bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Systematic Review and Meta‐Analysis of Telmisartan Versus Valsartan in the Management of Essential Hypertension
Authors: Zheng Zhenfeng , Lin Shan , Shi Huilan 
Published: April 2010

J Clin Hypertens (Greenwich). 2010;12:414–421. ©2010 Wiley Periodicals, Inc.This was a systematic assessment of the efficacy and safety of telmisartan and valsartan for the management of blood pressure (BP) in patients with essential hypertension. The authors reviewed randomized controlled trials (RCTs) and quasi‐RCTs comparing telmisartan and valsartan for the management of essential hypertension in which the participants were followed for at least 6 weeks. When a metaanalysis was possible, included studies were analyzed by Review Manager 5.0 provided by Cochrane Collaboration Group. Statistics were calculated as weight mean differences (WMDs) and relative risk with a random‐effect model. A total of 6 RCTs with 3762 patients were included in this metaanalysis. When the authors combined data from all treatment categories as a group, no difference was found between telmisartan and valsartan in reduction of systolic BP and diastolic BP. In subgroup analysis, telmisartan showed a significant benefit on lowering systolic BP and diastolic BP (WMD, −2.88; 95% confidence interval [CI], −5.03 to −0.73; P<0.01; and WMD,−1.73; 95% CI, −2.47 to −0.98; P<0.01; respectively). It was found that telmisartan had a higher rate of management of clinical BP compared with valsartan (relative risk, 1.09; 95% CI, 1.00–1.19; P=0.05). No difference was found in the incidence of adverse events. Telmisartan’s BP‐lowering capabilities were comparable to those of valsartan in monotherapy. When combined with hydrochlorothiazide, telmisartan was more effective than valsartan. Telmisartan had the same safety in the treatment of essential hypertensive patients in comparison with valsartan.
Prevention of Microalbuminuria in Patients With Type 2 Diabetes: What Do We Know?
Authors: Ruilope Luis , Izzo Joseph , Haller Hermann , Waeber Bernard , Oparil Suzanne , Weber Michael , Bakris George , Sowers James 
Published: April 2010

J Clin Hypertens (Greenwich). 2010;12:422–430. ©2010 Wiley Periodicals, Inc.Cardiovascular and chronic kidney disease are epidemic throughout industrialized societies. Diabetes leads to premature cardiovascular disease and is regarded by many as the most common etiological factor for chronic kidney disease. Because most studies of blood‐pressure lowering agents in people with diabetes and hypertension have been conducted in individuals who already have some target organ damage, it is unclear whether earlier intervention could prevent or delay the onset of renal or systemic vascular disease. In early disease there is only a low possibility of observing cardiovascular or renal events; thus intervention trials in this population must rely on disease markers such as microalbuminuria. Accordingly, the authors review the evidence to support the use of microalbuminuria as a disease marker in diabetic patients based on its strong association with renal and cardiovascular events, and discuss recent trials that examine the impact of preventing or delaying the onset of microalbuminuria.
Predicted Coronary Heart Disease Risk Reduction and Dual Blood Pressure/Cholesterol Goal Attainment in Patients With Hypertension Treated in Real‐World Clinical Practice
Authors: Neutel Joel M. , Eaddy Michael , Lunacsek Orsolya E. , Roberts Craig , Chen Linda , Kean Allison J. , Jackson James H. 
Published: April 2010

J Clin Hypertens (Greenwich). 2010;12:396–406. ©2010 Wiley Periodicals, Inc.Hypertension and dyslipidemia are highly co‐prevalent, but often poorly controlled, coronary heart disease (CHD) risk factors. A retrospective cohort study was conducted between January 2004 and April 2008 to compare estimated 10‐year CHD risk reduction and dual blood pressure and low‐density lipoprotein cholesterol goal attainment (Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure and Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults [Adult Treatment Panel III]) in patients with a first prescription for amlodipine monotherapy, co‐prescribed amlodipine + statin, or single‐pill amlodipine/atorvastatin. In total, 2739 patients were prescribed amlodipine monotherapy, 653 were co‐prescribed amlodipine + statin, and 227 were prescribed single‐pill amlodipine/atorvastatin. Baseline CHD risk was similar in all 3 cohorts (11.0%–12.5%). Relative CHD risk reduction was greater in those prescribed single‐pill amlodipine/atorvastatin (24.5%) compared with amlodipine monotherapy (14.4%, P<.01), and co‐prescribed amlodipine + statin (18.4%, P=.01). The findings were driven by greater dual goal attainment for patients prescribed single‐pill amlodipine/atorvastatin (50.2%) compared with amlodipine monotherapy (31.7%, P<.05) and co‐prescribed amlodipine + statin (37.5%, P<.05).
Efficacy and Safety of Irbesartan/HCTZ in Severe Hypertension According to Cardiometabolic Factors
Authors: Franklin Stanley S. , Neutel Joel M. 
Published: April 2010

