 2010

Introduction: An electronic portal imaging device (EPID) in cine mode can be used for validating respiratory gating and stereotactic body radiation therapy (SBRT) by tracking implanted fiducials. Manual tracking methods are time and labor intensive, limiting the utility of the validation. We have developed a fully automated algorithm to quickly and accurately extract the markers in EPID images and reconstruct their 3D positions. Materials and Methods: The markers were detected and recognized using an image processing algorithm based on the Laplacian of Gaussian (LoG) filter. To reduce false marker detection, a marker registration technique was applied using image intensity as well as the geometric spatial transformations between the reference marker positions produced from the projection of 3D CT images and the estimated marker positions. An average marker position in 3D was reconstructed by backprojecting, towards the source, the position of each marker on the 2D image. Results: From phantom studies, spatial accuracies of <1 mm were achieved in both 2D and 3D marker locations. Using only the LoG algorithm, the marker detection success rate was 88.8%. However, adding the registration technique which utilizes prior CT information, the success rate was increased to 100%. In addition, we have examined the cases of 5 patients being treated under an SBRT protocol for hepatic metastases. The intrafractional tumor motion (3.1–11.3 mm) in the SI direction was measured using the 2D images. The interfractional patient setup errors (0.1–12.7 mm) in the SI, AP, and LR directions were obtained from the marker locations reconstructed in 3D and compared to the reference planning CT image. Conclusions: The measured intrafractional tumor motion and the interfractional daily patient setup error can be used for off‐line retrospective verification of SBRT.This work was partially supported by a grant from Varian Medical Systems, Inc.
SU‐EE‐A2‐02: Validation of a Grid‐Based Boltzmann Solver for 6 and 18 MV Photon Beams Impinging On a Heterogeneous Phantom
Authors: Vassiliev O , Wareing T , McGhee J , Failla G , Salehpour M , Mourtada F 
Published: April 2010

Purpose: To benchmark the accuracy of a grid‐based Boltzmann solver, Acuros, against Monte Carlo for 6 and 18MV photon beams in a tissue‐bone‐lung‐tissue slab phantom. Method and Materials: Acuros was developed specifically for radiotherapy dose calculations. It solves for both neutral and charged particle transport, and incorporates spatial adaptation to automatically increase spatial resolution in regions of sharp gradients such as beam penumbra and material heterogeneities. Comparisons were made between EGSnrc and Acuros for single field photon beams impinging on a 30×30×30cm3 slab phantom consisting of: tissue (0–3cm), bone (3–5cm), lung (5–12cm), and tissue (12–30cm). Calculations were performed for square fields of 2.5×2.5, 5.0×5.0, and 10×10cm2 for both 6MV and 18MV energies. Comparisons were made between Acuros and EGSnrc on 2×2×2mm3 voxels along the beam centerline (0–30cm), and on transverse lines at depths of Dmax, 10, and 20cm. To minimize the influence of Monte Carlo uncertainties, the EGSnrc calculations were run to a tight statistical uncertainty (σ≈0.1%) and fine resolution, up to 1 mm in the penumbra. Acuros results were output on a 2×2×2mm3 cubic grid encompassing the 30×30×30cm3 phantom. All comparisons were made in terms of absolute doses, Gy per incident particle. Results: For all 6 cases, maximum voxel‐wise differences between EGSnrc and Acuros along the beam centerline were less than 2% of Dmax or 1mm distance‐to‐agreement (DTA). Maximum voxel‐wise differences along the transverse lines were less than 2% of Dmax or 2mm DTA. Acuros calculation times were less than 5 minutes on a two processor AMD Opteron workstation. Conclusion: The results indicate an excellent agreement between both codes. Since Acuros calculation times are primarily dependent on the volume of the region being solved, and not on the number of beams, it is well suited for arc‐therapy modalities.Conflict of Interest: Work funded by NIH Grant 2R44CA105806‐02.
SU‐EE‐A2‐04: Alternative Delivery Approach for RapidArc Using Constant Dose Rate
Authors: Tang G , Earl M , Yu C 
Published: April 2010

Purpose: Varian RapidArc™ is a new treatment technique that delivers conformal dose distributions to the target in one single gantry rotation. The segments in the treatment arc are allowed to have different monitor unit (MU) weightings requiring variable dose‐rate (VDR) for delivery. An alternative delivery approach for (VDR) RapidArc plans that utilizes constant dose‐rate (CDR) was developed. Method and Materials: For four patient cases (two head‐and‐neck (HN), one brain, one prostate), RapidArc plans were generated using the Eclipse treatment planning system. The resultant VDR treatment plans were converted into CDR plans by re‐distributing the equi‐spaced segments in the VDR arc such that the segments with larger MU weighting occupy a greater angular interval. To minimize perturbation from the optimized dose distribution, the angular deviation of the segments was restricted to 5°. This restriction requires the treatment arc to be broken into multiple sectors such that the local MU fluctuation within each sector is reduced, thereby lowering the angular deviation of the segments during re‐distribution. The converted broken‐sector CDR (b‐CDR) plans were delivered with a single gantry sweep as in the VDR plans but each sector was delivered with different values of CDR. Results and Conclusion: For plans with complex angular MU distribution, the number of broken sectors may increase in the b‐CDR plans in order to maintain the original plan quality. All b‐CDR plans produced similar dose distributions to the VDR plans by dissecting the arc up to 5 sectors. On average, the delivery times of the b‐CDR plans were 1 minute longer than that in the VDR plans. Since the majority of treatment time is spent on the patient setup, these results show that VDR RapidArc plans can be delivered using CDR without significantly compromising the plan quality or treatment efficiency.Research sponsored by Varian Medical Systems.
SU‐EE‐A4‐01: Evaluation of Noise and SDNR Characteristics of Blended ASIR and FBP Images Obtained with the GE Discovery CT 750 HD Scanner
Authors: Goodsitt M , Christodoulou E 
Published: April 2010

