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PubMed2002

The combined effect of public profiling and quality improvement efforts on heart failure management.

BACKGROUND: A before-and-after study was conducted to examine the combined effect of public profiling and quality improvement activities on management of heart failure (HF) in the hospital setting. METHODS: Thirty-one hospitals in southeastern Michigan participated in this profiling and quality improvement study. One hospital closed after the baseline measurement. Two quality indicators were developed to evaluate the key processes of HF care, and one profiling indicator was designed for public profiling. The baseline results of the profiling indicator were publicly released. The individual hospitals were identified in the profiling report by name as "having statistically higher (or lower) rates than average." Remeasurement results were compared to the baseline results by using t-tests for the individual hospitals and all 30 hospitals as an aggregate. RESULTS: Two-thirds of the hospitals improved ejection fraction documentation; the aggregate result improved 5.4 percentage points (p < 0.05). No change was observed in the aggregate measure of prescribing angiotensin-converting enzyme inhibitors (ACEIs) to eligible HF patients at discharge. Hospitals with low baseline rates made improvement in ACEI use at discharge, but those with good baseline performance tended to decline in performance. There was a 2.2 percentage point increase (p < 0.05) in the profiling indicator. SUMMARY AND CONCLUSIONS: There seemed to be differential impacts of interventions across indicators and hospitals. Public profiling may have the most positive impact on hospitals with low performance at baseline. Maintaining the baseline good practice was a struggle for hospitals with relatively high baseline rates.

Aged↗

PubMed2003

Ascaris egg profiles in human faeces: biological and epidemiological implications.

Since 2 morphological forms (fertilized and unfertilized) of egg can be produced by Ascaris, infected humans can release in their faeces fertilized eggs only (FEO), unfertilized eggs only (UEO) or both fertilized and unfertilized eggs (FUE) (designated herein as the 3 different egg profiles). Epidemiologically, fertilized eggs are of significance as they enable effective transmission of the parasite. This study, for the first time, characterizes the Ascaris egg profiles in human faeces in an endemic region of China, explores possible host- and parasite-factors related to these profiles, and discusses the biological and epidemiological implications of the findings. The 3 egg profiles were recorded throughout the study period of 2 years, and the overall percentages of people with FEO, FUE and UEO profiles were approximately 41-47%, 32-42% and 17-21%, respectively. The overall number of unfertilized eggs for the entire population accounted for approximately 6-9% of all eggs excreted. The different Ascaris egg profiles showed no correlation to host gender, but they did relate to age and worm burden of the host and to the sex ratio and developmental status of the parasite. While an annual universal anthelmintic treatment resulted in some fluctuation in the values of individual egg profiles, the general features of these profiles remained similar throughout the study period. The findings of this study should have significant implications for understanding transmission patterns of Ascaris and for the implementation of control measures against ascariasis in endemic regions.

Adolescent↗

PubMedDate not supplied

Similarity search profiling reveals effects of fingerprint scaling in virtual screening.

Fingerprint scaling is a method to increase the performance of similarity search calculations. It is based on the detection of bit patterns in keyed fingerprints that are signatures of specific compound classes. Application of scaling factors to consensus bits that are mostly set on emphasizes signature bit patterns during similarity searching and has been shown to improve search results for different fingerprints. Similarity search profiling has recently been introduced as a method to analyze similarity search calculations. Profiles separately monitor correctly identified hits and other detected database compounds as a function of similarity threshold values and make it possible to estimate whether virtual screening calculations can be successful or to evaluate why they fail. This similarity search profile technique has been applied here to study fingerprint scaling in detail and better understand effects that are responsible for its performance. In particular, we have focused on the qualitative and quantitative analysis of similarity search profiles under scaling conditions. Therefore, we have carried out systematic similarity search calculations for 23 biological activity classes under scaling conditions over a wide range of scaling factors in a compound database containing approximately 1.3 million molecules and monitored these calculations in similarity search profiles. Analysis of these profiles confirmed increases in hit rates as a consequence of scaling and revealed that scaling influences similarity search calculations in different ways. Based on scaled similarity search profiles, compound sets could be divided into different categories. In a number of cases, increases in search performance under scaling conditions were due to a more significant relative increase in correctly identified hits than detected false-positives. This was also consistent with the finding that preferred similarity threshold values increased due to fingerprint scaling, which was well illustrated by similarity search profiling.