J Clin Hypertens (Greenwich).2010;12:487–494. © 2010 Wiley Periodicals, Inc.This post hoc analysis of a 7‐week, randomized, double‐blind trial evaluated the efficacy and safety of initial irbesartan/hydrochlorothiazide treatment in 468 patients with severe, uncontrolled, hypertension (diastolic blood pressure [DBP] ≥100 mm Hg) at high cardiovascular risk. Systolic blood pressure (SBP)/DBP reductions ranged from 28.0 to 42.9/22.9 to 27.2 mm Hg in patients with obesity, diabetes, baseline SBP ≥180 mm Hg, and in the elderly. Blood pressure control to <140/90 mm Hg in the age and obesity subgroups ranged from 32.1% to 39.2% while control to <130/80 mm Hg in patients with diabetes was 11.5%. After 1 week of therapy, 72.5% of patients no longer had SBP ≥180 mm Hg; by 7 weeks, 51.3% had SBP 140 to 159 mm Hg and 26.5% had SBP <140 mm Hg. Treatment was well tolerated regardless of the subgroup. No excess of prespecified events was noted. Thus, initial treatment with irbesartan/hydrochlorothiazide was rapidly effective in high‐risk, difficult‐to‐treat, severely hypertensive patients.
Resolving conflicts in fire management using decision theory: asset‐protection versus biodiversity conservation
Authors: Driscoll Don A. , Lindenmayer David B. , Bennett Andrew F. , Bode Michael , Bradstock Ross A. , Cary Geoffrey J. , Clarke Michael F. , Dexter Nick , Fensham Rod , Friend Gordon , Gill Malcolm , James Stuart , Kay Geoff , Keith David A. , MacGregor Chris , Possingham Hugh P. , Russel‐Smith Jeremy , Salt David , Watson James E. M. , Williams Dick , York Alan 
Published: April 2010

AbstractAgencies charged with nature conservation and protecting built‐assets from fire face a policy dilemma because management that protects assets can have adverse impacts on biodiversity. Although conservation is often a policy goal, protecting built‐assets usually takes precedence in fire management implementation. To make decisions that can better achieve both objectives, existing trade‐offs must first be recognized, and then policies implemented to manage multiple objectives explicitly. We briefly review fire management actions that can conflict with biodiversity conservation. Through this review, we find that common management practices might not appreciably reduce the threat to built‐assets but could have a large negative impact on biodiversity. We develop a framework based on decision theory that could be applied to minimize these conflicts. Critical to this approach is (1) the identification of the full range of management options and (2) obtaining data for evaluating the effectiveness of those options for achieving asset protection and conservation goals. This information can be used to compare explicitly the effectiveness of different management choices for conserving species and for protecting assets, given budget constraints. The challenge now is to gather data to quantify these trade‐offs so that fire policy and practices can be better aligned with multiple objectives.
Mental health status of Japanese‐Brazilian children at Brazilian schools in Japan
Authors: Kondo Shu , Otsuka Koichiro , Sawaguchi Glaucia Tiyomi , Honda Elisa Tatsuko , Nakamura Yosikazu , Kato Satoshi 
Published: April 2010

AbstractIntroduction: Although the mental health of Japanese‐Brazilian children in Japan has become a matter of concern, few studies have employed a psychological approach and no research of these children's mental health has previously been performed at Brazilian schools in Japan.Methods: The present study used a sample of 241 children aged 4 to 10 years at five Brazilian schools in Japan. The Strength and Difficulties Questionnaire was applied for their guardians and teachers to detect the probable cases of mental disorders. Demographic data of the children were also collected from their guardians and a further analysis was made to determine the risk factors of the probable cases of conduct disorders.Results: The proportion of probable cases was 0.8% for emotional disorders, 9.1% for conduct disorders, 2.1% for hyperactivity disorders, and 10.0% for any psychiatric disorder. The detected risk factors of conduct disorders were male sex, 8 to 10 years of age, living without a father, and not talking often with their teacher.Discussion: The proportions of probable cases of mental disorders were not as high compared to general prevalence ranges or earlier studies. Considering the school and home situation of the children, living without a father seemed to be the foremost risk factor of conduct disorders.
Character tables of the maximal parabolic subgroups of the Ree groups 2F4(q2)
Authors: Himstedt Frank , Huang Shih-Chang 
Published: April 2010