Purpose: The new GE 750 HD CT scanner utilizes adaptive statistical iterative reconstruction (ASIR), which can be blended in various proportions with the filtered back projection reconstructions. A study was performed to characterize the dependence of noise and signal‐difference‐to‐noise ratio (SDNR) on %ASIR for a range of doses.Method and Materials: Scans of the low contrast resolution module in the ACR CT accreditation phantom were acquired using “full‐dose”, 2/3 dose, ½ dose, and ¼ dose techniques. Scans were obtained in normal resolution mode with the STD, edge, and soft kernels, and in high resolution mode using the STD, HD STD, and edge kernels. ROIs were placed in the 25 mm cylinder and adjacent background region in this module. Images were reconstructed with %ASIR ranging from 0 –100 in steps of 10. For each condition, mean and standard deviations in the ROIs were obtained for 5 central slices in the module. Noise and SDNR were computed and the %ASIR that yielded the same noise and SDNR as in the full‐dose cases were determined for the lower doses. Results: %ASIR and dose had no effect on the mean CT♯s in the cylinder and background. Noise was found to linearly decrease with %ASIR, (R2>0.997). SDNR increased quadratically with %ASIR (R2>0.996) . For normal resolution, STD kernel, the noise and SDNR at full dose were achieved at 2/3 dose, ½ dose and ¼ dose, using 30%, 50% and 84% ASIR, respectively. Corresponding %ASIR for high resolution, HD STD were 23%, 42% and 68%. Values for other kernels will be presented. Conclusion: ASIR reduces noise and improves SDNR. By applying appropriate %ASIR, one can achieve similar image quality at reduced dose. The frequency content of the noise is different which can affect the %ASIR that is acceptable in the clinic.
SU‐FF‐P‐02: Regulatory Compliance Without Quality Assurance ‐ Problems
Authors: Shepherd J 
Published: April 2010

This presentation shall cover the major problems that resulted from the purchase and use of a Radioactive Material Transport Package. Purchase of these containers does not require a fully implemented Quality Assurance program. Use and inspection requires adherence to a USNRC qualified Part 71 Quality Assurance program. The ‘old school’ thought process is that you get what you pay for, and you believe what people tell you, especially if you have paperwork to back it up. This is a model that is no longer viable. The consequences of trusting others without an internal confirmation has been significant.A chronological sequence of events shall be presented with sidebars detailing how problems could have been avoided at each step. The necessity of an independent and fully implemented Quality Assurance program will be discussed. A recap of the penalties and consequences which resulted from these issues will be provided at the end.
SU‐FF‐I‐123: Clinical Value of Diffusion‐Weighted MRI in White Matter in Vivo
Authors: Olariu E , Cameron I 
Published: April 2010

The excellent soft tissue contrast of diffusion‐weighted magnetic resonance imaging, DW‐MRI has made it an invaluable technique especially in oncological assessment bringing hope in distinguishing between brain abscesses and necrotic and cystic neoplasms. However, a clear characterization of brain tumors and the associated pathologic structures is still a challenge. In this study, a tissue model is proposed to interpret the water diffusion behaviour in white matter based on the measured apparent diffusivities and their volume fractions.Measurements were performed on a 1.5T clinical scanner (Siemens). The protocol included: DTI measurements (b=0 and 500s/mm2), DW images (96 b‐values ranging from 0 to 10,000s/mm2 with diffusion gradient rotated in the x‐z plane, NEX=6, TE=200ms) and 96‐echoes, non‐linearly sampled using T2‐sequence.All decay curves measured in the splenium agreed well with the assumed bi‐exponential function: .The fast water pool, ADCfast had a long apparent T2 relaxation rate while the slow water pool, ADCslow had a shorter T2 constant. The volume fraction fslow correlate with the volume fraction directly estimated from the T2 spectrum. Markedly anisotropy was observed in ADCfast and fslow and more subtle in ADCslow.Evaluation of water diffusion in normal appearing corpus callosum is clearly assisting the peculiar properties of water in biological system, invoking long‐range hydration structures modulated by the concentration of lipid‐protein complexes in the membranes, cellular size and tissue architecture. ADCslow originate from the water in the hydration layers, as ADCfast the rest of the tissue bulk water. The membrane and associated hydration layers form a barrier to water diffusion perpendicular to them since diffusion within the hydration layers is anisotropic.This model is very sensitive to cellularity and further to a brain tumor grade; cell swelling and increased density of membranes enlarge fslow resulting in a decreased ADCs linked to cell proliferation.