Journal Article↗

PubMed1997

Methods to compare dissolution profiles and a rationale for wide dissolution specifications for metoprolol tartrate tablets.

The objectives of this work were to apply several profile comparison approaches to dissolution data of four different but bioequivalent metoprolol tartrate tablet formulations to (1) identify the advantages and disadvantages of each approach, (2) quantify the metric for comparing dissolution profiles of each method, (3) determine metric limits that are consistent with the observed bioequivalence, and (4) rationalize the observed metric limits with respect to the role of dissolution in overall metoprolol absorption. Dissolution was performed by the USP monograph method on four formulations of metoprolol tartrate tablets (Lopressor plus fast, medium, and slow dissolving test formulations). Three general approaches to compare dissolution profiles were examined; they were ANOVA-based, model-independent, and model-dependent approaches. It is concluded that model-independent approaches and several model-dependent approaches yielded numerical results that can serve as objective and quantitative metrics for comparing entire dissolution profiles of the four metoprolol tartrate formulations. However, these methods presented complications. Some metrics were dependent on the length of the dissolution profile and the sampling scheme. Results from the pairwise procedures also depended on the pairing assignment of individual profiles. In spite of complications, these methods suggested wide dissolution specification limits. Wide dissolution specifications were rationalized through an analysis of in vitro-in vivo relationships, which indicated metoprolol dissolution from these formulations was not the rate-limiting step; hence, a range of dissolution profiles can be expected to yield equivalent plasma profiles.

Analysis of Variance↗

PubMed2001

Estimating toxic damage to soil ecosystems from soil organic matter profiles.

Concentrations of particulate and total organic matter were measured in upper soil profiles at 26 sites as a potential means to identify toxic damage to soil ecosystems. Because soil organic matter plays a role in cycling nutrients, aerating soil, retaining water, and maintaining tilth, a significant reduction in organic matter content in a soil profile is not just evidence of a change in ecosystem function, but of damage to that soil ecosystem. Reference sites were selected for comparison to contaminated sites, and additional sites were selected to illustrate how variables other than environmental contaminants might affect the soil organic matter profile. The survey was undertaken on the supposition that environmental contaminants and other stressors reduce the activity of earthworms and other macrofauna, inhibiting the incorporation of organic matter into the soil profile. The profiles of the unstressed soils showed a continuous decrease in organic matter content from the uppermost mineral soil layer (0-2.5 cm) down to 15 cm. Stressed soils showed an abrupt decrease in soil organic matter content below a depth of 2.5 cm. The 2.5-5.0 cm layer of stressed soils--such as found in a pine barren, an orchard, sites contaminated with zinc, and a site with compacted soil--had less than 4% total organic matter and less than 1% particulate organic matter. However, damaged soil ecosystems were best identified by comparison of their profiles to the profiles of closely matched reference soils, rather than by comparison to these absolute values. The presence or absence of earthworms offered a partial explanation of observed differences in soil organic matter profiles.

Animals↗

PubMed2002

Protein expression profiles indicative for drug resistance of non-small cell lung cancer.

