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Deep Learning (DL) models, such as Convolutional Neural Networks (CNNs) and Vision Transformers (ViTs), have become popular for change detection tasks, including the deforestation mapping application. However, not enough attention has been paid to the domain shift issue, which affects classification performance when pre-trained models are used in areas with different forest covers and deforestation practices. This study compares DL methods for deforestation detection, focusing on assessing how well CNNs and ViTs can adapt to the domain shift. Two different models, namely, DeepLabv3+ and UNETR, were trained using remote sensing images and references from a specific location and then tested in other sites to simulate real-world scenarios. The results showed that the ViT-based architecture achieved better performance when trained and tested in the same region but showed lower generalization capacity in cross-domain scenarios. We consider this a work in progress that needs further research to confirm its findings, with the evaluation of additional architectures on a wider range of domains.

Introduction. Oropharyngeal squamous cell carcinomas are often found to be associated with human papilloma virus (HPV) infection. The prevalence of HPV infection among oropharyngeal squamous cell carcinomas patients in India is comparatively lower to that of the same worldwide. Aim. To find out the prevalence of HPV infection among oropharyngeal squamous cell carcinomas patients who presented in our hospital.Settings and design. Retrospective cross-sectional study.Materials and methods. Tissue block of 60 patients with biopsy-proven oropharyngeal squamous cell carcinomas were subjected to immunohistochemistry for evaluating p16 expression. The p16 expression pattern was correlated with the demographic details. Data was entered in Microsoft Excel and Statistical Analysis was done with the help of SPSS version 22 (IBM Corp. Released, 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.).Results. Prevalence of HPV infection in our study was found to be 11.7 %. 85.8 % of all p16-positive patients had moderate-well differentiated disease. 6 out of 7 p16-positive patients had higher T stage (T3–4). All the patients who were p16+ were found to have a higher Nodal stage (N2–3). 100 % of all p16+ patients were found to have stage IV disease.Conclusion. Prevalence of HPV infection was found to be similar to that of previous studies conducted in India. These patients also presented with advanced nodal disease at presentation and thereby, an advanced overall stage.

Purpose: Interventional approaches to treat hypertension are an emerging option that may be suitable for patients whose BP control cannot be achieved with lifestyle and/or pharmacotherapy and possibly for those who do not wish to take drug therapy. Materials and Methods: Interventional strategies include renal denervation with radiofrequency, ultrasound and alcohol-mediated platforms as well as baroreflex activation therapy and cardiac neuromodulation therapy. Presently renal denervation is the most advanced of the therapeutic options and is currently being commercialised in the EU. Results: It is apparent that RDN is effective in both unmedicated patients and patients with more severe hypertension including those with resistant hypertension. Conclusion: However, at present there is no evidence for the use of RDN in patients with secondary forms of hypertension and thus evaluation to rule these out is necessary before proceeding with a procedure. Furthermore, there are numerous pitfalls in the diagnosis and management of secondary hypertension which need to be taken into consideration. Finally, prior to performing an intervention it is appropriate to document presence/absence of hypertension-mediated organ damage.

Background: Persons with HIV (PWH) have both more frequent depression and higher levels of plasma inflammatory biomarkers compared to persons without HIV (PWoH). Inflammation and depressive symptoms are linked, including in PWH; however, it is unclear whether these associations differ by HIV serostatus and biological sex. Methods: Six plasma inflammatory biomarkers were assessed using samples from PWH and PWoH who participated in six NIH-funded studies through the UCSD HIV Neurobehavioral Research Program (HNRP) from 2011 to 2019. Factor analysis was performed to identify intercorrelated groups of biomarkers. Factors and their components were then examined for relationships with Beck Depression Inventory-II (BDI-II) and modifying effects of sex or HIV serostatus using multivariable linear regression, adjusting for demographics, substance use diagnoses, and relevant co-morbidities. Results: Participants included 150 PWH (age = 48.3 ± 13.1 yr; 88% biologically male) and 138 PWoH (age = 46.3 ± 15.9; 56% male). Two inflammatory factors were identified: Factor 1 loaded on interleukin-6 (IL-6), C-reactive protein (CRP), and D-dimer; Factor 2 loaded on interleukin-8, chemokine C–C ligand 2 (CCL2), and chemokine C-X-C ligand 10 (CXCL10). Sex modified the effect of Factor 1 on BDI-II, with a more positive association for men than women (p = 0.04). No significant association between Factor 2 and BDI-II was found. Of the biomarkers in Factor 1, only IL-6 was significantly associated with BDI-II and was modified by sex (p = 0.003). In sex-stratified analysis, a positive association was found for men (β = 5.42; 95% confidence interval = [1.32, 9.52]) but not women (β = −3.88; 95% C.I. = [-11.02, 3.26]). No HIV-related interactions were detected. Interpretation: We identified a depression-associated inflammatory factor present in both PWH and PWoH, consistent with prior studies of PWH only. The association was driven by a correlation between IL-6 and depression exclusively in men, suggesting that the depression-inflammation link differs by sex. Future studies of depression etiology or treatment, including those on persons with HIV, should consider the impact of biological sex in both design and analysis.

