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At least 1,459 records · Page 81Linked to original sources
PubMed2003

Ultrasound-guided embryo transfer: a meta-analysis of randomized controlled trials.

OBJECTIVE: To conduct a meta-analysis of randomized controlled studies to evaluate abdominal ultrasound-guided embryo transfer compared to the clinical touch method. DESIGN: Meta-analysis. SETTING: Four studies performed in academic research centers in Barcelona, Vizcaya, Hong Kong, and Madrid. PATIENT(S): A total of 2,051 patients: 1,024 received ultrasound-guided embryo transfers and 1,027 received clinical touch method transfers. INTERVENTION(S): Fourteen studies were retrieved from the literature, but only four of them fitted our selection criteria. The meta-analysis was conducted using the RevMan software with the Peto-modified Mantel-Haenszel method and the fixed effect model. MAIN OUTCOME MEASURE(S): The primary outcome measures were the clinical pregnancy and ongoing pregnancy rates. The secondary outcome measures were the incidences of ectopic pregnancies, miscarriage rate, multiple pregnancies, and difficult transfers. RESULT(S): Compared to the clinical touch method, abdominal ultrasound-guided transfer significantly increased the clinical pregnancy rate and the ongoing pregnancy rate. There was no effect on the incidence of ectopic pregnancy, multiple pregnancy, or miscarriage rate. CONCLSUION(S): Ultrasound-guided embryo transfer increases the clinical pregnancy and ongoing pregnancy rates significantly compared to the clinical touch method.

Abortion, Spontaneous↗
PubMed1997

Intraoperative brain mapping in a community setting--technical considerations.

Intraoperative brain mapping is a surgical adjunct used during lesionectomy or epilepsy surgery in functional cortex. This procedure is typically performed at academic institutions by fellowship trained neurosurgeons. However, most of the technology is straightforward and adaptable to the private practice setting. This paper outlines our intraoperative methodology for brain mapping during lesion resection in eloquent cortex.

Brain Mapping↗
PubMed2001

The preoperative evaluation form: assessment of quality from one hundred thirty-eight institutions and recommendations for a high-quality form.

STUDY OBJECTIVE: To develop a rating system to evaluate the preoperative evaluation form in three categories: informational content, ease of use, and ease of reading; to analyze forms contributed by the Association of Anesthesia Clinical Directors; to offer an example of a more optimal form; and interest practitioners in evaluating the quality of their evaluation forms. SETTING: University medical center. DESIGN/MEASUREMENTS: The informational content of the forms was graded by a rating system developed to give a score based on the importance of the data to anesthesia management and legal documentation. Based on the amount of informational content, the forms were grouped into categories ranging from severely deficient to excellent. The ease of use and ease of reading were determined by specific criteria. MAIN RESULTS: 138 forms were analyzed. The mean +/- SD information score was 265 +/- 41, with a range of 140 to 333 (maximum score possible = 363). Fifteen percent of the forms were considered severely deficient to substandard whereas 52% were deemed very good to excellent. A large proportion of forms omitted at least one essential information item. Twelve percent and 6% were labeled poor with regard to ease of use and ease of reading, respectively. Academic centers performed significantly better in the content and ease of use of their forms compared to those from private centers. CONCLUSIONS: A good preoperative evaluation form is an important tool in the anesthetic management of a patient and plays a significant role in the medical legal arena. We found that a surprisingly high percentage of forms are missing important information. A form that contains all of the information and also meets our ease of use and reading standards was developed and offered as an example.

Preoperative Care↗
PubMed2004

Variable production of African American English across oracy and literacy contexts.

UNLABELLED: Many African American students produce African American English (AAE) features that are contrastive to Standard American English (SAE). The AAE-speaking child who is able to dialect shift, that is, to speak SAE across literacy contexts, likely will perform better academically than the student who is not able to dialect shift. METHOD: This investigation examined the AAE productions of 50 typically developing African American third graders across three language contexts-picture description, oral reading of SAE text, and writing. RESULTS: All participants produced AAE during picture description. A downward shift in contrastive AAE features was evident between spoken discourse and the literacy contexts. More students produced more AAE features during picture description than writing. Both morphosyntactic and phonological features characterized the picture description context. Phonological features predominated during oral reading. In contrast, morphosyntactic features were the most dominant feature in writing. CLINICAL IMPLICATIONS: The findings are discussed in terms of dialect-shifting abilities of African American students and the role of writing as a special context to support their entry into dialect shifting.