Data obtained from multiple sources indicate that no single mechanism can explain the resistance to chemotherapy exhibited by non-small cell lung carcinomas. The multi-factorial nature of drug resistance implies that the analysis of comprising expression profiles may predict drug resistance with higher accuracy than single gene or protein expression studies. Forty cellular parameters (drug resistance proteins, proliferative, apoptotic, and angiogenic factors, products of proto-oncogenes, and suppressor genes) were evaluated mainly by immunohistochemistry in specimens of primary non-small cell lung carcinoma of 94 patients and compared with the response of the tumours to doxorubicin in vitro. The protein expression profile of non-small cell lung carcinoma was determined by hierarchical cluster analysis and clustered image mapping. The cluster analysis revealed three different resistance profiles. The frequency of each profile was different (77, 14 and 9%, respectively). In the most frequent drug resistance profile, the resistance proteins P-glycoprotein/MDR1 (MDR1, ABCB1), thymidylate-synthetase, glutathione-S-transferase-pi, metallothionein, O6-methylguanine-DNA-methyltransferase and major vault protein/lung resistance-related protein were up-regulated. Microvessel density, the angiogenic factor vascular endothelial growth factor and its receptor FLT1, and ECGF1 as well were down-regulated. In addition, the proliferative factors proliferating cell nuclear antigen and cyclin A were reduced compared to the sensitive non-small cell lung carcinoma. In this resistance profile, FOS was up-regulated and NM23 down-regulated. In the second profile, only three resistance proteins were increased (glutathione-S-transferase-pi, O6-methylguanine-DNA-methyltransferase, major vault protein/lung resistance-related protein). The angiogenic factors were reduced. In the third profile, only five of the resistance factors were increased (MDR1, thymidylate-synthetase, glutathione-S-transferase-pi, O6-methylguanine-DNA-methyltransferase, major vault protein/lung resistance-related protein).

Carcinoma, Non-Small-Cell Lung↗

PubMed2007

Physiogenomic comparison of weight profiles of olanzapine- and risperidone-treated patients.

Atypical antipsychotics induce pre-diabetic symptoms in some but not all patients, characterized most notably by elevated weight. The side effect profiles of the various drugs in the class differ, however, raising the possibility of drug-specific mechanisms for similar side effects. We used physiogenomic analysis, an approach previously employed to study the genetics of drug and diet response, to discover and compare genetic associations with weight profiles observed in patients treated with olanzapine and risperidone as an approach to unraveling contrasting mechanistic features of both drugs. A total of 29 single nucleotide polymorphisms (SNPs) were selected from 13 candidate genes relevant to two potential pharmacological axes of psychotropic-related weight profiles, appetite peptides and peripheral lipid homeostasis. We applied physiogenomic analysis to a cross-section of 67 and 101 patients being treated with olanzapine and risperidone, respectively, and assessed genetic associations with the weight profiles. Weight profiles in patients treated with olanzapine were significantly associated with SNPs in the genes for apolipoprotein E, apolipoprotein A4 and scavenger receptor class B, member 1. Weight profiles in patients treated with risperidone were significantly associated with SNPs in the genes for leptin receptor, neuropeptide Y receptor Y5 and paraoxonase 1. These results are consistent with contrasting mechanisms for the weight profile of patients treated with these drugs. Genes associated with olanzapine weight profiles may be related to peripheral lipid homeostatic axes, whereas those associated with risperidone's may be related to brain appetite peptide regulation. Future physiogenomic studies will include neurotransmitter receptor SNPs and validation in independent samples.

Adolescent↗

PubMed2005

Effect of facial convexity on antero-posterior lip positions of the most favored Japanese facial profiles.

Soft tissue analyses are basic tools in planning orthodontic treatment. However, the perception of a well-balanced Japanese facial profile has not yet been established, particularly with respect to changes in facial convexity. The purpose of this study was to assess and determine the range of antero-posterior (A-P) lip positions of the top three most favored, well-balanced profiles from a series of various facial silhouettes with changing facial convexity. The average profile was constructed from the profiles of 30 Japanese males and females with Class I occlusions. Changes in facial convexity were established by altering the A-P chin position by protruding or retruding the chin in increments of 5 degrees and 10 degrees from the average profile. A series of 11 profiles were developed from each of the four changes in facial convexity. The lips were then protruded or retruded in one-mm increments from the average profile. Forty orthodontists were asked to rate the top three most favored, well-balanced profiles. We found that the raters tended to prefer more retruded lip positions as facial convexity decreased, for both males and females. The raters also tended to prefer slightly more protruded lip positions as the facial convexity increased. Because chin position is inherent in each patient, others may equate a retrusive or protrusive chin with certain personalities, thus, it is important for orthodontists to take into account the balance between the lips and the chin.