AbstractWe compute the conjugacy classes of elements and the character tables of the maximal parabolic subgroups of the simple Ree groups 2F4(q2). For one of the maximal parabolic subgroups, we find an irreducible character of the unipotent radical that does not extend to its inertia subgroup.
SU‐FF‐I‐86: Esophagus Segmentation in Thoracic CT Images for Radiotherapy Planning
Authors: Kurugol S , Sharp G , Dy J , Brooks D 
Published: April 2010

Purpose: Contouring organs at risk in thoracic CT images for radiotherapy planning is labor intensive. We propose a technique to semiautomatically segment the esophagus in thoracic CT images. Method and Materials: We used training datasets to learn the distribution of relative spatial location of esophagus centers with respect to neighboring structures and to construct models of their anterior‐posterior (x) and left‐right (y) coordinate trajectories as a function of cranial‐caudal (z) position after local normalization by transverse scaling and translation. In the z direction, we selected 8 anatomical reference points and matched these points for each training set. We observed that the centers can be modeled by a single cubic polynomial in the sagittal plane and by a shape‐preserving spline in the coronal plane. To segment the esophagus in a 3D dataset, we estimated the center based on histograms for each reference slice and fit the polynomial center models for other slices. We then used level‐sets to locate the esophagus wall. We initialized the level‐set function and shape prior using the estimated centers and updated to minimize an energy functional combining several existing region, shape and smoothness terms to impose a smooth slice‐to‐slice change of ellipse parameters. Results: Testing on 8 subjects against expert segmentations, the center‐estimation algorithm achieved 2mm average error in the x‐direction but was less accurate in the y‐direction with a 4.3mm average error. The level‐set method improved the average error in y‐direction to 2.8mm. Conclusion: Segmentation of the esophagus using prior information from training including spatial dependence between neighboring structures and models of the esophagus centers can be performed with a level set approach. Using spatial information and slice‐to‐slice smoothing improves the performance for regions with no contrast.Acknowledgement: The work of first and fourth author was supported by NIH/NCRR Center for Integrative Biomedical Computing (CIBC), P41‐RR12553‐09.
SU‐FF‐I‐121: Development of An Organ Surface Statistical Model for Uncertainty‐Weighted Deformable Image Registrations
Authors: Wu J , Murphy M , Weiss E , Williamson J 
Published: April 2010

Purpose: To develop an organ surface statistical model for uncertainty‐weighted probabilistic deformable registrations. Materials and Methods: The contours of the prostate, the bladder, and the rectum were manually delineated by five observers on fan beam CT images of four prostate patients. The reliability of the organ boundary delineation was estimated by calculating the intra‐observer, the inter‐observer, and the inter‐modality variability (e.g., standard deviation) of the organ boundary surfaces. For each set of contours, an average surface was computed by first superimposing individual organ contours and generating a composite bitmap image. Then after smoothing, a matching tetrahedron algorithm was used to extract the average surface mesh. The distance map between each individual segmentation and the average surface mesh can be calculated based on the normal defined on 1) each vertex or 2) each triangle of the average mesh. A simple 3D visualization program was developed using OpenGL to interactively viewing 3D organ surfaces and standard deviation surface maps. Results: Population‐based organ surface statistical models of the prostate, the bladder, and the rectum were created by mapping the patient specific standard deviation surface maps to the population‐averaged surface. 3D visualization indicates that the boundary uncertainties are anatomical location dependent. Conclusions: We proposed a general method for objectively constructing surface maps of uncertainties derived from topologically complex organ boundary segmentations from multiple observers. The computed boundary uncertainties can be used as weighting factors for a surface‐based probabilistic deformable registration.Supported in part by NIH grant P01CA116602
SU‐FF‐J‐59: Adaptive Gating of Radiotherapy Treatment Based On Marker‐Less Tracking of Lung Tumors with KV Fluoroscopy
Authors: Aristophanous M , Rottmann J , Park S , Berbeco R 
Published: April 2010