Black or African American↗
PubMed1991

A prospective analysis of 1518 laparoscopic cholecystectomies.

BACKGROUND AND METHODS: The Southern Surgeons Club conducted a prospective study of 1518 patients who underwent laparoscopic cholecystectomy for treatment of gallbladder disease in order to evaluate the safety of this procedure. RESULTS: Seven hundred fifty-eight operations (49.9 percent) were performed at academic hospitals, and 760 (50.1 percent) at private hospitals. In 72 patients (4.7 percent) the operation was converted to conventional open cholecystectomy; the most common reason for the change was the inability to identify the anatomy of the gallbladder as a result of inflammation in the region of this organ. A total of 82 complications occurred in 78 (5.1 percent) of the patients; this is comparable with the rates of 6 to 21 percent that have been reported for conventional cholecystectomy. Overall, the most common complication was superficial infection of the site of insertion of the umbilical trocar. A total of seven injuries to the common bile duct or the hepatic duct occurred during the operation, for a rate of 0.5 percent. Four of the seven injuries were simple lacerations, which were repaired after conversion to conventional cholecystectomy. The incidence of bile-duct injury in the first 13 patients operated on by each surgical group was 2.2 percent, as compared with 0.1 percent for subsequent patients. No complications were attributed directly to either cautery or laser-surgical technique, and similar numbers of complications occurred in academic and private hospitals. The mean hospital stay for the entire group was 1.2 days (range, 6 hours to 30 days). CONCLUSIONS: The results of laparoscopic cholecystectomy compare favorably with those of conventional cholecystectomy with respect to mortality, complications, and length of hospital stay. A slightly higher incidence of biliary injury with the laparoscopic procedure is probably offset by the low incidence of other complications.

Adolescent↗
PubMed2001

Social inclusion and career development--transition from upper secondary school to work or post-secondary education among hard of hearing students.

The aim of this study was to investigate the decision process and to analyse the mechanisms involved in the transition from upper secondary education to post-secondary education or the labour market. Sixteen students with sensorioneural hearing loss were selected. Among these eight of the students continued to university and eight did not. Twenty-five per cent of the students were women and the average age was 28 years. The investigation was conducted about 5 years after graduation from the upper secondary school. Both quantitative and qualitative methods were used. The results showed that none of the students came from a family where any or both of the parents had a university or comparable education. The differences in choice between the two groups cannot be explained in terms of social inheritance. Our study indicates that given normal intellectual capacity the level of the hearing loss seems to have no predictive value regarding future educational performance and academic career. The conclusion is that it is of great importance that a hearing impaired pupil with normal intellectual capacity is encouraged and guided to choose an upper secondary educational programme which is orientated towards post-secondary education (instead of a narrow vocational programme). Additional to their hearing impairment and related educational problems, hard of hearing students have much more difficulty than normal hearing peers in coping with changes in intentions and goals regarding their educational career during their upper secondary education.

Adult↗
PubMed2006

Life skills training outcomes and potential mechanisms in a community implementation: a preliminary investigation.

Within the context of a science-based dissemination initiative, this study sought to evaluate whether a community implementation of Life Skills Training (LST) would yield outcomes similar to previous clinical trials, to examine potential mechanisms of LST's effectiveness, and to explore potential gender-by-intervention effects. Life Skills Training was implemented with a high degree of fidelity to 263 (54% Male; 84% Caucasian) early adolescents in two Upstate New York school districts during the 2002-2003 academic year. Performance on the Life Skills Training Questionnaire yielded outcomes that were highly similar to those reported by the program's development team. Significant reductions in alcohol tension-reduction expectancies were detected on the Alcohol Expectancies Questionnaire--Adolescent Version, providing preliminary evidence that expectancies may mediate/moderate LST's influence. Exploratory gender analyses revealed that female participants exhibited greater improvements in terms of drug knowledge and anxiety reduction skills than male participants in one school district. Unexpected results, design limitations and implications for dissemination initiatives as a platform for research are discussed.