Adult↗

PubMed2002

A comparative study of root canal preparation using Profile .04 and Lightspeed rotary Ni-Ti instruments.

AIM: The purpose of this Study was to compare several parameters of root canal preparation using two different rotary nickel-titanium instruments: ProFile .04 (Dentsply/ Maillefer, Ballaigues, Switzerland) and Lightspeed (Lightspeed Technology Inc., San Antonio, TX, USA). METHODOLOGY: Fifty extracted mandibular molars with root canal curvatures between 20 degrees and 40 degrees were divided into two similar groups having equal mean curvatures. The teeth were then embedded into a muffle system as described by Bramante et al. (1987) and modified by Hülsmann et al. (1999b). All root canals were prepared using ProFile .04 or Lightspeed Ni-Ti instruments to size 45 following the manufacturers' instructions. The Lightspeed system was used in a step-back technique: ProFile .04 instruments were used in a crown-down technique. The following parameters were evaluated: straightening of curved root canals (superimposition of pre- and postoperative radiographs), postoperative root canal diameter (superimposition of pre- and postoperative photographs of root canal cross-sections), safety issues (file fractures. perforations, apical blockages, loss of working length) (protocol), cleaning ability (SEM-evaluation of root canal walls using a five-score system for debris and smear layer), and working time (protocol). Statistical analysis was performed using the Wilcoxon test (P < 0.05) for straightening, and Fisher's exact-test (P < 0.05) for comparison of cross-sections, for comparison of contact between pre- and postoperative diameter, root canal cleanliness and working time. RESULTS: Both Ni-Ti systems maintained curvature well; the mean degree of straightening was less than 1 degrees for both ProFile .04 and for Lightspeed with no statistical significance between the groups. Most procedural incidents occurred with Profile .04 instruments (three fractures), Lightspeed preparation was completed without instrument fractures. Loss of working length, perforations or apical blockage did not occur with either instrument. Following preparation with Profile.04. 64.0% of the root canals had a round, 30.7% an oval, and 5.3% an irregular cross-section, Lightspeed preparation resulted in a round cross-section in 41.3% of cases, an oval shape in 45.3% of cases: 13.3% of cases had an irregular cross-section. No significant differences were found between the two systems. Lightspeed instruments enlarged the root canal more uniformly with no specimen showing 50% or more contact between pre- and postoperative diameter. The difference was statistically significant only for the coronal third of the root canals (P = 0.032). Mean working time was significantly shorter for Profile .04 (105 s) than for Lightspeed (140 s) (P = 0.02). For debris removal Lightspeed achieved the best results (68% scores 1 and 2), followed by Profile .04 (48.4%) with no significant differences between the systems. The results for remaining smear layer were similar: the lowest amount of smear layer on the root canal walls was found after preparation with Lightspeed (30.7% scores 1 and 2). followed by Profile.04 (23.1%). In the coronal third of the root canals Lightspeed performed significantly better than Profile .04 (P = 0.029): in the middle and apical third the differences were not significant. CONCLUSIONS: Both systems under investigation respected original root canal curvature and were safe to use. Both systems can be recommended for clinical use.

Dental Alloys↗

PubMed2000

The process of defining a profile of student competencies at the University of Vienna Medical School.