Purpose: We investigated using kV fluoroscopy for adapting the respiratory gating window prior to each radiation treatment fraction. The gate adaptation was based on marker‐less tracking of the target and correlating the internal motion trace with the external breathing signal. Method and Materials: A phantom study was performed with the on‐board kV imager of the Novalis Tx machine. A dynamic chest phantom with a water‐filled sphere placed inside a movable lung density insert was utilized. Breathing traces from patients that underwent lung SBRT were used to drive the target and external surrogate motion. The Varian RPM gating system was employed to obtain an external breathing signal, while acquiring kV fluoroscopy images. The moving target was tracked and an internal signal was generated. One kV acquisition was used for adapting the gating window based on the correlation of the internal and external signal and another one for verifying the gated position of the target. Gating at end‐exhale is the most commonly used technique in the clinic, while gating at mid‐ventilation makes it more likely that the tolerance window for residual motion includes the tumor during the entire breathing cycle. The two gating windows were investigated and the results were compared. Results: No significant difference in the gated target position errors was observed between the two gating windows. The target was in the expected position about 90% of the time for each one. The maximum deviation outside the tolerance window for residual motion was 1.9mm for the end‐exhale and 2.2mm for the mid‐motion gating windows. Conclusion: The adapt and verify procedure examined in this study, if applied in real‐time, has the potential to improve the accuracy of lung cancer radiotherapy by facilitating the reduction of safety margins used for moving tumors.Conflict of Interest: Varian Medical Systems, Inc.
SU‐FF‐T‐21: The Optimal Number of Lumens for Multi‐Lumen Devices Used in Partial Breast Irradiation
Authors: Liu B , Jiang H , Kampp T , Astrahan M 
Published: April 2010

Purpose: To compare the dosimetry of single‐lumen MammoSite device to multi‐lumen devices and to find the optimal number of lumens Methods and Materials: Four designs of multi‐lumen devices are studied: a central lumen with two, three, four, or six off‐set lumens which are 180°, 120°, 90° and 60° rotationally symmetric around the central lumen. All lumens are straight and parallel to the central lumen. Patients of three different clinical conditions are simulated: (1) skin and chest wall spacing from balloon are larger than 10 mm, (2) smaller than 5 mm and (3) between 5 mm and 10 mm. 10 mm extension from the balloon is defined as planning target volume (PTV). In clinical conditions (2) and (3), where the spacing of skin and/or the spacing of chest wall are less than 10 mm, PTV are shaped to avoid skin and chest wall. The region of PTV excluding balloon is defined as PTV_EVAL, which is used for DVH constraints and dosimetric comparison. Results: For clinic condition (1), where the PTV is symmetric, single‐lumen MammoSite and multi‐lumen devices provide similar dosimetric results, whereas in clinic condition (2) and (3), the PTV is asymmetric, the multi‐lumen devices provide good coverage to PTV_EVAL with V95 > 90%, and the multi‐lumen devices deliver significantly less incidental dose to skin and chest wall: three‐lumen device reduce the dose to skin/chest wall by 10%, while four‐ five‐ and six‐lumen device provide similar results, reducing the skin/chest wall dose to be less than 120% of the prescription dose, a 25% drop. Conclusion: Compared with single‐lumen MammoSite device, Multi‐lumen device have better dosimetric results in partial breast irradiation where the PTV spacing is less than 10 mm. Devices with more than four lumens provide similar results to four lumen device.Research sponsored by Hologic
SU‐FF‐T‐25: Cervix Brachytherapy Dosimetry: Observed Improvement in Data Submitted to Clinical Trials
Authors: Lowenstein J , Roll J , Ibbott G 
Published: April 2010