Adolescent↗
PubMed2006

Bioreactors for tissue engineering: focus on mechanical constraints. A comparative review.

Considering the current techniques in cell culture, the stimulation of cellular proliferation and the formation of bidimensional tissues such as skin are widely performed in academic and industrial research laboratories. However, the formation of cohesive, organized, and functional tissues by three-dimensional (3D) cell culture is complex. A suitable environment is required, which is achieved and maintained in a specific bioreactor, a device that reproduces the physiological environment (including biochemical and mechanical functions) specific to the tissue that is to be regenerated. Bioreactors can also be used to apply mechanical constraints during maturation of the regenerating tissue for studying and understanding the mechanical factors influencing tissue regeneration. In this work, the main types of bioreactors used for tissue engineering and regeneration, as well as their most common applications, were reviewed and compared. The importance of the mechanical properties applied to the scaffolds and the regenerating constructs has been often neglected. This review focused on the influence of mechanical stresses and strains during the culture period that leads to the final mechanical properties of the construct.

Animals↗
PubMed1999

Student-school bonding and adolescent problem behavior.

Adolescent problem behavior, including substance use, school misconduct and delinquency, is a national concern. Implicit in the concept of middle school is the recognition that students who develop positive social bonds with their school are more likely to perform well academically, and refrain from misconduct and other antisocial behavior. However, little scientific attention has been given to the complex interactions between middle school students and the school environment. Prior to implementing a middle school problem behavior prevention program we conducted a survey in the seven middle schools in one US school district. Out of 4668 grade 6-8 students enrolled, 4263 (91.3%) completed the survey. Student-school bonding was positively correlated with school adjustment (r = 0.49) and perceived school climate (r = 0.77), but inversely correlated with problem behavior (r = -0.39 to -0.43). Problem behavior was significantly higher (P < 0.001) among males than females and among students in higher grades. Conversely, school bonding, climate and adjustment were significantly higher (P < 0.001) among females than males, but declined significantly from one grade to the next. The data support the conclusion that school bonding is associated with problem behavior. We describe the development of a multiple-component intervention in middle schools designed to increase student-school bonding and prevent problem behavior.

Adolescent↗
PubMed1999

Is color Doppler ultrasound useful in diagnosing ovarian cancer?

In summary, the emergence of CDUS presented an interesting new technical approach to the study of neovascularization in ovarian cancers. Techniques for CDUS are technically difficult and plagued with artifacts making correct interpretation difficult. Measures of blood flow (such as the resistive index) overlap significantly between ovarian cancers and benign ovarian tumors. Wide differences in estimates of the sensitivity and specificity of CDUS have been published, and fundamental norms such as resistive index also vary greatly among studies. Explanations for these differences are lacking. Most studies were performed in academic centers with referrals of high risk patients. This limits the ability to generalize results to the community. Data are insufficient to include CDUS in diagnostic protocols for ovarian cancer.

Evidence-Based Medicine↗
PubMed2004

Effect of magnetic resonance imaging on internal magnet strength in Med-El Combi 40+ cochlear implants.