CONTEXT: A new law enabling curriculum reform led a small circle of interested faculty members at the University of Vienna medical school to launch the Medizin Curriculum Wien project (MCW) to plan a new curriculum under the supervision of the Committee on Educational Affairs (Studienkommission). OBJECTIVE: The first stage of the project dealt with the definition of a profile of competencies (Qualifikationsprofil), which describes all the competencies we want our students to possess upon graduation. METHOD: This paper presents the approach to and process of defining this profile at one of Europe's largest medical schools, currently enrolling over 1500 new students per year. The procedure involved: preparing materials; communication with stakeholders; information dissemination; feedback gathering; information structuring, and formulating the profile of competencies. RESULTS: Application of the outlined steps in two rounds proved successful for the development of a profile of student competencies for Vienna. General acceptance and awareness of the new profile as well as commitment for a further reform process was engendered. The distinct characteristics of the profile are discussed. CONCLUSION AND UTILIZATION: A profile of student competencies must balance the demanding objectives of curriculum planners and the actual challenges presented by many local parameters; this can be done by employing the process outlined in this paper. The defined profile serves as an accepted reference point in the further development of the medical curriculum.

Austria↗

PubMed2000

Ultrafiltration profiling and measurement of relative blood volume as strategies to reduce hemodialysis-related side effects.

Hemodialysis (HD) side effects, such as hypotension and muscle cramps, may be related to excessive ultrafiltration (UF) in relation to refilling of fluids from the extravascular space, resulting in hemoconcentration and reduction of relative blood volume (RBV). This study examines the suitability of RBV measurements and UF modeling to reduce the incidence of dialysis side effects. We followed up 188 dialysis sessions in 53 patients. RBV and incidence of side effects were evaluated. Six treatment regimens were examined: UF profile 0, with a constant UF rate; UF profile 1, with a linear decreasing UF rate; UF profile 2, with a stepwise decreasing UF rate; and UF profiles 3 through 5, with intermittent high UF rates interrupted by UF pauses. During dialyses with a constant UF rate (UF profile 0), 10.6% of the treatments were associated with symptomatic hypotension. UF profiles 2 through 5, intermittently using high UF rates, caused a marked increase in hypotensive episodes (18.4%). In contrast, UF profile 1, providing a continuously decreasing UF rate, showed a reduced incidence of hypotension at only 5.7%. Symptomatic hypotension occurred in 13 of 53 patients during one or more dialysis sessions. With the help of RBV measurements, a subgroup of 8 patients with hypovolemia-induced hypotension could be identified. In these patients, an individual threshold of RBV could be defined, below which 92.3% of all hypotensive episodes occurred. In the remaining 5 hypotension-prone patients, there was no correlation between the occurrence of symptomatic hypotension and low RBV during HD treatments. In conclusion, UF profiles intermittently using high UF pulses cannot be recommended. RBV measurements help define a subgroup of patients at risk for hypovolemia-induced hypotension. Only these patients may benefit from blood volume-controlled UF. The incidence of symptomatic hypotension can likely be reduced if an individual threshold of RBV is avoided during HD treatments, eg, using lower UF rates in these patients.

Blood Volume↗

PubMed2000

Clinical sign profile likelihood ratios for bovine spongiform encephalopathy suspects.

This study has described a method for generating the probability of a bovine spongiform encephalopathy (BSE) suspect being a true positive BSE case. A weighting equivalent to the clinical sign frequencies recorded in histopathologically confirmed BSE cases was assigned to 14 clinical observations and a clinical profile score for the case was generated by the summation of the weightings. This method was applied to 50 histopathologically confirmed (true positive cases) BSE suspects and 50 histopathologically unconfirmed (false positive cases) BSE suspects. The profile scores for the true positive BSE suspect cases were statistically significantly higher than the profile scores of the false positive BSE suspect cases (P = 0.0014) using a Mann-Whitney U non-parametric test. The mean profile score for the true positive cases was 944 and for the false positive scores was 879. Likelihood ratios for BSE suspects with different clinical profile scores were computed using different clinical profile score cut off point and ranges. A BSE suspect with profile score of 727 or above (the lowest cut off point) and 1037 or above (the highest cut off point) had likelihood ratios for being BSE of 1. 09 and 4.00 respectively. The likelihood ratios for a BSE suspect being a true positive BSE case in the profile score ranges 627-866, 867-966, 967-1036 and 1037-1067 were 0.35, 1.06, 1.30 and 4.0 respectively. Further investigations or a revisit may be justified in animals with a low probability of being BSE.