Cysticercus is the infective larval form of the cystode T. solium that causes cysticercosis. It is has been declared as one of the neglected endemic zoonoses by the WHO. Poor sanitation, and consumption of undercooked infected pork and raw vegetables contaminated by human feces are the potential sources. Cysticercosis can affect various organs. India is one of the endemic countries where the parasite is prevalent in many states. This study aimed to analyze and report cases of cysticercosis based on the histopathological diagnosis. This is a retrospective study that included cases which had been reported as cysticercosis on histopathology from 2010 to 2018 at a tertiary care hospital. The clinical presentation of these cases along with macroscopic and microscopic features were reviewed. There were six cases of cysticercosis that were diagnosed on histopathology during the study period. Among them, two cases were intramuscular lesions, three were subcutaneous, and one case was an intraventricular lesion in the brain. Three of the cases presented as cystic lesions. On histopathological evaluation, cysts were identified in four cases on macroscopy. Microscopically, the cross section of the cysticercus was seen in all six cases with associated inflammatory change. To conclude, cysticercosis can clinically present as a benign neoplastic or an inflammatory lesion. Microscopic findings dictate the diagnosis of cysticercosis, although histopathological evaluation is not common.

Fully convolutional neural networks (FCN) are successfully used for pixel-wise land cover classification - the task of identifying the physical material of the Earth’s surface for every pixel in an image. The acquisition of large training datasets is challenging, especially in remote sensing, but necessary for a FCN to perform well. One way to circumvent manual labelling is the usage of existing databases, which usually contain a certain amount of label noise when combined with another data source. As a first part of this work, we investigate the impact of training data on a FCN. We experiment with different amounts of training data, varying w.r.t. the covered area, the available acquisition dates and the amount of label noise. We conclude that the more data is used for training, the better is the generalization performance of the model, and the FCN is able to mitigate the effect of label noise to a high degree. Another challenge is the imbalanced class distribution in most real-world datasets, which can cause the classifier to focus on the majority classes, leading to poor classification performance for minority classes. To tackle this problem, in this paper, we use the cosine similarity loss to force feature vectors of the same class to be close to each other in feature space. Our experiments show that the cosine loss helps to obtain more similar feature vectors, but the similarity of the cluster centers also increases.

Hypertension remains the leading risk factor for death worldwide. Despite its prevalence, success of blood pressure (BP) management efforts remains elusive, and part of the difficulty lies in the tool still used to diagnose, measure, and treat hypertension: the sphygmomanometer introduced by Samuel Siegfried Karl von Basch in 1867. In recent years, there has been an explosion of devices attempting to provide estimates of BP without a cuff, overcoming many limitations of cuff-based BP monitors. Unfortunately, the differences in underlying technologies between traditional BP cuffs and newer cuffless devices, as well as hesitancy of changing a well-implemented standard, still generate understandable skepticism about and reluctance to adopt cuffless BP monitors in clinical practice. This guidance document aims to navigate the scientific and medical communities through the types of cuffless devices and present examples of robust BP data collection which are better representations of a person's true BP. It highlights the differences between data collected by cuffless and traditional cuff-based devices and provides an initial framework of interpretation of the new cuffless datasets using, as an example, a CE-marked continual cuffless BP device (Aktiia BP Monitor, Aktiia, Switzerland). Demonstration of novel BP metrics, which have the potential to change the paradigm of hypertension diagnosis and treatment, are now possible for the first time with cuffless BP monitors that provide continual readings over long periods. Widespread adoption of continual cuffless BP monitors in healthcare will require a collaborative and thoughtful process, acknowledging that the transition from a legacy to a novel medical technology will be slow. Finally, this guidance concludes with a call to action to international scientific and expert associations to include cuffless BP monitors in original scientific research and in future versions of guidelines and standards.