OBJECTIVE: Magnetic resonance imaging (MRI) has been contraindicated when cochlear implants containing an internal magnet are in place because of concerns regarding torque, force, demagnetization, artifacts, induced voltages, and heating. The objective was to determine the magnetic field strength of Med-El Combi 40+ cochlear implant internal magnets after MRI studies. STUDY DESIGN/METHODS: Two fresh cadavers were used to study demagnetization using a repeated measures design and a magnetometer. Pre- and postMRI measurement of magnetic field strength was completed. Five sets of sagittal T1-weighted, axial T1-weighted, and axial T2-weighted sequences were performed on a cadaver at 0.2 Tesla in the device-up and device-down positions. In the other cadaver, 15 sets of sagittal T1-weighted, axial T1-weighted, and axial T2-weighted sequences were performed on a cadaver at 1.5 Tesla were conducted, 5 each with the head oriented at 80, 90, and 100 degrees rotated around the yaw plane (rotated around the z-axis). Subsequently, three cochlear implant patients completed 0.2 Tesla MRIs. For these patients, subjective and objective assessment of cochlear implant performance was performed. SETTING: Academic medical center. RESULTS: In the cadaver studies, analysis of variance showed no significant difference in the magnetic field strength after the 0.2 or 1.5 Tesla scans. There was no significant difference in the magnetic field strength for the three patients undergoing 0.2 Tesla MRIs and no adverse consequences, including no changes in telemetry, auditory sensations, nonauditory sensations, and sound quality. CONCLUSIONS: No significant demagnetization of the internal magnet occurred during repeated 1.5 Tesla MRI scans with the head orientations used in this study. In the cochlear implant patients, no significant demagnetization of the internal magnet occurred after a 0.2 Tesla MRI.

Artifacts↗
PubMed2006

Implementing achievable benchmarks in preventive health: a controlled trial in residency education.

PURPOSE: To evaluate the Preventive Health Achievable Benchmarks Curriculum, a multifaceted improvement intervention that included an objective, practice-based performance evaluation of internal medicine and pediatric residents' delivery of preventive services. METHOD: The authors conducted a nonrandomized experiment of intervention versus control group residents with baseline and follow-up of performance audited for 2001-2004. All 130 internal medicine and 78 pediatric residents at two continuity clinics at the University of Alabama School of Medicine, Birmingham, participated. Performance of preventive care was assessed by structured chart review. The multifaceted feedback curriculum included individualized performance feedback, academic detailing by faculty, and collective didactic sessions. The main outcome was difference in receipt of preventive care for patients seen by intervention and control residents, comparing baseline and follow-up. RESULTS: Charts were reviewed for 3,958 patients. Receipt of preventive care increased for patients of intervention residents, but not for patients of control residents. For the intervention group, significant increases occurred for five of six indicators in internal medicine: smoking screening, quit smoking advice, colon cancer screening, pneumonia vaccine, and lipid screening; and four of six in pediatrics: parental quit smoking advice, car seats, car restraints, and eye alignment (p < .05 for all). For control residents, no consistent improvements were seen. There was greater improvement for intervention than for control residents for four of six indicators in internal medicine, and two of six in pediatrics. CONCLUSIONS: Using a multifaceted feedback curriculum, the authors taught residents about the care they provide and improved documented patient care.

Adult↗
PubMed2005

Computer-aided detection for virtual colonoscopy.

Colon cancer is one of the leading causes of cancer deaths in the developed countries. Most colon cancers can be prevented if precursor colon polyps are detected and removed. Virtual colonoscopy, or CT colonography, has shown promise to be the future screening tool for polyp detection, with a number of studies performed at academic institutions showing high sensitivity and specificity. Two main factors limiting CT colonography in general use are its excessive interpretation time and the variable sensitivity among readers. This article discusses the potential of computer-aided detection to address these problems. We also review the current state of research in this field and the future roles and challenges of CAD for CT colonography.

Algorithms↗
PubMed2004

Bidirectional axial transmission can improve accuracy and precision of ultrasonic velocity measurement in cortical bone: a validation on test materials.

The axial transmission technique uses a linear arrangement of ultrasonic emitters and receivers placed on a same side of a cortical bone site in contact with the skin, involving ultrasonic propagation along the axis of bone. The velocity of the waves radiated from bone has been shown to reflect bone status. The thickness and composition of soft tissue may vary along the length of the bone, between different skeletal sites, or between subjects. Hence, accurate estimates of velocity require first to eliminate the effect of the overlying soft tissue that is traversed by the ultrasound wave. To correct for such bias without measuring soft tissue properties, we designed new ultrasonic probes in the 1-2 MHz frequency range. It is based on propagation along the bone surface in two opposite directions from two sources placed on both sides of a unique group of receivers. The aim is to obtain an unbiased estimate of the velocity without any intermediate calculation of soft tissue properties, such as thickness variation or velocity. Validation tests were performed on academic material such as Perspex or aluminum. We found that head wave velocity values could be biased by more than 10% for inclination of a few degrees between the test specimen surface and the probe. On test materials, the compensation procedure implemented in our probe led to a relative precision error on velocity measurement lower than 0.2 to 0.3%. These results suggest that the correction procedure allows measuring in vivo velocities independently of soft tissue properties.