Animals↗

PubMed1994

Physician profiling. An analysis of inpatient practice patterns in Florida and Oregon.

BACKGROUND: Physician profiling is a method of cost control that focuses on patterns of care instead of on specific clinical decisions. It is one cost-control method that takes into account physicians' desire to curb the intrusion of administrative mechanisms into the clinical encounter. To provide a concrete example of profiling, we analyzed the inpatient practice patterns of physicians in Florida and Oregon. METHODS: Data for 1991 from Medicare's National Claims History File were used to profile 12,720 attending physicians in Florida and 2589 in Oregon. For each attending physician, we determined the total relative value of all physicians' services delivered during each patient's hospital stay. Relative value was measured in relative-value units (RVUs), according to the resource-based relative-value scale used by Medicare in determining payments to physicians. The mean number of RVUs per admission was then adjusted for the physician's case mix according to the patients' assigned diagnosis-related groups. The influence of the physician's specialty and of selected types of services (such as imaging and endoscopy) was also examined. RESULTS: Florida physicians used markedly more resources, on average, than their colleagues in Oregon (46 vs. 30 case-mix-adjusted RVUs per admission). The difference was apparent for all specialties and all types of service. To illustrate the profiling data potentially available to the medical staffs of individual hospitals, we examined specific data on individual attending physicians and for various types of service for three hospitals' staffs. Despite similar overall profiles that fell below the national mean, each staff had a different practice pattern and would require different efforts to improve efficiency. CONCLUSIONS: In an effort to encourage further debate, we have described one method of physician profiling. Profiling data help identify and characterize differences in practice style to which individual physicians or hospital staffs can respond. Because profiling is not based on rigid rules, it is a cost-containment strategy that can easily accommodate legitimate exceptions; it is therefore preferable to methods in which the appropriateness of each clinical decision is judged separately.

Cost Control↗

PubMed2000

The perception of optimal profile in African Americans versus white Americans as assessed by orthodontists and the lay public.

This study was designed to assess the perceived optimal profiles of African Americans versus white Americans. A survey was conducted using profile silhouettes of 30 African American and 30 white patients, ranging in age from 7 to 17 years. Twenty white orthodontists, 18 African American orthodontists, 20 white laypersons, and 20 African American laypersons evaluated the profiles. The preference of each rater for each of the 60 profiles was scored on an attached visual analog scale. Eighteen cephalometric variables were measured for each profile, and statistical analyses were performed on the profiles that had a mean rating of 60 or greater from an analog scale of 0 to 100. The results show the following 6 cephalometric variables were significant: Z-angle, skeletal convexity at A-point, upper lip prominence, lower lip prominence, nasomental angle, and mentolabial sulcus. All raters preferred the African American sample to have a greater profile convexity than they preferred for the white sample. The raters preferred the African American sample with upper and lower lips that were more prominent compared with the white sample. However, only the choice of the African American orthodontists for the African American sample was significantly different for this parameter. The white orthodontists gave the highest mean scores for the profile chosen, whereas the African American laypersons gave the lowest scores.

Adolescent↗

PubMed1997

Variable memory profiles in Parkinson's disease.

Thirty-nine patients with Parkinson's disease (PD) were categorized into one of three subgroups using discriminant function analysis and three key indices from the California Verbal Learning Test (CVLT). Patients were classified as having one of three memory profiles: (a) a normal memory profile; (b) a memory profile often observed in patients with Huntington's disease (HD); or (c) a memory profile often observed in patients with Alzheimer's disease (AD). Twenty of the patients with PD were classified as having a normal profile, 10 as having an HD profile, and 9 as having an AD profile. The three subgroups did not differ on measures of global cognitive functioning, letter fluency, confrontation naming, or visuo-construction, suggesting that the patients with PD with an AD memory profile were not experiencing AD, per se. These results demonstrate that the memory deficits associated with PD can be similar to those found in patients with either HD or AD, and argues against the notion that the behavioral manifestations of PD are homogeneous.