Abstract Background Plasma cell disorders are a rare group of hematological malignancies that accounts for 10% of all hematological neoplasms. Solitary plasmacytomas are rarer entities accounting for less than 5% of all the plasma cell dyscrasias. They encompass three subtypes - Solitary Plasmacytoma of Bone (SPB) and Solitary Extramedullary Plasmacytoma (SEP) and multiple solitary plasmacytomas (MSP). In this study, we discuss the clinical, histopathological and immunohistochemical characteristics of solitary plasmacytomas. Methods A 13 year retrospective analysis of solitary plasmacytomas was performed from a single tertiary care center. Bone marrow evaluation was done concurrently at the time of diagnosis to rule out the presence of multiple myeloma. Results A total of 29 cases fulfilled the diagnostic criteria for SP during the study period. SPB accounted for 55.2%, SEP for 44.4% and MSP for 3.4% of the cases. The most common sites involved were the paranasal sinuses and vertebrae. Other infrequent sites included lymph node, tonsil and lungs. The mean age of presentation of SPB was a decade later than SEP. A male preponderance was observed in both subtypes. Conclusion Solitary plasmacytoma is a rare entity, the diagnosis of which requires a systematic approach. There is limited data available in the literature on the clinico-pathological characteristics of SP from India.

Campylobacter jejuni is a bacterial human pathogen causing gastroenteritis and sequelae like irritable bowel syndrome. Epidemiologists count the human campylobacteriosis by C. jejuni as the most common foodborne zoonosis and bacterial diarrheal disease worldwide. Based on bioinformatics predictions for potential protective compounds in campylobacteriosis, the question was raised whether the plant-based polyphenol resveratrol is sufficient to attenuate intestinal epithelial damage induced by C. jejuni. We investigated this by performing experimental infection studies in an epithelial cell culture and the secondary abiotic IL-10−/− mouse model. In C. jejuni-infected human colonic HT-29/B6 cell monolayers, transepithelial electrical resistance (TER) was decreased and the paracellular marker flux of fluorescein (332 Da) increased. Concomitantly, the tight junction (TJ) proteins occludin and claudin-5 were re-distributed off the tight junction domain. This was accompanied by an increased induction of epithelial apoptosis, both changes contributing to compromised barrier function and the opening of the leak pathway induced by C. jejuni. In parallel, the recovery experiments with the application of resveratrol revealed a functional improvement of the disturbed epithelial barrier in both models in vitro and in vivo. During treatment with resveratrol, TJ localization of occludin and claudin-5 was fully restored in the paracellular domain of HT-29/B6 cells. Moreover, resveratrol decreased the rate of epithelial apoptosis. These resveratrol-induced molecular and cellular effects would therefore be expected to improve epithelial barrier function, thereby minimizing the so-called leaky gut phenomenon. In conclusion, the induction of the leak pathway by C. jejuni and the restoration of barrier function by resveratrol demonstrates its effectiveness as a potential preventive or therapeutic method of mitigating the leaky gut associated with campylobacteriosis.

Aim: Morphologic examination of endometrial polyps and assess the occurrence of endometrial cancer. Materials & Methods: One hundred sixty cases of endometrial polyps received at the department of Pathology of a tertiary care hospital over 31 months i.e., from January 2014 and July 2016 were analysed. The clinical data was retrieved from the medical records department. Results: Out of the 160 cases of endometrial polyps, 94.4% of the endometrial polyps were non neoplastic & 5.6% were neoplastic. The mean age of presentation of non-neoplastic polyps was 45 years (21-76 years) & neoplastic polyps was 52 years (42-62 years). The mean size of non-neoplastic polyp was 2.4 cm (0.5-9 cm) & neoplastic polyp was 4.5cm (1.5-9cm). The non-neoplastic polyps were benign endometrial glandular polyp (83.7%), leiomyomatous polyp (2.2%), adenomyomatous polyp (1.1%) & stromomyoma (0.5%). The neoplastic polyps encountered were endometrial carcinoma type 1 (1.67%), endometrial carcinoma type 2 (0.5%), endometrial stromal sarcoma (1.67%), adenosarcoma (0.5%) & malignant mixed mullerian tumor (0.5%). Post-menopausal bleeding was seen in 27% of patients. Immunohistochemistry was performed in 3 of the cases. Tamoxifen induced endometrial polyp were seen in 1.67%. Conclusion: Endometrial polyps are rarely associated with malignancy, as most of them are hyperplastic glandular polyps. Multiple risk factors such as age, multiparity, tamoxifen usage show higher association with malignancy. Post-menopausal bleeding cases needs to be thoroughly evaluated for presence of endometrial malignancy. Histopathological evaluation of resected polyps proves the nature of the disease.