Purpose: For over 40 years, the Radiological Physics Center (RPC) has reviewed the completeness, consistency with protocols, and the dosimetric accuracy of data submitted for cervix patients treated with brachytherapy on national clinical trials. In 2005 the RPC presented data which showed that 65% of cervix patients placed on study had one or more dosimetry errors in at least one of their implants. This study was conducted to determine if brachytherapy dosimetry has improved in the last 4 years. Methods & Materials: In the last 4 years the RPC has reviewed 695 HDR and LDR implants. Independent dose calculations were performed at points A, B, vaginal surface, bladder and rectum as defined by the protocol in accordance with ICRU‐38. The vaginal surface dose was defined as a point lateral to the center of the source (s) at 0.5cm from the surface of the ovoid. RPC doses were compared to the institution's reported doses. Results: From 2005 to 2009 the RPC has determined that dosimetry errors have decreased by 50%. Most remaining errors result from incorrectly defining calculation points. However the use of CT has created some new issues due to the manipulation of the CT images when visualizing the tandem. Conclusion: The decrease in dosimetry errors is due to several different aspects: increase in rapid reviews, more timely reviews of patients and better communication with an institution when discrepancies are discovered.This work was supported by PHS grant CA 10953 awarded by NCI, DHHS
SU‐FF‐T‐34: Dosimetric Evaluation of Gammamed High Dose Rate Intraluminal Brachytherapy Applicators
Authors: Chandraraj V , Supe S , Manickam R 
Published: April 2010

Purpose: The aim of this study was to dosimetrically evaluate various intraluminal brachytherapy applicators for the Gammamed high dose rate afterloading system. Materials and methods: Dosimetric evaluation was carried out for 8 mm, 10 mm, 12 mm and 14 mm diameter intraluminal applicators available with the Gammamed high dose rate afterloading system. Treatment planning for these applicators was carried out with abacus treatment planning system for active source length and 8 cm, 10 cm and 12 cm. All evaluations were carried out for prescription dose of 5 Gy at the reference point of 1cm from source axis. Reference volume length (RVL), Treated volume (TV), Hyper dose sleeve radius (HSR) were noted down from the isodose plans. Iterative, geometric and equal times optimization routines were carried out for all evaluations with step size of 0.5cm. Results: The isodose curves showed tapering pattern towards the distal and proximal regions. The reference volume lengths were larger than active source lengths for 8mm and 10mm diameter applicators. Reference volume lengths were smaller than active source length for 12mm and 14mm diameter applicators hyper dose sleeve radius decreases with increase in diameter of the applicator. For 14mm diameter applicators, the hyper dose sleeve radius was smaller than the radius of the reference isodose. Iterative optimization routine gave better average in terms of reference volume length few are four diameter applicators.Conclusions: We evaluated the dosimetric parameters for various intraluminal applicators available with the Gamma med high dose rate remote after loading system. The values of RVL and HSR were within acceptable limits for the four applicators considered in this study.
SU‐FF‐T‐44: Dosimetric Analysis of the Effect of Edema in 131Cs Prostate Permanent Seed Implants
Authors: Kehwar TS , Jones HA , Huq MS , Beriwal S , Benoit RM , Smith RP 
Published: April 2010

Purpose: To investigate the effect of edema on different dosimetric parameters in prostate permanent seed implants. Materials and Methods: Transrectal ultrasound (US) and computer tomography (CT) images were used to determine pre‐ and post‐needle implant volumes, and post‐implant prostate volumes in 31 patients who had received implant. Dose volume histograms(DVH) were generated to determine the prostate volumes that received 100%, 150% and 200% of prescribed dose to calculate quality indices(QIs) and fractional D90(FD90) for each set of volumes for all patients. Results: No statistical differences were found between post‐needle and post‐implant(day 0) volumes obtained by US and CT images(p=0.56). The half life of the edema was found to be 9.72days.The change in mean values of coverage index(CI), dose non‐uniformity ratio(DNR), overdose index(ODI), relative dose‐homogeneity index(DHI) and FD90 can be described by (1) (2) (3) (4) and (5) differential equations. The values of correlation coefficients and time constants obtained from least square fit of these equations were found to be 0.9867 & 0.0316 for CI, 0.9988 & 0.0148 for DNR, 0.9958 & 0.00148 for ODI, and 0.9983 & 0.0125 for DHI, respectively. Conclusions: CI, DHI and FD90 decreased, while DNR and ODI increased from pre‐implant plans to post‐implant plans at day 0 due to edema formation. CI, DNR, ODI and FD90 increased and DHI decreased with increasing post‐implant time and attained optimal values in 4 weeks. During this period 85% dose is delivered due to short half life of seeds. Therefore, it is important to account for the effect of edema at the time of implant while defining seed positions. Implants performed based on pre‐implant volume study only result in poor dosimetric results in implants.