Age Factors↗

PubMed1998

Determination of motor vehicle profiles for non-methane organic compounds in the Mexico City metropolitan area

Non-methane organic compound (NMOC) profiles for on-road motor vehicle emissions were measured in a down-town tunnel and parking garages in Mexico City during 1996. Hydrocarbon samples from the tunnel and ambient air samples (C2-C12) were collected using stainless steel canisters, and carbonyl compounds were collected using 2,4-dinitrophenylhydrazine (DNPH) impregnated cartridges. Canister samples were analyzed by gas chromatography/flame ionization detection (GC/FID) to ascertain detailed hydrocarbon composition. DNPH samples were analyzed by high performance liquid chromatography (HPLC). NMOC source profiles were quantified for evaporative emissions from refueling, cold start, and hot soak, and on-road operating conditions. The ultimate purpose will be to determine the apportionment of ambient NMOC concentrations using the Chemical Mass Balance (CMB) model. The tunnel profile contained 42.3 ppbC% of alkanes, 20.6 ppbC% of unsaturated compounds, and 22.4 ppbC% of aromatics. The most abundant species were acetylene with 7.22 ppbC%, followed by ipentane with 5.69 ppbC%, and toluene with 5.42 ppbC%. These results were compared with those from studies in the United States. The cold start profile was found to be similar to the tunnel profile, although there were differences in the content of acetylene, isopentane, and oxygenates. The abundance of saturated NMOC in the hot soak profile was similar to gasoline head space profiles; it was also much larger than saturated NMOC in the roadway profile.

Journal Article↗

PubMed2001

Molecular epidemiology of Bordetella pertussis by pulsed-field gel electrophoresis profile: Cincinnati, 1989-1996.

Reported cases of pertussis have increased in the United States, with peaks occurring every few years. Bordetella pertussis isolates collected in Cincinnati from 1989 to 1996 were analyzed with pulsed-field gel electrophoresis (PFGE), to evaluate trends. Among 496 isolates, 30 PFGE profiles were identified; 32% were CYXXI-010, the profile that predominated each year. Eighteen profiles (198 strains) were identified in 1989-1992, 20 profiles (197 strains) were identified during the 1993 epidemic, and 11 profiles (101 strains) were identified in 1994-1996. From 1989 to 1996, among 42 patients, isolates from household members in 17 (89%) of 19 households had concordant PFGE profiles. There was no association between PFGE profile and seasonality, age, and hospitalization or pneumonia in infants <1 year old. The 1993 epidemic was associated primarily with an increased prevalence of PFGE profiles that circulated before and after 1993, which suggests that the epidemic was due to factors other than the emergence of a novel B. pertussis strain.

Age Factors↗

PubMed1991

Influence of detector size in photon beam profile measurements.

Correction is necessary to account for the detector size in clinical dosimetry of photon and electron beams. This correction is due to the absorbed dose gradient present in a finite-size detector. Further corrections are necessary when the detector and phantom materials are not the same. These corrections are due to the perturbation in the charged-particle fluence. Generally these corrections are applied to measurements along the central axis of the beam. Cross beam profile measurements, however, are not usually corrected for detector size. The ionization profile is also usually assumed to be equivalent to the absorbed dose profile. We have corrected the ionization chamber size effect by two approaches: extrapolation of measurements to zero detector size and deconvolution of measurements using a simple model for the detector response function. We have measured absorbed dose profiles to water using a small water-equivalent plastic scintillation detector. Film profile measurements were also studied. The ionization profile corrected for detector size and absorbed dose profile were not equal, probably due to loss of charged-particle equilibrium in the beam edges. For ionization chamber measurements, knowledge of the charged-particle spectrum is needed to convert ionization to absorbed dose to water. This is not necessary for relative absorbed dose measurements under charged-particle equilibrium. Film has been shown to be a straightforward and reliable method for cross beam profile measurements.

Film Dosimetry↗