Schistosomiasis is a parasitic trematode that is less commonly seen in India. The clinical manifestations range from acute, sub acute and chronic phases. A granulomatous type of lesion formed by Schistosoma hematobium in the lower urinary tract. We present a case of rare neglected tropical infection in this part of Dakshin Kannada. A 66-year-old man presents with history of irritative voiding symptoms, urgency, incontinence, and nocturia of 2 months duration. CT Urogram showed bladder wall thickening. Cystoscopy showed granuloma in the posterolateral wall of the bladder. Urine microscopy picked up Schistosoma hematobium eggs. Bladder biopsy showed chronic inflammatory type of lesion. This is a case of confirmed chronic granulomatous urinary schistosomiasis in a non-endemic region, and successfully treated. Clinicians should become aware of the existence of this parasite in few pockets in India.

The histopathological interpretation of a tumor still remains the gold standard for diagnosis and deciding the type of therapy. Furthermore, in the context of chemo-radio-therapies often leading to prominent cytological and stromal changes in the tumor, histopathological interpretation during treatment, thus, becomes all the more important in correctly diagnosing and grading the tumor for an effective and planned regimen of the therapy increasing prognosis and chances of survival of the affected patients. The aim of the present study was to evaluate such cytological and stromal changes rendered by the therapy during treatment in breast cancer cases. The present study was conducted over a period of 4 years from January 2014 to June 2017 at Kasturba Medical College, Mangalore, Karnataka, India wherein the clinical and histopathological details were collected for a total of 39 breast carcinoma cases during and post-therapy. Statistical analysis was done using IBM SPSS statistics 17 (Chicago, USA). Various morphological features were analyzed for their frequency and were compared with the final diagnosis using Chi-square value (χ2), paired t-test and Fischer's test. p-value < 0.05 was considered to be statistically significant. The results of the present study revealed that 32 of the 39 breast carcinoma cases changed their grades during the course of therapy (p-value < 0.05). The fundamental manifestation of the effect of therapy was an obvious decrease in tumor cellularity. Intracellular changes commonly noted after chemotherapy included nuclear enlargement, hyperchromasia and an increased N:C ratio which were found in upto 85% of the cases followed by presence of prominent nucleoli and karyorrhexis/karyolysis. The predominant stromal changes seen post-therapy included necrosis (74.4%), fibrosis (64.1%), desmoplasia (59%) and degenerative changes (33.3%). Breast cancer therapy causes morphological alterations in the cancerous as well as the surrounding healthy tissue. The histopathological interpretation in such cases, thus, requires a thorough knowledge of the cytological and stromal changes rendered by the therapy.

Context: Brain metabolite ratios derived from magnetic resonance spectroscopy (MRS) has been used to document changes in neuronal viability, glial activation and inflammation associated with Human Immunodeficiency Virus (HIV) infection and cardiovascular disease. Aims: To determine whether brain metabolite ratios in the left anterioar insula predicts cardio-autonomic regulation indexed by the ratio of low- to high-frequency heart rate varaibility (LF:HF) after accounting for post-menopausal age, HIV and hypertensive (HTN) status. Design: Thirty women, (n=14 HIV+ and n=16 HTN+) with an average age of 54.5 (SD=6.4) years and no history of neurological disease were recruited for the study. Methods: After conventional MR imaging, single-voxel 1H-MRS (TR = 1500 msec; TE = 35 msec) was performed by using a PROBE-SV system implemented on a 3T GE Discovery MR750 scanner. Shift-selective imaging pulses for water suppression were acquired from a voxel placed in the midline of the left anterior insula with an average voxel size of 15×15×15 mm. Heart rate variability was estimated over a 7 minutes resting state scan using an MR-compatible photoplethysmogram. Statistics: A stepwise regression analysis controlling for (1) age, disease status (HIV+ and HTN+) was modelled separately for the ratio of N-acetylaspartate (NAA), Myo-inostol (mI), and Choline (Ch) to Creatine (Cr) ratios to predict LF:HF. Results: Higher ratios of NAA/Cr were associated with lower LF:HF (β= -.393, t(29)= -2.26, p= .033). Ratios of mI:Cr and Cho:Cr did not predict LF:HF. Conclusions: Decreased neuronal viability in the left anterior insula, indexed by lower NAA/Cr metabolite ratios explain a significant proportion of the variance in the skew towards sympathetic overarusal in postmenopausal women at risk for cerebrovacular disease.