Algorithms↗
PubMedDate not supplied

Perceived discrimination and the adjustment of African American youths: a five-year longitudinal analysis with contextual moderation effects.

Longitudinal links between perceived racial discrimination and later conduct problems and depressive symptoms were examined among 714 African American adolescents who were 10-12 years old at recruitment. Data were gathered 3 times over a 5-year period. Hypotheses were tested via latent curve modeling and multiple-group latent growth modeling. Increases in perceived discrimination were associated with increased conduct problems and depressive symptoms. This association was weaker when youths received nurturant-involved parenting, affiliated with prosocial friends, and performed well academically. For conduct problems, the association was stronger for boys than for girls; for depressive symptoms, no gender differences emerged. The findings thus identify contextual variables that moderate the contribution of perceived discrimination to African American youths' adjustment.

Achievement↗
PubMed2005

Workload of radiologists in the United States in 2002-2003 and trends since 1991-1992.

PURPOSE: To measure the workload of radiologists in the United States in 2002-2003, variations in workload according to practice characteristics, and trends since 1991-1992. MATERIALS AND METHODS: Non-individually identified data from the American College of Radiology (ACR) 2003 Survey of Radiologists were compared with data from previous ACR surveys; all statistics were nationally representative. Workload according to individual practice characteristics, such as size, type, location, and setting, was tested for statistically significant differences from the overall average. Time trends and the independent effect on workload of practice characteristics were measured with regression analysis. Changes in average procedure complexity were calculated in physician work relative value units (RVUs) per Medicare procedure. RESULTS: In 2002-2003, the average workload per full-time equivalent (FTE) radiologist was 13,900 procedures annually (standard error of mean, 200), an increase of 8.1% since 1998-1999 (P < .05) and 25.1% since 1991-1992 (P < .01). Academic practices performed 9900 procedures per FTE radiologist, and private radiology practices performed 15,200 procedures per FTE radiologist. Within most practice categories, radiologists at the 75th percentile of workload typically performed at least 50% more procedures than radiologists at the 25th percentile. Average physician work RVUs per Medicare procedure increased by 6.2% between 1998 and 2002 and by 21.6% between 1992 and 2003, mainly because of an increase in the share of more complex techniques such as magnetic resonance imaging and computed tomography in the procedure mix. CONCLUSION: Workload per radiologist measured in procedures and RVUs increased steadily between 1991-1992 and 2002-2003. Because there is much unexplained variation, averages or medians should not be used as norms.

Data Interpretation, Statistical↗
PubMedDate not supplied

ADHD and reading disabilities: a cluster analytic approach for distinguishing subgroups.

Data suggest that children with reading disability (RD) and non-RD children with attention-deficit/hyperactivity disorder (ADHD) may comprise distinct subgroups. Research has been hampered by variance in definitional criteria, which results in the study of different subgroups of children. Using cluster analysis, this study empirically divided children with ADHD (N = 54), based on their Full Scale IQ (FSIQ) and reading ability. Four distinct subgroups emerged in which cognitive, behavioral, and neurochemical function was compared. Cluster 1 was of average FSIQ and reading scores; Cluster 2 was of average FSIQ but showed impairment in reading; Cluster 3 had high FSIQ and reading scores; and Cluster 4 had low scores in both domains. The groups had different patterns of cognitive, behavioral, and neurochemical function, as determined by discrepancies in Verbal-Performance IQ, academic achievement scores, parent aggression ratings, and a measure of noradrenergic function. These distinctions are discussed with regard to etiology, treatment, and long-term outcome.

Aggression↗