Building upon case-based evidence this paper explores the role of leaders in Ecomanglar, a community-based enterprise in the Black collective territory of La Plata-Bahía Málaga in the Colombian Pacific Basin, whose purpose is to provide 'eco 'and' ethno-tourism' services. This purpose is inextricably bound up with the region’s biophysical and institutional characteristics, both of which make management of common-pool resources a key strategic task for Ecomanglar. We propose an analytical framework to understand the role of these leaders based on the interaction of two dimensions: 'institutional transfer channels' and 'operational capacity'. We further analyse the role of leaders as essential ‘brokers’ to initialise and sustain collective action, a role that brings about entrepreneurial solutions for sustainable development but also creates, or exacerbates, conflicts within the community. Our findings challenge approaches which view collective action as an emergent decentralised group-oriented outcome. The paper contributes to the literature on leadership, entrepreneurship and collective action by identifying missing links and potential points of convergence. It also sheds light on some of the challenges in promoting entrepreneurship as a means to advance sustainable development in rural communities.

Animal and human data indicate pathological afferent signaling emanating from the carotid body that drives sympathetically mediated elevations in blood pressure in conditions of hypertension. This first-in-man, proof-of-principle study tested the safety and feasibility of unilateral carotid body resection in 15 patients with drug-resistant hypertension. The procedure proved to be safe and feasible. Overall, no change in blood pressure was found. However, 8 patients showed significant reductions in ambulatory blood pressure coinciding with decreases in sympathetic activity. The carotid body may be a novel target for treating an identifiable subpopulation of humans with hypertension.

Background Renal denervation has no validated marker of procedural success. We hypothesized that successful renal denervation would reduce renal sympathetic nerve signaling demonstrated by attenuation of α‐1‐adrenoceptor‐mediated autotransfusion during the Valsalva maneuver. Methods and Results In this substudy of the Wave IV Study: Phase II Randomized Sham Controlled Study of Renal Denervation for Subjects With Uncontrolled Hypertension, we enrolled 23 subjects with resistant hypertension. They were randomized either to bilateral renal denervation using therapeutic levels of ultrasound energy (n=12) or sham application of diagnostic ultrasound (n=11). Within‐group changes in autonomic parameters, office and ambulatory blood pressure were compared between baseline and 6 months in a double‐blind manner. There was significant office blood pressure reduction in both treatment (16.1±27.3 mm Hg, P

Introduction: Lung cancer is the pioneer among all the cancers and also the leading cause of cancer related mortality worldwide. In India unlike in western countries most patients are diagnosed at advanced stage (Stage III/Stage IV) which in turn adversely affects the patient prognosis and survival. Studying the proportion of the total lung cancer cases which will present in advanced stage and their clinical, pathological and radiological profile will give us an insight into the problem. Aim: To know the percentage incidence of patients presenting with advanced stage lung cancer (Stage IIIB/Stage IV) and to study the clinical, pathological and radiological profile of these patients along with treatment details and follow-up. Materials and Methods: This was a descriptive retrospective study spanning four years from January 2013 to December 2016. All patients with a histopathological diagnosis of Stage IIIB and Stage IV lung cancer, treated during this period were included. Clinical features, radiological (X-ray and CT) findings, histopathological findings including immunohistochemistry if done, treatment modality and survival were analysed based on the information collected from the medical records. Results: Out of 82 cases diagnosed as advanced stage disease, complete clinical data was available for 67 cases which formed the material for the study. Of 67 patients, 47 were male and 20 were female forming a Male: Female ratio of 2.35:1. The mean age of the patients was 61.3 years. Patients presented with cough (59.7%), chest pain (34.3%) dyspnoea (29.8%), weight loss (17.9%), fever (16.4%), haemoptysis (11.9%). Histologically majority were Adenocarcinoma (ADC) (35.8%) followed by Squamous Cell Carcinoma (SCC) (29.8%) small cell carcinoma (14.92%) and just one case of large cell carcinoma. Forty five cases (64.17%) presented with metastases. The most common site for metastasis was bone followed by brain. Three patients who tested positive for Epidermal Growth Factor Receptor (EGFR) mutation were treated with Erlotinib/Gefitinib. The remaining 64 cases were treated with regimens including combinations of premetrexed, platinum based compounds and etoposide. On follow-up 17 patients died during the course of the treatment. Conclusion: High proportion of lung cancer patients present at advanced stage. This demand for public awareness programs about the smoking hazards, early symptoms and importance of early treatment.

Introduction: Endometrial carcinoma ranks 3rd in India among gynecological malignancies. Endometrial cancer (EC) can be classified into two distinct groups – type I and type II, based on histology, which differs in molecular, clinical and histopathological profiles. Type II is nonestrogen dependent, nonendometrioid, more aggressive and carries poor prognosis. Although type II cancers contribute only about 10% of EC incidence, they present at advanced age and cause approximately 50% recurrence and deaths with a low 5-year, overall survival rate. Type II EC are also characterized by genetic alterations in p53, human epidermal growth factor-2/neu, p16 and E-cadherin. Materials and Methods: Endometrial carcinomas diagnosed from endometrial biopsies and hysterectomy specimens received in the Department of Pathology, Kasturba Medical College, Mangalore, from January 2007 to June 2012 were included in the study. Clinicopathological analysis of the 84 cases of EC was done with emphasis on morphology. p53 immunostaining was performed in two cases of serous carcinoma. Results: Out of a total of 84 cases of EC, ten cases were of type II (11.9%). Out of which, eight were serous carcinoma (9.5%) and two clear cell (2.4%). p53 immunostain was strongly positive in the serous papillary carcinomas. The age of the patients ranged from 45 to 75 years. Myometrial invasion was more than half. Treatment was hysterectomy followed by aggressive chemotherapy. Conclusion: Of the type II EC, serous carcinoma is the most common type. Clinical presentation and prognosis differs in comparison to type I EC, thus the recognition of this type of EC is pivotal.

BackgroundOptions for interventional therapy to lower blood pressure (BP) in patients with treatment‐resistant hypertension include renal denervation and the creation of an arteriovenous anastomosis using the ROX coupler. It has been shown that BP response after renal denervation is greater in patients with combined hypertension (CH) than in patients with isolated systolic hypertension (ISH). We analyzed the effect of ROX coupler implantation in patients with CH as compared with ISH. Methods and ResultsThe randomized, controlled, prospective ROX Control Hypertension Study included patients with true treatment‐resistant hypertension (office systolic BP ≥140 mm Hg, average daytime ambulatory BP ≥135/85 mm Hg, and treatment with ≥3 antihypertensive drugs including a diuretic). In a post hoc analysis, we stratified patients with CH (n=31) and ISH (n=11). Baseline office systolic BP (177±18 mm Hg versus 169±17 mm Hg, P=0.163) and 24‐hour ambulatory systolic BP (159±16 mm Hg versus 154±11 mm Hg, P=0.463) did not differ between patients with CH and those with ISH. ROX coupler implementation resulted in a significant reduction in office systolic BP (CH: −29±21 mm Hg versus ISH: −22±31 mm Hg, P=0.445) and 24‐hour ambulatory systolic BP (CH: −14±20 mm Hg versus ISH: −13±15 mm Hg, P=0.672), without significant differences between the two groups. The responder rate (office systolic BP reduction ≥10 mm Hg) after 6 months was not different (CH: 81% versus ISH: 82%, P=0.932). ConclusionsOur data suggest that creation of an arteriovenous anastomosis using the ROX coupler system leads to a similar reduction of office and 24‐hour ambulatory systolic BP in patients with combined and isolated systolic hypertension. Clinical Trial RegistrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT01642498.